8132 •
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CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
17
190
Date
This is to certify that work requested to be done as shown by Permit No. P,
has been completed.
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This structure may be occupied as a
Location of lv o (3 on an k74 r(-1 e
ar P 1
Owner
By Order Town Board
TOWN OF QUEENSBURY
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Building & Zoning Inspector
CREATIVE "INSTA• PRINTING, GLENS FALLS. N Y 12801 151E1)793-565B
BUILDING PERMIT
TOWN OF QUEENSBURY No. 8132
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Karl A. Paulsen
OWNER of property located at of f Pulver Road and on Lake Georg9treet,Road or Ave.
ro
in the Town of Queensbury,To Construct or place a One-Family Dwelling s
at the above location in accordance to application together with plot plans and other information hereto filed and F-'
En
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. MfD
1. OWNER'S Address is 10 Spr ingwood Manor
Loudonville, New York 12211
2. CONTRACTOR or BUILDER'S Name
Paulsen Realty Co. O
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3. CONTRACTOR or BUILDER'S Address ro
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1100 Central Avenue
Albany, New York n
4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X) r
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X Wood Frame ( ) Masonry 1 1 Steel ( ) D
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7. PLANS and Specifications O
34'x50' per plot plan, specifications and
No. application submitted including sewage system and m
Per Variance No. 816 granted 3-16-83 .
B. Proposed Use
One-Family Dwelling
5. 00 C/O Paid o
s105. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 1 19 84
I
If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the rz
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this -1 Oth Day of September 1983—
W
SIGNED BY 1l tfti, C J p
for the Town of Queensbury E
Building and Zoning Inspector N
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TOWN OF QUEENSBURY
WARREN COUNTY , NEW YORK
Application for: BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK
STATE ENERGY CONSERVATION CODE
A permit must be obtained before beginning work .
ANSWER ALL of the following:
1 . Gross floor area 4/
2 . Type of heat D Z RiY`'
3 . Is the building mechanically cooled?
4 . Percentage of area of windows and doors
A. Over 16% Only
1 . Uo value of gross area of walls , -roof/ceiling and floors
exposed to ambient conditions
2 . Floor over heated spaces YES NO
a. Are foundation walls insulated?YES NO
1. If YES, what is the R value?
3 . Slab on grade YES NO
a. If YES, what is the R value of insulation around
perimeter of floor?
4 . Is basement heated? YES NO
a. R value of insulation
5. Type of insulation
Und4r 16% Only
1. R value of roof and floors exposed to ambient conditions_
R 39
2 . R value of exterior walls
3 . R value of glazed area
4 . R value of doors
5 . R value of floors over unheated spaces
6: R value of slab edge insulation - unheated slab
7 . R value of slab insulation - heated slab
8. R value of heated basement/cellar walls (above grade)
9 . R value of heated basement/cellar walls (below grade)
10 . Type of insulation
C. Controls
1. Thermostat. maximum heat setting
D. Duct Systems
1. Is duct system installed in unheated spaces? YES X NO
a. If YES , R value of duct installation
b. R value of duct in other areas
E . Piping Insulation
1 . Size of hot water or cooling carrying agent pipe
2 . R value of pipe insulation
F. Service Water Heating
1 . Performance efficiency
2 . Temperature control setting maximum
G. For Swimming Pool Only
1 . Maximum heating
Telephone No.y3 8 73 l
pli cant ' s signature)
TOWN OF QUEENSBURY
Spa(e inside block to be filled n b,
WARREN COUNTY, NEW YORK Building Inslx"or)
Application for pp11(at1011 No.
1'c rmlt 1"'lled 19
BUILDING AND ZONING PERMIT Perm i I F"Fires. 19
7 nun_ U.trict
ilia• 1 \1'-rl. ,
THREE (3) Copies of a PLOT PLAN, Drawn to scale
showing the actual dimensions of the lot to be built kc111a1 k5
upon, The exact sire, and location on the lot of the
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION.
TOWN OF QUEEN SBURY
DATE
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK
ANSWER ALL OF THE FOLLOWING.
t W F P
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The undersigned hereby applies for a permit to do the following work A.M.
which will be done in accordance with the description, plans and specifi-
cations, and such special conditions as may be indicated on the permit.
The owner of this property is:
tczr.4.. .A,.z'aic.Z o.s .:h9yror .Trip nor. . . t «o1c.E!'Cer ./Y,. ., . . r z.i .INA AE) 9 P O ADDRESS)
The person responsibie for supervision of the work insofar as the Building Code and the Zoning Ordinance apply is:
I . . . . .
NAME)IP O ADDRESSI
Name of Builder. "./Gt.4t.R e./<l,. /e.a.l.L` . .Cc,. . . . .Address . fl4D.Cc c
Name of Plumber. . .j.3 C f.%Ye .A(rc,e.,:1?
J a He.(. ?/h m b ion Address . . /.6.C 4 e.-)..e R'` .5 ,. . .Cx g.as j./4r!!g/V,y"?baI
Name of Mason. . .1/ruA-*t. -B.a 4c.ck,-.,?.. . . . . . . . . . . . . .Address .t/o> t. o i.C. . .//[. .,
Lot Number. . . . . . . . . . Unit . . . . . . . . . . . . Estimated value of proposed work S /O.c?ds2,... . . . . . . . . . . . . . .
Name of Village . . . . .l,Pt te. . _. $e y. . . . . . . . . . . . . . . . . . . . . . .
Name of Street d-cy . . . . . . . . . . . . . . . . . Side of street. north , east , south jo. west
Nearest Cross Street . .'P/'.4 0 t . y h.o G Distance from this •-rocs street C`. . . . . . . Ft.
Property is north ,south ,east X,west from Cross Street
If on Corner, which corner, northeast 0, northwest , southeast Q, southwe.i
Designate by marking with an "X" in the correct space.)
NATURE OF PROPOSED WORK OCCUPANCY
Construction of a new building. Main Building
Addition to a building. One-family dwelling
Alteration to a building. Two-family dwelling
Demolition of a building. family apartment house
Store building
car attached garage
Other:
G"J41f . . . . . . . . . . . . . . . . . Accessory Building
One-car detached garageElOtherwork. Describe:. . .0• •ll•(?• • • • • • • • Two-car detached garage
Private chicken house
Private storage building
Other: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ZONING SPECIFICATIONS. Fill in for new building, or addition to existing building, or a change of occupancy.
Indicate on the plot plan street names, the location and
size of the property, the location, site and setbacks of pro-
NORTH posed buildings,and the location of all existing buildings.
Show proposed building(&) in dotted line and existing
buildings) in solid line.
Size of property . . . . ...3.. . . . . ft. x . . . 7.Q.'ft.
Size and use of existing buildings, if any . . . . . . . . . . . . . .
N N 1.
W
Size of proposed building . . .Co: . . . ft.x . . +T.O!. . . ft.
6 Height (from grade to ridge) . . . .16.1. . . . . .
I . . . . . . . ft.
Front yard . . . .7,7.'. . .A. . . . . . . . . . . . . . . . . . . . . . .
Side yards . . . P?.Q. . . . . . . ft. and . . . /42.O. . . . . . . ft.
Rear yard . . 1.00. . . . . . . . . . . . . . . . . . . . . . . . . . ft.
SOUTH If on corner,setback from side street . . . . . . . . . . . • . . . ft.
Note: All distances are net, as measured from street side
line to nearest part of building.
OVER)
7-73—M
TOWN OF QUEENSBURY
BUILDING & ZONING DEPARTMENT
SEG?AGF DISPOSAL PERMIT APPLICATION
1. Owner' s Name- L
Address lam^ t n,1 /.y - 1, .7i./yz y, '!/e IV 4 /22 //
Telephone No. 2/
2. Property location
3 . Name of person or firm responsible for installing system
c a 1•-t /19, '4 a" s/, C n Telephone No. 6 S6
Address o r E i L, Yr c. C-t-5 l•`L C 13 u y
4 . Number of bedrooms (residential buildings only)L: wo
5. Daily flow 0 D p gallons/day
6. Septic tank capacity cc 0 gallons
7. Topography: flat, rolling, steep
of slope pLoZt,,
8. Nature of soil and depth SQ /.,d Lo 7'
9. If ground water, bedrock or impervious material is apparent at what
depth does it begin? 8''ft.
10. Percolation test:A is required
B is not required
C If required what is the rate minutes/inch
11. Water supply: municipal, well, other
12. Type of system proposed: drywell, tile field , other
Any contractor, corporation, individual, etc. engaged in the construction
of a sanitary sewage disposal system who covers the same before inspection,
does not have an approved permit, or varies from the approved application
will be subject to a penalty of $250 as provided for in Section 6 . 010 of the
Queensbury Sanitary Sewage Ordinance.
Date 45 - 7 23
s gnature of-applicant
On separate sheet of paper submit a diagram of the proposed septic system
with all dimensions, including distance from any structure, distance from
property line and domestic water supply, etc. Include all dimensions of
the system itself.
Form 3-82
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TOWN OF QUEENSBURY
Building- Department
Refit Date_49
Naive
L.ocatian Pli
Permit No.3')Weather
Remarks
Exca0ation
Footing Forms
Footing & Piers
Foundation i
Cement Coat i
Waterproofing
Backfill j
Final Survey
Framing
Sheathing
Roof Felt
Roofingj
Siding I
Masonr2 Veneer
Rough P1b .
Relief Valves
Wall Board
Ext. Porches j
Finished Floor I
Interior Trim
Stairs & Railings i
Cellar Dr. Tile
Concrete Floors
P1bg. Fixtures
Gar. Fireproofing I
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation
Foundation
Walls
Ceilin j
I
Building Inspector
I
REMARKS
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TOWN OF Q*UEENSBUkY
Building Department
Inspectors Report Date '29ZL r
NameAl
Location
Permit No. 3 -2-- Weather 1
Remarks
F d r t1' C1 P
Excavation 1
Footing Forms A
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framin
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer l
Rough P1b .
Relief Valves
Wall Board i
Ext. Porches I
Finished Floor l
Interior Trim
Stairs & Railings r '
Cellar Dr. Tile 1
Concrete Floors
Plbg. Fixtures 1
Gar. Fireproofing IVI
Door Closers let
Chimney
Water Meter Inst.
Septic Approval
Floors '
Insulation
Foundation I
Walls j
Ceiling ,
I
Building Inspector
REMARKS
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TOWN OF QUEENSBURY
Building- Department
Inspectors Report Date_ / 16 A'P.41
Name_
I.oca tion ra l y e,, d.
Ptrmit No 9137 weather 1
i
Remarks
I
Exca0a tion
Footin 'Forms
Footing & Piers
Foundation
Cement Coat
waterproofing
Backfill I
Final Survey
Framing1
Sheathing
Roof Felt I
Roofing
Siding
Maso rw Veneer
Rough P1b .
Relief Valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railings Vi,
Cellar Dr. Tile
Concrete Floors
PI . Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors '
Foundation
insulation
Wa11.9
Ceiling —
zo'
Building Inspector
REMARKS
TOWN .OF OUEENSBU I(
Building- Department
In ra epart Date // _
Name
L.Ocat+o®_
Permit No. Weather
Remarks
Excatm ti on
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding'
Masonry Veneer
Rough Plb .
Relief Valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railings
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney i
Water Meter Inst.
Septic Approval
Floors
Foundation
Insulation
Walls
Ceiling
i
B ilding Inspector
I
REMARKS
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TOWN OF WEENSBURY
Building- Department
hopeetoirs Report Date /0 -AZ`8
Name4(l
Permit No. /3, Weather
Remarks
1
Exca0ation
Footing Forms
Footing & Piers
Foundation o
Cement Coat
Waterproofing
Backfill
Final Survey
FramingI
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plb .
Relief Valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim I
Stairs & Railings
Cellar Dr. Tile
Concrete Floors
P1 . Fixtures
Gar. Fireproofing
Door Closers
Chimney I
Water Meter Inst. I
Septic Approval I
Floors
Insulation
Foundatio l
Walls
Ceiling
Building Inspector
REMARKS