1986-148 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date March Z 19 —
•
This ism certify that worn requested to be done as shown by Permit No.
86-148
has been completed.
One-Family Dwelling
This structure may be occupied as a
Lit 41 Butternut Hill Drive
Location
Michael and Arlene Palumbo
Owner
By Order Town Board
TOWN OF QUEENSBURY
i �/ ,e
/i'L�CLC Building & Zoning Inspector
BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-148
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Michael and Arlene Palumbo
OWNER of property located at Lot 41 Butternut Hill Drive Street,Road or Ave.
in the Town of Queensbury,To Construct or place a One-Family Dwelling
at the above location in accordance to application together with plot plans and other information hereto filed an
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
I. OWNERS Address is RD Ill 15 Butternut Hill Drive o.
Glens Falls, New York
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2. CONTRACTOR or BUILDERS Name
Don Maynard
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3. CONTRACTOR or BUILDERS AddressHelen Drive
Glens Falls, New York
9. ARCHITECTS Name
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5. ARCHITECTS Address
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co6. TYPE of Constructon—(Please indicate by x1
Ix1 Wood Frame 1 1 Masonry 1 )Steel 1 1
5
7. PLANS and Specifications
34'x58' per plot plan, specifications and application submitted
No. including two-car attached garage and sewage system.
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8. Proposed Use
One-Family Dwelling
$5.000 Paid
November 1 79 86
$ 171.00 PERMIT FEE PAID -THIS PERMIT EXPIRES
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.) 1/44
t.
Dated at the Town of Queensbury this 22nd Day of April 19 86
co
SIGNED BY
' td e O. D for the Town of Queensbury
Builtlirg and Zoning Inspector
TO BE COMPLETED BY BLDG. DEPT.
Application No.
.9 ouin o0 nueenllur Permit Issued 19
/ E 7 OWN CF CiL':cWS"!::,••
BUILDING and ZONING DEPARTMENT Permit Expires 19 n II22 (ry (� '�,/ I��,
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation H h 6 LC. u V L':a f
Queensbury, New York 12801 Variance No. uu �pn. U
Site Plan Review No. ryfp 2 1iNtapri }.
Sy - 5 - Approved py: AM. For.[-p /1- ETM.
APPLICATION FOR 0 7I8I9' n ll?1314IUI6
l( '� i
BUILDING AND ZONING PERMIT
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *::*
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. ANSWER ALL OF THE FOLLOWING.
The undersigned hereby applies for a Building Permit to do the following work which will
be done in accordance with the description, plans and specifications submitted, and such
special conditions as may be indicated onp the P(er�mit. �/ .
The owner of this property/� is: MILI�Ctf✓C fll ISMe j cQunba
P.O. Address Is 6.4nQ�TIEYZNJr 1-01-f- hi(1�C A' 4).1j Tel. 7`,�3-y190
Property Location: ea, Let- * to Tax Map No.1*1 / 5 /
ell
Street`fiumber or building lot number
Subdivision name (if applicable) 13VTTEAP-M T }}?U..
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
MI c41a4 1, RJ 4o - o as o4u,11
Name P.O. Address
//�� Tel. No.
-,�
Name of builder Lan Mo / Address RelaMA !/ eyn, t Tel. /93 -3S3T-
Name of plumber To 6E oETt rct^mvO Address Tel.
Name of mason ljavi IVta,..,,.n,.cQ Address W-c.P .� DM•�'t Tel. 793- 3531—
NATURE OF PROPOSED WORK: 0a �- ZONING INFORMATION:
I/O of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED,
Addition to a building * drawn reasonably to scale and attached hereto,
_Alteration to a building * showing clearly and distinctly all buildings,
(no change to exterior dimensions) * whether existing or proposed and indicate all
Other work (describe) * set-back dimensions from property lines. Give_
_
* street and number or lot number and indicate
* whether interior or corner lot. Show location
FOR DEMOLITION PERMIT, STATE SIZE AND * of water supply and location and configuration
LOCATION OF STRUCTURES AFFECTED. _ * of septic disposal area.
*
/ * COMPLETE INFORMATION REQUIRED BELOW. r^fl tar
/{ * Size of property I � ft X 0 2 �f 15�
* Existing building(s) Size ---ft X ft.
*
PROPOSED BUILDING AND USE: base..•*.•- 36n3 Existing buildin se
Size of new structure 3/ ft X ill fte
Foundation-pier/slab/crawl/partial,tullO * Proposed building, distance from property line
(circle one) 2 * Front yard 'qn ft Rear yard 3S ft
No, of stories (habitable space) * Side yards .b f ft and 31 ft
Height (grade to ridge) -9 ft. * If on corner, setback from side street IIQ, r ft tic
If residential, no. of families j
No. of rooms(excluding baths) St)a •aryl+-* OCCUPANCY INFORMATION
No. of bedrooms i'f *
* PRIMARY BUILDING -
No. of bathrooms ail_
K One family dwelling
Primary heating system .r.Qpc• ho-{- +-
t �U., � • * Two family dwelling
Type of fuel Multiple dwelling / Number of units
No. of fireplaces to be installed one ** (Permanent occupancy
Will a wood stove be installed? no
Transient occupancy_
Central Air conditioning? les * Business
BUILDING STYLE, PRIMARY STRUCTURE * _Industrial
Other
Ranch Contemporary Log cabin * If addition, what will use be?
Raised ranch Mansion Duplex
Split level Old style Bungalow *
Cape Cod Cottage Other * ACCESSORY BIIILDING-
Colnia Row Town House * Detached garage/one car/ two car/ car
( CIRCLE ONE PLEASE ) * 'j Attached garage/one car/ two car/ ,2, car
* * * * * * * * * * * * * * * Private storage building
ESTIMATED MARKET VALUE OF Other
CONSTRUCTION $ I� ow • *
INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
Form BPA 4/86 and-vl
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS:
Type of construction, wood frame, fire safe,etc. /,lbbq fRAm/a
Will any second-hand or ungraded lumber be used? If so, for what? N p
Foundation wall material CbN(0 Thickness W. Pou2p0
Depth of foundation below grade (to bottom of footing) 51 [r Will there be a cellar? VHS Heated or unheated? (gyp.Qll/}I Floor sq. footage egg& sq ft
Will there be a basement? Will any portion bee used as living space? 110
(If so, what portion? sq.ft. - - Type of use?
Type of roof - sloped/flat/shed/other y,,, p Material of roof /off/[ /Nc/
Size, wood studs 9 "X C. " spacing //j "o.c. length 4 ft.
Joists(floor beams) 1st. floor 2 "X /b
Joists (floor beams) 2nd. floor „X spacing /4"o.c. span /(0 ft.
�/7 spacing ,(•- "o.c. span /6 ft.
Overlays(ceiling beams) "X spacing "o.c. span ft.
Roof rafters _. "X — " spacing — o.c. span — ft.
Roof trusses(pre-engineered) spacing 2 ) "o.c. span / ft.
Exterior wall finish _;ire ltl-CI( Of what material? :(/¶'Q. 6(D) (t-
Interior wall finish SN/5AT QNe
If a garaye s to be attached, describe materials to be used for FIRE SEPARATION:
5ii YPt V —
Is there to be an opening between garage and dwelling?. y05 If so will a Fire-rated
door, enclosure, and self-closing device be provided?
Will a flue-lined chimney be installed? 'f j Height above roof a' ft.
Depth of chimney foundation below grade _ 6 ft. jo Poor/St-
Depth Depth of fireplace hearth � •�ft. �• '
Water supply - Municipal or �'R.>•—
SEPTIC SYSTEM Distance fro ivate well(including adjoining properties /O O ft.
(A separate application is necessary for any repair or new installation of septic system)
Town of Queensbury -----'
County of Warren AFFIDAVIT STATE OF NEW PORK
I swear that to the best of my knowledge and belief the statements contained
in this application, together with the plans and specifications submitted, are a true and
complete statement of all proposed work to be done on the described premises and that all
provisions of the BUILDING CODE, THE ZONING ORDINANCE, and all other laws pertaining to
the proposed work shall be complied with, whether specified or not, and that such work is
authorized by the owner. �,/�/�� //q %}�/// //�
SWORN • BEFO'E ME THIS Signature /✓'"'s'L[u clic%
Owner, owner' gent,arcnrrect,contractor
day 19
Notary Public Warren County, N.Y.
• • * * • * * * * * * • * * • • * • • * * * * * • * * * • * * * * • * • * * * • * * * • • *
SPECIAL CONDITIONS OF THE PERMIT:
By
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 obtainedn before beginningwork.
lLti
ANSWER ALL of the following: Pi, t l--o/1#y/ - 6 if
1. Gross floor area 01aS M3 ---(((���///'��/'"" �
2 . Type of heat C. &LI ( /
3. Is the building mechanically cooled? / -
4 . Percentage of area of windows and doors /a 2-p
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
j B. Under Only
1. R value of roof and floors exposed to ambient conditions
R - 3e
2 . R value of exterior walls /'--�/77
3 . R value of glazed area d . y - �1- �7
4 . R value of doors /" i(
5. R value of floors over unheated spaces frig
6. R value of slab edge insulation - unheated slab
7 . R value of slab insulation - heated slab [1
8. R value of heated basement/cellar walls (above grade) R-11
9 . R value of heated basement/cellar walls (below grade) R-11
10. Type of insulation (T1f{.Sj
\ C. Controls 1 . Thermostat maximum heat setting `(3Sp
D. Duct Systems
1. Is duct system installed in unheated spaces? YES NO
a. If YES , R value of duct installation
b. R value of duct in other areas
E. Piping Insulation 3/I/
1. Size of hot water or cooling carrying agent pipe f
2. R value of pipe insulation - ---
F. Service Water Heating ...--
1 . Performance efficiency
—
2 . Temperature control setting maximum 19Si'
G. For Swimming Pool Only
1. Maximum"iQ� heatingg '�{�(n�/�
Telephone No. / {(1 - gYJv / '/'ct' 2 t
b .
(appl ant ' s signature)
. Own of Queendbury
BUILDING and ZONING DEPARTMENT
Bay and Havi!and Road, R.D. 1 Box 98
Oueensbury, New York 12801
q, p SEPPTIC DISPOSAL/ PERMIT APPLICATION y 'f
Owner' s Name ('i1GG11df Tl). I!M'.(.(.kw(!J(J Tel. /93- / ?90
Address 13 fititrti a #& 41,44pe
Person/Firm installing systerr Dcr,.e- goi-trza- 2
Number of bedrooms(residential only) H /
Total daily flow: (compute @ 150 gal.per bedroom per day)_ 6 0 0
Topography: fla t - rolling - steep - (circle one) Decree of slope 'k
Nature of soils: sand4fam-clay other- Depth ft.
Ground water-- at what
\\depth? 14y ft. ��
Bedrock or impervious material--at what depth? NI/""r ft.
Percolation Test Not required Required -Rate II min/inch.
Domestic Water Supply - Municipal 0 Wel - Other
IMPORTANT !
On a separate piece of paper , submit a diagram of the proposed septic
system with all dimensions; including distance from any structure,
distance from property lines and distances from any domestic water
supply or shore-line of lake, stream, pond or wetlands. Include all
dimensions of the system itself.
Description of proposed system:
Septic tank size 4000 gal.
'file field- Length of each trench ft. Total field,33t ft.
Size of stone # # 2
--Seepage Pit (s) Number / Size ftXft. Size of stone*
•
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 Town of Queen sbury Sanitary
Sewage Ordinance.
O
' ..4a
Signature of pplicant Date
01/86 and/vl
Septic System Inspections:
A. All applications for septic system installation,
alteration or repair, as reouired by the Town of
Oueensbury Sanitary Sewage Ordinance, shall be
submitted to the Buildino Department at least
24 hours before start of construction and shall
include a plot plan showing:
1) the proposed location of the system
2) location and distance to lot lines
3) location and distance to structures
4) location and distance to any water supply
5) size and dimensions of all tanks, distribution
boxes, tile fields and/or drywells
B. No system shall be covered before inspection and
approval by the Building Inspector. Failure to
comply with this requirement may result in the
uncovering of the system by the .installer and a
fine of up to $250.00.
C. An approved copy of the plot plan shall he
available .on the construction site. Failure
to produce said plot plan at time of inspection
may result in an immediate work stoppage.
D. Should unforeseen problems during construction
prevent proper installation, alteration or
repair of an approved system, a new proposal
must be submitted to the Oueensbury Building
Department before further construction.
�y / 3lyb ✓own of QeensL ry
BUILDING and ZONING OE-PAbENT
Bay and Haviland Road. R.D. 1 Box 98
Dueensbury, New 12801 �0
G16into - Re_
BUILDING INSPECTOR' S REPORT
NAME /HiKt PAII+ MJ0
LOCATION Lor /../ / /3„iter n
LAT
.4- u erdi
Date , e. f9 /yG Permit No. 36 - pl3
x *
✓*_* k APPROVED * * *YES / NO
Footing/Pier Forms
Foundation
waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
ryrye�lief Valves A�
t. Porches 4Qp/1 TEMP. ¶5. 1- rovr.0
(/Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures
gar. Fireproofing
I/boor Closers \ f`\
Smoke Detectors
Cpimney
(/INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION /3.t
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-(A II Ieave iovro o door or-,,
FL 0141
bit
[f
Building Inspector
6/86 and-vl
Joutn of Queenstury
BUILDING and ZONING[StPARFMENT
Bay and Haviland Road, R.D. 1 Box 98
Oueensbury, New York 12801
BUILDING INSPECTTOR'S REPORT
NAME mike I G.,L1,�/✓J3
�
4T�
LOCATION t1/ I cc " i
Date ) (1 / 1 Permit No. ?rQ(e_ lifg
* * * * * * * * * * * * * * * * * * * * * * *
= APPROVED - YES I NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing ✓
V Roofing /
)(Siding
Masonry Veneer
Rough Plumbing
X Relief Valves
Ext. Porches twin .S'k/�3 'F(Y.u-�S
J( Finished FloorsWi9, Un ty(or Qofp ert_ ✓
)(Interior Trim �
(stairs & Railings
Cellar Drain Tile
Concrete Floors ..
/`Plbg. Fixtures y
/Gar. Fireproofing ✓ /
`(Door Closers / ✓
)LSmoke Detectors ✓
Chimney
INSULATION:
. Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION OK iy/ PI I gL_re;
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call Swhen ready)
Remarks- :I- 61 `.
oda S tL/ /AS 6x-(zre fie C.U•
�53 gy96 d 4t ip 5EPTI t A-PP " ��✓rr e C
dap 14421
Building AI d
6/86 and-vl
awn of Queenilury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, RD. 1 Box 98
Oueensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NPltE PA D I l
LOCAT ION - t '
DATE /34.. PERMIT NO.n_
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch -
TYPE of SYSTEM:Absorption field, total length
Length of each trench
Depth of trenches '
Size of gravel_
SEEPAGE PITSENumber of)
Size- ft. X __ft. ��—
Gravel size
PIPING: Size Type
Bldg. to tank `
Tank to dist. box
Dist. box to field/pity- Partial
Openings sealed? / YES NO
LOCATION/SEPA TIONS: ft.
Foundation o tank --'ft.
Foundation to absorption —ft.
Absorption to lot line —ft.
Separation of pits •ERTY(circle one)
LOCATION OF SYS Right side -
Front - Rear
COMMENTS:
Rist 4 V(lye% ` e
SYSTEM USE APPROVED 49 NO /
-
Buil• 'ng ,,-pector
01/86 and vl
Jotun of Queen Jalopy
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME ea-r-cr
LOCATION /;y p
DATE 74y/ pl7 PERMIT NO. p D� -NA
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length a
Length of each trench Sir
Depth of trenches 1-L"
Size of gravel cht 7--
SEEPAGE PITS{Number of)
Size- ft. X ft.
Gravel ize
PIPING: ize Type
Bldg. to t-. k / 4
4
Tank to dist. box /--`��' -L7)3
Dist. box to f -1d/•it 4 7_713
Openings sealed? YES NO Partial
LOCATION/SEPARAT ONS. i
Foundation to t k \ a ft.
Foundation to sorption ?ft.
Absorption to of line ft.
Separation of pits ft.
LOCATION OF SYSTEM ON PROPERT ircle one)
Front - Rear - Left side - Righ side -
CCMMENTS:
Se L ' 40 ell +--r"
' - 4,,1' LaiA _ �a---Ai --
L,f•/'tl✓A4Q YJ, � C h`is
SYSTEM USE APPROVED S 0
Bun ing Inspector
01/86 and vl
r I
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date yjp.A
Mune r P L A, •
Locatien Onwa" . LL
Permit Na , Weather
Remarks
Excagation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing O f-
ackfill
Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs s Railings
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Car. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval 1
Floors
Insulation Foundation
Walls
Ceiling
Building Inspector
REMARKS
TOWN OF QUEENSBURY
Buildiar Department
Ieapemats Repel Date 32(3cAr6
Name AA130
Location r,Grrc uvr 1d-iic-
Permit Na_. R 6 _ iyg __ Weaker
Remarks
Excat)a tion
Footing Forms
Footing & Piers
Foundation
Cement Coat ///
Waterproofing ✓ I /
Backfill r`
Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves
Wall Board ,
Ext. Porches
Finished Floor j
Interior Trim /
Stairs & Railings
Cellar Dr. Tile
Concrete Floors /
Plbg. Fixtures /
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation
Walls
Celli Si
H_e rr//��
UY\ 1 Inspector
REMARKS
7:10 it0 SI4L�pnrtt/6
TOWN OF QUEENSBURY
Building Department
6 itu.tInapaciars
N 'I Report- ___ Date o LL/A�_
Location Lot
Permit No.di _ Weather
Remarks
Excadation
Footin. Forms
Footin. S Piers
Foundation
Cement Coat
Water.roofin.
Backfill
Final Surve
Framin.
Sheathin. _-
Roof Felt _
Roofin.
Siding
Mason Veneer
Rou.h Pl ...
Relief Valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs S Railin.s
Cellar Dr. Tile
Concrete Floors
P1.. , Fixtures
Car. Fire.roofin.
Door Closers
Chimne
Water Meter Inst.
Se.tic A..roval
Floors
Insulation Foundation
Walls
Ceilin
uii Ding Inspector
REMARKS
TOWN OF QUEENSBURY
Building Department
Inip.aer+ Report Date
Mania PALu,h 130
P enaM—IrrC-ii.
-- ._ Wather
Remarks
Excavation
Footing Forms i(1 /
Footing & Piers CC//
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railings
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation
Walls
Ceilin
Building I Spector
REMARKS
w/ InGrc rO 07i 06_1
cc77 Io: ad a.hL,
awn of Queenstury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Oueensbury, New York 12801
BUILDING INSPECTOR 'ScPE REPORT,
NAME Mike 7 Ct 1/u.�tC/-Y/ (ielg /.
9P
LOCATION 4. // /. .L
Date 3 /�] 3aerrmnit1 No. C�i lLt4/�
* * * * * * * * * * * * * * * * *6*i0* * * * *
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves A
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled insgerecTA yruhenready)
Remarks- LL--QQ�/ /7: /..bl 11/1// 1//gmke-
Z93— &4q9
Buildin• Inspector
6/86 and-vl