1986-227 r
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK -
Nov. 21 19 86
31 r � ,1 _i i( � Date ..-
This is to certify that work requested to be done as shown by Permit No. a6-227
has been completed.
One-Family Dwelling
This structure may be occupied as a
Location Lot 2 Sugar Pine Road (St. No. 4) The Piney of Queensbury
Paulin Construction Co. Inc.
Owner
By Order Town Board
TOWN OF QUEENSBURY
yI//qy// / .�`..
/ Building b Zoning Inspector r
BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-727
WARREN COUNTY, NEW YORK ;,t
PERMISSION is hereby granted to
Paulin Construction Co. Inc.
Lot 2 Sugar Pine Road (St. No. 4) Street,Road or Ave.
OWNER of property located at °
the Pines ot Queensbury
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 and w
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is 532 Rte 67
Mechanicville, New York 12118 H
•
D
2. CONTRACTOR or BUILDERS Name
same
3. CONTRACTOR or BUILDER'S Address
same
0
rt
4. ARCHITECTS Name w
w
n
ro
6. ARCHITECT'S Address p
w
6. TYPE of Construction—(Please indicate by XI
ti
(X)Wood Frame ( 1 Masonry 1 )Steel I 1 r'
7. PLANS and Specifications
64'x32' per plot plan, specifications and application
No. submitted including two-car attached garage and sewage
cyatom
8. Proposed Use
One-Family Dwelling
m
$5.00 C/O Paid g
$ 164.00 PERMIT FEE PAID-THIS PERMIT EXPIRES December 1 1986
(If a longer period is required an application far an extension must be made to the Building and Zoning inspector of the
town of Quaenabuly before the expiration date.) £
Dated at the Town of Queensbury this 15th Day of May 19 86
H
SIGNED BY .251""x'^' a' leistannj for the Town of Queensbury
Building and Zoning Inspector ( )
TO BE COMPLETED BY BLDG. DEPT.
Application No.
Jot✓n of Queenit ury Permit Issued 19 TOWN OF QUEENSBURY
BUILDING and ZONING DEPARTMENT Permit Expires 19 ^ nn
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation ylUry1,1LL(1' 1UW
Queensbury, New York 12801 Variance No.Site Plan Review No.
MA1v
9198 '
Approved by: 5.1e/691' AIL
APPLICATION FOR 516
7181 i1z1a 41
BUILDING AND ZONING PERMIT
A PERMIT MUST BE OBTAINED BEFORE BEGINJING 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 on the Permit.
The owner of this property is: 9 .4'0,. A) Itti CONS} Co T.1\--C
P.O. Address 532 Rfi>e ( 1 ✓v)ec hha-166cu(1) \e NY 121R Tel. 799 -24\1
Property Location: 5uo r IT) S KL Lof-42, Tax Map No. C116 / p/ .2
Scree number or building1 lot number S i-. '1
Subdivision name (if applicable) �n Q 4) (1r1c S.
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
N Z NY\2 Tel. No.
Name P.O. Address
Name of builder S-C/.MQ._ Address Tel.
Name of plumber Q\4 e 'S*etu a Address Tel.
Name of mason cS}pv$ Address Tel.
NATURE OF PROPOSED WORK: * ZONING INFORMATION:
Construction 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.
* Size of property 1 3 O ft �17ft.
* Existing building(s) S�epl f-fi_ ft.
PROPOSED BUILDING AND USE -L * Existing lout : sc\se --
Size of new structure r ft K t
Foundatat ^l ion-pier ab crawaw l/partial/full * Proposed building, distance from propertyline
(circle one) * Front yard 7
ft Rear yard / / ft
No. of stories (habitable space) * Side yards ft and -2-CD ft
Height (grade to ridge) III - ?j ft. * If on corner, setback from side street ft
If residential, no. of families
No. of rooms(excluding baths) \7 , * OCCUPANCY INFORMATION
No. of bedrooms *
* pgI,MP RY BUILDING -
No. of bathrooms viOne family dwelling
*
Primary heating system Pe Pow- _* Two family dwelling
Type of fuel * Multiple dwelling / Number of units
I
No. of fireplaces to be installed —permanent occupancy
Will a wood stove be installed? -
* Transient occupancy
Central Air conditioning? * 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 *
C- .- Cottage Other * ACCESSORY BUILDING-
Row Town House * Detached garage/one car/ two car/ car
,*Attached garage/one car/ t ..o car/ car
CIRCLE ONE PLEASE ) !`
* * * * * * * * * * * * * * * * * * _Private storage building
ESTIMATED MARKET VALUE OF * Other
*
CONSTRUCTION $ 1 3 -a l P�-�
INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
Form BPA 4/86 md-vl
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS:
Type of construction E fire safe,etc.
Will any second-hand or umber be used? If so, for what? TUC\'e
Foundation wall material € j (.c .r x _ tet Thickness 1 I/
\c'
Depth of foundation below grade (to titan c1�
am of footing) — id) I
Will there be a cellarHeated o heated. Floor sq. footage )Q Lf() sq ft
Will there be a basement. Will an ' be used as living space? hJO(If so, what per ? sq.ft. - - Type of use?
Type of roof - = lat/shed/other Material of roof Aspbt@/-/- S>N9-es....-,
Size, wood studs 'X CD " spacing 7 U "o.c. length Zc ft.
Joists(floor beams) 1st. floor 2 "X ID " spacing 'o.c. span I9 ft.
Joists(floor beams) 2nd. floor - "X I o " spacing °o.
Overlays(ceiling—beam g . (p ' i span.
IL, ft.
s,
Roof rafters "X �_ 7 ft.
" spacing o.c. span ft.
Roof trusses(pre-engineered) spacing'74 "o.c. span4 n ft. Ui
Exterior wall finish ''SiOf what material? �7 x /
Interior wall finish ft-i �y� I -1Y- lfJ
If a 'garage is to be attached, describe
materials to be used for FIRE SEPARATION:
Is there to be an opening between garage and dwelling?
door, enclosure, and self-closing device be provided? KY S If so will a Fire-rated
Will a flue-lined chimney be installed? d Height above roof 2_ ft.
Depth of chimney foundation below grade 1 ft.
Depth of firepl. - -.rth ft. in.
Water supply f unicipa ..r private well
SEPTIC SYSTEM Distance from ANY private well(including adjoining properties ft.
(A separate application is necessary for any repair or new installation of septic system)
Town of pueensbury
County of Warren AFFIDAVIT STATE OF NEW YORK
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.SWORN TO BEFORE ME THIS Signature 1 ) ffll
Clc Owner, owner's agen arcnitect,contractor
day of I p i�1* 19 CP
Notary Public, 'W'arr�en County,ou N.Y.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
SPECIAL CONDITIONS OF THE PERMIT:
By
TOWN OF QUEENSEURY
• 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 2� l3
2 . Type of heat y' QQ r
3 . Is the building mechanically cooled? I v'
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
Under 16% Only
1 . R value of roof and oors exposed to ambient conditions
2 . R value of exterior wallsRie
3 . R value of glazed area —7 .5
4 . R value of doors /
5 . R value of floors over unheated spaces P//
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 Cgrade)
10. Type of insulation T ? `
C. Controls a5 o
1 . Thermostat maximum heat setting
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 p,�
E . Piping Insulation • 1/ V
1 . Size of hot water or cooling carrying agent pipe G�
2 . R value of pipe insulation �/,¢
F. Service Water Heating
1 . Performance efficiency
2 . Temperature control setting maximum / 'y
G. For Swimming Pool Only ���
1 . Maximum(mu heating � ,`
Telephone No. V \ \ " Z 19 /I"y�y�' I ty,� +) Q �
(applicant ' s si nature)
Jown of Queenelury -
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Oueensbury, New York 12801
SEPTICa DISPOSAL� ` PERMIT APPLICATION �G
Owner's Name ?aa_k. ti .-c Cyg..3v��' C(3 �Nle 7 Tel.V-I I — I�
Address )�2 _ likkc I 1' IQc_V-;tt Vc V1A\e SX) T 12-1\F
Person/Firm installing system Q-&„ \\ 1l\ C CYNS*
Number of bedrooms (residential only) Qp
cceCc
Total daily flow: (compute @ 150 aal.per bedroom per day)_ (o O'
Topography:ial)- rolling - steep - (Circle one), Degree of slope %
GG II
• Nature of soils t loam-clay- other- Depth J -bft.
Ground water-- at what depth? -Oi' ft.
Bedrock or impervious material--at what depth? ft. •
Percolation Test - Not required / Required -Rate /9 '-J min/inch.
Domestic Water Supply - Municipal -\Well - Other
IMPORTANT! JJ
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 aat 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/QOO gal.
Tile field- Length of each trench5O£t. Total £ield0£t.
Size of stone # Z
Seepage-Pit(s) Number / Size ftX- ft. 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 Queensbury Sanitary
Sewage Ordinance.
T/!)r1-__ v / °1 ) so
Signature of Ap licant Date
01/86 and/vl
Section II Septic System Inspections:
A. All applicationd for septic system installation,
alteration or repair, as reauired by the Town of
Queensbury Sanitary Sewage Ordinance, shall be
submitted to the Buildina 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 be
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.
-__7 //�� /
_/otun of Queenl6 ury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Oueensbury, New York 12801
BUILDING INSPECTOR' S REPORT
NAME 1�
LOCATION 7-e tJ_/ 50, r'L n
Date Permit No. �� - a a
* * * * * * * * R * * * * * * * * * * * * *
s/ n APPROVED - YES NO
Footing/Pier Forms _
Foundation
Waterproofing
Backfill _
Framing —�
oofing
vsidiug =��
Masonry Veneer
ugh Plumbing V--
lief Valves =1�
xt. Porches
finished Floors �__
(/r}}terior Trim _n
(4tairs 6 Railings
Cellar Drain Tile _
Cyncrete Floors
rreproo
'Aar.
Fireproofing OM
9eor Closers `�
✓Smoke Detectors _
Chimney
4Nyundati0fl
III
k41o0rKoundation MI
✓Floors : -.�. E - [CEO _
Walls _
Ceiling
FINAL ELECTRICAL INSPECTION din
DRIVEWAY APPROVAL VI,
>final Building Survey
Next scheduled inspection (call when ready)
Remarks-
Q
Buil 'ng Inspec or
6/86 and-vl
Air—
Jowl' of Qure„sbury
BUILDING and ZONING DEPARTMENT
Bay O eensbury. New York 12801z 98
BUILDING INSPECTOR'S REPORT
NAME Pa-:
LOCATION A
Date
/_ Permit No. p6- ' _C_
// . , x x x x , , , .
r`lyNJ
/�-x7, , x + x x •✓ - APPROVED - YES NO ;
Footing/Pier Forms1111111
Foundation _
Waterproofing __
Backfill
Finning —[�7!
IIIII
9ofing 7— J
LSasonr =
Masonry Veneer
Rough Plumbingel _�ea7.
xt. P VPorves
IIIches
AIIIIIIIIIIII
xt. Porches rao
r'J
shed Trim Arnie,„
i bnag ,
narg
�//pterior Trim /
44tairs & Railin•s - —
Cellar Drain Tile _�:��
Concrete Floors •
L.�
loOlbg. Fixtures
tear. Fireproofing
r Closers 1111111
tMN
Chimney
Detectors _
Chimney
ttcaidATION: ^ '_
tdation ati-e ,� imi �j�.a
Walls
C ing . , SS
INAL ELECTRICAL INSPECTION ' NMDRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks- � �'���,�'����.,...
;CaI
at
�'� °��
O
Building Inspector
6/86 and-vl
tiwn of Queendbury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R D. 1 Box 98
O eensbury, New York 12801
SEPTIC D1 OSAL SYSTEM INSPECTION
NAME
LOCATION
DATE / PERMIT NO.
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate
- Min/Inch
TYPE of SYSTEM:
Absorption field, total le • h�—
Length of each trench
Depth of trenches ' -
Size of gravel_ of) _--
SEEPAGE PITS4Numba
Size- ft. X - t.
Gravel size - Size Type
PIPING:
Tang. tto
t
Tank to disist. box
Dist. box to field pit NO Partial
Openings sealed? YES
LOCATION/SEPARAT ,ONS: ft.
Foundation to t- k tion ft.
Foundation to a•sorp ft.
Absorption to 1. ine —ft.
Separation of pits ON PROPERTY(oircle one)
Fron OF -SYSTEM Left side - Right side -
Frontt - Rear
COMMENTS: ; qN
o� "'iAl C I
e.__
SYSTEM USE APPROVED E NO
Building Inspector
01/86 and vl
aga
_ l4 c inn
c7}a-y Iis�/� i i ! vs
l0Wn of QueenaLurt
BUILDING and ZONING DEPARTMENT
TB
Bay and Haviland Road. R.D.
1 Box Oueensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME_
LOCATION DATE •-
J/�-*— PERMIT NO.
SOIL TYPE - Sand - Loam - Clay
Percolation Test Required? YES - NO
Percolation rate - Min/Inch ________--
TYPE of SYSTEM: total length—
Absorption field,
Length of each trench _ —
Depth of raveltrenches��
Size of gravel_
SEEPAGE PITS.Number of) _ —
Size- _ft. X ft. _____—.------
Gravel
SIZE Size Type
PIPING: ---------
Bldg. to tank —�
Tank to dist. box
Dist. box to field/pit Partial
Openings sealed? YES NO
LOCATION/SEPARATIONS: ft.
Foundation to tank ft.
Foundation to absorption --ft.
Absorption to lot line eft.
Separation of pits LOCATION OF SYSTEM ON PROPERTY(circle one)
Right side
Front - Rear - Left side
CCt4MENTS:
ig�rn'.y P>e<Icn
NO l
/
SYSTEM USE APPROVED/ 1' 1
Buih Yng In pector
01/86 and vl
C,aIIIIc ypy"
flownQueend ury
ofT
BUILDING and ZONING DEPA RTBo%98
Bay and Newland Road. R D.k 1 B01
oueensbury, New
Pad-l4
SEPTIC ISPOSAL SYSTEM INSPECTION
NAME_
i GO
LOCATION Lnt d S� ' " e
/gc PERMIT NO. B(
DATE 0 (
SOIL TYPE - Sand - Loam - Clay --NNO
Percolation Test Required? YES
Percolation rate - Min/Inch _____._---
TYPE of SYSTEM:
Absorption field, total length !O O
Length of each trench 00` O
eh o raveltrenc es��
Size of gravel_
SEEPAGE PITS.Nninber of) _� _____
X ft. ��
Size-Gravel size Size Type
sA
PIPING: r/ p(/, Pi
Bldg• to tank -
TankDist to Biro. box NO Par
Open. box toea field
tial
Openings sealed?
LOCATION/SEPARATIONS: ft.
Foundation to tank (�0 ft.
Foundation to absorptionk, ft.
Absorption to lot line (/
YSitsTEM ON PSWPERTY(c• le one)
Separation of pits
Front - Right side -
Front
Left side
COMMENT • r
b
SYSTEM USE APPROVED YES N
C
yliitt
Building Inspector
01/86 and vl
TOWN OF QUEENSBURY
Building Department
I--VeatS p Datei
Name
Location Wat6er��
Permit Nw�
Remarks
floatation
Poetic- Forms
Footi • & Piers
Foundation
Cement Coat
Water•roofin•
Backfill
Final Surve �e
Frami •
Shea thin.
Roof Felt
Roofin•
Sidin•
Mason Vene=,I�,
Rou•h Fl.•.
Relief Valves
Wall Board
Ext. Porches _
la
Finished FloorIMI_
Interior Trim
Stairs & Railin•s
Cellar Dr. Tile
Concrete Floors
Pl.. . Fixtures
Gar. Fire•roofin-
Door Closers
Chimne
Water Metero nst
Re,tic A•• Floors
Foundation
Insulation Walls
Celli
(Allf Building JiBInspector
REMARKS
uiriet
Ru, 6-
TOWN OF QUEENSBURY
Building Department
Data 5/iii gi
Name
Localise to -$c,Q/tt.OL 6-
Permit No. 5?G-- ZZ'] Weather
Remarks
Excavation
Footin• Forms [ u 6- .r - a. b ..
Footin• & Piers
Foundation
Cement Coat
water•roofin•
Backfill
Final Surve
Fraain•
Sheathin•
Roof Felt
Roofin•
Siding
Masonr Veneer
Rou•h P1.• .
Relief Valves
Wall Board 011k
Ext. Porches EliteInterior Floor Mar Trim
Stairs & Railin•s _2
Cellar Dr. Tile ink
Concrete Floors allk
Pl.. . Fixtures
Gar. Fire•zoofin•
Door Closers
Chime
Water Meter Inst.
Se.tic A• •roval
Floors
Foundation.
Insulation walls II` +1/4"BuildingeTn e lingtor
REMARKS
,op_Gur(P0 ors coeg-114.49 -
W ak (0)c1 ToSrtP1aonu6
pe_-(A15PG{nf7,i/ 513o -AM
roar(Al65 SIEPP&D- WiW- iy Groat
TOWN OF QUEENSBURY
Building Department
Name
s Date 57)/fl'
Location --Gr e d /'t rj
Permit No. A 6-,. a 7 Weather
Remarks
Excaiation
Footing Forms K
Footing a piers,/ Q'
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
Ceiling
ilding Inspector
REMARKS