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CER- -T1F ,QA'TE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Dated `� 19 �`
This is to certify that work requested to be done as shown by Permit No. 88-350
has been completed.
This structure may be occupied as a One family dwellin_q - addition
Lake George Road
Location
Owner Mr & Mrs.Steve Sutton
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoning Inspector
BUILDING PERMIT
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TOWN OF QUEENSBURY
No. 88-350 �
WARREN COUNTY, NEW YORK b
0
PERMISSION is hereby granted to Steve Sutton
OWNER of property located at Lake George Road Street, Road or Ave.
1
in the Town of Queensbury,To Construct or place a Addition to dwelling
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
Same
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2. CONTRACTOR or BUI LDER'S Name
Hilltop Construction n
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3. CONTRACTOR or BUILDER'S Address
P.O. Box 576
Glens Falls, N.Y. 12801
4. ARCHITECT'S Name
Q)
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
(X)Wood Frame ( ) Masonry ( )Steel ( )
a�
7. PLANS and Specifications
No. 24' X 42'6" as per plot plan, specifications and application
INOXk including two car garacTe
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8. Proposed Use
Addition to dwelling
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5.00 C/O January 1 89 ti
$ 59.00 PERMIT FEE PAID —THIS PERMIT EXPIRES 19
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the LQ
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 7th Day of June 19 'q8 _
SIGNED BY ��� /J for the Town of Queensbury
Building and Zoning Inspector
TO BE COMPLETED BY BLDG. DEPT.
TOWN ®V QU E7'M$V?;'1 r-
�] Application No.
_Jown o/ QueenJlury Permit Issued 19 W-
Bay L tia •-1 - -- 3
BUILDING and ZONING DEPARTMENT Permit Expires 19 and Haviland Road, R.D. 1 Box 98 Zoning Designation NAY 7
Queensbury, New York 12801 Variance No.
��u ✓` ��CJ Site Plan Review No. BUILDING a CODE DF-PT.
1 ^� Approve 4LW 4�
APPLICATION FOR /� //a 9 `
S O
EUILDING AND ZONING PERMIT 6y
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 on the Permit. '
-----------------------------------------------------------------------_ -----------------------
The owner of this property is: Mr. F- Mrs . Sieve- ^yC uf on
P.O. Address lr.C1�p� 1920Y-62 1�OCLJ b )e-ns �f���5� au IQ30 ) Tel.
Property Location: `S Airne , Tax Map No. 69
Street number or building lot number IS
Subdivision name (if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
P 1 140 D (20rn5fru cf o y) P.0 , ROX 51(o �' I e,05 CA-1(S q 3-0 331'
Namel P.O. Address Tel. No.
Name of builder Address Tel.
Name of plumber . / Address Tel.
Name of mason 16 jj Address Tel.
:r 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.
x-
COMPLETE INFORMATION REQUIRED BELOW.
Size of property yf9 ft X ft_
Existing building(s) Size___,gFft X ft.
PROPOSED BUILDING AND USE: * Existing building(s) Use
Size of new structure ft X d9ft�n '� hOrYi e-
Foundation-pier/slab craw partial/full Proposed building, distance from property line
(circle one)
Front yard l e g ft Rear yard 5-Y ft
No. of stories (habitable space)_ _
�. Side yards 7''"/q ft and '7c9 ft
Height (grade- to -ridge) - ft.-- If on corner, setback from side street ft
If residential, no. of families
No. of rooms(excluding baths) " OCCUPANCY INFORMATION
No. of bedrooms /Voile- PRIMARY BUILDING -
No. of bathrooms /U0v?
� �L � x One family dwelling
Primary heating system
Type of fuel Two family dwelling
Multiple dwelling / Number of units
No. of fireplaces to be installed 'POtl
�. Permanent occupancy
Will a wood stove be installed? 1U 0y? -e-
Transient occupancy
Central Air conditioning? Business
BUILDING STYLE, PRIMARY STRUCTURE Industrial
Ranch Contemporar Log cabin Other '
Raised ranch Mansion Duplex If addition, what will use be.
Split level Old style Bungalow
Cape Cod Cottage Other * ACCESSORY BUILDING-
Colonial Row Town House Detached garage/one car/ two car/ car
( CIRCLE ONE PLEASE ) Attached garage/one car/ wo ca / car
* * * * * * * * * * * * * * * * * * Private storage building
ESTIMATED MARKET VALUE OF Other
CONSTRUCTION
$ �D Oo�
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.
Will any second-hand or ungraded lumber be used? If so, for what? �JQ
Foundation wall material COl�1C1�e�P/ Thickness G? �!
Depth of foundation below grade (to bottom of footing) '
Will there be a cellar? B)O Heated or unheated? Floor sq. footage sq ft
Will there be a basement? Ny Will any portion be used as living space?
(If so, what portion? sq.ft. - - Type of use?
Type of roof - slope flat/shed/other Materialcof roof
Size, wood studs "X it spacing "o.c. length ft.
Joists(floor beams) lst. floor "X _" spacing /6 "o.c. span N ft.
Joists (floor beams) 2nd. floor "X�,�" spacing��"o.c. span ft.
Overlays(ceilin beams) a "X spacing /Lp"o.c. span ft.
Roof rafters "X spacing�o.c. span 14P ft.
Roof trusses(pre-engineered) spacing "o.c. span ft.
Exterior wall finish ®C� Of what material?
Interior wall finish C a 1�0
zi=a garage,-is to be attached, describe materials to be used for FIRE SEPARATION:
"/R rl h Pi rob- SSA eefroc/G
Is there to be an opening between garage and dwelling? b If so will a Fire-rated
door, enclosure, . and self-closing device be provided? 2 5
Will a flue-lined chimney be installed? N O Height above roof ft.
Depth of chimney foundation below grade ft.
Depth of fireplace hearth ft. in.
Water supply - Municipal or 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 Queensbury A F F ,7 D A V I T
STATE OF NEW YORK
County of Warren
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 doneion 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.
_9
SWORN TO BEFORE ME THIS Signature^_LJ(/{ _ _ --__ _ __ ______________
Owner, o i s agent,arcnirect,contractor
day of 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 obtained before beginning work.
ANSWER ALL of the following:
1 . Gross floor area (P3�
2 . Type of heat
3 . Is the building mechanically cooled? O
4 . Percentage of area of windows and doors
A. Over 16% Only
1 . U 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
B. Under 16% Only
1. R value of roof and floors exposed to ambient conditions— .
2 . R value of exterior walls
3 . R value of glazed area / I 7
4 . R value of doors /13-1
5 . R.value of floors over unheated spaces /S -&O
6. R value of slab edge insulation - unheated slab -
17
7 . R value of. slab insulation - heated slab ZIA
8. R value of' heated basement/cellar walls (above grade):
9 . R value of heated basement/cellar walls (below grade)
10 . Type of insulation Fl Ger,g7lt5s
C. Controls
1. Thermostat- ma xi-ffum heat setting - -- -D. Duct Systems
1. Is duct system installed in unheated spaces? YES ®O
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 insulaioni:
F. , Service Water Heating �/�
1. Performance efficiency
2 . Temperature control setting maximum
G. For Swimming Pool Only
1 . Maximum heating
Telephone No. V - 033 0"J
(applic nt ' s signature)
,Y. o �tt �
APPLICATION FOR SEPTIC DISPOSAL PERMIT
flo
DATE
LOCATION OF PROPERTY FOR INSTALLATION 1,-a,Ce- e �Gf, F
Owner's Name: &e_yel &.*OIL Telephone:
Address: Uke- Ceorce Rd. 1et?5
Installer's Name: Telephone:
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom)
Topography: circle one: Flat Rolling Steep Slope % of slope
Soil Nature: circle one: Sand Loam Clay Other / Depth: feet
Ground Water: At what depth? feet
Bedrock or Impervious Material: At what depth? feet
Percolation test: circle one: not required required / rate min. inch.
Domestic water supply: circle one: Municipal Well Other
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption feet
PROPOSED SYSTEM: Septic Tank _gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench feet / Total system length feet
SEEPAGE PIT(S): Number of _ / Size each feet by feet
Size of stone to be used # _ / Depth or Thickness _ feet
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
IMPORTANT
...Please...LIST NEW EQUIPMENT TO BE INSTALLED
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
(over)
Section II Septic System Inspections:
A. All applications for septic system installation, alteration or repair, as
required by the Town of Queensbury Sanitary Sewage Ordinance, shall
be submitted to the Building 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 Queensbury Building Department before further construction.
I have read the regulations above and agree to abide by these and all requirements
of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
Signature of responsible person:
Date:
Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832
SETTLED 1763 . . . HOME OF NATURAL BEAUTY . . . A GOOD_PLACE TO LIVE
TOWN OF.QUEENSBURY
BUILDING ANDICODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
c
REQUEST FOR IN� ECTION RECEIVED
NAME
LOCATION e.
DATE PERMIT #
TYPE OF STRUCTURE
RECHECK St;\�V �� a I�"P PROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS FOLLOWING
THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE',,ON SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE s%
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE';,
PLUMBING UNDER SLAB f`
FRAMING:
JACK STUDS/HEADERS r`
BRACING/BRIDGING t
JOIST HANGERS i
JACK POSTS/MAIN BEAM
HEATING ROUGH-IN ;r
INSULATION: <
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS: //''��
all 11�
ARRIVE
DEPART
Jv INSPE OR
Jown o f Queenilury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION ��'`"/�
Date/� Permit No. - f�
* * * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Ven er
Rough Plumbin
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofin
Door Closers
Smoke Detectors
Chimney
t'111's,ULATION:
Foundation
Floors
Walls -aG t i s
Ceiling
FINAL ELE TRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-
Building Inspector
6/86 and-vl
Jown of QueenjLry
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
V//BUILDING INSPECTOR ' S REPORT
NAME
LOCATION
Date/ Ida— Permit No. ,
* * * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES NO
Footing/Pier Forms
Foundation
Waterproofing
kfill
raming
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Til
Concrete Floors
Plbg. Fixtures
Gar. Fireproof'ng
Door Closers
Smoke Detecto s
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-
\ Building Inspector
6 and-vl
Jown of Queenitury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR' S REPORT
NAME
LOCATION��
Date/ Permit No. �l
* * * * * * * * * * * * * * * * * * * * * * *
1" = APPROVED - Y�E / NO
yr
<ot
Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Vene r
Rough Plumbin
Relief Valves
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 inspection (call when ready)
Remarks-
Building Inspector
6/86 and-vl
THE NEW YORK BOARD OF FIRE - UNDERWRITERS I` T, i
BUREAU OF ELECTRICITY
41 STATE STREET,ALBANY,NEW YORK 12207
Date Application .on
1.2 1'�?, _
THIS CERTIFIES THAT PEI,31 I T NX ,
on,Vo.on b ap ca named
only the electrical equipment as described below and introduce d-. he applica" 'named on the above application number in the premises of
C1
P 1)
01- Section ,.r,Block Lot
ID11 C'IT"I"
a.
I.
in thefollowing location; ❑ Basement ❑ st Fl. M`2nd Ft.
was examined on
and found to be in compliance with the requirements of this Board.
59 FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS ECEPTACLES1 SWITCHES INCANDESCENT[FLUORESCENT OTHER AMT. I K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
K W. OIL H.P. SYSTEMS
GAS H.P. AMT. NO. A.W.G. AMT. AMP. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS
SERVICE
ni;
ERVICE DISCONNECT NO.OF S E R V I C E
AMT. AMP. TYPE METER EQUIP. 10 2W 10 3W 3 0 3W 3 X AW NO.OF CC.COND. A.W.G. NO.OF HI-LEG A.W.G. NO.OF.NEUTRALS A.W.G.
PER Z OF CC.COND. OF HIAEG OF NEUTRAL
OTHER APPARATUS:
BRANCH MANAGER
Per e
This certificate must not be altered in any manner;return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
=WNW 5 n MW MEMMM IM n MW MW 5 MW 5 5W nnswimm
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
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