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1986-262 CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date Sent. 76 19 & This is to certify that work requested to be done as shown by Permit No. 86-262 has been completed. This structure may be occupied as • One-Family Dwelling Location Lot 59 Willow Road (St. No. 18) Owner Joe Rouiier By Order Town Board TOWN OF QUEENSBURY Building b Zoning Inspector 1 TEMPORARY CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date August 8 19b6 This is to certify that work requested to be done as shown by Permit No. 86-262 has been completed. One—Family Dwelling This structure may be occupied as a Let 59 Willow Road (St. to. 18) Location Owner Joe Roulier TEMPORARY CERTIFICATE OF OCCUPANCY FOR By Order Town Board 30 DAYS. 2/aTOWN OF QUEENSBURY Building & Zoning Ins for BUILDING PERMIT TOWN OF QUEENSBURY No 86-262 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Joe Roulier OWNER of property located at Lot 59 Willow Road (St. No. 18) Street.Road or Ave. in the Town of Queensbury.To Construct or place a One—Family Dwellingco 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. F� 1. OWNER'S Address is Box 301 rt Cleverdale, New York r 2. CONTRACTOR or BUILDER5 Name rrt H same C '0 m rot W Y+ 3. CONTRACTOR or BUILDERS Address m r m same o E 0 0 o w 4. ARCHITECT'S Name W m m to cn N • 0- G rs z 5. ARCHITECTS Address 'n o co co 6. TYPE of Construction—(Please indicate by XI ( k1 Wood Fame ( )Masonry 1 1 Steel ( 1 7. PLANS and Specifications 53'x34' per plot plan, specifications and application submitted No. including two-car attached garage and sewage system. . . 8. Proposed Use One—Family Dwelling F m t- $5.00 C/0 Paid 1 $ 158.00 86 co PERMIT FEE PAID —THIS PERMIT EXPIRES December 1 19 (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the town of Oueensbury before the expiration date.) Dated at the Town of Queensbury this ]�277th Day/ offt1 May 19 86 SIGNED BY 797/7 / �[< /0�w/w� for the Town of Queensbury Building and Zoning i npRor g TO BE COMPLETED BY BLDG. DEPT. Application No. own o Queensiury Permit Issued 19 r,OWN OF QUEENSBURY BUILDING and ZONING DEPARTMENT Permit Expires 19 1`I IL I(k f2 Ilfl D Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation LS lID LS �7 Queensbury, New York 12801 Variance No. MAY 191986 Site Plan Review No. a'4 Approved bY' � 7I81,PPFM 2Isl I6Ie APPLICATION FOR / 4.dd — I G b teinefrP BUILDING AND ZONING PERMIT * * * * * * * * * * * * * e * * * * * * * * * e e * * f * * * * * N * M a *::• 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: - e /\ ..y4, P.O. Address �y Se�//1// Gl,..,44 /V'./� / J/J ,ta / Tel.7 rL -3:�%5/ Property Location: .72{, �Lx 7 z 11 ni 4A 6ST 1 d> Tax Map No.7 U / 2 / A9 Street number or buildingbuui lot number Subdivision name (if applicable) /".* .s % /�..,,/. / THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS RFFARDS BUILDING CODES IS: —. /�rir, �x Se/ �% era/ e •✓. V GfC - 3i Ny Name P.O. Address Tel. No. Name of builde 6cr Address 0•44 Tel. Name of plumber STr.. :4l/e.✓ Address /J .,/ ��/7 ro. / Tel. Name of mason ,(�,, s„C, Address ,C/a/4?.r ,t . rv./ Tel. 7Spr 0e77 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 FOR DEMOLITION PERMIT, STATE SIZE AND * whether interior or corner lot. Show location LOCATION OF STRUCTURES AFFECTED. of water supply and location and configuration * of septic disposal area. * * COMPLETE INFORMATION REQUIRED BELOW. * Size of property /,3e ft X /7e ft. * Existing building(s) Size ft X ft. * PROPOSED BUILDING AND USE: * Existing building(s) Use Size of_new structure j'3 ft 4.,j/ft * %Found onati pier/slab/crawl/partial/full * Proposed building, distance from property line (circle one) * No. of stories (habitable space) of * Front yard Gd ft Rear yard L 7C ft * Side yards —,38 z ft and - ;8, ft Height (grade to ridge) .j3 ft. * If on corner, setback from side street ft If residential, no. of families / No. of rooms(excluding baths) ,t * OCCUPANCY INFORMATION * y No. of bedrooms * PRI)4ARY BUILDING - No. of bathrooms * ✓One family dwelling Primary heating system f/ * Two family dwelling Type of fuel elt/., No. of fireplaces to be installed / * Multiple dwelling / Number of units Will a wood stove be installed? a10 * Permanent occupancy Central Air conditioning? * Transient occupancy * Business BUILDING STYLE, PRIMARY STRUCTURE ----Industrial Ranch Contemporary Log cabin 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 ca two car0 car * * * * * * * * * * * * * * * * * Private storage building ESTIMATED MARKET VALUE OF * Other CONSTRUCTION $� //0 en, * 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? Foundation wall material Ga--c-.;.� /S(4- Thickness /e " Depth of foundation below grade (to bottom of footing) er' Will there be a cellar? y2/.5 Heated orcnheated-P Floor sq. footage in-tr.- sq ft Will there be a basement? ^/ Will any portion be used as living space? (If so, what portion? sq.ft. - - Type of use? Type of roof c-slope lat/shed/other Material of roof ,p /<T sZ to Size, wood studs x " spacing .ty "o.c. length e ft. l Joists(floor beams) 1st. floor _2 "X /e " spacing // "o.c. span/3';ft. Joists (floor beams) 2nd. floor .2 "X /o " spacing /G "o.c. span /ft ft. Overlays(ceiling beams) 0Z "X 5/ " spacing "1y/"o.c. span/i/ ft. Roof rafters 1 "X y " spacing 04Y o.c. span ft. Roof trusses(pre-engineered) spacing .,y "o.c. span3/ ft. Exterior wall finish eta, s,e/ f Of what material? ( '±-O*( Interior wall finish If a garage is to be attached, describe materials to be used for FIRE SEPARATION: '/a/ s(. �. 'C )a/2 2Atu0 Is there to be an opening between garage and dwelling? )s If so will a Fire-rated � door, enclosure, and self-closing device be provided? Will a flue-lined chimney be installed? >xs Height above roof ^-3 ft. Depth of chimney foundation below grade 7 ft. Depth of fireplace hearth _3 ft. in. • Water supply - Municipal or private well ,.704( 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 County of Warren AFFIDAVIT STATL 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. i 7 SWORN TO BEFORE ME THIS Signaturg_- -- i p "Z. % Owner, owner's ageL,arcnicect,contractor /9 day of / .e�/ 19 Notary Public, Warren County, N.Y. * * * * * • * * * * * * * * * • * * * * * * * * * * * * * * * * * * * * * * * * * • * * * * SPECIAL CONDITIONS OF THE PERMIT: By Lf/ h down of Quavnsbury APPLICATION FOR SEPTIC DISPOSAL PERMIT BUILDING and ZONING DEPARTMENT Bay and Haviland Road. R.D. 1 Box 98 Oueensbury, New York 12801 DATE /7 / �/�/ /Ft( LOCATION OF PROPERTY FOR INSTALLATION ��� �9 / ZK0 w /��/e OWNER'S NAME /// ADDRESS j� 3e/ �� �� t Y...'. Atria TEL 61G - 3 t'Yy INSTALLER'S NAME //✓r . wad CXc TEL Number of bedrooms(residential only) y Total daily flow(compute @ 150 gal per bedroom) G 0---r-r— y:Topograph Flat Rolling - Steep slope - (circle one) % of slope l . 4:ht Soil nature. Sand -- Loam - Clay - Other Depth ft. Ground water -At what depth? - ft. Bed-rock or impervious material - At what depth? ---- ft. Percolation test - Not required - Required - -Rate min-inch. Domestic water supply unicipal Well - Other Separation - Watersupply(if well) from Sepy,tic absorption ft. Proposed System: Septic tank /a- - gal. ( Minimun size, 1000 gal. ) Tile Field - Each trench ..la ft. Total system legnth _4 ° ft. Seepage pit(s) Number of . Size each ft X __ft Size of stone to be used % - e2 Depth or thickness / ft. • * R • * • * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * IMPORTANT! ! On a separate piece of paper, submit a diagram of the proposed system with all dimensions shown; including distance from any structure , distance from property lines and from ANY DOMESTIC WATER SUPPLY or shore-line of lake, stream,pond or wet-lands. Include all dimensions of the system, itself . * * * * * * * * • * * * * * * * * * * • * * * * * * * • * * * * * I .have read the regulations on the reverse side of this sheet and agree to abide by these and all requirements of The Town of @ueensbury Sanitary Sewage Disposal Ordinance. J ,Q Signature o responsible person J - Date -jam �J �� /J 05/86 and/vl Section II Septic System Inspections: A. All applications for septic system installation, alteration or repair, as required by the Town of Oueensbury 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 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. TOWN OF QUEENSBURY WARREN COUNTY , NEW YORK t 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 ej rcr- 7 2 . Type of heat /e< < 3 . Is the building mechanically cooled? N. 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? \ I' 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 59 of andme� floors exposed to ambient conditions_ 2 . R value o-'fl(/exterior walls /f- /jr / 3. R value of glazed area g.)' ) 4 . R value of doors / ' //1 5 . R value of floors over unheated spaces ir lo 6. R value of slab edge insulation - unheated slab 7' 7 . R value of slab insulation - heated slab B. R value of heated basement/cellar walls (above grade /i/ 9. R value of heated basement/cellar/ walls (below/ grade) AJ ' // 10. Type of insulation il�•y!<sS '� �z1f�;1 C. Controls / � , 1 . Thermostat maximum heat setting D. Duct Systems 1 . Is duct system installed in unheated spaces? YES 10 a. If YES , R value of duct installation b. R value of duct in other areas I . Piping Insulation 3//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 /904 G. For Swimming Pool Only 1 . Maximum heating Telephone No. 4::i/C - 32-4 — (applican ' s ::ignatu ;c7 ✓own of Qacenitury BUILDING and ZONING DEPARTMENT Bay and Haviland Road. R.D. 1 Box 9B Queensbury, New York 12801 BUILDING INSPECTOR' S REPORT NAME „NQ � LOCATION /.O'( c? “2„_aaQCrat) Date/ e� p Permit No. 10- aLa + x • • x x x ✓x_ APPROVED *YES x✓xNO Footing/Pier Forms . Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing 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 �1 �Nsr di ln g-- ➢FCTION /-' 1 Building Survey :) Next scheduled Inspection(call when ready) Remarks- - /`e _ C d atie OX Building Inspector 6/86 and-vl 3 ,. c7 Jown of Queenibury IyD BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR' S REPORT NAME LOCATION sr'q Date b /J<{//<" permit No. n 19 - a.(o 2. t/ = APPROVED - YES / NO Footing/Pier Forms Foundation Waterproofing Backfill Framing I./Roofing O.Y. (siding Ar Masonry Veneer Rough Plumbing Oh ✓Relief ValvesrY ^"�'I- tlt. Porches VS640_ 1 4.0.4- otvytt t� f!inished Floors 0 iterior Trim /,q�IC ✓✓Stairs S Railings *,- , a+.e. /�[.rs•il' / a1 Cellar Drain Tile 9ypncrete Floors stlbg. Fixtures QJt 4 Fireproofing Q•Vt lboor Closers (AC kEGoke Detectors an Chimney INSULATION: Foundation Floors Walls C}iling �J `I. • LECTRICAL INSPECTION Q41111pD-Ma-v c�( ilding Survey Next scheduled Inspection(call when ready) Remarks- - Building c nspector 6/86 and-vl i Jown of Queendbur5j BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Oueensbury, New York 12801 BUILDING INSPECTOR' S REPORT NAME T64- 2/ QJL -C I ( - LOCATION J cr59 L7/I(Lotf Date g` / Or Permit No. Ql0/ ^ a C. 2- . . . . . . . . . . . . . . . . . . . . . = APPROVED - YES J NO Footing/Pier Forms Foundation Waterproofing Backfill Framing Roofing e'r Siding Masonry Veneer Rough Plumbing Relief Valves Ext. Porches Finished Floors Interior Trim Stairs S Railings Cellar Drain Tile Concrete Floors Plbg. Fixtures it/Car. Fireproofing O K l . Door Closers O(t la Smoke Detectors - , Chimney INSULATION: Foundation Floors Walls Ceiling Per ELECTRICAL INSPECTION (Final BuildrnTtUrV 9) Next scheduled Inspection(call when ready) Remarks- - &ILO I,I/!n( ,44no K41615regs 3S462 P i. CouoIrto wa-c-, 71cM PonmcLl el 15 5 Ut-I9. 51-6- Atli- M x.SrA-r6MtvT- o r hew—L(4 aiLirll. Buildin Inspect 6/86 and-vl awn of 4Queeniturf BUILDING and ZONING DEPARTMENT Bay and Haviland Road. R.D. 1 Box 98 Oueensbury, New York 12801 BUILDING INSPECTOR'S REPORT NAME ?Cu LL LOCATION 5 9 W(LC-ouI Date g/fi / % Permit No. F,.. ,)GZ * * * * * * * * * * • * * * • * * * * • * • * {� = APPROVED - YES ,/ NO Footing/Pier Forms Foundation Waterproofing Backfill Framing Roofing t/ Siding .4 scgr -s Masonry Veneer Rough Plumbing Relief Valves Ext. Porches Finished Floors Interior Trim ✓` Stairs & Railings Cellar Drain Tile Concrete Floors Plbg. Fixtures t� Gar. Fireproofing Door Closers {� Smoke Detectors 1--- Chimney INSULATION: Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION Xx Final Building Survey Next scheduled Inspection(call when ready) Remarks- - CAnA46 Dead Ow&.t juro ffvsr �trt f Ctoswb - WO5A.4 - EG s- ALL-pookS thic 0I•V(, PA- -toPoox5 - 03A Srvtua-covA mt.vvtS (Al 1r/m»S C4-� me (�(.a Build n speo 6/86 and-vl Called ilI3) /(1. tf✓ill own o/ •Qeenibury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Clueensbury, New York 12801 ) - I P.m BUILDING INSPECTOR'S REPORT NAME X O ,e 4L0 k h e1- LOCATION L+ r 59 W) /ld 'Cl gel Date 0 I / 9L Permit No. 1'6 - aCD 2 * * * * * * * * * * * * * * * * * * * * * * * ✓ = APPROVED - YES / NO Footing/Pier Forms Foundation Waterproofing Backfill /_ ✓Ro o ing544/Wf4(.V4 fwC6.40ar - Ikir ✓Siding Masonry Veneer R gh Plumbing lief Valves 4011 �_ ✓✓✓✓✓✓E . Porches /1n✓ nished Floors �/ - !Interior Trim Ittairs & Railings Cellar Drain Tile f Cpncrete Floors / 1:4 g Fixtures ire �� ct . Fireproofing V r Closers Smoke Detectors l Chimney * INSULATION: I \ . Foundation Floors Walls Jailing FINAL ELECTRICAL INSPECTION Finalinal Building Survey 1/ I`O U.30ifCr/di/— Next scheduled Inspection(call when ready) Remarks- - ) Lt 6GAL. OcCUPtrty' /110 CSii Pit A-re-of acegitival lssL60 Buil ing Inspe for 6/86 and-vl Jown of Queenilury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR' S REPORT NAME i LOCATION w J Bd , Date'-// / %6 Permit No. a10- 2L2 * * * f f * f * * f * f * * * f * * f * * f * c APPROVED - YES J NO Footing/Pier Forms Foundation Waterproofing )ackfill V Framing Scr, �N�s.Qo -.) Q 0 Roofing Siding ylasonry Veneer ✓Rough Plumbing O,K, 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 Final Building Survey Next scheduled Inspection(call when ready) Remarks- - 0.0a-AI ^t-rlFp 61 c-rwQ CNan- rnfeErvi6 krrj- .zw4 (41142) Building Inspector 6/86 and-vl _town of Queenatury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, RC) 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME din/ �e-t., LOCATION dirt $'7 (tiz/DATE ! ti PERMIT NO. g1 -. 02G 2 SOIL!%TYPE - Loam - Clay - Percolatio Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM: Absorption field, total length a 5-t::' Length of each trench C L Depth of trenches ./)( Size of gravel J 0 SEEPAGE PITS{Number of) Size- ft. R ft. Gravel size PIPING: Size Type Bldg. to tank vet KO Tank to dist. box Dist. box to field/pit Openings sealed? YES NO Partial LOCATION/SEPARATIONS: Foundation to tank lb ft. Foundation to absorption a.oft. Absorption to lot line 5 Uft. Separation of pits — ft. •, OF SYSTEM ON PROPERTY(circle one) firri".-- Rear - Left side - Right side - CGMMENTS: rn SYSTEM USE APPROVED YE NO Buildingdi/ Inspector 01/86 and vl TOWN OF QUEENSBURY • Building Department �,/,, hupretre Date CU? ' )yea Name ' I • Location LJ S'4 (a/,ftscu• Li Permit No. Ago- 1 68 Weather Remarks Excavation Footing Forms Footing & Piers Foundation Cement Coat / Waterproofing (/ /9i Backfill ✓ B, 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 Gar. Fireproofing Door Closers Chimney Water Meter Inst. Septic Approval Floors Insulation Foundation Walls Ceiling Building Inspector REMARKS TOWN OF QUEENSBURY Building Department ImmeName etma mt i Date S�j 'cyo Nam Location I ,rt- 5-9 LAJAP4,,n Reg Permit No. 86 — .26.t Weather '2 Z Remarks Excavation Footing Forms Footing 6 Piers `� O fc 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 a Railings Cellar Dr. Tile Concrete Floors Plbg. Fixtures Gar. Fireproofing Door Closers Chimney Water Meter Inst. Septic Approval Floors Insulation FOUnde GiOn. Walls Ceiling Ifni)I Building Inspector REMARKS 1' i I 1 /70 I 3`1 3r� ? 1 s -3 4° 1 /3> - > / �.._./,