1986-281 a %
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date November 3 19 86' ;
This is to certify that work requested to be done as shown by Permit No.
86-281
has been completed.
One—Family Dwelling
This structure may be occupied asa
Location Lot 5 Tina Lane (M and M Subdivision)
Mark and Annette Wellington
Owner
By Order Town Board
T OF QUEENSBURY ,
/
Buildii
Zoning Inspector
BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-281
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Mark and Annette Wellington
OWNER of property located at Lot 5 Tina Lane (M and Mf Subdivision) Street,Road or Ave. w
One—Family Dwelling o.
in the Town of Queensbury,To Construct or place a
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.
rt
m
1. OWNERS Address is '1
2. CONTRACTOR or BUILDERS Name rt
0
Hilltop Construction
3. CONTRACTOR or BUILDERS Address
RD it Box 308A
Hudson Falls, New York
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4. ARCHITECTS Name p et
a �
.3
En 0
a w
5. ARCHITECTS Address
Nr w
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6. TYPE of Construction—(Please Indicate by X) 0,
(XI Wood Frame ( 1 Masonry 1 )Steel (
7. PLANS and Specifications
No. 281x28r per plot plan, specifications and application submitted
including sewage system.
B. Proposed Use O
One—Family Dwelling 'I
$5.00 C/0 Paid
$ 105.00 January 1 t9 87
PERMIT FEE PAID—THIS PERMIT EXPIRES
pf a longer period is required an application for an extension must be made to the Building and Zoning inspector of the r
town of Queensbury before the expiration date.) F'
V•
Dated at the Town of Queensbury this ^5th Day of/ June 19 86^-' aq
SIGNED BY /Y{ + a. for the Town of Queensbury
Building and Zoning Inspector
TO BE COMPLETED BY BLDG. DEPT.
Application No.
own of Queendtury Permit Issued 19
BUILDING and ZONING DEPARTMENT Permit Expires 19 TOWN OF U ENc '"'
Bay and Haviland Road, R.D. I Box 98 Zoning Designation d ' , L�J
i
Oueensbury, New York 12801 Variance No.
/ Site Plan Review No.
J ~o2 � .G _ PP
A roved ////�fp A.M. I�Dy, (, _
APPLICATION FOR � /�-F„� ,{�, ,� . f., ..111M,1111L1412�51,
BUILDING AND ZONING PERMIT Clolp/:_c__ _
* * * * * * * * * * * * * * * * * * * * * * * * * * *. * * * * * * * * * * *:`*
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.
. 'II
The owner of this property is: nil( A. RNNe/(e We/I1 n +on
P.O. Address L -�� ,J Tel.
Property Location: .3 / n i. Lattie. Tax Map Nod .2C/ Co /C
Street number or building lot numbe
�r
Subdivision name (if applicable) AA +M . (? ANOr,
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS RFrAR BUILDING CODES IS:
f,/l/ap Cons/. R041 &o/4IW4 s7udson railsrails7 8 9F-033
Name f
LL //// P.O. Address Tel. No.
Name of builder i �/ibp (_On57 1. Address Tel.
Name of plumber no/el LU,n ne Address $8/300 Din Aye 6 f- Tel.
Name of mason Ken 5-{p e j -e Address Tel.
NATURE OF PROPOSED WORK: ZONING INFORMATION:
X 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 ;'60 d ft X gcJ5-O ft. {—
* Existing building(s) Size ft X ft.
*
PROPOSED BUILDING AND USE: ,eft
Existing building(s) Use
Size of new structure a fl ft X ,p ft *
Foundation-pier/slab/crawl/partial ful " Proposed building, distance from property line
(circle one) *
�i * Front yard 3,5 ft Rear yard /9 ft
No. of stories (habitable space) _
Height (grade to ridge) AS ft. * Side yards 4/0 ft and yC� ft
If residential, no. of families / * If on corner, setback from side street ft
No. of rooms(excluding baths) 9 * OCCUPANCY INFORMATION
No. of bedrooms *
* PRIMARY BUILDING -
No. of bathrooms * Y One family dwelling
Primary heating system deC-/r. C- _ * Two family dwelling
Type of fuel —
No. of fireplaces to be installed AiO/:, C• Multiple dwelling / Number of units
* _Permanent occupancy
Will a wood stove be installed? NOWT= Transient occupancy
Central Air conditioning? NO " ---Business
Business
BUILDING STYLE, PRIP:\RY STRUCTURE * _Industrial
Ranch IContemporar) 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/ two car/ car
* * * * * * * * * * * * * * * * * Private storage building
ESTIMATED 4ARKET VALUE OF Other
CONSTRUCTION 'Zan
$zan 4ea225. co
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: W�,, ?7 /
Type of construction, wood frame, fire safe,etc. OO a
Will any second-hand or ungraded lumber be used? If so, for what? NO
Foundation wall material C'O✓)CYefe i3 /C0k5 Thickness IU
Depth of foundation below grade (to bottom of footing) rJ
Will there be a cellar? vtsfleated o.( Floor sq. footage '7 2 / 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 - slope flat/shed/other Material of roof E,/,erg/a SS S%' '19//cc
Size, wood stud "X Le " spacing Ii "o.c. length ft.
Joists(floor beams) 1st. floor a "X ) - " spacing / (p"o.c. span /y ft.
Joists (floor beams) 2nd. floor "X /p " spacing /(o"o.c. span iq ft.
Overlays(ceiling beams) "X O" spacing o(L/ "o.c. span ft.
Roof rafters ,? "X /a " spacingc?q o.c. span ft..
Roof trusses(pre-engineered) spacing "o.c. span ft.
Exterior wall finish 'T /// Of what material? f/2
Interior wall finish el rock-
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? If so will a Fire-rated
door, enclosure, and self-closing device be provided?
Will a flue-lined chimney be installed? Height above roof ft.
Depth of chimney foundation below grade ft.
Depth of fireplace hearth ft. in. a�
Water supply - Municipal or private well MUM C ! pat
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 AFFIDAVIT
County of Warren 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. COP,
/
SWORN TO BEFORE ME THIS Signature__ COP, ci / ( ' _R4-
Owner, owne s agent,arcnitect,contradfor
day of 19
Notary Public, Warren County, N.Y.
* * * * x * * * * * * * * * * * * * * * * * * * * * * • * * * * * * * * * * * * * * * * * *
SPECIAL CONDITIONS OF THE PERMIT:
By
_own of Queendbury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC/ DISPOSAL PERMIT PER�MMIT APPLICATION�
Owner ' s Name �Qikl JTNNete /(/P//i919f0/V Tel.
Address tS //^/Q %I We
Person/Firm installing system //0aa/QIIS TXClaka//hF
Number of bedrooms (residential only)
Total daily flow: (compute @ 150 aal.per bedroom per day)
Topography: flat - rolling - steep - (circle one) Decree of slope 6
Nature of soils•aF loam-clay- other- Depth ft.
Ground water-- at what depth? ft.
Bedrock or impervious material--at what depth? ft.
Percolation Test - Not required / Required -Rate min/inch.
Domestic Water Supply Municipa - Well - 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 anx 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 /000 gal.
Tile field- Length of each trench Ant. Total field,ft.
Size of stone # ,3
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 Queensbury Sanitary
Sewage Ordinance.
Signatur of Applicant O Date
01/86 and/vl
.'dellhigftN Yub, ,.. ..ufl ,
WARREN COUNTY , NEW YORK
Application for: BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK
STATE ENERGY .CONSERVATION CODE
4 A permit Must be obtained before beginning work.
ANSWER ALL of the followings _
1 . Gross floor area / % •
2 . 'Type of heat /,.//./c/T/ C _.. .
I •
3. Is the building mechanically cooled?__
4. Percentage of area of windows and doors
A. Over 16S 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 wells insulated? YES NO
1 . If YES, what is the R value?
a
3. Slab on grade YES NO
a. If YES, what is the R value of insulation around
perime ter 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 andJloors expusee to ambient conditions_
c'
2 . R value of exterior walls /
3. R value of glazed area
4 . 4 R value of doors /? /.3
5. R value of floors over heated spaces -. //i!
6. R value of slab edge insulation - unheated slab
—r
7. R value of slab insulation - heated slab /1-
a. R value of heated basement/cellar walls (above grade) f_/_
9. R value of heated basement/cellar vials (below grade) .,
10. Typo of insulation Gi 7.1.'c',,--777-/ ( --
C. Controls
1 . Thermostat maximum heat setting -7c
D. Duct Systems
1 . Is duct systtm installed in unheated space? YFS . Ce \
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 o
1 . Performance efficiency //l T . ._
2. Temperature control setting maximum
. G. For Swimming Pool Only . 12 '
1 . Maximum heating 'r /2 //J
•rlepnenPNo. 791-D33 7 . ,
Qe/ lariat)
• • I, (a,pplic is signature)
Ca II et? lola3faL 3IP"
.town of Queenit ury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Oueensbury, New York 12801
G/Uins/yc4701
BUI
LDING INSPECTOR'S REPORT
NAME hi a I,It (JJ IIrfyr h
LOCATION 1 rina La "
c c
M �
Date d6 f (a 3-6 -
Permit No.mor a28/
* * * * * * * * * * f * # * f * # * f * #
*
= APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
*-Roofing ✓/
)(Siding ✓
Masonry Veneer
Rough Plumbing
Relief Valves
gExt. Porches ✓�
)(Finished Floors
)(.Interior Trim b'
14 Stairs & Railings
Cellar Drain Tile
Concrete Floors
\LPlbg. Fixtures
V.Gar. Fireproofing
p(Door Closers
,LSmoke Detectors
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-
NQcd El
uilding Inspector
6/86 and-vl
.l own of Queenibury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Oueensbury, New York 12801
BUILDING INSPECTOR'S REPORT
((/¢ lli r.1t on
NAME lei//TdV Conyr,
LOCATION l_oT S T/na kanc
Date 9I11 / G Permit No. 26_ Z J/
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs 6 Railings
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers i
Smoke Detectors
Chimney
'(INSULATION:
Foundation
Floors
walls 7 9K
Ceiling (/ /DrL
FINAL ELECTRICAL INSPECTION
Final Building Survey
Next scheduled Inspection(call when ready)
Remarks- -
Buil ing nspector
6/86 and-vl
flown of Queendbury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Dueensbury, New York 12801
BUILDING INSPECTOR' S REPORT
NAME
LOCATION �b
Dated/`, / ///!!!1""'''"h��wr"Permit No. 366- 181
* * * F! * * * *9 * * * * * * * * * * * * * *
✓ = APPROVED - YES J NO
Footing/Pier Forms
Foundation
Waterproofing n ,,
B33��kfill t 13tt.-.2 0
Cframing
Roofing
Siding
Masonry Veneer
VRough Plumbing A.t
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs 5 Railings t\
)K(/
Cellar Drain Tile 1`
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- - /1
C
Building nspector
6/86 and-vl
Jown of Queendbury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Oueensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME btu-VI Lb & I I i a TarOn
LOCATION 5 r ) n4_ j,4 q
DATE 9Ip '$ PERMIT NO. pto — 28
SOIL TYPE ddlik Loam - Clay - a...
Percolation Test Required? YES NO
Percolation rate - Min/Inch
TYPE of SYSTEM: I
Absorption field, total length /SD
Length of each trench CS
Depth of trenches /,Q r( - —
Size of gravel_ JYf'+-2—
SEEPAGE PITS{Number of)
Size- ft. X ft.
Gravel size
PIPING: Size Type/�/[_
Bldg. to tank 5((i Sag
Tank to dist. box 'I 2 7(c..
Dist. box to field/4 2'7(4
Openings sealed? NO Partial
LOCATION/SEPARATIONS: /
Foundation to tank gift.
Foundation to absorption it.
Absorption to lot line ft.
Separation of pits ft.
LOCATPc TEM ON PROPERTY(circle one)
Front Left side - Right side -
dOCiiiiCCMME .
pauiJ &{JWcLL4 coh[ra-c1-''
SYSTEM USE APPROVE YE NO
r
Building In ector
01/86 and vl
,4nn;,z_LQ#�t-d - p& VGx POEM i
flown of Queenilury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR' S REPORT
NAME L*-LL(AJC rot.)
LOCATION T-(n/A LAAte-
Date 7//> / qc Permit No. �rr}1I ^a0Ll
* * * * * * * * * * * * * * *y/«v APPROVED«- YES J NO
Footing/Pier Forms �_
✓Foundation
✓Waterproofing ✓Y/
✓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
o. Fireproofing
Do \ /
Door Closers
Smoke Detectors
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
Final Building Survey
(PAM i C—
Next scheduled Inspection(call when ready)
Remarks- -
�k-
Building Inspector
6/86 and-vl
t�f� Hiner
c7S, MILLTop Conn. 1
Jown of Queensbury •
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Oueensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME IU cU.v6 T. ,T—
LOCATION 711/4 �&
Date 7A / R�o Permit No. g *�
R * * * * * * * * * * * * * * *
* ✓ = APPROVED lye./ NO
✓oozing/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.. FireproofingI,
Door Closers
Smoke Detectors
Chimney
INSULATION: '..
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
Final Building Survey
Next scheduled Inspection(call when ready)
Remarks- -
bifik
1.. AAIVI
Inspector
nspector
6/86 and-vl