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1985-490 CERTIFICATE OF OCCUPANCY TOWN OF QUEENSSURY WARREN COUNTY, NEW Y©RK OCfD xr 3c> %5 Bate c t n F c_.r n 19 -r ` This is to certify that work requested to be done as shown by Permit ^No. has been completed. �� ` 1Y�1 This structure may be occupied as a 'off'' c,--" "im i S v ocl a la r I'7,r� e11 i r cr k LA. V' Xxw-. Ufa Location ' T cx e r r }` w\ Qrcl Ownerti `., 7% 7r%M `]''eT!�'{�?`? i{ y(1r7 By Order Town Board PrOVII V OF QUEENSBURY Building & Zoning Inspector ' GREATIVS "lNSTA" FRONTING GLENS FALLS. N Y }SOO ! !l1/113.9�SL } BUILDING PERMIT TOWN OF QUEENSBURY No. f35— d4 (1 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to_ Gary and. Tammy Mcw3n OWNER of property located at LOt 5 5 T ui3Ine r,a ne (0 1 el Fnrgy Parks Street, Road or Ave. K in the Town of Queensbury, To Construct or place a _ 01n a Pam i l M Maha u l a r nwi: l l j nig Iy 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 Oueensbury Building and Zoning Ordinance. H 1 . OVVNER'S Address is Davis .mat . Glens Falls , New York rc 0 2. CONTRACTOR or BUi LDER'S Name � Assembly Dev . & Tectonics , Inc . 3_ CONTRACTOR or BUILDER'S Address 20 Saratoga Avenue r, South Glens Falls , New York 0 4. ARCHITECT'S Neme Ln 5. ARCHITECT'S Address (b B. TYPE of Construction — {Please indicate by X) (X) wood Frame { ) Masonry f I Steel 1 ] 0 7. PLANS and Specifications 40tx241 per plot plan , specifications and application o No. submitted including sewage system and two-car garage ( under ) La THE ATTACHMENT OF THE Two PARTS MUST BE APPROVED BY A � S. Proposed Use LICENSED PROFESSIONAL ENGINEER . 75' One-Family .Modular Dwelling $ 5 .r� 00 C/O Paid o $'R u ' 00 PERMIT FEE PAIR - THIS PERMIT EXPIRES A ri l j t9�$__f_ 0f a longer period is required an application for an extension must be made to the Building and Zoning inspector of the p town of Queensbury before the expiration date.) C7 11- Dated at the Town of Oueensbury this 5th rosy of September 1985 (D SIGNED BY � G for the Town of Queensbury Suildlog and Zoning I nsp+ecto + ri TOWN OF QUEENSBURY ISpace inside block to lx• filled in b% WARREN COUNTY. NEW YORK Building: lnvywctrsr) Alipl `` " ``"'Application for l'vo-1111r 1sa110h[1 lg BUILDING AND ZONING PERMIT P9 .1,711= l %pil'4b lei i?r3: mvp, District \ ;11 THREE ( 3 ) Copies of a PLOT PLAN. Drawn to scale showing tine actual dimensions of the lot to be built lip ::,.: :'IKS upon, The exact size. and location on the lot of the building to be *reefed or altered MUST BE SUB. MITTED WITH THIS APPLICATION. August, 2 3 , 1.985 . TOWN {C(��]F �{�Q+ LItE]EE(�{1rV� 5l^ TRY jjjl �`-`�y Ir7ATF } f ]/ FE Cc 1E Y U L { � f ' A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK � tttt_.]��. 'Jffi ANSWER ALL OF THE FOLLOWING. �� The undersigned hereby applies for a permit to do the following work ANA! � •i^ �� '� �'�`�'•N- whieh will be done in accordance with the description. p plans and ecifi- 1213141516 cations, and such special conditions as may be dicated on the permit. "'?I i ' ltl E1 (.uf�_ The owner of this property is: Qary. A . Tammy Noon, . . . 1 _ 4. .Davis St . , Glens Falls r -IFO6 ?A[}iS�11 IN :£1 The person responsihie for supervision of the work insofar as the Building Code and the Zoning Ordinance apply is. John G . Walsh , 17 l3urggyne .Ave .. ,. . Fort_ Edward ., ,N . �. . -12828. . . . . . . . . . . . . . . . . . . . . . . . . . _ _ . . - (NAME) (P O ADDRESS) Nameof Builder .A*13seml�l.y , Pev, .-§TevtonicS , . .Inc . . . . . . . Address . . 20- Saratoga .Ave.. .,- .South .Glens Falls , NY Name of Plumber . . . . . . . . . . . . . . . . . . . . . Address . . . . , . . . . . . . . . . . . . . . . . . . . - Name of Mason . . . Ken, Baldw. .in. . . . . . . . . - . . . - . . Address . 13adlcxck . Poxt . R _,,. West- .3E'cor t. Ann , . N.. Y' . - . Lot Number . . . �A. . . . . . - Unit .OJ4 . �e 5 �- rAfstunated value of proposed work S . 37 , 0]DO . 00. . . . - Nameof Village . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Street . . Lupine Lane Side of street : north Q , east ® , south ❑ . west Q Nearest Cross Street Arbutus ,Drive. . . . . . . . . . . . . . . . . . . Distance from this cross street . . . . . . 150. . . . . . Property is north Q, south 0 , east i . west Q from Gross Street If on Corner, which corner, northeast northwest southeast Q . southwest (Designate by marking with an "XII in the correct space.l NATURE OF PROPOSED WORK OCCUPANCY ® Construction of a new building. Main BuRding 0 Addition to a building. One-family dwelling Alteration to a building. Twa family dwelling 0 Demolition of a building. -family apartment house C-1 StorelYtklldln�' � ra � .� `'i ,Yi_ -car attached garage C} C}ther: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Accessory Building �A_ One-car detached garage © Other work. Describe: . . . . . . CJI.r,. . . . . . . . . . . . . Two-car detached garage 0 Private chicken house . . . . . . . . . . . . . " Private storage building C7 Oxher: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ZONING SPECIFICATIONS. Fill in for new building, or addition to existing building, or a change or occupancy. Indicate on the plot plan street names, the location and size of the property, the location, site and setbacks of pro,- old. Rd . posed buildings, and the location of all existing buildings. Show proposed building(s) in dotted line and existing lsuilding(s) in solid line. Size of property . . . . . . . .10+6 . . _ . ft, x . . . 17.55 . . . . . ft. c Size and use of existing buildings, if any . . . . . . . . . . . . . . ro . Size of proposed building •24 . . , . ft. x . q{} . . . ft. Height (from grade to ridge) . . . . . . . . . . . . ft. r'a Front yard . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.a . . , . . ft. Side yards . . . . . , . . . . 'r3.. 3, ft. and . . . . . A3 . . . . . . . ft. Rear yard . . _ . . . . . . 121 . . . . . ft. SOUTH If on corner, setback from side street . . . . . - . . • • . . • • . ft. Arbutus Drive Note: All distances are nat. as rn,sesurad from street side 7!!! line to nearest }cart of building. l'OY�RI 7-73 -1?1 (cont'd.) BUILDING SPECIFICA.TIClNS. Kind of construction: Wood frame, fire safe, etc.? . , . - . . . . Wood Frame Will any second-hand lumber be used? . . . . ,No . . . . . , - . If so, for what? . . . . . . . . . . . . . . . Material of foundation walls . . . . . +P-.criCrete .Block . . . . . . .1 . . . . . . . . . . . . . . . . . Thickness . . . . . . . . . . . . . . . . . . . . . Depth of foundation walls below grade . . . . . , , . . , , . . 6 . ft.. . . . . . . . . . . . . . . . . . . Continuous foundation? . . Yes . , , . Will there be a cellar? Yes . . . . . If so, material of cellar floor , , . Concrete . . , . . . . Sloped P1 od 235 # Shin lea Type o1 roof: Sloped or flat. Material of roof . . . , Ywf? r . . . . . . . . . . . . . 3 . . . . . . . . . . . . . . . Size, wood studs . . . _ . . . . . 2 . . . . . . . . . " x . . . 4. . . . . . . . . . . ", spacing; . . . . . . . , 1,6, , . . "o.c., length . . . , . 7-t5. . . _ . . ft. Size, floor beams, Ist floor 2 . . . . . . . . . Impx . . . 13, _ . . . . . . . . ", spacing, . . . . . . . , 1 fa . . . "o.c., span . . . . . 1.L . . . . . . ft. Size, floor beams, 2nd floor . . . , . . - - - . . It x . . . . . . . . . . . . . . . " spacing - , . . . , . . . . . . "o.c., span . . . . . . _ _ . . . . . . fit., Size, ceiling beams . . . . . . . 2, , , . . , . . , . " x . . . 4. . . . . . . . . . . "'. spacing . . . . . . . . . . . . . '"o.c., span . . . . . . . , . . . . . , fc Siie, roof rafters or beams 2. , . . . . , . . . " x . . . 4. . , spacing . . . . . . . . . . . . . "o.c., span . . , . . , . . . . . . - . ft. Exterior finish - . Siding. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . With what material ? . . . . . . Finish of interior walls . . . . . , . All . PKmYwall.r. .painted . . . . . . . . . . . . . . . . . . . . . . If garage is to be attached, of what material is wall between garage and main building to be constructed? . . . . . . . . . . . . . . . . . . . . . . , . . , - . , . . , . . . , . . , . . . . . . . . - , . . - , - . , . . . . , . . . . . . . . . . . . , . . , , . . . , . . . Is there to be an opening between garage and building? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Kind of heating system . . , - , .necmtr ic. . . . . . . . . . . . . . . . . . . . Oil burner or coal? Will a flue-lined chimney be provided? . . . . . No. . _ . . . , . Depth of chimney foundation below ,grade . . . . . . . . . . . . . . . . Height of chimney above roof . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Will there be a fireplace? . . . . . . . . . . . . . . . . .No. . . . . . Depth of fireplace 'hearth . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . Will a toilet be installed? . . . . . . . . . . . . . . . . Yes , . . . . . . . . . , . . . . . . . . . . . . . . . . . . Willa kitchen sink be installed and connected to water supply? . . - . . . . . .yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Water supply (public water supply or pump) . . . . , . .Public . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Distance of cesspool from any private well . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . feet . . Will drainage system be provided with required traps, cleanouts, and vents? - - - - - Yes. . . . . . . . . . . . . . . . . . . . . . . . . . . . Town of Queensbury AFFIDAVIT County of Warren State of New York I swear that to tr, pay gof my knowtetlge and belief the statements oontained in this applieation, together with the pane and sp0ciftcxtkms mb- mitted, are a true and 0D.L. lete statement of all proposed work to be done on the described premises and that a ions of the BUILD- ING CODE, THE ZONING ORDINANCE, and all other laws pertaining to the pmpo work shall be complied , whether e ified or not, and that such work is authorized by the owner. Sworn to before me this Signature . . . . . .. -. . .. f'y [�i ER. F�IfiECT" CCITI?RIiCT IR . . .-. 23rd I . . . . . day of. . .. . . .Auc3ust. . .. .. . . . . . . ... . . 1985 N47YARY PVBLIG, 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 . Grass floor area 960 Sam Ft , 2 , Type of heat - ,ow ElecjK ic 3 , Is the building mechanically cooled ? - No 4 . Percentage of area of windows and doors 12 , 3 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 B . Under 16 % Only 1 . R value of roof and floors exposed to ambient conditions. 2 , R value of exterior walls 19 3 , R value of glazed area 1 . 92 4 , R value of doors 10 5 , R value of floors over unheated spaces 19 6 . R value of slab edge insulation - unheated slab 7o R value of slab insulation -- heated slab s , R value of heated basement/ cellar walls ( above grade ) 9 , R value of heated basement /cellar walls ( below grade ) 14 , Type of insulation Fiberglass C . Controls 1 . Thermostat maximum heat setting 8 Do 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 10 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 G , For swimming Pool Only 1 . Maximum heating Telephone No . 7o - 1RIA X Ole ( app zcarit signature ) TOWN OF OUFFNSBURY BUILDING & ZONING DEPARTMENT SEWAGF DISPOSAL PERMIT APPLICATION 1 , Owner ' s Name Gary and Tammy Moon Address 4 Davis Street Glens Falls N . Y . Telephone No . 798- 1816 2 . Property location- Lupine Lane Glens Falls N . Y . 3 . Name of person or firm responsible for installing system Dick Lee Telephone No . 793- 2363 Address Luzerne Rd Glens Falls N . Y . 4 . Number of bedrooms ( residential buildings only) 3 5 . Daily flow. 450 gallons/day 6 . Septic tank capacity 1000 gallons 7 . Topography : flat : ollin steep % of slope 8 . Nature of soil and depth sand - 15 Feet 9 . If ground water , bedrock or impervious material is apparent at what depth does it begin? None ft . 10 . Percolation test : A is required B xxxx is not. required C if required what is the rate minutes/inch ll . Water supply : municipal , well , other_ Municipal 12 . Type of system proposed : drywell , the field , other seepage PitS ( � �1 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 Queensbury Sanitary Sewage Ordinance . Date At3 u 2 1985 `K s atu ap01 !cant On separate sheet of paper submit a diagram of the proposed septic system with all dimensions , including distance from any structure , distance from property line and domestic water supply , etc . Include all dimensions of the system itself . c� Form 3- 82 1 - YD 4 Sr. Y-5 Cy > x �- - [c �`•(; L' � L'/.'Grt c'."'j Lv/'rw7 Y ,— '�.L��'. � .�. �j' TOWN OF CUEENSSURY Date lS+oae*�� c�© ' Name L�oreafiao ''i 1 . PtAit ,AF.I Permit Na �r s - '!e�' o w carper Remarks ' Exoat'►a t on Footin Forms Footin & Piers Foundation Cement Coat Water roofin gackfill. Final Surve Framin Sheathin Roof Felt ROO .in sidin Masonr Veneer Rou h PI - (p }G Relief valves mall Board Ext . porches Finished Floor Interior Trim T Stairs & Bailin s Cellar Dr , Tile Concrete Floors p3 Fixtures G Chimne hater Meter rest . Se tic A roval FJocsr Foundation --- Xnsulation pVaItls -- -� - Cei.linc�t ---�... pull ing Inspector REM"KS J A45 0 v im -- THE NEW YORK BOARD. OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY := Fair 41 STATE STREET, ALBANY, NEW YORK 12207 Date October 29 , 1985 Application No. on file 095029- 85 A 6 5 Q g 6 8 THIS CERTIFIES THAT Only the electrical equipment as described beLowP and introduced by the applicant named on the abate oppflcatioas number in theprremises of Gary & TsW7. Moon , Luptne RAie , r4Laeembt y, iiew York It�� in thefollowing location; ® Basement ❑ lot FT. ❑ End Fl. outside Section -119alocis 1 Lot 2 was examined on .1 0/18/85 and found to be in compliance with the regmirements of this Board. FIXTURE FIXTURES RANGESSCFLUORESCENT GOOK�NtT oEClts OVENS DISH WASHERS E%HAUST FANS OUTLETS HrTACLES SWITCHES INCANDEEMT FLUO NT y AMT. K. W. AMT. K. W, I AMT, I K.W. I NSI. K. W A W. AMT. H. P. 3 2 2 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS IsreaAL iscrPTI TIME CLOCKS I oak I UNIT HEATERS MLULT1.OUTLET DdMlAERS a: AMT. K. W. dl - H. P, GAS H. P. AMT. MO. A, W. G. AMT. AMP. AMT. AMPS. TRAN5. AMT. H. P. NO. SYSTEMS .AMT, WATTS . . NO. OP FEET sonncE DiscoNNECT No. OF S E R Y I C E AMT. AMP. TYPE Raw. 1.e' 7W 1 X 9W S X SW 3 X 4W No.. pm A,COND. OF C COND. NO. CK H4lEG C• WSM HU- OF NEUTRALS #NEUTT"L 200 IM I x l 4/0 2/0 OTHER A"ARATUSt PA Gry & Tammyr tm7cn 4 DavIs Street Glens Falls , New York 12901 BRANCH MANAGER Per COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. TOWN OF CUEENSBURY Buildiuff Department iuspeckwu Repart Date '2 Nasuft � LAHMSM Permit Weather Remarks Excavation Footing Forms Footing & Piers Foundation Cent Coat Waterproofing ,Backfill Final Surve Frzwd n Sheathing Roof Felt Roof-in Sidin Masonry Veneer Rough Plbyw Relief Valves Wall. Board Sxt . Porches Finished Floor Interior Trim Stairs & Railings cellar Dr . Tile Concrete Floors Pl Fixtures Gar . Fire roofin Door closers Chimney Water Meter rnst . Se tic A roval Floor*V Insulation Foundation _ Walls Cei1i Buxl sng Inspector REMARKS r TOWN OF QUEEN5BURY Building Department Date 2zf Naue. f o �7 l.ocwtio,n J.v � .raE ,vim Remarks B'xcava t�on Footing Forms Footing & Piers Foundation Cement Coat waterproofing hl D S Backfill Q Final Survey Framin Shea thin Roo# Felt Roofin Siding Masonry Veneer ROU h Pl Relief Valves Wall. Board Ext . Porches Finished Floor Interior Trim Stairs & Railings Oef Cellar Dr . Tile Concrete Floors Plbg . Fixtures car . Fireproofing- Door closers wT Chimney Water Meter Inst . Se tic Approval Floors Insulation pounda t3on Walls Ceiling I B1511d2ong Inspector REMARKS TOWN OF QUEENSBURY Build`ane Depa<rtme:at 9y Q� N G C Lnara►tion 9%-p Weather Remarks Excavation Footing Forms Footing & Piers Foundation Cement Coat i�7a ter roofi n Backfill Final Survey Framing Shea thin Roof Felt RoofIncr Sldin Masonry Veneer Rough PI Relief Valves Wall Board Ext . Porches Finished Floor Interior Trim Stairs & Railings Cellar Dre Tile Concrete Floors �pl:t2v Fixtures Gar . Fire rota€in Door Closers Chimme Water Meter Sns t , Se tic Approval Floors Xnsulation Foundation Walls Ce.t l in Bull ing Inspector REMARKS c>c> n GEORGE KLJROSAKA JR-. P.E. r-1 (��` 9CB131LOINQ SYSTEMS CONSULTANT e) �--` VKMT OFFICE BOX NO. Soo GLENS FAN a 4, 3+ FW YORK 1260 t t5181 792-1522 13 ARBUTUS DRIVE OUEENSHGRY, N. Y. 12801 PH pNC 51B 792 -15x2 N BUILDIG INSPECTORj d Town of Queensbury re: Factory Manufactured Home Town Hall Installation Certification. Queensbury % New York 12801 Attention: Mack DeanY i 25 + Dear sir , This is to certify that I have observed and inspected the installation of a ""Factory Manufactured Home" ; as defined by the New York State Uniform Fire Prevention and Building Code , Chapter D - MANUFACTURED HOUSING , Article 2 w FACTORY MANUFACTURED HOMES , as applicable to your local building regulations ; there appeared to be no apparent structural damage to the units , due to or attributable to the transportation or loading/unloading of the units , herein after described as follows : Bate of Installation : �1�A� Site L.ncation : G"'ft +�— r _ �•�i* ••�4 �+'.�r.'f'. .i. Community : Town of Queensbux-y County: Warren Manufacturer/Supplier : Address : 400 Tnsignia Serial No . ¢ Ar 3'3� Plan Approval No. ,/Y +y" Cam!' 4 2 -... .+�/�jr...r7 Maanufacturer ! s Model/Component No . : �y,.q�.,p�t 3 , Soo Date of Manufacture : 45011P,40* �''/°��"�► -�'�qqt ova Installer/Supplier : 4000 40vj0, J dp ++0c!. o 7" I have also examined the approved Plans & Specifications for the abovementioned "FFactory Manutactured Home" . and to the best of my knowledge and belief , this *"Home" has been installed in accordance with these approved Plans & Speci-fications , and all other applicable laws codes , ordinances , standards &/or regulations . p F Me +WRO Ras tfull s rnit ed3 Tc sq� 0 `• ' m GEORGE KUROSAYA .SR . , P . E . ti .• w N'YS PE Lic . Now 35869 a .e H�! ass6a wa