1986-428 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
• Date October 20 19 86
Cict 14-1
This is to certify that work requested to be done as shown by Permit No. 86-428
has been completed.
Addition to one family dwelling
This structure may be occupied as a
one bedroom etticency apartment) .
Location • ,2 4 Bennett Road
•
Raymond Bronzene.
Owner
By Order Town Board
TOWN OF QUEENSBURY''"
•
Building & idling Inspector
Iv
BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-428
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Raymond Bronzene
OWNER of property located at 4 Bennett Road Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Addition to dwelling (living area)
z
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.
0
1. OWNER'S Address is 4 Bennett Road
Glens Falls, New York
0
2. CONTRACTOR or BUILDER'S Name m
Stanley Wood
3. CONTRACTOR or BUILDER'S Address
9 Kiley Lane
Glens Falls, New York
4. ARCHITECT'S Name
rt
rt
7y
0
a.
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( 7/Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications R9
24'x26' per plot plan, specifications and application submitted oo H.
No. m rt
H.
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CD 0
8. Proposed Use a
One—Family Dwelling (one bedroom eff. apt. added) o °
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$5.00 C/O Paid H' ~
$ 40.00 PERMIT FEE PAID —THIS PERMIT EXPIRES Feb. 1 1987
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.) ..
Dated at the Town of Queensbury this 24th Day of July 1g 86
SIGNED BY for the Town of Queensbury
Building and Zoning Inspector
TO BE COMPLETED BY BLDG. DEPT.
Application No.
own of Queenilury Permit Issued 19
BUILDING and ZONING DEPARTMENT Permit Expires 19 1 `SOWN OF QUEE'". _ —.
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation ! V '! - 0 "E _ '/' -. ')
I�Queensbury, New York 12801 Variance No. �
Site Plan Review No. ' spa
0 3 Approved
'�,,byy� A :K� 9,]f ` vt v c-o,,
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APPLICATION FOR 11/6/tgt;Ce '— I �u��e� o IPPT) f 1415 a t
BUILDING AND ZONING PERMIT
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: /29,O r 92 i5 l • , fi ' /. e2 Z /�
P.O. Address 1.7,/ V4F j,` ./ Tel. �� , ,7 7
Property Location:_ ,%j ./, 77 , / ,-jJ �-!, ,� A/c; Tax Map No. / /
Street number or building lot number
Subdivision name (if applicab1 e)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
// s�r/
Name / I .O. addre s Tel. No.
Name of builder . /.2 -7//00(.77 Address /,,4 `!- C. Tel. -7l-� --90.cl
Name of plumber Address Tel.
Name of mason 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
*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 ' / , ft X //'o ft.
* Existing building(s) Size ft X ft.
*
PROPOSED BUILDING AND USE:
Existing building(s) Use /9;47": > a/
Size of new structure ft X?7 ft * 0-e
Foundation-pier/slab/AMP/partial/full * Proposed buil ing, distance from property line
(circle one) *'
* Front yard Q ft Rear yard )0 ft
No. of stories (habitable space)
* Side yards i2, ft and �{.(i. ft
Height (grade to ridge) 16 ft.
If residential, no. of families * If on corner, setback from side street ft
_g .
No. of rooms(excluding baths) . ' d * OCCUPANCY INFORMATION •
*
No. of bedrooms / •
No. of bathrooms / * PRIMARY BUILDING -
Primary heating System G ,•, T-,09/ * One family dwelling
* Two family dwelling
Type of fuel e9 * Multiple dwelling / Number of units
No. of fireplaces to be installed Ai/jq
Will a wood stove be installed? /j * �C Permanent occupancy
* Transient occupancy
Central Air conditioning?g' /L/J Business
BUILDING STYLE, PRIMARY STRUCTURE * • Industrial
* Other.
Contemporary Log cabin If addition, what will use e?
/`jam•ised ranch Mansion Duplex * b � 3
Split level Old style Bungalow * /?,: ,eZ'�� /6 e'
Cape Cod Cottage Other * ACCESSORY BUIL ING-
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 MARKET VALUE OF * Other .. . . ' ' • '
CONSTRUCTION $_.-da a67
, ------
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? .4/0
•
Thickness Foundation wall material 6 ,�6-.Y,Depth of foundation below grade (to bot . o footing) 7 '�
Will there be a cellar? A/0 Heated or unheated? ou Floor sq. footage ( sq ft
Will there be a basement? 442 Will any portion be used as living space? ,,#7
(If so, what po o ? sq.ft. - - Type of use?
Type of roof - sloped flat/shed/other Material- of roof 2 , s'�,
Size, wood studs �I "X 4 " spacing /( ' "o.c. length: A.ft.
Joists(floor beams) 1st. floor "X 3 " spacing ,t( o.c. span/// ft.
Joists (floor beams) 2nd. floor "X " spacing "o.c. span ft.
Overlays(ceiling beams) "X " spacing "o.c. span ft.
Roof rafters "X " spacing o.c. span ' ft'.
Roof trusses(pre-engineered) spacing. "o.c. span / ft.
Exterior wall finish }( ,( Of what material? k,;4. --
Interior wall finish �?4.a� c :/� - e X
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? iib If so will a Fire-rated
_door, enclosure, and self-closing device beprovided?
Will a flue-lined chimney be installed? Height above roof ft.
Depth of chimney foundation below grade ft. j.o-,vk 1:ge-
Depth of firepla .. hearth ft. in.
Water supply unicipa or private well
SEPTIC. SYSTEM _ ance from ANY private well(including adjoining properties ft.
(A separate application is necessary for any repair or new installation of septic system)
Town of Q Warren A F F .'I D A V I T STATE OF NEW YORK
County of Warren
1 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 --- ---- -
OWner, er's agent,arcnitect, ontractor
t/ day ofdrtk,..-19
•
Notary Public, Warren County, N.Y.
* * * * * * * * * * * * * * * * * * * * * * * ' * * * * * * * * * * * * * * * * * * * * * * *
SPECIAL CONDITIONS OF THE PERMIT:
•
•
•
By
-1.- 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 \) -32f Pr-
•
2 . Type of heat _ 422/ 4 :2 •
3 . Is the building mechanically cooled? A.,0 -
4 . Percentage of area of windows and doors /e. o
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_
ite ;--- 720
- 2 . R value of exterior walls , = %aj
3 . R value of glazed area , '
4 . R value of _doors %/%9
5. R value of floors over unheated spacesi /9'
•
6. R value of slab edge insulation - unheated slab /fj,/91
7 . R value of slab insulation - heated slab /�/..
8 . R value of heated basement/cellar walls (above grade)_O _
9 . R value of heated basement/cellar- walls (below grade) ,/ti�
10 . Type of insulation , �^'Ke,--69 `
C. Controls 4
1. Thermostat maximum heat setting AtJ
D. Duct Systems
1 . Is duct system installed in unheated spaces? YES CD
a. If YES , R value of duct installation
b. R value of duct in other areas
E . Piping Insulation 3 /�
1. Size of hot water or cooling carrying agent pipe /Li 1/
' 2 . R value of pipe insulation r/..
F. Service Water Heating / ate
1. Performance efficiency ,j.4 (3 !6
2. Temperature control setting maximum / z/9 I5 )
G. For Swimming Pool Only
1 . Maximum heating /li/�
Telephone No. _7 '73 - 7,3 027 i
a-f46--vie,„
(apicant ' s signatur
awn of Queensbury APPLICATION FOR SEPTIC DISPOSAL PERMIT
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98 •
Queensbury, New York 12801 DATE /
LOCATION OF PROPERTY FOR INSTALLATION '4 5, 4„,vc -17l? 0,
OWNER' S NAME ,qy .0,u D 8 IF d �
ADDRESS � ae ✓V/Vv Fr rAJ TEL
INSTALLER' S NAME TEL
4.
. Number of bedrooms (residential only) .
Total daily flow(compute @ 150 gal per bedroom) cl,C°
Topography: Flat - Rolling - Steep slope (circle one) % of slope FiL -7
Soil nature: Sand Loam - Clay - Other" S 4-/U D Depth ft.
Ground' water -At what depth? f/ � ft. ': F
Bed-rock or impervious materiall/ '- At what .depth? . No_ ft.
Percolation test - Not required - Required - -Rate pi-, min-inch.
Domestic water supply - Municipal Well Other /4 U h/ i C ( 1P, L
Separation - Watersupply(if wel�j) from Septic absorption ft.
Q
Proposed System: Septic tank gal.-( .Minimun size, 1000 gal. )
. Tile Field - Each. trench ft. Total system legnth ft.
Seepage pit(s) Number of . Size-each" ' ft X . ft
Size of stone to be used #- Depth or thickness ft.
* * *ORTA*NT* ! *. ** * `*
IMP * * * * * * * * * * * * * * * * * * * * * * * * * * *
'
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 aZZ requirements of The Town of Queensbury
Sanitary Sewage Disposal Ordinance. Ga x= -r`,a ,4 e '�
.176 4:',74"4
Signature of responsible person . ,_. 5v -e
)
Date 77/6 /qtp
05/86 and/vl ',
•
Section II Septic System Inspections:
• A. All applications for septid 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 the1installer 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 a_n,/approved system, a new ,proposal
must be submitted, .to the Queensbury Building
Departient .before,! urther construction.
.
•
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61
Down of QueenAur y
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ` S REPORT
NAME
LOCATION
� j,
&„„Lgt:-
Date/0 / 1 _ Permit No. g le -Lt d
* *_k * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing /�
1.ofing b I�
L6Iding a
Masonry Veneer
Rlgh Plumbing
ief Valves
Ext. Porches d'
`'F ished Floors
l/�i .erior Trim
Stairs & Railings , V
Cellar Drain Tile f
C9m-c rete Floors j
" l bg. Fixtures O
j„ergr. Fireproofing
Door Closers LL
eke Detectors c9 K
L.-
Chimney
INSULATION:
Foindation
l `loors 0,k
Walls
Ceiling
FINAL ELECTRICAL INSPECTION E`= , 6 0/4, •
DRIVEWAY APPROVAL
Final Building Survey
•
Next scheduled inspection
(call when ready)
Remarks- ` V
•
(A))71/13/1Al2
Building Inspector
6/86 and-vl
Jouin o/ Queenitury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME &/./rytry1/4-e.
LOCATION
f
Date ��i / Permit No. U -142oo
* * * * * * * * * * * * * * * * * * * * * * *
b� = 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 & Railings
Cellar Drain Tile /
Concrete Floors /
Plbg. Fixtures ./
Gar.. Fireproofing
Door Closers
Smoke Detectors
� ChimneyC/
\/INSULATION:
Foundation
Floors i-
Walls • d,r
Ceiling bk
FINAL ELECTRICAL INSPECTION
Final Building Survey •
Next scheduled inspection(call when ready)
Remarks- -
1.4-7)1I2V14.7tL3
InspBuilding
ector
ector p
6/86 and-vl
COA.L1---44 714.51�
_awn of Queenihur1
�� BUILDING and ZONING DEPARTMENT
Se cly Bay and Haviland Road, R.D. 1 Box 98
a Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME Rai 3 YO h
LOCATION l/ ,//h e A'
Date '7/ / Permit No. X(.0. - a,:)"
* * * * * * * * * * * * * * * * * * * * * * *
10' = APPROVED - YES / NO
Footing/Pier Forms 1
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
n Rough Plumbing ( r,
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- - d 1,
/L
1/(7)1<i)---5/1
Building Inspector
6/86 and-vl
Jown of Queeniiurcy
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME `1
LOCATION )
Date ? / 50 Permit No.
* * * * * *. * * * * * * * * * * * * * * * * *
= APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
147aming oft('
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
FINAL ELECTRICAL INSPECTION
Final Building Survey
Next scheduled Inspection(call when ready)
Remarks- -
Building Inspector
6/86 and-vl
_loom of Queeniur1
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New_York 12801
BUILDING INSPECTOR ' S REPORT
NAME BOAAJ-
LOCATION f titi,6-7-T- PO/
Date gill / t Permit No. 5'6- jiLa Y
* * * * * * * * * * * * * * * * * * * * * * *
APPROVED - YES / NO
Footing/Pier Forms
Foundation
(katerproofin fi (,tir p -er(raar
(ackf
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
FINAL ELECTRICAL INSPECTION
Final Building Survey
Next scheduled Inspection(call when ready)
Remarks- -
•
� jC
Buil in ' Inspect 'f ^�
6/86 and-vl
03 gp_o
Jotun of Queeniur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
•
BUILDING INSPECTOR ' S REPORT
NAME 174% dix),(lZ6,V6r
LOCATION 6,6A/A/6-7-r Po
Date 0-0/Tc Permit No. ' L a Y
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Water.roofing
°1 ✓�
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 E
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
Final Building Survey
Next scheduled Inspection(call/� .when read )
/a
Remarks- - `� t� w rJ v p
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;/14,i1,44
Gam ' Luvt�
Building Inspe
6/86 and-vl
()1 !!! ...awn of Queeniturc�
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME fiati fr/d-h/4 h €h/�2
LOCATION eh� 7./ M
Date ) y /pc,, Permit No. {�G
* * * * * * * * * * * * * * * * * * * * * * *
// = 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 & Railings
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers \ ,/
Smoke Detectors
Chimney /
INSULATION: j
Foundation `J
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
Final Building Survey
Next scheduled Inspection(call when ready)
Remarks- - CO i2,16,„
ding Inspector
6/86 and-vl
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