1986-456 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
November 21
Date 19
This is to certify that work requested to be done as shown by Permit No. 86-456
has been completed.
This structure may be occupied as a One—Family Dwelling
• Location Lot 35 Willow Road (St. No. 31)
• Joe Roulier
Owner
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoning Inspector
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 86-456
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Joe Roulier
OWNER of property located at Lot 35 Willow Road (St. No. 31) Street,Road or Ave.
The Pines of Queensbury One—Family Dwelling
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. ro
•- o
1. OWNER'S Address is Box 301
Cleverdale, New York
1-1
2. CONTRACTOR or BUILDER'S Name
same
3. CONTRACTOR or BUILDER'S Address En r
rt 0
same • rt
_ z w
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4. ARCHITECT'S Name L..) H.
N N
0
0
5. ARCHITECT'S Address a'
6. TYPE of Construction—(Please indicate by X)
(X)Wood Frame ( I Masonry ( )Steel ( )
7. PLANS and Specifications
687x24' per plot plan, specifications and application submitted
No. including sewage system and two—car attached garage. �o
8. Proposed Use
0
One—Family Dwelling 1-4
$5.00 C/O Paid
$ 143.00 PERMIT FEE PAID —THIS PERMIT EXPIRES Feb/ 1 1987 N
(If a longer period is required an application for an extension must be made to.the Building and Zoning inspector of the prq
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 29th Day of July 19 86
SIGNED BY /r l a a-4 �a for the Town of Queensbury
Building and Zoning Inspector
. TO BE COMPLETED ]3Y BLDG. DEPT. •
ac� Application No.
wn of Queeniturj Permit Issued 19
BUILDING and ZONING DEPARTMENT Permit Expires 19 t Ck VI/N! OF QUEENSBURY
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation �, (�� El
Queensbury, New York•12801 Variance No. LEti�
Q L 3.- 5- Site Plan Review No. MA_ 1 5 1966 a
•
Approved by: 9°.t C-�- r
A.A. /`1� F P.M.
APPLICATION FOR CA/7/6/L,t� tj81911�?)�.1112) 121g3 '!¢¢e 16,
BUILDING AND ZONING PERMIT _ �_ ,�(a '�` 1
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: ! .ti /rot/t'e
P.O. Address �.y 30/ / /7 -e-%4, �.. .V e ,'a Tel. �.52 ',3d yf✓
Property Location: ,/a° ,3y�
P Y ��ss /. ad�� ...<<l�•✓J Tax Map No. / /
Street number or building lot er 6-r,Ate) , /
Subdivision name (if applicable) iti•a ....e.,,,Z
THE PERSON RESPONSIBLE FOR SUPERVISION OF ORK AS REGA S BUILDING CODES IS:.
o` n,,6e' .S rl2 As #.14VL
Name P.O. Address Tel. No.
Name of builder .� .:�r,' Address Tel.
Name of lumber „, e../ Address // Tel.
P � .v �.1 -:.a liG,.T � .
Name of mason ,� - Address / �.L' .,u, Y Tel. 7yP_ oo7.
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 andfindicate 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 /3d ft X /71, ft.
•
* Existing building(s) Size -- ft X -- ft.
*
PROPOSED BUILDING AND USE: * Existing building(s) Use . . . . .
Size of new structure `, ft X-2`V ft *
Foundation-pier/slab/crawl/partia1451. * Proposed building, distance from property line
(circle one) *
No. of stories (habitable space) * Front yard./ ea ft Rear yard " s/ ft
* Side yards
Height (grade to ridge) �a. „ell ft. :�,3/ ft and �- 3/ ft
* If on corner, setback from side street ft
If residential, no. of families .
No. of rooms(excluding baths) "7 * OCCUPANCY INFORMATION
No. of bedrooms . __:? *
* PRIMARY BUILDING -
No. of bathrooms a—
*" / One family dwelling
Primary heating system ,L,uI / y,j.� , * Two family dwelling
Type of fuel o * Multiple dwelling / Number of units
No. of fireplaces to be installed /
Permanent occupancy
Will a wood stove be installed? "/p * Transient occupancy
Central Air conditioning? ,✓Q Business
*
BUILDING STYLE, PRIMARY STRUCTURE * Industrial '
*' Other. . .
Ranch Contemporary Log cabin * If addition, what will use be?
Raised ranch Mansion Duplex
Split level Old style Bungalow *
Cape Cod Cottage Other * ACCESSORY BUILDING-
olonial Row Town House * 0 Detached garage/one car/ two car/ car
( CIRCLE ONE PLEASE ) * Attached garage/one carKlwo car car
* * * * * * * * * * * * * * * * * * Private storage building
ESTIMATED MARKET VALUE OF * Other . ' ' ' . . ' . .
CONSTRUCTION $ /Qo¢��, �� *
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?
A/6
Foundation wall material 6,,,,s,.7 i /16,,At Thickness /® .0
Depth of foundation below grade (to bottom of footing) A- 7.2"e fa "
Will there be "a cellar? Heated or unheated? Floor sq. footage sq ft
Will there be a basement? )45 Will any portion be used as living space? ,✓o
(If so, what portion? — sq.ft. - - Type of use?
Type of roof slopeflat/shed/other Material. of roof ,q 44j si7 el-
Size, wood studs "X e " spacing ,1 y"o.c. length J7 ft.
Joists(floor beams) 1st. floor _..,Z "X /o " spacing ,‘ "o.c. span /3 ft.
Joists (floor beams) 2nd. floor "X /e " spacing/L "o.c. span/3 ft.
Overlays(ceiling beams) -? "X y " spacing 1 y "o.c. span,J ft.
Roof rafters "X V " spacing_49 o.c. spanf-._ ft.
Roof trusses (pre-engineered) spacing c„„, / "o.c. spans ft.
Exterior wall finish C , �.444 Of what material?
Interior wall finish 1,4 3,jam. i /c
If a garage is to be att ched, describe materials to be used for FIRE SEPARATION:
s7 f 3 .. /C
Is there to be an opening between garage and dwelling? /es If so will a Fire-rated
door, enclosure, and self-closing device b :provided? y'cs
Will a flue-lined chimney be installed? e Height above roof ft.
Depth of chimney foundation below grade ?a ft.
Depth of fireplace th p/ ft. in.
Water supply unicipal o 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 Queensbury AFFIDAVIT 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 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 .
„..,(/%7
J �wner, owner's agent,ar nitect,contractor
/Y day of ,�.._, 19 jt
Notary Public, Warren County, N.Y.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
SPECIAL CONDITIONS OF THE PERMIT:
•
BY /li/'
i
pit
' 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 /� . - f -
• 2 . Type of heat �.�,.5 ' /, ' 1%1Z.i
i
3 . Is the building mechanically cooled? ti o ' '
' 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?
•
• 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
J
B. Under 16% Only - .
1. R value of roof and floors exposed to ambient conditions_
/r: -Sib
• 2 . R value of exterior walls /r/�' .
•
3 . R value of glazed area ,j..)� .
4. R value of doors pr' /.Z .
5. R value of floors over unheated spaces jr.
.�
' 6. R value of slab edge insulation - unheated slab
7. R value of slab insulation - heated slab
.8. R value of heated basement/cellar walls (above grade)
9 . R value of heated basement/cellar walls (below grade)
10. Type of insulation mil, 2: .7.,1/ o. 5('/ ,�
C. Controls " .
1 . Thermostat maximum heat setting dda
•
D. Duct Systems
1. Is duct system installed in unheated spaces? YES ( )
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 3/�C
2 . R value of pipe insulation •
(/
F. Service Water Heating
1. Performance efficiency 8 Co 67n
2. Temperature control setting maximum /Kt>
G. For Swimming Pool Only
1 . Maximum heating ,
Telephone No. 4-,--7- ..3., -1-/r .--.
(applicant ' s gnature)
gown of Queen��ur� APPLICATION FOR SEPTIC DISPOSAL PERMIT
BUILDING and ZONING DEPARTMENT CW1J3
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801 DATE
LOCATION OF PROPERTY FOR 'INSTALLATION �� ��+/i �Ca c,+ �� / .cs Qaa..rC+•�/ ..
OWNER' S NAME
. AiresZe/ ^r
ADDRESS / � e94/ TEL���C-33W
INSTALLER' S NAME TEL
Number of bedrooms (residential only)
Total daily flow(compute @ 150 gal per bedroom) >e
Topography: Flat Rolling - Steep slope - (circle one) % of slope
Soil natur : 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 Municipal Well - Other
Separation - Watersupply(if well) from Septic absorption -- ft.
Proposed System: Septic tank / .-ww- gal:( Minimun size, 1000 gal. )
Tile Field - Each trench t.j'o ft. Total system legnth .lea-- ft.
Seepage pit(s) Number of . Size each ft X ft
Size of stone - to be used 4 Depth or thickness ft.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
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 Queensbury
Sanitary Sewage Disposal Ordinance.
Signature f esponsible person
Date 7 /7 1. -
05/8 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 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.
•
•
/// /Y6 /; /r 02/11
5autaof Quecni4ur1
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
al •
b/
BUILDING INSPECTOR' S REPORT
NAME A--de
LOCATION to 1 3 S iV;• //en,d /pcla
Date /l/9 /FL Permit No. yi, .-y
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
`Framing
v-Roofing
'Siding
Masonry Veneer
Rough Plumbing
Relief Valves i/
itExt. Porches •
,(Finished Floors
1� Interior Trim
4. Stairs & Railings
LI
Cellar Drain Tile
Concrete Floors •
)(Plbg. Fixtures :1,� /
,`Gar. Fireproofing 1/0"-
)(Door Closers 1/
Smoke Detectors
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-
A/42& / 44 O/A //////Y -FL e A ,
k1,6i C . ,
A//
Building Inspector
6/86 .md-vl
4eid j'15 l'IM)OM
aual of Queenurj
,,/ BUILDING and ZONING DEPARTMENT
1,) Bay and Haviland Road, R.D. 1 Box 98
Cis(� Queensbury, New York 12801
•
\9i BUILDING INSPECTOR ' S REPORT
NAME / 04.) l
LOCATION
Date ilk' / hp Permit No. pP - �S�j
i/ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding I.
Masonry Veneer
Rough Plumbing
/Relief Valves ,✓/
Ext. Porches r�
Finished Floors
LInterior Trim V
)(Stairs & Railings
Cellar- Drain Tile
Concrete Floors •
)(Plbg. Fixtures 1,
Oar. Fireproofing i/
Door Closers ,✓
Smoke Detectors V
Chimney I
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey !
Next scheduled inspection (call when ready) ,
Remarks-
E1e 0- n- -ec4Cli
dam tvlvi Ae_a_cil__ ,
W. 0 Cit-e_01 .
Building. Inspector
6/86 and-vl \,
_Down of Queeniury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION to -)
Date J6/ . /_'_ Permit No. �(p -`/5�"'
* * * * * *_ * * * * * * * * * * * * * * * * *
APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
/raming
Roofing
Siding
Masonry Veneer
ough Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim ;_
Stairs & Railings N.
Cellar Drain Tile `L.,;
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- -
110/1/0/
Building Inspector
6/86 and-vl
ecttt- 4 cc��91/1-0 P 06- '41
Jown of Queeniur1
BUILDING and ZONING DEPARTMENT 1
•
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME 6 e e
LOCATION I.o
3E- to; OrGki ga/
Date - yS J) / �� Permit No.
* * * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
X Framing (?�Ptv (113
Roofing
Siding
Masonry Veneer
X 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- - ,Jpp i0,,
'vhJ L,p�Gc�t �,G�
0
Building Inspector
6/86 and-vl
cO /frq 1l3I/Y & o : yd f/°7
Jown of Queeniktry
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
paa- C°1"4 -°--'l''Queensbury, New York 12801
Ale e-`( i n- 'a7. 1-..+7". I n day /4-u y
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME -T oQ. /R d 't /; e
LOCATION Ld T D ( WI 11 ao f I
DATE rrl l / jf 4P PERMIT NO. 6 ii-5 6.
SOIL TYPE - and - Loam - Clay -
Percolation Required? YES NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length ,r2e0+
Length of each trench 5J
Depth of trenches `
Size of gravel
SEEPAGE PITS{Number of)
Size- ft. X ft.
Gravel size
PIPING: Size Type
Bldg. to tank 4a WO
Tank to dist. box _
Dist. box to field/ '
Openings sealed? ES NO Partial
LOCATION/SEPARATIONS:
Foundation to tank ft.
Foundation to absorption Q ftt-
Absorption to lot line -y.) ftc4-
Separation of pits ft.
LOCATION OF SYSTEM ON PROPERTY(circle one)
on - Rear - Left side - Right side -
ENTS:
\'
///// NN
SYSTEM USE APPROVED NO
ill,
ti0/184AICS)
Building Inspector
01/86 and vl
.own of Queeniur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME SRo e L-
LOCATION / r 3
Date 7/a7 /sc, Permit No. P '
* * * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
v/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 i
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- -
(A,fir"Je)
Building Inspector
6/86 and-vl
OE
uR OULIER * Home Improvements and Maintenance
BOX 301
eLEVEROALE, N.Y. 12820
•
(518) 656-3544 n
•
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