1986-471 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
,•
• WARREN COUNTY, NEW YORK
Date 19 _
()No
This, is to certify that work requested to be done as shown by Permit No. 86-471
has been completed
This structure may be occupied as a One-Family Dwelling
Meadowbrook Road
Location
Owner Donald Kruger
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoning Inspector
BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-471
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Donald Kruger
OWNER of property located at 142 Meadowbrook Road Street, Road or Ave.
in the Town of Queensbury,To Construct or place a One—Family Dwelling o
at the above location in accordance to application together with plot plans and other information hereto filed and 0
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is 10 Sugar Pine Road
Glens falls, NY
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2. CONTRACTOR or BUILDER'S Name
same
• 3. CONTRACTOR or BUILDER'S Address
same N
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4. ARCHITECT'S Name 0
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0
5. ARCHITECT'S Address o
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a.
6. TYPE of Construction—(Please indicate by X)
( Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
No. 36'x26' per plot plan, specifications and application submitted
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including sewage system.
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8. Proposed Use
One—Family Dwelling
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$5.00 C/O Paid
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$ 70.00 PERMIT FEE PAID —THIS PERMIT EXPIRES March 1 19 87
CIQ
(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 8th Day of August 19 86
SIGNED BY //7 aGv a for the Town of Queensbury
Building and Zoning Inspect �o
TO BE COMPLETED BY BLDG. DEPT.
// Application No.
own ofQueen iur1 Permit Issued 19 _ TOWN OF QUE NSBUEr
BUILDING and ZONING DEPARTMENT Permit Expires 19 " Thi ��,�) F.
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation iU 2- S ) S i l 1' i 1
Queensbury, New York•12801 Variance No. j OCR 9 miA
_ Site P1 eview No. (p -- 5S(p ,JUL a. k 98
Approve by. • ` l8 $¢Iv'11�i2131l � as
5 C h B l 8 t 9
APPLICATION FOR E7.
C 0 C i le& .
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: (b o vt e, V r\ ,0 6.1_,5 •-ems
P.O. Address /c9 S uc1 ar '4.-<-C Cl?d)a-cf Tel. rJ
Property Location: f �a 2cc_cCB-ul D Tax Map No. .0/ a/ 2SS7
Street number or building lot number
Subdivision name (if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
cc-,.-__ _o
Name P.O. Address Tel. No.
Name of builder tc Address Tel.
Name of plumber , e Address Tel.
Name of mason re 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 -2 ft X j(.5 ft.
* Existing building(s) Size ft X ft.
*
PROPOSED BUILDING AND USE:
* Existing building(s) Use
Size of new structure _ ) c , ft X C-ft *
Foundation=pier/slab/crawl/partial/full * Proposed building, distance from property line
(circle one) * a
* Front yard 5-0 ft Rear yard 3 i ft
No. of stories (habitable space) * Side yards ft and a ft
Height (grade to ridge) et—/— ft.
If residential, no. of families * If on corner, setback from side street ft
No. of rooms(excluding baths) " 4 * OCCUPANCY INFORMATION
No. of bedrooms *
No. of bathrooms * ,PRIMARY BUILDING -
Primary heating systemC �. . *. .fie family dwelling
Type of fuel ,, * Two family dwelling
No. of fireplaces to be installed * Multiple dwelling / Number of units
Will a wood stove be installed? * Permanent occupancy
Central Air conditioning? — * Transient occupancy
* Business
BUILDING STYLE, PRIMARY STRUCTURE * Industrial
Ranch Contemporary Log cabin * other
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 �-wo car/ car
( CIRCLE ONE PLEASE ) * Attached garage n car/ two car/ car
* * * * * * * * * * * * * * * * * * Private s rage building
'ESTIMATED MARKET VALUE OF * Other
CONSTRUCTION * -
$ e/O.,D�Jr --
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 fra , fire safe,etc.
Will any second-han ungraded lumber be used? If so, for what? /�31-9 —
Foundation wall material 0Q-1_,` (a,< Thickness
Depth of foundation below grade (to bottom of footing) ' ``.
Will there be a cellar? k -a Heated or unheated? Floor sq. footage 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 - oped�flat/shed/other Material of roof ?t'/,,o GJ,1 XL—. (f.
Size, wood stu "X 6 " spacing ((q "o.c. length ft.
Joists(floor beams) 1st. floor "X " spacing "o.c. span ft.
Joists (floor beams) 2nd. floor "X " spacing "o.c. span ft.
Overlays(ceiling beams) "X " spacing "o.c. span ft. '4--H--,
k.
Roof rafters "X " spacing o.c. span ft.
Roof trusses(pre-engineered) spacing dcl "o.c. span ft.
Exterior wall finish U c y S',`c ��S Of what material?
Interior wall finish <.o --, ()e
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
1L9v
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? (00 Height above roof ft.
Depth of chimney foundation below grade ft.
Depth of fireplace hearth ft. in.
Water supply - Municipal or private well
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 STATE OF NEW YORK
County of Warren
.•I swear that to the best of my knowledge nd belief the statements contained
in this application, ogether with the plans and spcif cations submitted, are atrue and
complete tatement o all proposed work to be don- on t e described premises and that all
provisions of the B ILDING CODE, THE ZONING ORDINANCE, nd all other aws bertaining to
the propose work shall be complied with, whethe spec fied or not,'a d that such work is
authorized by t e owner.
SWORN TO BEF ( _
• THIS Signature__ 4 /' lC
Owner, .wner's agent,arcnitect,contractor
day/1
ay of 19
Notaryjublic, 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. Gross floor area 93
2 . Type of heat
6
3 . Is the building mechanically cooled? ova
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 o heated spaces YES NO
a. Are fou ation walls insulated? )�YES --"1410
1. If YES, hat is the R value?
. -7-. ,
3 . Slab on grade 411,
a. If YES , what s the R -a -ue of insulation around
perimeter of floor? —2 . ) --
4 . Is basement hea ? YES NO
a. R value insulation
5. Type insulation
B. Under 16% Only
1. R value of roof and floors exposed to ambient conditions_
- 3�
2 . R value of exterior walls Y.-1
3 . R value of glazed area
4 . R value of doors /O. O
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5. R value of floors over unheatedspaces
6. R value of slab edge insulation - unheated slab /7. S
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 r p,M •(-1 812.k. GfAS
C. Controls �� O
1 . Thermostat maximum heat setting
D. 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
1 . Size of hot water or cooling carrying agent
• 2 . R value of pipe insulation
F. Service Water Heating 5 1 . Performance efficiency p
2. Temperature control setting maximum / y o
G. For Swimming Pool Only
1. Maximum heating
Telephone No. r--) -3 ' ��—
( p"licant ' s signatu e)
Jouin o/ Queen3114ry APPLICATION FOR. SEPTIC DISPOSAL PERMIT
BUILDING.and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 99
Queensbury, New York 12801 DATE 7 / "a
LOCATION OF PROPERTY FOR I NSTALLAT ION / `t7p2._ _ -ea: P(19-8 Pc(
OWNER' S NAME (c(
cL
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ADDRESS SPe• kr •
TEL >5 3 -- c.9
7
INSTALLER' S NAME •
TEL
_Number of bedrooms (residential only)
Total daily flow(compute @ 150 gal per .bedroom) e-o
Topography Fla - Rolling Steep slope - (circle one) % of slope
Soil nature Sand Loam - Clay - Other .Depth ft.
Ground water -At what depth? 0- 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 I gal. ( Minimun size, 1000 gal. )
Tile Field - Each trench -5� ft. Total system legnth k0-® ft.
Seepage pit(s) Number of Size each ft X - ft
Size of stone to be used . ' - Depth or thickness • • ft.
IMPORTANTII
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
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the system, itself .
* * * * * * * * * * * * * * * * * *. * * * * * * * * * * * * * * * * * * *
I have read the regulations on the re er e side of this sheet and agree
to abide by these and aZZ requir•emen s f The Town Queensbury
Sanitary Sewage Disposal Ordinance.
Signature of responsible person el-L1:
-=f.r �.. mG
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
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 •
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must be submitted to the Queensbury Building • ''
Department before further ,construction.
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L9 .ALL F7R. r ?9 — 5 101-
Jown o/ Queenitury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME kRidt6(6L.
LOCATION 417. E
DATE 7//5- / .ICJ PERMIT NO. No '-7/
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length
Length of each trench cb
Depth of trenches Prt
Size of gravel 'L
SEEPAGE PITS{Number of)
Size- ft. X _ ft.
Gravel size
PIPING: Size Type
Bldg. to tank
Tank to dist. box 4"
Dist. box to field/pit
Openings sealed? YES NO Partial
LOCATION/SEPARATIONS:
Foundation to tank 1 )- ft.
Foundation to absorption .2 0 .
Absorption to lot line e ` f.
Separation of p'ts ft.
LOCATION 0 YSTEM ON PROPERTY(circle one)
•
Front - Left side - Right side -
COMMENTS:
3 , 4 'i
P-‘0A4-2:16-2--
SYSTEM USE APPRO Y S NO
Buildi g Inspector
01/86 and vl
Jouin of Queeniury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
• Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME Yfeii / 6-
LOCATION 41440OW g vlC:
Date Vf/ 0 G Permit No. -qi C
* * * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backf' 1
Roofing
Siding
Masonr Veneer
ou h Plumbin
Relief Va ves
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- - ` Clod_ /11
41:1",_6a3tver.
14464,
Building Inspector
6/86 and-vl
criql
lips' • . _ wn of QutieVertury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98 •
• Queensbury, New York 12801
•
BUILDING INSPECTOR' S REPORT
NAME
•
LOCATION
Date �.Jl f/ / �' _ Permit No. g6 - 4/7/
* * * * I* * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES / NO
( Footing/Pier Forms �Ir
Foundation
Waterproofing •
Backfill
Framing
Roofing
Siding
Masonry Veneer •
Rough Plumbing <
Relief Valves
Ext. Porches
Finished Floors .
Interior Trim
Stairs & Railings
Cellar Drain Tile' i/
Concrete Floors
Plbg. Fixtures J�
Gar.. Fireproofing
Door Closers �\
Smoke Detectors k
Chimney
INSULATION:
Foundation
•
Floors
Walls •
Ceiling •
FINAL ELECTRICAL INSPECTION
Final Building Survey •
•
Next scheduled Inspection(call when ready)
Remarks- -
•
(./(143/1-0AS
Building Inspector
6/86 and-vl
Jown o/ Queenihurty
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME r2 /_ Zit_
LOCATION *A OIC-Reivititicr
Date 6//j;/ K2 Permit No.
• * * * * * * * * * * * * * * * * * * * * * * *
✓ = 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 a/
Plbg. Fixtures
Gar.. Fireproofing
Door Closers
Smoke Detectors •/
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
Final Building Survey
Next scheduled Inspection(ccall when ready)
Remarks- -/, f&C l7 . /T+FYI 11417 `J;G17 Piy -
POCIY660 iU ti O uT (,is p rr74/\r_
/t so a oW-1Z C)A1 1.1 L
p 0 T-(A/6 S G-x Po S 6 J
I/J5 ee-c i oil
Building Inspector
6/86 and-vl
S�X
r... Iron pin I '51ZL
seF set 1
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„ 125•00'
13 o• o E.
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to nd V vl
� d- O• o cr e. o�
19
iron rod ~ '1
found Z
N. 83 - 13 - 00 W. 125.00 no}e property corder being S. of. - 47'-00"W.
225.4 -fee+ fror n an iron nor ipe found on +he
of Lot line Lot31 of the Firsi Division
a_ o r}the cueertsbur-y Rafien+ and 67 Z5 �ee+
nor-therin of tine- approKimate in'1erSec}ions o'-
m
c�nterlles orr veey-tt of Meadowbrook
Road wi+li Cronin Road.
>onald lands conveyed 1Lj / ' 4-
je 476 Kruger to Bull is 3
July 26, 1985
iron Pin Ahp
set
fof a suryaq of a parcel of land prepared for
iron rod� Donald Kr u
found
Being a Pori-ion
of +he premises described in a deed da+ed July 26, 1984 from Bohn
E. 5innott -to Donald Kruger recorded in the Warren Coun-+y Clerks
Office in Liber of De.,e-ds 60 at Rage 825.
Situate in the Town of Queensburg, Coun+5 a Warren, S•1'a}e of New York.
7' Scale.. I'- 20' date Julc 29, 1985
P .. 60.
1 .. inn n