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1987-041 CERTIFICATE OF 0CCUPA 'CY TOWN OF QUE'ENSSURY WARREN COUNTY, NEW 'Y`ORK Date October 6.19 87 - This is to certify that work requested to be done as shown by Permit No. 87 -41 has been completed. _ Qne-Famlly Dwelling This structuremay -voY. Sh ve7v-CA C-e.. wcation I.ot 123 Brookull1re Trace ( St . No . 11 D.au Burke Owner By Order Town Board - - TovVN OF QUEENiSBURY Building & Zoning inspector jl +CERTI "I ATE C7JL C7�+ +CU1'AN ' TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date June " 6 19 $� "i This is to certify that work requested to be dale No, 87- 41 has been completed. One-Farail.y Dwelling This structure may be occupied as a Lot 123 Brookshire Truce ( St . No . Location cation il ) Dan Burke Owner TEMPORARY CERTIFICATE OF OCCI'PANCY By Order Town Board FOR 30 DAYS Ij TOWN OF QUEEMBURY Building N Zoning Inspector f f BUILDING PERMIT TOWN OF +QUEENS ' URY No. 87-41 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Darn Burke OWNER of property Located at Lot 123 Brookshire 'Trace ( St . No . ll)Street, Road or Ave. in the Town of Queensbury, To Construct or place a one-Family Dwellin 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. ,r r�D t . OWNER'S Address is 2, CONTRACTOR or BUILOER'S Name cn CD O r3 rr Norman Ouelette r* Y• • F C3 N 3. CONTRACTOR or BUILDER OS Address 26 Elm St . Hudson Falls , New York to o c. PV rs, cn 4. ARCHITECT'S Nameram H ra C ] }- r3 o pa to w rD rD 5, ARCHITECT'S Address Cn rt 6. TYEarO uction — (Please indicate by X) a od Frame ( ) Masonry i 1 Steal V 7. PLandcificetions 32 ' x67 ' per plot , specifications and application submitted including two-car attached garage and sewage system . 0 m a_ Proposed Use CD One—Family Dwelling •c $5 . 00 C /O Sept . 1 1987 $ 211 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES A° t- r (If a longer period is required an appii cat ion for an extension musk be made to the Building and Zoning inspector o t r town of Oueensbury before the expiration date.) OX 2Stkn February fg 87 Dated at the Town of Queensbury this -�, Day of SIGNED BY MQd 47 095� for the Town of Queensbury Building and Zoning Inspeetar TO BE COMPLETED BY BLDG , DEPT . Cc�� Application No . 47own O/ QiceenJ1"P4y Permit Issued 19 TOWN <)F QUEFN"SC:' % � BUILDING and ZONING DEPARTMENT Permit Expires Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation '�i 1'Aiull ik J f Queensbury, New York 12801 variance No, Site Plan Review No . { FES 2 4 1987 Ap/groved by : BUILDING & CCZDL DEP• APPLICATION FOR 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 they�Permit . The _owner-of this property is : D0921el U ;o)9 Tel . P . O. Address Property Location : € 1W Tax Map No . Street number or bu,�illding lot number Subdivision name (if applicable) €:' 4 4::� THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS : _ ^ " Name P . O. Address Tel . No . Name of builder &�7'l UCILA6:'Address e F L f7) �f Tel . Tel . Name of plumber ,rrs� Address Name of mason �7/d i is - 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 whether interior or corner lot . Show location FOR DEMOLITION PERMIT , STATE SIZE AND * of water supply and location and configuration LOCATION OF STRUCTURES AFFECTED. * of septic disposal area . COMPLETE INFORMATION REQUIRED BELOW . Size of property_ TC(O ft X o ft . Existing buildings) Size ft X ft • PROPOSED BUILDING AND USE : Existing building (s ) Use Size of new structure ft X ,/ Foundation-pier/slab/crawl/partial �C Proposed building , distance from property line (circle one ) ,r Front yard 0 ft Rear Yard. ft Now of stories (habitable space ) Side yards �e n _ft and ft Height ( grade to ridge ) , �2 _ ft * If on corner , setback from side street tt If residential , no . of families No . of rooms ( excludi.ng baths ) !3r * OCCUPANCY INFORMATION W No , of bedrooms pRImAR.Y BUILDING No . of bathrooms _jZne family dwelling primarys !. G heating system ,� Two family dwelling Type of fuel �- * Multiple dwelling / Number of units No . of fireplaces to be installed. ^ Permanent occupancy Will a wood stove be installed? r1�,_ * Transient occupancy Central Air conditioning? 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 Ca od Cottage Other '" ACCESSORY BUILDTNG- Colonial Row Town House '� ,D,��tached garage/one car/ two car/ car ( CIRCLE ONE PLEASE ) " +../Attached garage/one car/ two Car/ _car 11 Private storage building ESTIMATED MARKET VALUE OF * Other CONSTRUCTION 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 : DO Type of construction , wood frame , fire safe , etc . G�� OAO mill Will ; atny second-hand or ungraded lumber be used? if so , for what ? / ales Foundation wall material /�✓� Thickness / / [ Depth of foundation below grade (to bottom of footi.ng ) _ ma' s Will there be a cellar? W-3 Heated or unheated ? �d sq ft �.?� l�R�h�i loon sq. footage Will there be a basement? Will any portion be used as living space ? ( If so , what or ? _ p sq . ft . - Type of use? Type of roof slope flat/shed/other Material of roof Sizes , wood studs "X's'OFt spacing "a . c . length j ft . Joists ( floor beams ) .1st , floor _��A "X 1 ,., " spacing } ' 'O .. c . span �ft * i josts ( floor beams ) 2nd . floor _ `,"X__`"' spacing�9" a 0 c , span l V� ft . Overlays ( ceiling beams ) ,X l' acing _. . '"o . c . span ft . Roof rafters _ -`"'x ", spacing�o . c . spanft . Roof trusses (Pre-engineered) spacing yl '"a , c . span ft . Exterior wall finish �/ Q �} f> r^ 7—pf Interior wall finish �-� what mate — wL._ 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? _ ,t Will a flue--lined chimney be installed? r Height above roof _ ft . Depth of chimney foundation below grade _7 t -- Depth of fireplac th. _L_ft . _in . Water supply unicipa ar private well SEPTIC SYSTEM. Dzs a 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 County of Warren A F F I D A V I T 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 . SWORN TO BEFORE ME THIS SignatureOOOOF day 4f yr p. I - (oft+ Owner , owner ' s agent , arcristect , contractor Notary Public , Warren County , N . Y . SPECIAL CONDITIONS OF THE PERMIT : By TOWN OF QuEENSSURY WARREN COUNTYr NEW YORK Application for : BUILDING PERMIT IN COMPLIANC VATION CODE THE NEW YORK STATE A permit must be obtained before beginning work . ANSWER ALL of the following : le Gross floor area 2 . Type of heat 3 , is the building mechanically cooled ?_ /~t'r {. — 4 . Percentage of area of windows and doors A . Over 16 % Only 1 . Uo value of grass 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 S . under 16 % Only 1 . R value of r of and floors exposed to ambient conditions 2 . R value of exterior walls_ + ! 3 . R value Of glazed area / le 3 • � 4 . R value of doors~_ , f 'f floors over unheated spaces 5 . R value of 6 . R value of slab edge insulation - unheated slab ,S 7 . R value of slab insulation - heated slab_. ✓ _ 4 8 . R value of heated basement/ cellar walls ( above grade ) mmmm g , R value of heated basement/cellar walls ( below grade ) t - m 14 . Type of insulation /' 1r C . Controls 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 be R value of duct in other areas E , piping Insulation agent Pipe 1 . size of hat water or cooling carrying g 2 . R value of pipe insulation F . Service Water Heatin 1 . Performance efficiency 2 . Temperature control setting maximum / DJ � G . For Swimming Pool Onl 1 . Maximum heating 1 Telephone N o . ( applicant ' s signature ) .Jl�1 n Of aeeftd APPIACA170N FOR SEPTIC DISPOSAL PERMIT DATE LOCATION OF PROPERTY FOR INSTALLATION Owner's Name : Ab ��. iV "40e}ezz:- Telephone: Address: Installer's Name: +� +EL I 1 /" �' elephone: 1 1�' w43 rl e> Number of bedrooms (residential only) Total daily flow (compute @ 150 gal per bedroom) Ar 40G2 Topography= circle one 6at Rolling Steep Slope % of slope Soil Nature: circle one Sand Loam Clay Other / Depth: feet Ground Water: At what depth? " feet Bedrock or Impervious Material: At what depth? feet Percolation test: circle one: not re uir required / rate min. inch. Domestic water supply: circle one 42unici a Well Other IF domestic water supply is a Well: Separation: Watersupply from Septic absorption _ feet PROPOSED SYSTEM: Septic Tank 4k2 gal. (minimum size: "000 gal.) TILE FIELD: Each Trench S G7 feet / Total system length feet SEEPAGE PIT(S) : Number of / Size each -w- feet by feet Size of stone to be used # I Depth or Thickness ea? feet IMPORTANT ...Please...LIST NEW EQujP"MENT TO BE INSTALLED (over) 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 Z.} 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 $Z50.00. Ce 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. I have read the Mgulations above and agree to abide by these and all requirements; of the Town of Queensbury Sanitary Sewage Disposal Ckdinance. Signature of responsible person: Date: Town of Queensbury Building and Code Department Bay at Haviland Road Queensbury, New York 1Z801 (518) 792-5832 SETTLED 1763 . . . HOME OF NATURAL BEAUTY . . A GOQD. PLACE TO LIVE �louvn o/ Quee,njlurcy BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Glueensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME L.O C A T I O N-Z (late .? /�� Permit NO * 41 * * * * • *jy'* * APPROVED YES NO Footing/Pier Farms --- -.- Foundation waterproofing B k£ill •- Taming Roofing Siding M onry Veneer fOugh Plumbing Relief Valves Ext . Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors plbg , Fixtures Gar . Fireproofing Door Closers sm>ke Detectors Chimney INSULATION : Foundation Floors Walls ceiling FINAL ELECTRICAL INSPECTION DRIVFjWAY APPROVAi Final Building Survey ---- Next scheduled inspection (call when ready ) Remarks- Building Inspector 6/86 and-vl own o/ Queensiury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box $8 Queensbury, New York 12601 BUILDING INSPECTOR ' S REPORT NAME 1 " LOCATION sT /-��� Date 6/T Permit No APPROVED - YES No Footing/Pier Forms Foundation waterproofing Backfill L PFaming 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 Faun da t ion Floors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection (call when ready } Remarks- Aire Building Inspector 6/86 and-vl ._./'stun 1)� 1,eQei7 .3+b1tre� BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.O. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME rru g4c:c& - Q .) L L L— LocAT IC / )TZ,-3 ca o lz- s ++}sa/s DATE � /� PERMIT NO . SOIL TYPE - Sand - Loam - Clay -_ Percolation Test Required? YES - NO Percolation rate - Min/inch TYPE of SYSTEM: Absorption field , total length �v' o Length of each trench /n[ Depth of trenches ?10' Size of gravel SEEPAGE PITS{Number of) Size- ft.� Graze ' PIPINGz S , xze � T,Iype �R lz Bldgo to tank - Gei.,_I.rf.-_. Tank to list. box L e 1ZL= Dist. box to field/pit _ 1-f Openings sealed? ES N0 Partial LOCATION/SEPARATIONS : Foundation to tank ft Foundation to absorption � . Absorption to lot line Separation of pits ft. LACATION SYSTEM ON PROPERTY (Circle one) Front - ea - Left side - Right side - COMMENTS . SYSTEM USE APPROVED YES NO lop !7Z Bui cling Ins ec r 01/86 and v1 awn 0/ Q"eenjt "ry BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT l LOCATION OCATION , o I - / q 3 , r1-. 40A_y,�; p e f _ Permit No . #+ APPROVED - YE 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 :. Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION Final Building Survey Next scheduled Inspection ( tail when ready) Remarks- 'F=1 ov, ' ' # yC 2-4 +�1- B ildi g pector 6/86 and-vl awn o/ Queenshurs� BUILDING and .ZONING DEPARTMENT Bay and Haviland Road, R. D_ 1 Sox 98 Queensbury, New York 12801 BUILD-IING_ INSPECTOR ' S REPORT NAME LOCAT I C3N_ Date�f-JP�rmi ✓ = APPROVED - YES NO Footing/Pier Forms &Foundation Amoa�terproofing p �Sackfill 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 DRIVEWAY APPROVAL _ Final Building Survey Next scheduled Inspection [call when ready Remarks- - - Building Inspector 6/86 and-vl BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R,p. 1 Sox 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME LOCATION ,+' ,IL / "�► Date L.Footin ~ APPROVED - XE NO g/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 : Foundation Floors Wails Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection ( caI.l when ready ) Remarks- Building Inspector! 6/86 and-vl i{ twz* - �� spy Jf 41f �44W Or Tw-r7 LW TW4 f4ft(*4MaJ FqZ- IlWo, &4J c f'— DESIGN BY: LANDSCAPE M"qpy RA'nON 11 - 15 KA7T*W#4E SIFT.GLEM UM FAU& � IMI (5181792-2021 .4 f