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
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DESIGN BY:
LANDSCAPE M"qpy RA'nON
11 - 15 KA7T*W#4E SIFT.GLEM
UM FAU& � IMI (5181792-2021
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