1986-709 3 Ili
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
m _
Date May 14 19 87
6b-709
This 3o\o certify that work requested to be done as shown by Permit No.
has been completed.
This structure may be occupied as a One-Family Dwelling
Lot 42 Willow Road (St. No. 17)
Location
Owner Stephen Kelly
By Order Town Board
TOWN OF QUEENSBURY
7:44 A 11/ --/AJZ/L
--v Building & Zoning Inspector
BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-709
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Stephen M. Kelly
OWNER of property located at Lot 42 Willow Road (St. No. 17) Street, Road or Ave.
The Pines of Queensbury
in the Town of Queensbury,To Construct or place a One—Family Dwelling cn
at the above location in accordance to application together with plot plans and other information hereto filed andro
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
m
1. OWNER'S Address is
15 Willow Road
Glens Falls, New York
m
2. CONTRACTOR or BUILDER'S Name
same
3. CONTRACTOR or BUILDER'S Address
same
rt
4. ARCHITECT'S Name
r•
0
5. ARCHITECT'S Address o
a
cn
rt
6. TYPE of Construction— (Please indicate by X)
z
(x)Wood Frame ( I Masonry ( ) Steel ( ) o
I�
7. PLANS and Specifications
No. 26'x64' per plot plan, specifications and application submitted
including sewage system and two—car attached garage.
8. Proposed Use
One—Family Dwelling
$5.00 C/0 H.
171.00
$ PERMIT FEE PAID—THIS PERMIT EXPIRES May 1 1987
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the co
town of Queensbury before the expiration date.)
H.
Dated at the Town of Queensbury this 20th Day of October 19 86 00
SIGNED BY C a io for the Town of Queensbury
Building and Zoning Inspector �)
• • TU BE COMPLETED BY BLDG. DEPT.
Application No.
QIown o/ eirr
Permit Issued 19 TOWN OFQUEEMBLIFee BUILDING and ZONING DEPARTMENT Permit Expires 19 (�
Bay and Haviland Road, R.D. 1 Box .•; Zoning Designation I). EGiEliV .E
Oueensbury, New York 12801 Variance No. jflj
�j Site Plan i iew No. SEP 91 6
! ° .
Approve by. A. 4: � � PA.
APPLICATION FOR ��/ 7181911,111)12)1)213141516
BUILDING AND ZONING PERMIT t/%/ .
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * •* * * * * * * * *:;*
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: 5 fej°lj eM /7 , `°'
P.O. Address `< Ljji'/1 o Ad
14/ Tel. 29:? G ci...--.. Z
Property Location: ,10/ 7z- ,4 9 Z e /9 aw ,tee,/ Tax Map No. / /
Street number or building lot number • •
Subdivision name (if applicable) 714 ! L/1 ecf'
THE PERSON RESPONSIBLE FOR SUPERVISION OF •WORK AS REGARDS BUILDING CODES ISs
(.5-N 7I-E/CV. 1) ri? /16'e../i/ •
Name ,�i' P.O. Address 7 Tel. No.
Name of builder S ell Address ' ,Q -, Tel. ? A� o' - . -.-
Name of plumber Address Tel.
Name of mason . !2 Address Tel.
NATURE OF PROPOSED WIRK: * ZONING INFORMATION: •
VC 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 dot 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 /Se/ ft X_/7 d ft.
* Existing building(s) Size -- ft X -- ft.
* ..
PROPOSED BUILDING AND USE: •
* Existing building(s) 'Use .-
Size of new structure 46 ft X to Yft
Foundation-pier/slab/crawl/partial co * Proposed building, distance from property line
(circle one)
No, of stories (habitable space) Front yard ] ft Rear yard ]Z- ft
Height (grade to ridge) ft. * Side yards ,,9,1 ft and ft
If residential, no. of families / * If on corner, setback from side street ft
No. of rooms(excluding baths) 7 . * OCCUPANCY. INFORMATION
No. of bedrooms
No. of bathrooms 2 *• PRIMARY BUILDING -
Primary heating system e=/ec. J/em * One family dwelling
Type of fuel 1. l GG4,/p/G * Two family dwelling
No. of fireplaces to be installed / * Multiple dwelling / Number of. units
Will a wood stove be installed?. A/0 * Permanent occupancy
Central Air conditioning? 11/d * Transient occupancy
* Business
BUILDING STYLE, PRIMARY STRUCTURE ,F Industrial
Ranch Contemporary Log cabin * Other "
* 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 * ' Detached garage/one car/ two car/ car
( CIRCLE ONE PLEASE ) * y Attached garage/one car/ two car/ ,k car
* * * * * * * * * * • * * * * * * * * ' Private storage building
ESTIMATED MARKET VALUE OF * Other_
CONSTRUCTION s •A cr *
INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
Form BFA •I/f . m.1-vl
BUILDING SPECIFICATIONS:
Type of construction, wood frame, fire safe,etc. . W a a d
Will any Second-hand or ungraded lumber be used? If so, for what? A/d • •
•
Foundation wall material .4/acf Thickness /4 ''
Depth of foundation below grade (to bottom of footing) 9 1"
Will there be a cellar? y'S Heated or unheated? ff - Floor sq. footage,e/Oo sq ft
Will there be a basement? ,eS Will any portion be used as living space? ti o
(If so, what portion? sq.ft. - - Type of use? •
Type of roof - sloped/flat/shed/other J^ Material. of roof iga/VA/rc, 44/07, /,e.
Size, wood studs o. "X 4 " spacing /( "o.c. length & ft.
Joists(floor beams) 1st. floor "X Io " spacing , "o.c. span / . ft.
Joists (floor beams) 2nd. floor $0. "X ,/o " spacing /0 "o.c. span /dm. ft.
Overlays(ceiling beams) "X " spacing "o.c. span ft.
Roof rafters "X " spacing o.c. span / . ft.
Roof trusses(pre-engineered) spacing jr "o.c. span,?‘ ft.
Exterior wall finish ,Stet', it.x• Of what material? `//R Y0
Interior wall finish r3 r e vt. 1e p-c'
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
(fi s,e 8 e f-e2 f Fttie. A,2-iied
Is there to be an opening between garage and dwelling? ye . If so will a Fire-rated
door, enclosure, and self-closing device be provided? y.es
Will a flue-lined chimney be installed? Yea Height above roof ft. e "
Depth of chimney foundation below grade 9 ft.
Depth of fireplace hearth ft. in.
Water supply - Municipal or private well rf lih t c 1/-42
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 and belief the statements contained •
in this application, together with the plans and specifications submitted, are 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 Signature4 - - --
Owner, owner's a nt rcfitect,contractor
day of 19
Notary Public, 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: p�
1. Gross floor area 2- 2' 41 �J
2 . Type of heat F 11' °
3 . Is the building mechanically cooled? /V d
4 . Percentage of area of windows and doors 04 e&S 7 ' e
A. Over 16% Only
1. Uo value of gross area of walls , roof/ceiling and floors
exposed to ambient conditions ;ad
2 . Floor over heated spaces , CO NO
a. Are foundation walls insulated? YES NO
1 . If YES, what is the R value?
3 . Slab on grade YES
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
A9 ,mod
2 . R value of exterior walls 49 / 9
3 . R value of glazed area /i 7 2--
4 . R value of doors .2. �o
5 . R value of floors over unheated spaces `~
6. R value of slab edge insulation - unheated slab `"
7 . R value of slab insulation - heated slab r-
8. R value of heated basement/cellar walls (above grade)
9. R value of heated basement/cellar walls (below grade)
10. . Type of insulation f/ eR' G/ASs
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
b. R value of duct in other areas
E. Piping Insulation
1. Size of hot water or cooling carrying agent pipe
• 2 . R value of pipe insulation _
F . Service Water Heating
1. Performance efficiency
2 . Temperature control setting maximum 1 fro
G. For Swimming Pool Only
1 . Maximum heating
Telephone No. 719-g—Zd • 7
(app icant ' s s gn/ure)
Cl
Jown of aueenibury APPLICATION FOR SEPTIC DISPOSAL PERMIT
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98 •
Queensbury, New York 12801
DATE % / 9/,'6,
LOCATION OF PROPERTY FOR 'INSTALLATION o t 02 hi, l/U.‘, //e -i e1 .
• OWNER' S NAME S/e/D ePI lt ,/e1 .
ADDRESS / 5— lv/ # 0,4.} %.a Aar/ TEL 79.E -,;d -2-z.
INSTALLER' S NAME SA-49 -e 4s 742v e TEL
Number of bedrooms (residential only) 7
Total daily flow(compute @ 150 gal per bedroom)- G' Q 0
Topography: - Flat - 6li6).- Steep slope - (circle one) % of slope
Soil nature: nand - 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 • j'yj rc h t c.i p,a J
Separation - Watersupply(if well) from Septic absorption • ft.
Proposed System: Septic tank A''— gal. ( Minimun size, 1000 gal. )
Tile Field - Each trench ", Cy ft. Total system legnth '7C7 ft.
Seepage pit(s) Number_o . Size e ft
Size of stone to be used # Depth or thickness 2+ ftP
* * * * * * * * * * . * * * * * * * * * * * * * * * * * * * * * * * * * * *
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
r
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 Ordinan7/
ce.
Signature of responsible person 4 .
Date
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 thetinstaller and a
fine of up to $2 50.00.
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.
_awn of ?ueeniLur ,
BUILDING and ZONING DEPARTMENToo
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REf. RT
NAME 5---4As,/,
7{ •
LOCAT I ON 17 // .
/��v
Date : r£`/ /_ Permit No. 0 6- i 0 7
* * * * * * * * * * * * * * * * * * * * * * *
= APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext. PorchesXf
Finished Floors
Interior Trim
Stairs & Railings '
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing X
Door Closers
Smoke Detectors
Chimney y
INSULATION:
Foundation
t
Floors - �
Walls ;
Ceiling
FINAL ELECTRICAL INSPECTION
(:\\
DRIVEWAY APPROVAL
Final Building Survey ( ,
Next scheduled inspection (call when ready)
Remarks-
-
12e,/ /wf CC:7 /id/
1:1 401(r 7:d .
�ss
me-_
0- ,
/I-
...-
Building Insp ctor
6/86 and-vl
` Jown of Queenitury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME X /77
LOCATION /7 (,,,v, 7/.,6,/
Date 5� it/ Si Permit No. fft,, - 7°7
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves 2(
Ext. Porches iN
v'
Finished Floors
Interior Trim X
Stairs & Railings )(
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures X
Gar. Fireproofing 7(
Door Closers X
Smoke Detectors x
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
x::\
Final Building Survey / \ !
Next scheduled inspection (call when ready)
Remarks- / 7�
afe 0� I // c1 Pii/ f
� ld' pie
��l/r✓ dt rd/1-i �J vl /lrc r
A-avl • N
vLk'
A,,,,,/ ' � � ���
.>
Build ng Inspector
6/86 and-vl
l
r c_7 I/
Jown of Queenibur1
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION /7
Date _6/2-41/ (97 Permit No. g — 67
* * * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves 1 / X
Ext. Porches \ / X
Finished Floors X
Interior Trim
Stairs & Railings / \
DC
Cellar Drain Tile / 1,
Concrete Floors i
Plbg. Fixtures
Gar. Fireproofing X Door Closers )(
Smoke Detectors X
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
Cc L 9€P /o/:2 1-- (cF /72
awn of Queenitur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME 3 re rin o
LOCATION l-�T Lc-Z (2);r JLcc J facc/
Date /6/,Z3/ R, 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
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION:
Foundation
Floors
Y Walls 096-
'�Ceiling (t��r
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-
Building Inspector
6/86 and-vl
10/1 7/8 (9 11 A-141
_Down of Queenitur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
•
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME STee h ems, I(-t iI y
LOCATION I___o t V-. , W i I/O u) Al
86 ,4707
DATE loins /6, PERMIT NO. ip ,,i
SOIL TYPE - . - Loam - _Clay -
Percolation est Required? YES
Percolation rate - Min/Inch - 0-
TYPE of SYSTEM: r
Absorption field, total length a g--Z7
' Length of each trench 57(5
Depth of trenches ' �k
Size of gravel (2.__
SEEPAGE PITS-Number of) •
Size- ft. X ft.
Gravel size
PIPING: Size Type
Bldg. to tank f!l( Ai
'Tank to dist. box
Dist. box to field/ '
Openings sealed? ES NO Partial
LOCATION/SEPARATIONS:
Foundation to tank lQ ft.
Foundation to absorption �0ft.
Absorption to lot line ft.
. Separation of pits ft.
LOCATION O_ SYSTEM ON PROPERTY(circle one)
Front - Rear - Left side - Right side -
COMMENT .
7 p '\
SYSTEM USE APPROVED NO
•
' LOO
Building Inspector
•
01/86 and vl
adt11 7 I PI d & 1
Jown of Queeni1ur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME 3 ep �► eh ke. I
LOCATION I - �.y willow 21.
Date /a / J / 8 (, Permit No.
* * * * * * * * * * * * * * * * * * * * * * *
V = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
'(Framing r!
Roofing
Siding
Masonry Veneer
X Rough Plumbing 5 4. I L b fit) �O
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: ; Y
Foundation
Floors ,/
Walls
Ceiling
FINAL ELECTRICAL I SPECTION
DRIVEWAY APPROVAL
Final Building Survey
�LvM IUU-4-e—
Next scheduled inspection (call when ready)
Remarks-
KOSIP �+b WAS i 11-C� Po_Alitr-
rafr-iver
1/A'vtfl - Jrook
6-21-71
Buildin Inspector
6/86 and-vl
Ca//-°t 97�cc /a (/a'� �: 3 )�
Jown of Quecniur�
cy
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME . / P /f y
LOCATION LUr z/c), 0J; //Q (.4/ /lr(
Date / f a7 /16 Permit No. y ‘ ..'7 c 9
* * * * * *. * * * * * * * * * * * * * * * *
4,' = APPROVED - YES / NO
` _
Footing/Pier Forms �j' cIv Cij �,
Foundation cJ
I 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(call when ready)
Remarks- -
19
f `r Building nspe tor 1'
6/86 and-vl
C.ot Visl `(. 7, /5- 41
. own of Queenibur1
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME S:et /( 11 y
LOCATION 4_13 r LrC /N//k /2d,
Date 7 //C /d'� Permit No ,, O ?
. .
= APPROVED - YES,N
)(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(call when ready)
Remarks- -
��An
Building Insp ctor
6/86 and-vl
i% /lW
T 4/3a1
14VP
steps 9 /1r/y
�eY
�
Y r