1987-076 --------------
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSSURY f
WARREN COUNTY, NEW YORK
Date June a lq 87
This is to certify that work requested to be done as shown by Permit No. 87_7
'P
hss been C4DMP1eud.
This structure may be occupied as a _ one—Family Dwellirzg
Location ;�)kQ Eldridge Road
wtll.lam J . Desblens kKini )
Owner
By Order Town Board
TOWN OF QUEENSBURY
Building gi Zoning Inspector
r
BUILDING PERMIT
TOWN OF QUEENSBURY R7-76 •
WARREN COUNTY, NEW YQRK
PERMISSION is hereby granted to Wm T Desbiens �{ ; a a
CJ
ro
OWNER of property located at Eldridge Road Street. Road or Ave. on
r•
in the Town of Queensbury. To Construct or place a
one-Family Dwelling m
uo
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.
t . 0 4ER•S Address is 7 Butternut Hill Drive
Glens Falls , New York
aC�
2. CONTRACTOR or BUI LDERAS Name
Town and Country Const • p
t rs
CIA
N•
t ao
3. CONTRACTOR or BUILDER'S Address
Rte . 196 o
�I.J
Hudson Falls , New York CIA
r4, ARCHITECTS NameARCHITECT"S Address
t
CA i
r7-
TYPE of C:nst=ruction — ase indicate by X)
( x ( ) Masonry ( ) Steel I )
n --.
PLANS and Specifications +�
24 ' x62t per plot plan , specifications and application submitted
No- including sewage system and two-car attached garage . 'b w
Per Variance No . 1207
c
S. Proposed Use (^S
one-Family Dwelling 1�`7♦� E
$5e00 C /O a'
$ 800 0 ) PERMIT FEE PAID - THIS PERMIT EXPIRES October 1 19g7
(if a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of ameensbury before the expiration date.)
Dated at the Town of Queensbury this , 20th Day of March 19 87
SIGNED BY for the Town of Queensbury
wilding and Zoning I ....1
TO BE COMPLETED BY BLDG . DEPT .
j ►1 Application No .
_/+� " 0/ Qu�e'enihrt,i[► y Permit Issued 19 TOWN OF Q;UEE.4NSLDUa:tf
BUILDING and ZONING DEPARTMENT Permit Expires 19 ; �"ti
Bay and Haviland Road, R .O. 1 Box 98 Zoning Designation <" > . O e> ( Lr�
E0 M
Clueensbury, New York 12801 variance No . e'SA � �
Site Plan Review 1*0
� / I _
✓ ' �' / ` ; F'ppr BUILDING CODE DEPT.
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 the Permit .
S
The owner of this property is / ' �7 C J
P . O . Address Z-'' Tel [L ".G
Property Location : Q.
�� Tax Map No .� /�
reet number or building lot number
Subdivision name ( if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS 15UIIODINC CODES IS : .+�
�/
Name P . O . Address ,�c ,/� Tel . Nov
Name of builder tJ .f!/!� G,tY.i *00 J�Gs,� ddress /�y� �/� r� �Tel .�/" � /�-' '
Name of plumber Address
Name of mason Address
NATURE OF PROPOSED WORK : {{ Q
'a( Construction of a new building L,rc�� � l JJ� �`" SUBMITTED ,
_Addition to a building 111 """"""' ��,, 1 f -ached hereto ,
Alteration to a building P �G' I buildings .
(no change to exterior dimensions ) Indicate all
Other work (describe) QC p lines . Give
��7 ► �' d indicate
FOR DEMOLITION PERMIT , STATE SIZE AND ; ` � 7w location
LOCATION OF STRUCTURES AFFECTED . nfiguration
*
*
ft .
* y ft .
PROPOSED BUILDING AND USE : * E . tea Use
Size of new structure ^£t X X"2' ft
Foundation--pier/slab/crawl/partial/full * Proposed building , distance from property line
( circle one )
* Front yard �[a ft Rear yard ft
No . of stories (habitable space) ' Side yards ft and ft
Height ( grade to ridge) /6 ft . * If on corner , setback from side street ft
If residential , no . of families /
No . of rooms ( excluding baths ) * OCCUPANCY INFORMATION
Now of bedrooms ,� PRIMARY BUILDING -
No . of bathrooms ,' ;" One family dwelling
Primary heating system /`� ,vim, �;�r/ G *'
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
TransienCentral Air conditioning? * Business occupancy
Business
BUILDING STYLE, PRIMARY STRUCTURE Industrial
nch 4-� Contemporary Log cabin * Other
Raised 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/ two car/ car
( CIRCLE ONE PLEASE ) * _,:*! 'Attached garage/one Car/ two ca car
* * * * a * * * * * * * * * * * * _Private storage building
ESTIMATED MARKET VALUE OF Other
CONSTRUCTION
INFORMATION ON BUILDSNCi SPECIFICATIONS , ON REVERSE SIDE OF THIS 'SHEET , TO BE COMPZ.ETED !
Form BPA 4/86 and-vl
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS :
Type of construction , wood frame , fire safe , etc .
Will iany second-hand or ungraded lumber be used? If so , for what ?
Foundation wall material Thickness �4p
Depth of foundation below grade (to bottom of footi�g)
Will there be a cellar? Heated or unheated? !l/1✓ Floor sq. footage / ,[a te
_ �.sq f t
Will there be a basement? �5 Will any portion be used as living space ? Aooeo
( If so , what portion? _sq . ft . - - T/ype f use?
Type of roof - sloped/flat/shed/other Sl�s Material of roof
Size , wood studs_ ," X spacing "o . c , length ft .
Joists ( floor beams ) lst . floor �rox spacing_„Z "o . c _ span /0;� ft ,
Joists ( floor beams) 2nd . floor "X " spacing "o . c . span ft .
Overlays ( ceiling beams ) "X " spacing "o . c . span ft .
Roof rafters "}� � l spacingwo . c . span �ft .
Roof trusses (pre-engineered) s ci Ir " o . c . span r7�t
Exterior wall finish `ex Of hat material
Interior wall finish
If a.9Srage is to be attar d , descr ' be ateria 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? e+s
Will a flue-lined chimney be installed? 000�4 Height above roof ft .
Depth of chimney foundation below grade ft .
Depth of fireplace hearth ft . an . s
Water supply - Municipal or private well
SEPTIC SYSTEM _ Distance from ANY private well ( including ad!olning properties /' ft .
(A separate application is necessary for any lr�epair or new installation of septic system)
Town of f Warren A F F I D A V I T 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 -_ Fr
Owner , owner en t , arch].Cect , contractor
day of 19
Notary Public , Warren County, N . Y .
SPECIAL CONDITIONS OF THE PERMIT :
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 /�Q[ � `'
2 . Type of heat e.
3 , is the building mechanically cooled ? 00000OV4�
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 NCJ
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 CIO
a . R value of insulation
l �
5 . Type of insulation. ' QYS? 1PS-
B . Under 16 % Only
1 . R value of ,raLof and floors exposed to ambient conditions
r
2 . R value of exterior walls e<m
3 . R value of glazed area
,+
4 . R value of doors 5 ee J
5 . R value of floors over unheated spaces ,p _____ _
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
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
G . For Swimming Pool Only
1 . Maximum heating
Telephone No . +�� If ' �/'1y' � � �f
icant ' s signature )
%AM OlWft Jf
APPLICATION FOR SEPTIC DISPOSAL PERMIT
DATE _ 00
13
LOCATION OF PROPERTY FOR INSTALLATION / .5��
Owner's Name : LrL' _ Telephone:
Address: 2f �+
Installer's Name: Telephone:
i
Number of bedrooms (residential only) _
Total daily flow (compute @ 150 gal per bedroom)
Topography: circle one: la boiling Steep Slope % of slope
Soil Nature: circle one: and Loam Clay Other / Depth: feet
Ground Water. At what depth? feet
Bedrock or Impervious Material: At what depth? _ feet
Percolation test: circle one: not required required / rate min. inch.
1�
Domestic water supply: circle one: uni sepal Well Other _
IF domestic water supply is a Well:
Separation*. Watersupply from Septic absorption _ feet
PROPOSED SYSTEM: Septic Tankef 4 G2 gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench feet / 'Total system length e!5;_(:D— feet
SEEPAGE PIT(S) : Number of / Size each feet by feet
Size of stone to be used # / Depth or Thickness feet
IMPORTANT
_..P'lease...LIST NEW EQUIPMENT TO BE INSTALLED
* * * * * * * * * * * * s * * * * s * * * * * * a s * * * * * * a s * s * s
(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
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.
I have read the regulations above and agree to abide by these and all requirements
of the Town of Queensbury Sanitary Sewage Disposal. Ordinance.
Signature of responsible person:
C
Date:
Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832
SETTLED 1763 . . . HOME OF NATURAL BEAUTY . . A GOOO, PLACE TO LIVE
`DD BUILDING and ZONING DEPARTMENT
J . 15 Bay and Haviland Road, R.D. 1 Box 98
3 ` ❑ueensbury, Now York 12801
BUILDING INSPECTOR ' S REPORT
NAME_ k1 m,,� a5
LOCATION• At:-�1144 r f c -
Date � �3 -/ �_ Permit Noe
�+ 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
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAt.
Final Building Survey
Next scheduled inspection (call when ready )
Remarks- 1,12
611,0
00
lee, '� f
Building Inspector
6/86 and-vl
_ /oeun 01 'Queensiurry
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME <?- i eigg
LOCATION c; ►..4 y1 e.w he t p 4r� Y-t j l"O-
Idr-. d5<. Ado
DATE / PERMIT NO. +
SOIL TYPE -- - Loam - Clay - 7�an
Percolation t Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field , total length o4 1
Length of each trench
Depth of trenches 2- M- �!ry
Size of gravel_
:SEEPAGE PIT ofiz €t. X _
ravel size
PIPING : Size Type
Bldg . to tank _ ►11 i ,Q Agile
Tank to dirt. box A-/ Y
Dist. x to f field/pat w
Opening sealed? E NO Partial
LDCAT "CLd/ P� TxON5 ;
Foundation tank. f / ft.
Foundation [] absorption
Absorptio t lot line ft . -
Separati o pits ft.
LOCATIO OF S EM ON PROPERTY (circle one )
ran Rear - eft side - ht si -
CCMME S :
-7'AA.rsG * )
A-,/ �� ',� ,,,, �d
/ o an d -�� D- 13r x Vc) n4-6►r
Zan
SYSTEM USE APPR VED 7YE NO
ZA
Bui ding Tn" 9.pe or
01/85 and vl
� / �f W
W
A N
�
A
t
r
0 � y
41
1
m m {a p .o
1
� 3 � � I
1 � Q
,} D
t�/�r y 7 1
_Jose" 0/ Q"eensbury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R, D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME W rh D_► , 2
LOCATION
Date_ / r _ Permit No . _ [7 �1 �► (0
APPROVED - YES NO
Footing/Pier Forms
Foundation
waterproofing
Back£ill
Framing
Roofing
Siding
Masonry Veneer
X Rough Plumbing a
Relief Valves
Ext , Porches
Finished Floors
Interior Trim_
Stairs & Railings
Cellar Drain 'Pile
Concrete Floors
Plbg . Fixtures
Gar . Fireproofing
Door Closers
Smoke Detectors
Chimney
INSL)LATION :
Foundation
Floors
walls
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Fislal Building, Survey
Next scheduled inspection (call when ready
Remarks--
nui 4dingnspector
6/66 and-vl
7oty n O/ Q"ce " 31 " MIV
BUILDING and 70NING DEPARTMENT
Bay and Maviland Road. R.D. i Sox 98
pueensbury. New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION cirr 1 r °
Date /S / ��+ Permit Tao . -- 4
"7
* * * * * * * * * ✓* * * * YES NO
APP RC)V ED
Footing/Pier Forms
)(F oun da t io n
Ka t erproof ing �.
ackfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing _�_,_�—•-----� --
Reiief Valves
Ext . Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
6'lbg . Fixtures
Gar . Fireproofing
Door Closers
Smoke Detectors
Chimney
IN SU I.AT ION
Faun dat icon
Floors
WaL l I s
Ceilinq
FINAL KLECTRICAL YN SPECTY Tom—.--
DRIVFWAY APPROVAL
Final Building Survey
Next scheduled snap
ectisrn (call when ready )
Remarks
(hd t
Funding Inspector
Ei/85 and-vl
._.I'owrt o� '�ueen � �urc�
BUILDING and ZONING DEPARTMENT
Bay and i-iaviland Road. R-D. 1 Box 98
pueensbury. New+ York 12801
BUILDING INSPECTORS REPORT
NAME
LOCATION
ate , y _7/ Permit No .
9r
y ' APPROVED - Y " NO
+�[ Booting/Fier Forms G
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry veneer
Rough Plumbing
Relief Valves
Ext , Porches
Finished Floor's
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg . Fixtures Ilk
Gar . Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION :
Foundation
Floors
Walls
Ceiling
FINAL ELECCRICAL INSPECTION_
DRIVEWAY APPROV"T
Final Building Survey _
en ready )
Next scheduled inspection (call wh
Remarks-
.
Building Inspector
6,/66 md-vl
flown o/ Queen3i "ry
BUILDING and ZONING DEPARTMENT
Bay and Hauiland Road, R.D. i Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME �I- -*��, {- Al
LOCATION !' LIB [ l� ►��_ r . _ —
Date Permit No
AP VD 'YES NO
�CFooti_ng/Pier Forms _
Foundation
waterproof in
Backfi l l
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
INSUI ATION :
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL _
Final Building Survey
Next scheduled inspection (call when ready3
Remarks- �]� � f WCL A I
lip 04
Building Inspector
6/86 and-vl
BUILDING DEP•f. COPY
O THIS APPLICATIO
COPY N FOR 46 NG NEW YORKWHE BARD OF IRE UNDERWRITERS.
TEMP.
CITY OR t COUNTY
VILLAGE 1/"'/ ..^yT-�:.> TOWNSHIPS r` 3 ^�=--./'
STREET AND NO, OR ` POLE NO.
ROAD AND POLE NO.
CROSS STREETS Is •'" y�r ,r
PREMISES LOCATED'+ .-�'rf �+"� "` W f IY SECTION .'� BLOCK / LOT
BUILDING -.-'.3
OCCUPANT'S OCCUPANCY
NAME
OWNER'S NAME / r ..
AND ADDRESS �•f < r= Cf !�.- f r'.. ..�` TEL. # �/''1r". .- �I"�" Ji•
CU N JE .
SUPPLIED ���%f„r r�„ +'^" �,.- .�I",f,:-J•' /���;�'a ,f��f� :E`..''�i` FROM THEIR �"'" .r OFFICE
BY .� • DEFECTS
BUILDING I—{ WORK
i5 f4EW �_y OLD LJ IS NEW ADDITIONAL 0 REMOVED
•ice' LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
No. of Fixtures & BRANCH OFFICE USE
NUMBER OF OUTLETS Lamp Receptacles MOTORS HEATERS CIRCUITS ONLY
Loco• H.P. Walla A.W.G.
tion Side Attach't No, Typo No. No. Gauge INSPECTION
Ceiling Wall Ro~'Ia Switch perxlent Braeket Eech Each
Out-
side
Sub-
BASIN
meat
tat FI.
2nd FI.
Std Fl.
REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE:
60 NOT USE THIS SPACE.
This application is intended to cover the above•I isted equipment to be "pecti d but if at time of inspection there is found additional aquipment not abcave listed.
you are au chor ix ed to make the inspection and adjust the fee to cover the additional equipment, M pros ided by the applicant-
ELECTRIC SIGN TOTAL
SIZE OF FEEDERS LAMPS WATTS
MAINS
CHARACTER EXPOSED GAS TUBE SIGN
OF WORK CONCEALED TRANSFORMERS OF VA
W
WORK TO BE (NUMBER} (CAPACITY)
STARTED COMPLETED SIZE OF SIGN
SERVICE OVERHEAD UNDERGROUND MAKER
ENTERS OF SIGN
fLOING
I
ON OR AS NEAR AS NEWNSPECTION REQUESTED OLD
POSSIBLE
AVOJO DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAYBE RETURNED.
PRINT NAME AND ADDRESS ,
DATE OF
NAME OF -7ANT "� r - :' ,..+r�' F APPLICATIONAPPLI
.y /
..!'" TELEPHONE
STREET ADDRESS
,ITY OR /�,j F ZIP / Id
LICENSE NO.
ppp
POST OFFICE � x "`.f r"' !Y~ ter CODE,/ f'"�+�.�/1 YM1IFiEN APPLICABLE
4e EL (REV. des) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING