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1987-127 CERTIFICATE OF OCCUPANCY TOWN OF +QUEENSSURY WARREN COUNTY, NEW YORK Date r u t 19 ., t This is to certify that work requested to be done as shown by Permit`Na. has been cotnplcted. Dy- t r� . +�L n This structure may be occupied a�s\/a Id le 1 SL.L/4.. 1 3 S: L .. .. - �' i r �. i5 �1 : t i'.. : u. I= R:. - 1AXMtit«n CY`+S (]vimer By Order Town Board -ro N OF QUEENSBURY Building & Zoning Inspector C RE AT�VC 'IMyT II" rRIPI T'FNG. OLFN3 F^L" N Y 12001 la+sl�,] 5644 BUILDING PERMIT TOWN OF QUEENSBURY No. 87-127 WARREN COUNTY, NEW YORK a� m rti PERMISSION is hereby granted to Barbara A . Perkins � K m OWNER of property located at Lot 16 Lakeview Drive ( St . No. 'Street, Road or Ave_ Lake Sunnyside Estates Subdivision in the Town of Queensbury, To Construct or place a One Fam�v Dwelling � 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. w 1 . OWNER'S Address is 52 Helen Drive Queensbury : New York 2. CONTRACTOR or BUILDER'S Name Wm . McCoy or rt FY' [S+ 3. CONTRACTOR or BUILDER'S Address r Glen Lake Road Queensbury , NY C N• ro E 4. ARCHITECT'S Name CJ n dA< f'D S. ARCHITECT'S Address 6. TYPE of Construction — (Please indicate by X) I X) Wood Frame I ) Masonry C ) Steel I I 0 7. PLANS and Specifications 'D I 62 ' x37 ' per plot plan , specifications and application submitted No, including sewage system and 1 } car attached garage . ,. �c 8_ Proposed Use One—Family Dwelling ON: ro M I9 $5 . 00 C /O 44 $ 10A DO PERMIT FEE PAID — THIS PERMIT EXPIRES November 1 1987. (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 . April _lg 87 SIGNED BY Q . zir for the Town of Queensbury Building and Zoning inspector TO BE COMPLETED BY BLDG . DEPT & �] / Application No . _Jowrt nlueerr3hslrt� Permit Issued 19 i r TOWN OF y�QUEc�;V�SCtii � cY BUILDING and ZONING DEPARTMENT Permit Expires � 19� Bay and Haviland Road, R. D. 1 Box 98 Zoning Designation 2" -5 � , �ILJl{Il LJ l� UUU L1 rLL y,I{ O+ueensbury, New York 12801 Variance No . MAR 311987 Site Pla �iew No . 3 Approv b B111LCANG a com: DEPT. APPLICATION FORS f� BUILDING AND ZONING PERM I 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 . AV The owner of this property ist �r � I P . O_ Address ,� Tel . ,/ k 4 1.6 Property Location ; /t7 Tax Map No . r}t > / / Street number or building lot number Subdivision name (if applicable) f^+ f" tt5w THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS A- Alk Name P . O . Address Tel . No . Name of builder Addres /��*- ' Tel . /"r3?49 Name of plumber r / Address / ` Tel. . Name of mason Address Tel . NATURE OF PROPOSED WORK : ZONING INFORMATION : kX_,/ Construction of a new building 'F A PLOT PLAN MUST BE PREPARED AND SUBMITTED , _Addition to a building " drawn reasonably to scale and attached heret© , 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 ! _ ft X7 ft . * Existing bui ldIng ( s) Size.J ft X�_ ,. .., ft , PROPOSED BUILDING AND USE : � �� � Existing buildi U ng ( s ) se Size of new structure ft X ft Foundation-pier/slab/crawl/partial ul Proposed building, distance from property line ( circle one ) Front yard, t. _ft Rear yard W lo_ ft Side yards No , of stories (habitable space) +l ft and f * Height (grade to ri.dge ) 4!t ft - If on corner , setback from side street ft If residential , no . of families No . of rooms ( excluding baths ) _! OCCUPANCY INFORMATION No. of bedrooms PRIMARY BUILDING - No . of bathrooms �Cne family dwelling Primary heating system , Two family dwelling Type of fuel Multiple dwelling / Number of units Nom of fireplaces to be installed _VPermanent occupancy` Will a wood stove be installed?J Transient occupancy Central Air conditioning? Business BUILDING STYLE, PRIMARY STRUCTURE Industrial Other Raxiah Contemporary Log cabin If addition , what will use be? ised ranch Mansion Duplex 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 car/ Saar _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 M BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICA,TICNVS : Type of construction , wood frame , fire safe , etc . yoe'.?"' m Will any second-hand or ungraded lumber be used? If so , for what ? Foundation wall material 452 ' r� I Thickness f(j '� yi �/ I1 Depth of foundation below grade (to bottom of footing ) /�zl/i Will there be a cellar ? Heated or unheated? ,,01/ _ Floor sq. footage /�7!',�T 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 - sloped/flat/shed/othergd"Efj Material of roof Size , wood studs�Z spacing,/ "o . c . Length _;�£t . Joists ( floor beams ) 1st . floor ^X _"' spacing-_�+�"'o . c . spanft . Joists ( floor beams) 2nd . floor ��+X ++ spacing ao . c . span ft . Overlays (ceiling beams ) "X_ -^ spacinc}�-„_"o . c _ span�f�_ft . Roof rafters "'X_.. � _+' Spa cing -�/�r'y o . c . span _ft . Roof trusses (pre-engineered) spacing "o . c . span ft . Exterior wall finish +�,�►, Of what material ?-.41040 Interior wall finish -A Lot if a garage is to be at ache , describe materials to be used for FIRE SEPARATION * do Is there to be an opening betwe n garage and dwelling? If so will a Fire-rated door , enclosure , and self-closing device a provided? ,f Will a flue-lined chimney be installed? tXf Height above roof ft , Depth of chimney foundation below grade " 4' 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 �I County of Warren A F F I D A V I T STATE OF NEW PORK 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 - - - -- _ SignaturO e --- ' ��yy--�� r , owner ' s agertt , arcnizect, contractor Iday of 19 $ -J CHARLES W. WOLLrNG r �r Notary Public, Stale of w York (v/t .;,�Jr " Qualified in State Notary Public , Warren nty, N . Y . Expire mm r�t �,'%9*,+Zi' It * * * * * * * t * * * * * * * SPECIAL CONDITIONS OF TEE PERMIT : By TOWN OF QUEENSHURY WARREN COUNTY , NEW YORK Application for : BUILDING IMIT IN RCOMLIANCE WITH THE NEW YORK ENERGYSTATE A permit must be obtained before beginning work . ANSWER ALL of the fallowing : 1 . Gross floor area �i �. 2 . Type of heat 1II9,14 r lal-r- f / 3 . is the building mechanically cooled ? 1 4 . Percentage of area of windows and doors ' ,8 3 A _ Over 16 % Only 1 U value of gross area of walls , a 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 B , Under 16 % only 1 . R value of roof and floors exposed to ambient conditions O'. c 2 . R value of exterior walls 3 , R value of glazed area 4 . R value of doors 5 , R value of floors over unheated spaces 6 . R value of slab edge insulation - unheated slab N -I _ 7 . R value of slab insulation - heated slab— / ! g , R value of heated basement/cellar walls ( above grade ) g , R value of heated basement / cellar walls ( below grade ) Aq& 40 100 Type of insulation_ C . Controls 1 . Thermostat maximum heat setting "? D . Duct Systems 10 is duct- system. irts �. al1 ii7 :liaYreated spaces ? YES I30 a . If YES . R value of duct installation b . R value of duct in other areas E . P112ina Insulation a ent pipe 1 . Size of hot water or cooling carrry�xn4 g 2 . R value of pipe insulation_ F . Service Water Heating L7 1 . Performance efficiency j(62 2 . Temperature control setting maximum t7 G , For Swimming pool Only 1 . Maximum heating_ ? Yf .. Telephone Nov ( applicant ' s signature ) APPLICATION FOR SEPTIC DISPOSAL PERMIT MATE LOCATION OF PROPERTY FOR INSTALLATION r- ��� Owner's Name : .1 .t�i`�iP/9 /� .C✓Q,, / f Telephone: Address: a v'� /7t. fir ��' {- , G`ol('J� � ,�f" yo% Installer's Name: Tl O�jQ rScu!cj�/`3 ! Telephone: Number of bedrooms (residential only) 3 r Total daily flow (compute @ 150 gal per bedroom) Topographp: circle one: Flat Rolling Steep Slope % of slope Soil Na#ure: circle one: andyy=Lo�amClay Other / Depth: _ feet Ground Water: At what depth? Od feet Bedrock or Impervious Material: At what depth? _ 4/114 feet �%l� l r�� /1v✓ rQIP / s/�O SCC' "'ta�S Percolation test: circle one: not required required / rat min. inch. Domestic water supply: circle one: Municipal Well Other / N BT-e_ i..� 4 f l IF domestic water supply is a Well: Separation: Watersupply from Septic absorption feet PROPOSED SYSTEM: Septic Tank j 00 D _ gai. (minimum size : 1 ,000 gal.) TILE FIELD: Each Trench feet / Total system length :` i; feet SEEPAGE PI (S) : N er of / Size ealcb, f efflt by eet Size of ston to a used D or Thi ne feet IMPORTANT ...Please...LIST NEW EQUIPMENT TO BE INSTALLER * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * (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 17isposal Ordinance, Signature of responsible person: Date: p ,J Town of Queensbury Building and Code Department Bay at Haviland Road Queensbmwy, New Park 12801 (518) 792-5832 SETTLED 1763 . . . HOME OF NATURAL BEAUTY . . A GOOD. PLACE TO LIVE ffeo° �lveun o u cc Pens6r '� _Ei G and ZONING DEPARTMENT Bay and avifand Road. R. D. 1 Box 98 Clue nsbury, New York 12801 0 B INSPECTOR ' S REPORT NAME LOCATION Date, //J l Permit No . 2, 1 / r ✓ APPROVED - YES NO Footing/Pier Forms Foundation Waterproofing FAack f i 1 l Framing Roofing Siding Masonry Vene r Rough Plumbin Relief 'Halves k2Lxt . Porches finished Floors 4^ '� nterior Trim kll� tairs Railings Cellar Drain Tile Concrete 'Floors N..Pl 'bg . Fixtures )eGar . Fireproofing )eDoor Closers KSmoke Detectors Chimney INSULATION : Foundation Floors Walls Ceiling FINAL EI ECTR11tAL INSPECTION _ l7RIVEWAY APP VAL Final Buildi g Survey Next scheduled inspection ( call when ready } Remarks- Ruil ing Inspector 6/86 and-vl �i �} 6 1 ,y� _Jneun G/ Q"ueens6ur&f IA/ BUILDING and ZONING DEPARTMENT �I I' Bay and Haviland Road, R. D. 1 Box 98 + Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME LOCAT I ON t#:9 fI ` DATE ' �I PERMIT NO. /r SOIL TYPE - Sand - Loam - Clay Percolation Test Required? YES O Percolation rate - Min/Inch TYPE of SYSTEM: Absorption f ' Id , total 1et1h y` ` Length of eac trench G' Depth of trenc s 7^ Size of gravel _ SEEPAGE PITS#N e of) _ Size- ft. X ft . Gravel size PIPING : S��iz/e.y Type Bldg . to tan - �E rG �D Tank to dis box �e ede fe Dist . box field at " sue- �.�' rfr Openings sled? NO Partial LOCATION EPA RATIONS : Foundat n to tank ,/may-.ft. Foundat n to absorpti �nft. Absorpt on to lot line ft. Separation of pits ION OF SYS ONP PERTY (circle one) Fron Rear Left side Right side - ENTs : 4e SYSTEM USE APPRC)VE< YES NO BZildain4 fnspector 01/86 and v1 . lvean 0/ �uQk ►i36Eeri�I (� [ BUILDING and ZONING DEPARTMENT U � Bay and HaViland Road, R. D. 1 Box 98 Queensbury, New York 12801 101 BUILDING INSPECTORNS REPORT NAME- LOCAT ION ,,e?' `�� �_ Date^ ,r Permit N . -- -f- ✓ = APPRO V= Footing/Pier Forms - YES NO Foundation Waterproofing kfill 4. raming Roofing Siding Masonry 'Veneer w cw ugh Plumbing Relief Valves Ext . porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors -'lbgw Fixtures Gar. Fireproofing Door Closers Smoke Detectors Chimney INSULATIQN ; Foundation Ploors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROV Final Building Survey Next scheduled �ienspection (call when ready Remarks- t55e w Ace Build ng Inspector �-�� T 6/86 and-vl BUILDING and ZONING DEPARTMENT Bay and Hawiland Road, R.D. 1 Box 98 Oueensbury, New York 12801 BUILDING TNSPECTOR ` 5 REPORT NAME /4 ( , - LOCATION r ' Date_ �?_/� _ Permit No t- tom ✓ = APPROVED - YES N �^root.i g Pierc7Forms L OV Foundation Waterproofing Backfilk 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- 6/86 and-vl Buildin nspector _../©urrt o/ Quee" Aury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 88 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME LOCATION �vA,+A r f 0Os"IOs"ID e Date ,r„ 1 , Permit Noe ! , ' ✓ =Doting/Pier Forms APPROVER '- YES NO 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 Plbge 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- i i Insp 6/86 and-vl �e wpr 0/ Queenslury 13UILIDING and ZONING DEPARTMENT Bay and HaViland Road, R. D. i Box 98 Queensbury. New York 12801 BUILDING INSPECTOR '}S REPORT NAME 0 CA T ION, L d T J, Alt tc 1` _ Permit No . S P7 _ / Z 7 ?C Footing/pier Formes APPROVED - y'ES NO Foundation Waterproofing Backfi l l Framing Roofing Siding Masonry 'Veneer Rough Plumbing Relief Valves Ext , Porches Finished Floors Interior Trite 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 APPRDV Final. Building Survey Next scheduled inspection (call when Remarks- �� r ady) ZIPto 4 E/86 and-vl Building Inspector BUILDING OEPT" COPY OF APPLICATION FORM 46-ELr NEW YORK BOARD OF FIRE UNDERWRITERS. FILE THIS COPY WITH BUILDING DEPT- WHEN REnUIRED. TEMRe: # , CITY VILLAGE .--+':--•� �'"•F �,-7 p STREET AND NO. OR TOWNSHIP r-; -r , ROAD AND POLE NOI COUNTY " 6ETWE EN III TWO r •: ,�' ." ';6,0 CROYSS STREETS IS _ x `� PO NO. PREMI E T OT .. OCCUPANT'S r .'f`,.., - r:' .,:K.,...... ..:/.✓re+j".^ 4�y: . s arloN NAME BUILDING 'BLOCK LOT' f bWNE R"S NAME OCCUPANCY AND ADDRESS . B YPPL#EO �. :Y ` - ' TEL. BUILDING r � ' �` FROM THEIR IS NEW WORK OFFICE OLD ❑ is NEW E-7 I DEFECTS LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLEDDNAL © REMOVED ❑ NUMBER OF OUTLETS No, of Fixwres III Lace- onn 'i-en'tP ReeePaedee MOTORS HEATERS RANCH OFFICE USEiIrN 'Slow R R+ r Switch Petry! Brkkn No. Typo yyKy ONLY Out- Eeeh Na. Each Na A.W.G. INSPECTION Sub. hme Bar A nMnf fort Fi" 2nd f1. 8rd FL 4 . REMARKS; LIST OTHER ELECTRICAL DEVICES HOT SET FORTH A80VE: DO NOT USE THIS SPACE. This application is int ed la cover the above_lisxed you are authorized fo make the i ettltipment to be intA'ectad but it at time of i rtepection end adjust the fee to Craver the additional a ui Provided b than is tbllnd edditionel Oqu!Pment not above 1 SIZE OF 4 pmenx, as provided by the applicant. iexetl,MAINS ELECTRIC SI O N CHARAC FEEDERS LAMPS „ ;�// TOTAL OF WORK E ED OAS TUBE SIGN WATTS WORK TO BE Ile C EALED TRANSFORMERS OF STARTED INCfMBERI VA SERVICE OVERHEAD COMPLETE" SIZE OF SIGN ICApACITYI EN+b S UNDERG OUND y! ij INSPECTION REQUESTED MAKER zOF SIGN f PO SI AS NEAR AS POSSIBLE AVOID DELAY BY GIVING FULL ANp ACCI MATE I N F OR MATT ON. ALL SPACES NEW ❑ 'OLD Q MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. PRINT NAME AND ADDRE $ ", DATE OF NAME OF APPLICANT y ' APPLICATION "�'w' f SIGNATURE f +L�OF APYLI CANT " r- ' STREET ADDRESS .' _.�,�✓ .. .. C1TY. 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