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1987-121 1 i � I r 1 CNERTIFICAFM TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date .July 14 , 19 i k � o • •- 87- 1 1This is to certify that work requested to be done as shown by Permit No4 has been c+otnPleted. C1ne- Farsily This structure may be c""Pied ss a t7welli.ng Lot. 50 Willow Rdd ( St . hc• . 1 ) The Pines of �uezer.:hury bovation Richard 5 Nancy PurPora Owner By order Town Board 1i TOWN of QUEENSBURY Building & Zoning Inspector i I BUILDINGPERMIT ' TOWN OF QUEENSBURY No. WARREN COUNTY, NEW YOR K - PERINISS#ON is hereby granted to Pliney Tucker b Lot 50 Willow Road (St . No . 1) Street, Read or Ave. OWNER of property located at rD in the Town of Queensbury, To Construct or place a One-Family Dwelling `4 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. ro r1 F2. OWNER'S Address is Box 425 RD #4 Queensbury , New York 12801 CONTRACTOR or BU1 LDERS Name same 3. CONTRACTOR or BUILDEWS Address same ,- o H rt a i9 l n b 4. ARCHITECT`S Name tD k_A to 0 C] 0 � h-h 5. ARCHITECT'S Address A � (D � [n cY rr C 6. TYPE of Construction — (Please indicate by X) a Wood Frame ( ) Masonry I ) Steel F7P:LAN'S and Spec#float#ons 27 ' x64 ' per plot plan , specifications and application submitted No' including sewage system and two-car attached garage roposed Ilse fD dne-Family Dwelling ' w i-� $5 . 00 C /O 87 � 178 . 00 PEftN1lT FEE PAID — TF# I5 PERMIT EXPIRES November 1 79 ,= llf a to ngar period is required an application for an exte nsian must be made to the Building and Zoning inspector of the town of Queensbury before the expiration date_} N• A ril 19 87 Do Dated at the Town of Queensbury thislek E'th Day of p SIGNED BY •�f�- �� , d' for the Town of Queensbury Building and Zoning Inspect TO BE COMPLETED BY BLDG . DEPT . CC77 / Application No . _Journ o/ Queenjhury Permit Issued 19 ! TOWN OF G�UEcNSE3e , BUILDING and ZONING DEPARTMENT Permit Expires 19 ? r Bay and Haviland Read, R. D. 1 Box 98 'Zoning Designation � 1� Queensbury, New York 12801 variance No . Site Plan Review No . j ,APR 2 1987 70 � � � Approved by : BUILDING Bc CODE DEPT_ APPLICATION FOR _ - fro 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 . The owner of this property is : / el 00� P . O . Address_ r's�s_ .s' -C;" t4 P 2> e f ram+ z ,.. , ,(?,. �. t� .� _ Tel i �-3 � . -r Property Location : `� { Tax Map No , '�� Street number or building lot number Subdivision name ( if applicable) THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS : Name P . O . Address Tea . No . Name f Address' 22`. , . v . ¢ �' . Tel . Name of plumber � f ,r �„ Address Name of mason Tel . -NATURE OF PROPOSED WORK : ZONING INFORMATION : 4'r 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 . x COMPLETE INFORMATION REQUIRED BELOW . Size of property /� ft X c3 ft . Existing buildings) Size tft X ft . 7� wee PROPOSED BUILDING AND USE : Existing building ( s ) Use ,rLf Size of new structure ft X i2fi!0_; Foundation-pier/slab/crawl/partial/ to D Proposed building : distance from property line (circle one ) ft Front yard ��� ft Rear yard �'` No , of stories (habitable space ) Y ft v ft . Side yards .2 4S ft and � Height ( grade to ridge ) if on corner , setback from side street ft If residential , no . of families _/ No , of rooms ( excluding/ baths ) OCCUPANCY INFORMATION No . of bedrooms `_ PRTMARY BUILDING No . of bathrooms 2 One family dwelling Primaryheating system ,/ g _ - —s- Two family dwelling Type of fuel Multiple dwelling / Number of units No , of fireplaces to be instal ed A � Permanent occupancy Will a wood stove be installed? ,t + rJ Transient occupancy Central Air conditioning? /ice i Business BUILDING STYLE, PRIMARY STRUCTURE Industrial Other Ranch Contemporary Lag cabin If addition , what will use be? Raised ranch Mansion Duplex Split level Old style Bungalow CaTpe d Cottage Other * ACCESSORY BUILDING- ,_ Row Town House * Detached garage/one car/ two car/ car ( CIRCLE ONE PLEASE ) Attached garage/one car/ two car/ _ , , :3 car Private storage building ESTIMATED MARKET VALUE OF Other CONSTRUCTION r '� INFORMATION ON BUILDING SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET , TO BE COMPLETED ! Form BPA 4/86 and-vl BUILDING PERMIT APPLICATION CONTINUED BUILDING SPECIFFICATIONS : Type of construction , wood frame , fire safe , etc . Will any second-hand or ungraded lumber be used? If so , for what ? /c } / r Foundation wall material___ ` z G { Thickness "' '� Depth of foundation below grade ( to bottom Of footing ) r Will there be a cellar ? I '/' t Heated or unheated? �. ;ram loot sq , footage sq oft Will there be a basement? __jA�ea-_Will any portion be used as living space ? ( If so , what portion? sq . ft . - - Type of use? Type of roof - sloped/flat/shed/other Material of roof �r� ,� �r - Size , wood studs _ �' f " Y "X e._ spacings „ D . C . length ft . Joists ( floor beams ) 1st . £loot "x r� �1 - h Spacing r "o . c , span .joists ( floor beams ) 2nd . floor .� X " spacings o , c . span 000000z �� ft . Overlays ( ceiling beams ) "X " spacing "a . c . span ft . Roof rafters "X It spacing o . C * span ft . Roof trusses (pre-engineered) spacinq "o . c . span -, G ft'. Exterior wall finish of what material ? r 7 .Y C c Interior wall finish �-3f If a garage is to be attached , desgribe materials to be used for FIRE SEPARATION : Is there to be an opening between garage and d elling? ,�?� .� Ef sa will a ire-rated door , enclosure , and self- closing device be provided? Will a flue-lined chimney be installed? ' c Height above roof 1 .7ft , Depth of chimney foundation below grade � ft . Depth of fireplace hearth "� f't _ in . Water supply - Municipal or private well i'a'jc. , �. ) f jr .��� SEPTIC SYSTEM i 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 T� T County of Warren A F F I D I A V f 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 , 000SWORN TO BEFORE ME THIS day of 19 Signature / -_ .-. _._._� - - 1 __ '-o.rC_"vwn�•�„&. Own;, er ' s a ent , architect , contractor Notary Public , Warren County , N. Y . * * * * * * AF * * * x * * * * it * * * * it * * * * * * * * * SPECIAL CONDITIONS OF THE PERMIT : BY- ......... ... TOWN OF QUEENSHURY , 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 flour area ' r — 2 . Type of heat 3 . Is the building mechanically cooled ? Y \ 1 J 4 . Percentage of area of windows and doors 1 G[ C1 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 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 S . Type of insulation B . Under 16 % Only 1 . R value of roof and floors exposed to ambient conditions_ 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 7 . R value of slab insulation - heated slab A 8 . R value of heated basement/ cellar walls ( above grade )fy_ 9 . R value of heated basement/cellar walls ( below grade ? f 106 Type of insulation c :` / / 01- ' e C . Controls �+� �J 1 « Thermostat maximum heat setting sp (' D . Duct Systems 1 . Is duct system installed in unheated spaces ? YES NO a . If YESf R value of duct installation b . R value of duct in other areas E . Piping Insulation rf 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 l `tC> _G . For Swimming , Pool Only 1 . Maximum heating Telephonj No . Z� , ( aCpplicant gnature ) APPLICATION FOR SEPTiC DISPOSAL PERMIT DATE d I LOCATION OF PROPERTY FOR INSTALLATION Owner's Name: Telephone: Address: I k Z.f .;12 Z z..} / C se= 4X4— �' Installer's Name: A qz� 'Telephone; Number of bedrooms {residential only} Total daily flow (compute @ 1150 gal per bedroom ) i r Topography. circle one: lat + Rolling Steep Slope % of slope Soil Natures circle one: Saner Loam Clay Other / Depth: feet Ground Waters At what depth? �`_ feet Bedxaack or Impervious Materials At what depth? _ feet Percolation test: circle ones not required required / rate min. inch. Domestic water suppplys circle one: •M�un- nicipal Well Other IF domestic water supply is a Well: Separation; Watersupply from Septic absorption feet PROPOSED SYSTEM : Septic Tank / n�•, gal, (minimum size: 1 ,000 gal.) TILE FIELD: Each Trench ::5c5 feet / Total system length �'� _ feet SEEPAGE PIT(S) v. Number of / Size each feet by feet Size of stone to be used. # aZ_,......._.. / Depth or Thickness ;2. feet IMPORTANT ...Please...LIST NEW EQUIPMENT XO BE INSTAIAXD * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * (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 $Z50.00. G. 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 react the regulations above and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage EKsposal Ordinance, r T Signature of responsible person: Date: Town of Queensbury Building and Code Department Bay at Haviland Road Queensbury, New York 1Z801 (518) 79Z-5832 SETTLED 1763 . . . HOME OF NATURAL BEAUTY . . A GOOD. PLACE TO LIVE (J - y r PO ff urn v Queensb "ry BUILDING and zONYNG DEPARTMENT Bay and Haviyand Road, Ft.D. i Box 98 C)ueensbury. New' York 12801 BUILDING INSPECTOR ' S PEPORT NAME 1s LOCAT I ON� ed, Date i � a �,�.�- Permt No . p * * * * * * * * * * * APPROVED - YES N Footing/pier Forms Foundation Waterproofing Backf i11 „Framing Roof ing % eliding Masonry Veneer Rough plumbing golTeli.ef Valves u,,xt . Porches 1.pornished Floors '~~- Trim �-ri+ter for "Fairs & Rai_lings Cellar Drain Tile concrete Floors Plbg . Fixtures Gdar . Fireproofing L000r closers _�- t..Slhoke Detectors t+Chimney Foundation Floors Walls ceiling L INSPECTIOL3_ � - 'FINAL ELECTRIC llR'iVEWAY APPROV SurveYr� {nal Building Next scheduled insP ection call when readY ( Remarks_ t 6 4 gUilding Inspector gown o� �ueenshurt� BUILDING and ZONING DEPARTMENT Bay and Haviland Road. A, D, 1 Sox 98 aueensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION LOCATION DATE *t/ 4wl--PERMIT NO.� - SAIL TYPE - _ Loam - ClayPercolationj5jj Required? YES G -Percolation rate - Min/Inch _ 7 TYPE of SYSTEM: Absorption field, total length. Length of each trench CCJJ Depth of trenched size of grauel SEEPAGE PITS#Number of) size- ft. X Gravel size PIPING : Site TY+P�e� to tank _ Bldg .Tank �- to dist . box ` _ Dist. box to field NA Partial openings sealed? YES LOCATION/SEPARATIONS : # ft. Foundation to tank L1.2rp-ft. Foundation to absorption + 'f t� Absorption to lot line ft, Separation of pits IACATI STEM CiN PROPERTY (circle one ) Front Rear t side - fight side - c SYSTEM usE APPROVETV 'YES NO Building Inspector 01/86 and vl 6000001 ' ' Qeseer23b " ry 131j1LDING and ZOhUNG DEPARTME 9$ Say and Haviland Ro yorkD. i B ox Queenstiyuy,r SLf I Lt] I NG 01 INS P ECT(3R ' S REPORT NAME LOCATION _ NO Permit N * * * * * * * * r,.' APPROVED - YES NO Footing/'Pier Forms Foundation wa to rprOo € in9 a 1cf ill araming ROO f in g Siding on ry veneer___ uc9m plumbing ,,lief Valves Ext . Porches Finished Floors --� lntericr Trim _----- Stairs a Railings cellar Drain Tile Concrete Floors Pl'bg • Fixtures ,Car . Fireproofing Door Closers smoke Detectors Chimney L .'rg Su I,AT 1 ON ; x4ioundation lonrs 6111 s f�qefiling I35PECTIO F1,,ni, kLECT'RICAL 1 llj.jal- Final Ru di g Survey IyexC sGl�ed insP uled ecCion (call when ready) Retnarks- 4 B lding lnspeGtor b/R� nxd-ul _„Town o� �uQens � ura� ENT BUILDING and ZONING DEPART 9$ Ray and Hawwiand Road, R.D. C]ueensburY. New York 12801 BUILDING INSPECTOR ' S REPORT NAME 0 LC] CAT I O , - - �r Permit Date APPROVED - YES NO Footing/Fier Forms Foundation % terproofing r zcxfill Framing Roof ing Siding Masonry Veneer Rough plumbing __------ Relief Valves Ext _ Porches Finished Flaora Interior Trim Stairs & Railings Cellar Drain Tile___ Concrete Floors_��� Plbg * Fixtures Gar . Fireproofing Door Closers Smoke Detectors Chimney INSUIIATION Foundation Floors Walls Ce 1 11Tfg .�— F IN AT, ELECTRICAL IIS SPECTI ON �- I)RIVEWAY APPR{lV Sy* - Fi [iz� l Buildingurve Next s�,heduled in$P ection (call when ready ) Remarks- B,xlding Inspector E,/86 and-vl Jvwrr of Qweenjl"ry BUILDING and Z<]NING DEPARTMENT Say and Haviland Road. Ft-D. 1 Sox 98 Queensburyr, New York 12601 BUILDING INSPECTOR ' S REPORT NAME LOCATION 4r� / Date Permit NO . O ! � ;L * * * * * APPROVED YES NO ootingfpier Forms oe Foundation Waterproofing Backfill Framing Roofing siding Masonry Veneer Rough Plumbing Relief Valves Ext , Porches Finished Floors Interior Trim Stairs & Railings -� Cellar Drain Tile Concrete Floor$ 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 DEPT. COPY OF APPLICATION FORM 46-EL, NEW YORK BOARD OF FIRE UNDERWRITERS. FILE THIS COPY WITH BUILDING DEPT, WHEN REQUIRED. / TEMP. « �� r' r. OUNT YZ TOWNSHIPL.,G 6y..1 � e� +.�' � STREET AND NO. oR ,, - } �, / I ,� � Y 'f ¢ �• ROAD AND POLE NO. C O S owcTS m SECTION r e BLOCK LOT Is E L T£D7 _ OCCUPANTS '_/ ,/� v j BUILDING / r• NAME f Gam,.' ,� ,•L.: OCCUPANCY +' OWNERS NAME _ ,.i C. > t TEL. # -i t' - AND ADDRESS EUWREWT -OF -ICE SUPPLIED � . ,J f / �. -+ � .,_. {" FROM THEIR BY "Ii��'I I-1 DEFECTS BUILDING T NEW,aai.,l,_ OLD © IYVSDRK NEW ADDITIONAL i_I REMOVED LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED No. of Fixtures m BRANCH OFFICE USE NUMBER OF OUTLETS LamP RewPac tlee MOTORS HEATERS CIRCUITS Lava- don H.P. WatYPa Each No. Ead1ts A.W"G, Ceiling Side Attec6't Swkch Pendant Bracket No, T No' QauSr .. INSPE ..�`' 'lOW Wall . aeeaP'Is Out-side Sub- base Baea- m..tt 1n FR. tad Fl. y,». Srd FR. REMARKS- LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: DO NOT LlSE THIS SPACE.. This applicalioP is intended to carer the abarerlisaed equipment to be inspected but it at time of iospeetion there is found additional equipment not abora listed, you are authorised to make the inspection ",ndimt the fete to cover the addit:cnd equiPm*m' as Provided by the appliannt. ELECTRIC SIGN d TOTAL Size OF FEEDERS LAMPS WATTS MAINS CHARACTER EONC TUBE SIGN AL ED OAS TRANSFORMERS OF VA OF WORK ... ^L-' iNUMBER! (CAPACITY) - WORK TO BE COMPL£.TEO SIZE OF SIGN STARTED SERVI6E OVERHEAD iJNDERGROUND MAKER ENTERS ` OF SIGN ILDIN ON OR AS NEAR�ESTEO MEW C� OLO POSSIBLE AVOID DELAY BY GIVING FULL ANp ACCURATE INFORMATION. ALL SPACES DATE OF MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. APPLICATION PRINT NAME AIVD A DRESS SIGNATURE ��- - '�STREET ADDRESS j:: '[,,,; ,.=t,C.- --'t'...- f'�/ h1" t�` {`i.�-- "'--�'— T N CITY DR ..��, 1C ENSE NO, zipPOST OFFICE e f CORE WHEN APPLICABLE — ,— '�+.�+ Jar --r_ ., aCZ •G. ae EL (REV. 1fe6) A SEPARATE APPLICATION MUST BE F� Y P G1RAGI I SEt� RATE BU {LDI NCs I � x c5rr 1 AJ�; j7 1 Y 4j � T 5 )ILI � �