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1987-240 s . I +CER.T`ITrDATE UP C���UPAT`�T+�� TOWN OF QUEENSSURY i WARREN COUNTY, NEW YOR :fuZ 12 19 88 DateaAD n This is to certify that work requested to be done as shown by Peranit No. 1 + O has been completed- DVX � 1 � ��, Y\ 's oneIIIIIIIFamlly Dwe3 in This structure may be Occupied as a Lot 73 White Pine Road ( St . No . 13 ) The Pines Of Cjueeaisbvey ' XCI 1S l .I owner Fitz e kd By Order Town Board ,I T{7WhT OF QUEENSDURY I / Building H Zoning Inspasctor I s BUILDING PERMIT TOWN OF QUEENSBURY No. 87 zoo WARREN COUNTY, NEW YOR K Dennis F`ztzger'a " d PERMISSIf3N is hereby gr anted to owNER of property located at Lot ? 3 White Pine Road (St . No . 13) Street, Road or Ave- The Pines of Queensbury A one Famjly Dwellin in the Town of Queensbury, To Construct or places laps and other information hereto filed and at the above location in accordance to application together with plot p N approved and in compliance with the Town of O.ueensbury Building and Zoning Ordinance. CrQ co rs N 1 . OWNER"S Address is 18 Anderson Ave . r- North Tarrytown , New York c. 2. CONTRACTOR or SUi LDER'S Name French Nit - Ent * Inc r O tt 3. CONTRACTOR or SUILDEF Address RR #1 Lake George , New York Y• rs N 4. ARCHITECT"S Name ny W fD 7� O 5, ARCHITECT"S Address o. rn ,-r 6. TYPE. of Construction — (Please indicate by X) � 0 IX 1 Wood Frame I } Masonry I 1 steel w 7. PLANS and Specifications 3p x8l per plot plan , spe c and application submitte No. ' including sewage system and three-car attache garage . M +e 8_ Proposed Use .Ir One-Family Dwelling w0 r r ••C $5 - 00 C /O December l 288 . 00 19 87 C $ PERMIT FEE PAID - THIS PERMIT EXPIRES � f fif a longer period is required an sppiication for an extension musk be made to the 8uildin9 and Zoning inspector of the r town of Oueend'sury Deface the expiration date_) �r NIa3r 19 87 Dated at the Town of Queensbury this 12th Day of 7, + for the Town of Queensbury SIGNED SY Su;ding and Zoning Inspector TO BE COMPLETED BY BLDG . DEPT. O �] ® �" Application No . � _J©Wn QJfuE'¢njfskf"t� Permit Issued 1-9 BUILDING !1 L! l ] BUILDING and ZONING DEPARTMENT Permit Expires 19 Bay and Haviland Road, R. D. 1 Box 98 Zoning Designation MAY $ 19tir Queensbury, New York 12801 Variance No. 1 Site Plan Review No . BUILDIN 8c�/CODE DE�PT. Approved by : '/ { � pL (/G�,' �' .�26 APPLICATION FOR G f r 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 : ]QeA/Ale -s .,✓iti P . O. Address (rSj� fL�✓ ✓" e AV Ede AV rdk/AJ _ A�l Tel . 41Y 431 -�Z A� Property Location : &+eyy4nor I"Irye 11 &4WAI Apex Tax Map No . Street number or building lot number I, Or Subdivision name (if applicable) 7 L 0�&V S a, THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS : Name P . O. Address Tel . No . �i��A&.-, /�j ti SC g€ Tel . te"1�9+o Name of builder ,o �., � _ ,,�,-r' lA.C_ Address _ Name of plumber I . Address Telo Name of mason . r Address Tel . NATURE OF PROPOSED WORK : ZONING INFORMATION : V/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 , i (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 J ' ' 01� ft X / ,'"+i 7/7.ft . Existing building ( s) Size�_44 �ft X ft . PROPOSED BUILDING AND USE : * Existing buildings ) Use Size of new structure eft X� * . . foundation-pier/slab/crawl/partial fu Proposed building, distance from property line (circle one ) No . of stories (habitable space) ' , Front yard _ 9 ft Rear yard -2Z ft Height ( grade to ridge ) f t o W Side yards :q7 ft and '32ee ft If residential , no . of families If on corner , setback from side street ft Now of rooms ( excludi.ng baths ) OCCUPANCY INFORMATION No. of bedrooms Now of bathrooms * PRIIP+RY BUILDING - Primar heating system ! One family dwelling y g y -- _ — * Two family dwelling Type of fuel Multiple dwelling / Number of units No . of fireplaces to be installed 2oo permanent occupancy Will a wood stove be installed? roFO Central Air conditioning? . Transient occupancy -� n * Business BUILDING STYLE PRIMARY STRUCTURE Industrial Ranch Contemporary Log cabin * Other Raised ranch Mansion Duplex x If addition , what will use be? Split level Old style Bungalow C�Ca.Qo Cod Cottage Other ACCESSORY BUILDING- nia Row Town House Detached garage/one car/ two car/ car ( CIRCLE ONE PLEASE ) * �+ Attached garage/one car/ two car/� car * * * * * * * * * * * * * * * * * * Private storage building ESTIMATED MARKET VALUE OF Other CONSTRUCTION INFORMATION- ON BUILDING SPECIFICATIONS , ON .REVERSE SIDE OF THIS SHEET , TO BE COMPLETED ! Form EPA 4/86 and-vl BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATIONS : Type of construction , od frame fire safe , etc . Will any second-hand or ungra ed lumber be used? If so , for what ? Foundation wall material - sn,,. eai2< A&"4 _ 'Thickness / �► `r j � ` r Depth of foundation below grade (to bottom of footing ) Will there be a cellar? 5 Heated or unheated? UA1, Floor sq. footage 3$p,p sq ft Will there be a basement? cam_-Will any portion be used as living space ? AW ( If so, what porno ? sq . ft . - - Type of use? Type of roof sloped flat/shed/other Material of roof _ �1� r Size , wood stu s " X , "' spacing l(p "o . c . length ft . Joists ( floor beams ) lst . floor 7 - "X--- �" spacing "o . c . spanPft . Joists ( Boor beams) end . floor "X " spacing�(�"o . c . spank ft . Overlays (ceiling beams ) . 7 IrX _ rag " spacing--(,_"o . c . span_j.&:::fft . Roof rafters 7 spacing_"U .o . c . span_ 1'j!( ft . Roof trusses (pre-engineered) spacing 7-1?o . c . span„ =eft . Exterior wall firxish add- ,d,,Aw9, r Of what material? Interior wall finish If ae�garag oe is be attached , describe materials to be used for FIRE SEPARATION ; r-f It or Is there to be an opening between garage and dwelling? j If so will A Fire-rated door , enclosure , and self-closing device be provided? S Will a flue-lined chimney be installed? yeS Height a_Tye�r-0 y - £t . T Depth of chimney foundation below grade_. ft . Depth of fireplace >. from �_ft . in . Water supply Municipr private well SEPTIC SYSTEM _ DiS an ANY private well ( including adjoining properties ft . (A separate application is necessary for any repair or new installation of septic system) Town of A F F I D AV I T STATE OF NEW YORK ry Warren County off 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 er , owner S agent , arcna.te , contractar� 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 : 1 . Gross floor area 2 . Type of heat _ H 3 . Is the building mechanically cooled ? 4 . Percentage of area of windows and doors � �[ ► A . Over 16 % Only 1 . UQ 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 5 . Type of insulation B , Under 16 % Only 1 . R value of roof and floors ex osed to ambient conditions. 2 . R Value of exterior walls - r 3 , R value of glazed area '173 ow2 X - via 4 , R value of doors 5 . R value of floors over unheated spaces 60 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 Caf e �-^ C . Controls p 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 10 size of hot water or cooling carrying agent pipe 2 , R value of pipe insulation F , Service Water Heating C a 1 . Performance efficiency J fb 2 . Temperature control setting maximumtCja G , For Swimming Pool Only 1 . Maximum heating Telephone No . ` �"" "� ( applicant ' s signature ) * - ' a6wp APPLICATION FOR SEPTIC DISPOSAL PERMIT DATES IS LOCATION OF PROPERTY FOR INSTALLATION 6JVA1Cd Xv,sOr 1!, C Owner's Name: D15!,, j 6rZ46642LD 'Telephone: Address: se & Le" v 44 a / Installer's Name: /yam r, ,c/ _ a ",.#e Telephone: rr" Number of bedrooms (residential only) _ Total daily flow (compute @ 150 gal per bedroom) Topography: circle one: F at Rolling Steep Slope % of slope Soil Natuves circle one: San Loam Clay* Other / Depth: feet Ground. Water. At what depth? feet Bedrs ck or Impervious Material: At what depth? feet Percolation test_ circle one: not required required / rate min. inch. Domestic water suPPIp: circle one: unicipa Well Other IF domestic water supply is a Well: Separations Watersupply from Septic absorption feet PROPOSED SYSTEM: Septic Tank �{� gal. (minimum size. 1 ,000 gal.) TILE FIELD: Each Trench feet / Total system length feet SEEPAGE P1T(S) : Number of :— / Size each . 2 - feet by 'S. feet Size of stone to be used # _� / Depth or Thickness feet IMPORTANT ...Please...LIST NEW EQUIPMENT TO BE INSTALLED * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * (over) Section II Septic System Ins ections: A. All applications for septic system installation, alteration or repair, as required by the Town of Queensbury Sanitary Sewage Clydinance, shall be submitted to the Building Department at least 24 hours before start of construction and shall include a plot plan showing: I.) 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 So) 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 $Z5o.o0. 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 reg latioms above and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal. Ordinance. Signature of responsible person: Date: Town of Queensbury Building and Code Department Bay at Haviland Road Queensbury, New York 12801 (518) 792-583Z SETTLED 1763 . HOME OF NATURAL BEAUTY . . . A GOOD PLACE TO LIVE 40D17 ° THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY �Ul � $ I. W eTATE STREET, ALBANY, NEW YORK 12207 Date Y P �f Application :Yo. on file 0 1 1 3 2 0 / 8i 7 A 7 9. 1. q 7 4 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by t1I�ee applicant .�l on t obaoe number irk he of Dennis Flttzctera:ld corner of Pinion Pine & WWeite Pine t�e+nt'�ur�r r L�e�L in the following location 1 0 Basement ❑ -mat Ft. ❑ Znd FT. Section dock R Lot 7 3 was examined on andfocend to be in compliance with the requirements of the& Board. FLXTURS ACIRS SWITCHES FIXTURES RANGES 1COOKING DECKS I OVENS I DISH WASHERS EXHAUST FANS OUTLETS ECEPT I j1P4CAN[*SCtNT FLUORESCENT w AMY. K_ W_ ^MT. K. W. AMT. K.W. AMT. C W. AMT. . ►. 43 78 1 25 1 42 DRYERS FURNACE MOTORS RLTURE ^!NUANCE FQDIHA ISFECIAL RECOPY TIME CLOCKS ALL UmT TREATERS MULrt,DUTLET MMMM SYSTEMS AMT_ K_ W. OIL H. P. GAS H. P. AMT. NO. A. W. G. AMT. AMP. AMT. AMPS. TRANS. AMT. H. P. No. or FEET AMT. WATTS . fr 1 ring 0 101 1 g SERVICE DISCGNNECT No, OF S E It V I C E AMT. AMP. TYPE METlR I X 7W f W 9W $ X 3W 3 0 4W NO. OF CC. CCINb. A. W. G- NO. OF HI-LEG A. W. G. No. OF NHITRALS A. W. G- CC.FER AY G! CC. COND- OF HI-lEG GF 1 200 sb 1 OTHER APPARATUS. 3 . g f C i 2 -graokd detectdr John P . Matthews .. • �« ,L�� I"RY7 # 1 Lake George , 14Y �92 �4a 239 BRANCH MANAGER � . Per. ; This certificate must riot be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. gU1L[]tNG and ZONING DEPARTMENT Say and }iaviland Road* a York)- I ox 98 r oueensbury, BUILDING INSPECTOR ' S REPORT NAME AV L LOCATION7 'r permit No Bate -- - * APPROVED - YES NO Footing/pier Forms Foundation waterproofing Sack.fill Framing Roof inc3 ✓ siding Masonry Ve ee Rough Plua[►I in9 Relief Valves ------� Fxti porches Finished Floors' �- Interior Trim_�,�� �,- Stairs & Railings — Cellar Drain Tile Concrete Floors plpg . Fixtures Gar . Fireproofin Door Closers Smoke DetectO Chimney INSULA'TTON ° Foundation Floors walls Ceiling INSPECTION �- FINAL ELECTRICAL ��. DRIVEWAY AI'PROV SurveS' Final Building Next scheduled inspection call when Ready ) Remarks- o Buil Inspector 6/86 m,d-VI low Queenlibury gel � BUILDING and ZONING DEPARTMENT C Flay p Queensbu y, New YO'k 12801 98 U BUILDING INSPECTOR ' S REPORT NAME oy LOCATION " ii 11 Awl Date l�l Permit Idcr . � * * * * * * * * IN * * * * * * + APPROVED - YES NO Footing/Pier Forms �--�- Foundation Waterproofing Backfill Framing Roof ing siding Masonry Veneer jugh Plumbing Relief Valves Ext . Porches Finished Floors interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors plbg . Fixtures Gar . Fireproofs. Door Closers Smoke Detector Chimney INSUTATION Foundation Floors Walls Ceiling IpiSPECTIDN FINAL ELEC'TI. CAL -�-�- DRIVEWAY APPRo Vsuruey Final Building Next scheduled snap ect3cyn (call when ready) Remarks- IlIPI Building nspector 6/s6 and-vl , own o Queenjurc� BUILDING and ZONING DEPARTmF T Bay and Haviland Road, R.D. 98 oueensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME rI Z L o C A T I ON L-T' F 1Aj �� P � c 7 Pe]CmiL NowI * Late * * � * * * * * �* APPROVED - DS YES O Footing/Pier Forms Foundation W aterPrOO f ing Sacx€ill )(Framing Roofing Siding Masonry Veneer - 1 ARough P1umlain13 ---^— Ftelief Valves Ext - Porches Finished Floors Interior Trim Stairs & Railing Cellar Drain Ti e_^ Concrete Floor Plhg . Fixture Gar . FirePro ing ,,or Closers Smoke Detec ors Chimney INSULATION Foundatio Floors Walls Ceiling FINAL EL CT'RICAL INSPECTI�JN��_— .- - -� I7 A AppROVALL Finalinal Bu Y lding Survey call when ready? heduled inspeconC �. , jR e m k f/ " I{.e TIl3r4C8- D \ guilding Inspector 6/86 md--vl ' �� �Jow►ti o� �ueer� s6ure�f !Q BUILDING and ZONING 17EPARTMENT Owl $ray and Maviland Road, R. D. 1 Box 98 Clueensbury, New York 12601 BUILDING INSPECTOR ' S REPORT NAMEi? +�f.G LOCATION Date /,G' /[ �/ % 'errmitt No . _ dr APPROVED YES NO F,oting/Pier Forms Foundation Waterproofing Backfill co-taming Roofing Siding Masonry eneer Rough PI Bing_ Relief V a l es Ext . Porche Finished Flo rs interior Trim Stairs & Raili s Cellar Drain Til Concrete Floors plbg . Fixtures Gar . Fireproofin Dour Closers Smeake Detector chimney INSULATION : Foundation Floors Walls Ceiling FINAL ELECT ICAL INSPECTION DRIVEWAY APP OVAL Final Building Survey when ready) Next scheduled inspection (call Remarks- . �- F3uil i g Inspector 6/86 and-vl wn o� �ueens � urt� ! G and ZONING DEPARTMENT n a Haviland Road, R. D. 1 Box 98 6 eensbury, New York 12801 Bu (T�I C DISPOSAL (SYSTEM INSPECTION E LOCAT I ON G' DATE � PERMIT NO . LE 4Y SOIL "TYPE - Sand - Loam - Clay - Percolation Test Required? YES - Percolation rate - Min/Inch TYPE of SYSTEM : Absorption field , total leng Length of each trench Depth of trenc s Size of gravel: _ SEEPAGE PITS414 er of) _ Size- ft. X f Gravel size PIPING : Size Type Bldg to tank Tank to dist . box Dist_ box to fiel it Openings sealed? S NO Partial LOCATION/SEPARA ONS : Foundation to t k ft. Foundation to sorpti ft . Absorption to of line ft . Separation of its ft• LOCATION OF STEM ON PROP TY (circle one ) Front - Rear - Left side - ght side COMMENTS : lee SYSTEM USE APPROVED YES NO Buildings inspector 01/86 and vl _Jvwn c� �cceen36ure� BUILDING and ZONING DEPARTMENT / Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME �/ 4 iX LOCATION ,�'li►I/�l �'�`�p+/r' � C / •'�'C' 7' d71�q .�i Dated/}2 Permit No . - 2Yo Ouoting/Pier Forms APPROVED - E NO ndation 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 APPROVAL Filiail Building Survey Next scheduled Inspection (call wizen ready Remarks- - F3 ilding Inspector G/RG mc3-vl BUILDING DEPT. COPY OF APPLICATION FORM 41 NEW YORK BOARD OF FIRE UNDERWRITERS. F1LE THIS COPY WITH BUILDING DEFT. WHEN REQUIRED. TEMP- • TE . 4 it TOWNSHIP STREET AND NO. on �- � . , COUNTY fr,4. �,. ROAD AND POI No. d ! / tst:s eaCtN WHAT TWO L _ i �4 . POLE NO. CROSS STREETS IS PREMISE OCA7E0? SECTION OCCUPANT'S _ BL BUILDING OCK LOT NAME i. - y OCCUPANCY OYYhI£R"S NAME AND ADDRESS SUPPLIED BY /fo, FROM THEIR BUILDING ..r / FFICE IS NEW OLD ❑ WORK DEFECTS 1—I IS NEW ADDITIONAL Q REMOVED E3 LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED NUMBER OF OUTLETS fin, of Fixtures & BRANCH L� LAMP Rseaptaalrt MOTORS HEATERS CIRCUITS OFFICE USE tion Sloe III 1 0 ONLY �N^a Wait It Swjtd� As.sdrtt Brackas Na Type Each No. EWaefi No. A.W. INSPECTION Out- 1I Sub- bata Bar I ses It at Fl, 2nd Ft. 9rd Fl. REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE; DO NOT USE THIS SPACE. This application is intended to cower the above.listed rpuiprnent to be inspectad but it at tints of i V ou are authorized to make tad inspection anel adjust the too to corer the ,additional ' vide th are it found additiond equipmerrt net above lasted, SIZE OF aquipmrnt, as prowidrd by the applicant. MAINS FEEDERS ELECTRIC SIGN TOTAL LAMPS WATTS CHARACTER EXPOSED GAS TUBE SI GIe Of WORK CONCEALED TRANSFORMERS OF WORK TO BE VA STARTED COMPLETED IINSIZE NSERI SIGN (CAPACITY) SERVICE OVERHEAD UNOERGROUND ENTERS MAKER IL ING OF SIGN INSPECTION REQUESTED ON OR AS NEAR AS POSSIBLE NEW OLD AVOID BELAY BY GIVING FULL AND ACCURATE INFORMATION. A!L SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. DATE OF PRINT NAME AND ADDEIESS APPLICATION NAME OF ✓ APPLICANT ' - dA If SIGNATURE OF APPLICANT"" ---- STREET ADDRESS .L? I ,_� TELEP ONE _ CITY OR / LICENSE NO, POST OFFICE I_ '�} { .v 21P WHEN APPLICABLE CODE If�}'yy i 40 EL (REV. t/se) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING c -) > 4 < 1sa,oS' P��� PLA JV116' Z-LE- e-