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1987-358 • M 4 OF OCCUPANCY CERId ' `IF� , ENSBURY TowN ore QU WARREN C©UNTY , NEW '1C"C3►RK C3ctober 9 s 19 37 87 --358 requested to he done as shown by permit N o' ,-his is to terti'fy that work eq has been cornPle*ed. L]ne-Farm�. I7wel3. iu rMis stru//c``tt�urre\e tr+sy be oceuPied as a West iinunttlin Road £across from Stonecroft Lsevc>. lo sner:t b1:Ichae ] 33ucek per By C7rder Town Board TOWN OF QU1&ENSBURY Building & Zoning lnaPectnr ...,.. BUILDING PERMIT TOWN OF QUEENSBURY No. 87 -358 WARREN COUNTY, NEW YORK cr Michael Bucek 00 PERMISSION is hereby granted to w West Mountain Road (across from 5tonecro ireet, Road or Ave_ 1 OWNER of property located at Development) r lace a One—Family Dwellingfi in the Town of Queensbury' To Construct ar p Q, application together with plot plans and other information hereto filed an 0 at the above location in accordance to app Building and Zoning Ordinance. ;;6 approved and in compliance with the Town of Clueensbury r Butler Road t. OWNER'S Address is South Glens Falls , New York w n 2. CONTRACTOR or BUILDER'S Name ¢' Harvey ' s Speclalty Const . rD e n ro 3. CONTRACTOR or BUILDER'S Address RD #1 Box 1432 � Lake George , New York 4. ARCHITECT'S Name r n rn r4 rn a rr oho 0 5_ ARCHITECT'S Address H � rr} � 6. TYPE of Construction — (Please indicate by X) r t O {XI Wood Frame { I Masonry { 1 Steel { I n o M r? rn IIIM i PLANS and Specifications licatiori tv 53 ' x53 ' per plot plan , specifications and app No_ including sewage system and two-car attached garage . 8. Proposed Use Dwelling One-Family $5 . 00 C /O Jan . 1 1988- -- $ 122 . 00 PERMIT FEE PAID — THIS PERMIT 'EXPIRErs _ to the Building and Zoning inspector of the tension must be made {If a longer period is requ licatioexpiratn lorin an }x town of au,eensbunf before the June 19 87 Dated at the Town of O.ueensbury this 17 th Day of for the Town of Queensbury SIGNED SY guilding and Zonirp Inspector TO BE COMPLETED BY BLDG . DEFT . � Application No . _7oty" Of 'Qte.tg?n3j4er•I4 Permit Issued 19 TO1Nfvt OF �tLiEGP�3SBII� _ v BUILDING and ZONING DEPARTMENT Permit Expires Bay and Haviland Road, R. D. 1 Box 98 Zoning Designatio ,� G- ©ueensbury. New York 12801 Variance No .Site 151987 Site Plan Review No .�f��.� Approved by a BUILDING a CODE DEFT. q� IP a--fir' ��'7G �Lr�C /N % XN 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 descriptions plans and specifications submitted , and such special conditions as may be indicated on-the-Permit_---_{,__y---__--] -------........... ---------- y�' 'y 0. E }1 ,�✓ -i.. ��2. Inc The owner of this property is : 1 C� 'r • ' L } hi mel . 7 S- P . O. Address �'� � e<A I. _ S a ` ( i f �l Ir►1 e5 . +TM� hi + . f;'�t - cx cx a55 tro+n r� n eLx 6 Je a 4�1 Tax Map No . Property Location : Street number or building lot number Subdivision name (if applicable) THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS � �c. v . �lcxrvrE f + L7 I 18}� 1*-f3 + �cLlre Tel . Na . Name P . O. Address rar'3k\ (on3fiAddressr-> 3c+xly� LakeGcor- a Tel . '793 Name of builder rTar v+e S ��` wf 5� Qy 6fE el . Name of plumber e t Address�� o Irr.. �� pr ti, Address Name of mason t `a [ NATURE OF PROPOSED WORK : _ * TONING INFORMATION : `,s{ Construction of a new building A PLOT PLAN MUST BE PREPARED AND SUBMITTED , _Addition to a building drawn reasonably to scale and attached here-to , * showing clearly and distinctly all buildings . Alteration to a building and indicate all (no change to exterior dimensions ) whether existing Or proposed ert lines . Give * .set-back dimensions from property Other work (describe) 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 REQ IRED BELOW . S/ * Size of property,' ft _4��7 Existing buildings) ae "A f t X f t . * PROPOSED BUILDING AND USE : * Existing Dui. lding ( s ) Use / la AI-' t x13. eft " Size of new structure -I ,� distance from property line ier/slab/crawl/partial ull Proposed buildings boundation-p * ft (circle one ) * Front yard �iJ"r f E gear yard /� 7� ft and Y OR ft No . of stories (habitable space) * Side yards fSC? �}�5� ft Height ( grade to ridge) _. /` 5L £t ' If on corner , setbac3c from side street if residential , nov of families��__ * OCCUPANCY INFORMATION No , of rooms ( excluding baths ) No. of bedrooms �✓ * PRIMARY BUILDING - No0 of bathrooms _One family dwelling � Isr � �j�� ¢ba.c Primary heating system r� l Two family dwelling Type of fuel ef" rcc3�-; G r Multiple dwelling / Number of units No . of fireplaces to be inst led * _ Permanent occupancy Will a wood stove be installed?-+�' S * Transient occupancy Central Air conditioning? j 0 * Business BUILDING STYLE, PRIMARY STRUCTURE * Industrial Other La cabin Ranch Contemporary g * If addition , what will use be Raised ranch Mansion Duplex * Split level Old style Bungalow ACCESSORY BUILDING- Cape Cod Cottage Other car Town house Detached garage/one cart two cox/ Colonial Row * yr: Attached garage/one car/ two ca car ( CIRCLE ONE PLEASE ) NO Private storage building ESTIMATED MARKET VALUE OF * �6irher CONSTRUCTION r> C C7 2 6> ON REVERSE SIDE OF THIS SHEET , TO BE COMPLETED ! INFORMATION ON BUILDING SPECIFICATIONS , Form BPA 4/86 and-vl BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATIONS : Type of construction , wood frame , fire safe etc . tr 10 a Will any second-hand or ungraded lumber be used? if so , for what. ? . .......... _ Foundation wall material Depth Of foundation below reds Thickness �J (to bottom of footing ) r Will there be a cellar? &5 Heated or unheated? /-)g:,, Flaox sq. footage s ft Will there be a basement? till any portion be used as living space ? g ( If so, what portion? sg . ft . - Nc 'Type of roof - rrs-lo ed flat shedfother- Type ©f use? Size , wood studs--� Material of roof ct5 p Ak 6 „3[ ., spacing Joists ( floor beams) Ist . floor g r O . C . length d ft. Joists (floor beams ) 2nd . floor a to of -„ spacing �� "'o . c span J' ' ft . Overlays ( ceilin „ �,X '� spacing "o . G , span fto g beams ) W!• X spacing "o . c . span ft . Roof rafters ,e , s '�X _„ spacin re-en g © - c - span-/ ft , Roof trusses ( P gineered) spacing " Exterio O . ca span ft , Exterior wall finish pv oc Of what material ? r— Interior wall finish If a garage is to be attached , describe materials to be used for FIRE SEPARATION : a G!� Is there to be an opening between garage and dwelling?door , enclosure , and self-closing device be provided? If so will a Fi re-rated Will a flue-lined chimney be installed . �S Depth of chimney foundation below ✓ c) Height above roof ft . Depth of fireplace hearth grade ft . Water supply - Municipal or private well - SEPTIC SYSTEM _ Distance from ANY private well ( inc udxn+g adjoinin (A separate application is necessa g properties ft . ry for any repair or new installation of septic system) Town of Queensbury T r V►County of Warren A F F I D A I T STATE Or 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 atement of all proposed work to be done ' on the described premises and that a.11 prOvisio s of the BUILDING CODE , THE ZONING ORDINANCE , and all other laws pertaining tO the prop sed work shall be complied with, whether specified Or not , and that such work is authorize by the ot�fier . SWORN TO B RE THIS Signature _ p✓+n oc _ - da of Owner* Owner ' s agent , a -- tect, contractor - 19 Notary Public , Warre County, N . Y . It * * * * IF ,t It * * IF * * * * At * * * * * * * * * * * * * * * * It At * * * At SPECIAL CONDITIONS Or THE PERMIT : A4 4 T' AC W. . N L w cam, ! S 'S v B TOWN OF QOEENSBURY 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 . ] Gross floor area / �, c7C7 S, 2 . Type of heat 3 . is the building mechanically cooled ? 44 percentage of area of windows and doors a A , Over 16 % Onl and floors 1 . Uo value of gxass area of walls , roo £ /ceiling exposed to ambient conditions NO 2 . Floor over heated spaces YES NO a . Are foundation walls insulated ? YES 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 8 . Under 16 $ On1y fj _ a, n exposed to ambient conditions. 1 . R value of roof and 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 • NA 6 . R value of slab edge insulation - unheated slab 7V. R value of slab insulation - heated slab Mrs g , R value of he basement/cellar walls ( above grade ) ` JZ cD g . R value of heated basement/ cellar walls (below grade ) -� 10 . Type of insulation t'� 4e C . Controlsd o ximum heat setting 1 . Thermostat ma D . Duct Systems NO l , Is duct system ' installed in unheated spaces ?` YES s If YES , R value of duct installation b _ R value of duct in other areas E . Pinina Insulation cooling carrying agent pipe 3 , size of hot water or x . R value of pipe insulation F . Service Water Beta in �� — qrD 1 . Performance efficiency maximum o 2 . Temperature control setting G . For Swimming Pool Only+ 1 . Maximum heatsng Telephone No . _ 7 - ( �' ( applicant ' s signature ) � / APPLICATION FOR SEPTIC DISPOSAL PERMIT DATE p w rklo . , �� c eNVizw LOCATION OF PROPERTY FOR INSTALLATION VVeS- M1h Owner's Name: _ ■ r r ■ {+ c �-.w C t H e. Telephon+et Address: . rA l 2 r 15Fii I � T Installer's Name: �Q-"ier seer Va'c e Telephone: 72 Number of bedrooms (residential only) Total daily flow (compute @ 150 gal per bedroom) �T Topography: circle one. Flat Rolling Steep Slope 3I of slope Soil Nature: circle one: Sand Loam Clay Other / Depth: _ feet Ground Water: At what depth? *WimbS feet Bedrock or Impervious Material: At what depth? � /V feet Percolation test: circle one<norequired required / rateej -*� min. inch. Domestic water supply: circle one: <J9unici aD Well Other IF domestic water supply is a Well; Separation: Watersupply from Septic absorption _ /y l� feet r PROPOSED SYSTEM: Septic Tank / 00 gal. (minimum size: 1 ,000 gal.) TILE FIELD: Each Trench feet / Total system length feet SEEPAGE PIT(S) : Number of / Size each _I feet by feet Size of stone to be used # / Depth or Thickness C feet IMPORTANT ...P'lease___LIST NEW EQUIPMENT TO BE INSTALLED (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: l .) 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 13. 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. co 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 ail requirements of the Town of Queensbury Sanitary Sewage Disposal Clydinance. Signature of responsible person: � �,+.^ Date: _ Town of Queensbury Building and Code Department Bay at Haviland Road Queensbury, New York 12801 (518) 792-5832 SE 'fTLEO 1763 . HOME OF NATURAL BEAUTY . . . A GOOD. PLACE TO LIVE 4084264 THE NEW YORRK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY F- A.Y . 41 STATE STREET, ALBANY. NEW YORK 12207 Date October 20 . 1987 Application No. on fife 016553/87 A 697484 THIS CERTIFIES THAT only the electrical equiptr.ent sa described below and introduced by the applicant named on the above application number in the promises of Mr . Michael Bucek . West Mountain Road * quoensbury : Now York � in the following location: Ld Basement Loa let Fl. ❑ $Pad Fl. O'ilts:Lde Section 83 Block 1 Lot 1 a 4 & and found to be in compliance with the requirementa of this Board. 1 a rj was examined on 10/7/87 CC FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DOCKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT v AMT. K- W. MAT- X. W- AMT_ K.W. AMT. K. W. AMT. K. P, VF 21 39 16 21 3 � " DRYERS FURNACE MOTORS FifTLIRE APRIANCE FEEDERS SPECIAL RRC'PT TIME C1 KS van 1tNIT FtE.ATERS MULTI-OWLET DIMMERS STSTEMS CNl H. P. GASAMP_ NO. A. W. G- AMT. AMP. AMT, AMPS. TRANS. AMT. M. P. No. of FRET AMT. WAr17L 1 Range #6 SERVICE 11)01 NHEC7 _ of 1 S E R v 1 C E AMT, AMP'. TYPE 1 .e 7W t X tW t 0 3W t l' 4W NO, OF CC. roNt" No. OP NbLEG A. I- G. NO. OP tou"Jua. A. W.G. EdY1P. PER A CPF CC_ COPPD. OF HI-LEG OP NEu►RAJL 1 200 cb 1 4/0 2/0 OTHER APPARATUS: .� Electric F,alom Heaters - 3 - 2 . 5 KW 2 - 2 . 0 Kid 4 - 1 . 75 KW 2 - . 75 KW 3 1 - Smoke Detector WIN is David M. Havvey � r-�• �- y _ Harvey' s Specialty Construction � BRANCH MANAGER l/ _ RD 1 Box 1432 i.ake George . New York 12845 p� This certificate must not be altered in ony manner, return to the office of the Boord if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. Qy{Pp ►13 �Ltfl� )12 BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 �y Queensbury, New York 12601 + � BUILDING INSPECTOR ' S REPORT (,yf NAME &4e G[ LOCATION j Date ,/e /� Permit No . * * * x * * * * * ✓* * APPROVED* -* YES* NO Footing/Pier Forms Foundation Waterproofing Sackfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext . Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Til Concrete Floors p1bg . Fixtures Gar . Fireproo rig Door Closers Smoke Detect rs Chimney INSULATION Fcaundat ion Floors Walls Ceiling FINAL ELECTRICAL INSPECTION f] IVFWAy APPROVAL finaI Building. Survey Next scheduled inspection (call when ready ) Remarks- C r/ iAq Fuilding Inspector 6/86 and-vl _ lover+ ofj7q ar iseens urn BUILDING and ZONING DEPARTMENT Sp Say and Haviland Road, R. D. 1 Box 98 qd Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME LOCATION / / - Date / G Permit NO * . APPROVED - YES NO Footing/Pier Forms Foundation Waterproofing Backfill ✓^'naming Roofing Siding Masonry Veneer ugh Plumbin Relief Valves Ext . Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg . Fixtures Gar . Fireproofing Door Closers Smoke Detectors Chimney IN SUI,ATION : Fc3un da t ion Floors Walls Ceiling FINAL 1 LCR IE 1 AL IN ECTION�� I)RIVF.WAY AF f'R VAL Final 'Building Survey Next scheduled inspection ( call when ready ) Re Ina r ks Buil ing Inspector G/B6 and-vl 6d 14v _Jown o Queens ury 01 BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Oueensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME — f e .!-' ►' � LOCATION.. DATE , ,R PERMIT NO. F7 - r SOIL TYPE - Sand - Loamt - Clay - Percolation Test Required? YES - NO Percolation rate - Min/Inch - TYPE of SYSTEM: Absorption field , total length Length of eac trench Depth of trenc es Size of gravel SEEPAGE PITS#N er f) Size- ft. X ft. ¢ - Gravel size PIPING : S e� Bldgo to tank Y Tank to diet . box Dist_ box to field/ . Openings sealed? O Partial LOCATION/SEPARAT Foundation to t k fto Foundation to sorption Absorption to of line �� to Separationo pits t- LOCATI STEM ON PROP TY (circle one) Front - e Left side - ght side - COMMENT SYSTEM USE APPROVE YES N Bu l g nspector 01/86 and vl own of Queen.sl "r+yF BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDINq INSP TORS REPORT NAME LOCATION . Date �'�/ Permit No . F " ooe * APPROVED YES NO Footing/Pier Forms Foundation waterproofing gackfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief valves Ex.t . Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors P1bg . Fixtures Gar . Fireproofing Door closers Smoke Detectors r1ni,mrLey AF00YS iL suATI:ON : undation M1 4 walls Ceiling FINAL ELECTRICAL IIISPECTION�_ DRIVEWAY AppROVAi._ Final Building Survey Next scheduled inspectlon (call when ready Remarks- i nspector 6/66 and-vl .....,!noun o/ Q"eenshorrty BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. i Box 88 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME LOCATION Date/ Permit No . S'I� ' ✓ � APPROVE[] - YES NO Foot±ngy"Pler Forms Foundation Waterproofing Backfitl $,�eam_ing Roofing Siding Masonry Veneer 6,41ough Plumbing Relief valves Ext . Porches Finished Floors Interior Trim Stairs & Railing 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- Building Inspector 6/86 and-vl 011i, BUILDING and ZOrVIttirC, DEPARTMENT S Bay and Havikand Road. R. D. 1 Box 98 v ' Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME �v'�• a' �►t� �'� •'� */ - LOCATION Date-=��� -f � Permit No . t2 APPROVED - YES NO Footing/Pier Forms tref pundation waterproofing "ackfill Framing Roofing Siding Masonry Veneer Rough Plumbin Relief *calves Ext . Porches Finisher] Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg , Fixtures Gar . Fireproofin Door Closers Smoke Detecto Chimney INSULATION )( Foundatio l� d a Floors walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAl[ "PROVAL�, Final Building Survey Next scheduled inspection {call when ready Remarks- / D iiding I spAcor 6/86 and-vl cit. firwin a/ �BUILD�NG and ZONING DEPARTMENT I Bay and Haviland Road, R. D. 1 Box 98 Clueensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME p Y Opt Q 000� = APPROVED - NO mooting/Pier Forms Foundation Waterproofing Sackfiill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext . Porches Finished Floors Ar Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg . Fixtures Gar . Fireproofing Door Closers Ar Smoke Detectors Chimney kL INSULATION : Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building survey Next scheduled inspection ( call when ready) Remarks- Building rnspector 6/86 and-vI f Y) ok 1� r- L190 o 43Y To p TI c 5E T L C^ lift I cl* /75 Tpok