1987-431 f�
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CERTIFICATE (DF OCCUPANCY
TOWN OF QUEENSBURY
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WARREN COUNTY, NEW YORK
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r DateOctober 16 , 19 S7 {
This is to certify that work requested to be done as shown by Permit No. 87-431 j
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has been completed.
This structure may be occupied as a
ONE-FAMILY DWELLING
k Lx0cation . -- LOT #3_0 WILLOW RD. (ST . NU . 41 )
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jOwner MAR.T2I MI MOSIIE=R.
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JBy Order Town Board
{ TOWN OF QUEENSBURY
Building H Zoning Inspector
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BUILDING PERMIT
TOWN OF QUEENSBURY No. 87-431
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Martin Mosher '
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OWNER of property located at lot #30 Willow Rd . ( St , No . 41 ) Street, Road or Ave. co
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in the Town of Queensbury, To Construct or place a One Family 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.
t. OWNERS Address is 26 Sugar Pane Rd . �
Queensbury , N . Y . 03
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2. CONTRACTOR or BUILDER'S Name n
Same
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3. CONTRACTOR or BUILDER'S Address y
4. ARCHITECT'S Name
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S. ARCHITECT'S Address
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6. TYPE of Construction — (Please indicate by X1 C �7
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K3 Wood Frame ( I Masonry ( ) Steel
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7_ PLANS arx11 Specifications •..c
No. 301 x 601 One-Family Dwelling , including two car attached garage
and septic system as per plot plan , application and specifications .
S. Proposed Use
One—Family Dwelling
$5e00 CIO ro
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s 171 . 00 PERMIT FEE PAID - THIS PERMIT EXPIRES February 1 , 19 88
(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 10th Day of July 19 87
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SIGNED BY � � / -!"--� -" far the Town of Queensbury aq
Building and Zoning Inspector
TO BE COMPLETED BY BLDG . DEPT .
// Application No .
(awn [)� ueere36uYt Permit Issued 19
BUILDING and ZONING DEPARTMENT Permit Expires 19
Bay and Haviland Road, R. Q. 1 Box 98 Zoning Designation
Queensbury, New York 12801 Variance No . JUL
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Site Pl iew No aiill�. JDI
Appro Sd Eby - BUILDING & C0DE DE'PT_
0 0 F "APPLICATION FOR 7 lam / rF
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 .
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The owner of this property is : '� �l, -- ----
P . O. Address � (Q c 77 Tel . 7 ,9..-'
Property Location : oS &_ C;6 4�4 ?.�' x_.,, y ,o�'d 7�L r , .. F g _Tax Map No .
Street number or building loot number �fjf, A&0
Subdivision name ( if applicable)
THE PERSON RESPONSIELE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS :
Name P . O . Addres Tel . No .
Name of builder _ t _ Address Tel .
Name of plumber ,C,.y„., 1 Address. Tel .
Name of mason �,jA::2a6 A Address Tel .
NATURE OF PROPOSED W RK : * ZONING INFORMATION
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
FOR DEMOLITION PERMIT , STATE SIZE AND * whether anterior or corner lot . Show location
LOCATION OF STRUCTURES AFFECTED . of water supply and location and configuration
* of septic disposal area .
COMPLETE INFORMATION REQUIRED BELOW .
Size of property /3 0 ft X /74:1P ft .
* Existing building ( s ) Size ft X ft .
*
PROPOSED BUILDING AND USE . * Existing building ( S ) Use
Size of new structure'�70 ft X 1' e ft
Foundation-pier/slab/crawl/partial full * Proposed building , distance from property line
( circle one )
* Front yard �� ft Rear yard ' S � ft
No . of stories (habitable space }
Height ( grade to ridge ) �Sl ft " * Side yards :tF5 ft and s _ ft
if residential , no. of .families * If on corner , setback. from side street � ft
No . of rooms ( excluding baths ) OCCUPANCY INFORMATION
No . of bedrooms
No . of bathrooms � ,r PRIMARY BUILDING -
* � One family dwelling
Primary heatin system f,�x * Two family dwelling
Type of fuel * Multiple dwelling / Number of units
No . of fireplaces to be installed f . . Permanent occupancy
will a wood stave be installed? `9r.r Transient occupancy
Central Air conditioning?
* Business
BUILDING STYLE, PRIMARY STRUCTURE * Industrial
Ranch 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-
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 * w
INFORMATION ON BUILDING SPECIFICATIONS . ON REVERSE SIDE OF THIS SHEET , TO BE COMPLETED !
Form BPA 4/86 md-vl
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
2 . Type of heat !�l f [s
rhr62 _�.
3 , Is the building mechanically cooled ?
4 . Percentage of area of windows and doors _
A • Over 16 % Only
1 , U value Of gross area of walls ,
exposed tMtgMblent conditions roof/ ceiling and floors
2 . Floor Over heated sp es YES
a . Are foundation wal insul ?
1 . If YES , what YES NO a value ?
3 . Slab on grade YES NO
a . if YES , what ' the R value insulation around
perimeter floor ?
4 . Is base t heated ? YES NO
a . alue of insulation
51 Type of insulation
H . Under 16 $ Onl
1 . R value of roof and floors exposed to �a-,mbient conditions
2 . R value of exterior walls_
3 , R value of glazed area
41 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
S , R value of heated basement/ cellar walls ( above grade )
90 R value Of heated basement/cellar walls ( below grade )
10 , Type of insulation
C . Controls
1 , Thermostat maximum heat setting 0 �
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
F =- -- - - Piping Insulation
1 . Size of hot water or cooling carryingagent
2 , R value of pipe insulation gnt pipe
F , Service Water Heat !
1 , Performance efficiency
2 . Temperature control setting maximum c
G . For Swimming Pool Only
1 . Maximum heating ^�
Telephone No , 79 1
( applicant ' s signature )
APPLICATION FOR SEPTIC DISPOSAL PERMIT
DATE + r t f_ Co +� 1�72 L_
AP
LOCATION OF PROPERTY FOR INSTALLATION s f &0
Owner's Name: /�� �, +x t ,- Telephone: 7 y° . - / ;Z SEO
Address:
Installer's Name: t�a� Telephone: ,r1-�,.....
Number of bedrooms (residential only) _`-Y _
Total daily flow (compute @ 150 gal per bedroom) Cv Q d
Topography: circle one: Fla Rolling Steep Slope of slope
Soil Nature: circle one: (SanJ Loam Clay Other / Depth: feet
Gvound Water_ At what depth? feet
Bedrock or Impervious Material: At what depth? i feet
Percolation test: circle one: not required required / rate min. inch.
Domestic water supply: circle one: 6Municipal ell Other
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption feet
PROPOSED SYSTEM : Septic Tank gal. (minimum size: 1 ,000 gal.)
TILE FIELD: Each Trench . feet / Total system length :� S d feet
SFEPAGE PIT(S): Number of / Size each feet by feet
Size of stone to be used # / Depth or Thickness feet
IMPORTANT
...Please...LIST NRW EQUIPMENT TO BE INSTAET
(over)
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Y/own of Queens6edry
13UYLL71NCa and ZONING DEPARTMENT
Bay and Hawiland Road, R.L], 1 Sox 98
Oueensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION
Date ff.) f _. Permit No . f;7-- ff4
APPROVED YES *Nq
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
L^Roof ing LO�„
Ldriding
Masonry Vene
Rough Plumbin
L4!Telief Valves L�
e.Ext . Porches
Finished Floors
Interior Trim
&S'tai rs & Railings
Cellar Drain Tile
Concrete Floors
i. plbg . Fixtures
fQar . Fireproofing
`"Door Closers
y,Emoke Detectors
Chimney
INSULATION
Foundation
40�moors
Walls
Ceiling
LECT CA
{,.8*'INAL EL INSPECTION
DRIVEWAY AP ROVAL�„_
Final Buil ing Survey __.-- -
Next schadu . ed inspection (call whe ready/)y
Remarks- 7V ,
Building Inspector
6/86 and-vl
C 1 awre o/ ueerr3 � ure�
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEMI INSPECTION
NAME
L.00AT I ON
DATE PERMITPERMIT NO . {{�
SOIL TYPE - an - Loam - Cl - -7
Percolation st Required? ES - NO
Percolation r to - Min/Inc -
TYPE of SYSTEM:
Absorption fiel total length
Length of each nch rC:l
Depth of trenches C
Size of gravel ---
SEEPAGE PITS#NWumber f)
Size- ft• X
Gravel size
PIPING : S e Type
Bldg * to tank f� --
Tank to dirt _ x rr r ytz
Dist. box to f eld/
Openings seal d? YES N Partial
LOCATION/SEP RATIONS :
Foundation o tank ft-
Foundation 0 absorption '"' C>ft - el
Absorption to lot line
Separatio of Pits ft.
. TION SYSTEM. ON PROPERTY (circle one)
Front - R - Left side - Right side --
CCH MIEN
SYSTEM USE APPROVED YES NO
Building Inspector
01/86 and vl
I�/jj �.I'own o� �eseere .sbur+r�
413UIILDING and ZONING DEPARTMENT
1 . tQ 1 Say and Haviland Road. R,D. 1 Sax 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
es_
NAME '�/J'/1 /�.1
LOCATION
permit No . / " 7 .
APPROVED* -*YES* NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
teotframi ng
Roofing
Siding
Masonry Veneer
ugh Plumbing
Relief Valves
Ext , Porches
Finished Floo
Interior 'trim
Stairs & Railin
Cellar Drain Ti.l
Concrete Floors
Plbg . Fixtures
Gar . Fireproofln
Door Closers
Smoke Detector
Chimney
IN SUTAATION :
Foundation
Floors
walls
Ceiling
FINAL EL TRICAL INSPECTION
DRIVEWAY APPROVAL . -
Final Building Survey
Next scheduled inspect on (call when ready )
Remarks- C
Building Inspector
6/86 and-vl
flown n of Q"een sfaurey
BUILDING and ZONING DEPARTMENT
Say and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION .3e)' r14elel
Date // Permit No . ��' T- '')
✓ — APPROVED NO
Foting/Pier Forms
Foundation � —
waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext , Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Til
Concrete Floors
Plbg . Fixtures
Gar . Fireproof ng
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-
.
G
Bull ng Inspector
6/86 and-vl
Jo urn of Queen3t urq
/10 /a( 'BUILDING and ZONING DEPARTMENT
f Bay and Haviland Road, R.D_ 1 Box 98
Queensbury. New York 12801
r
5VILDING
��INSPECTORrS REPORT
NAME
LOCATION
Date Permit Na .
*/ - APPROVED - YES N
' O
L- Ooting/'Fier 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
P1'bg . Fixtures
Gar . Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION :
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION^ _...,.
DRxyLWAY APPROVAL
Final 'Building Survey
Next scheduled inspect/ Cca 1 en ready
Remarks--
Building Inspector
6/86 and-vl
Jocurl cr/ ueeres �ure�
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R. D. 1 Box 98
oueensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME � �
LOCATION L� r :?'e;) WAY.,
Date,SII F', /- Pc rmit No . y6c
✓ = APPROVED - Y S NO
voting/Pier Forms
Foundation
waterproofing
Backfill
Framing
Roof ing
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 ELECTRI L INSPECTION _,,,
DRIVEWAY APPR At . __ -- _,
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-
8
Buil ing Inspector
6/86 and-vl
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