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87-406
4 CERTIFICATE OF OCCUPANCY TOWN Of QU'EENSBURY WARREN COUNTY, NEW YORK rtb 13 /\ Date February , 14 .�.`� 1y jam. 4LN O This is to certify that work requested to be done as shown by Permit No. -406 has been completed. This structure ma�be�� d a Location Nat-Ilan St . is 11yA L . +o rt Owner By Order Town Board irowN OF QUEENSDURY Building & Zoning inspector W �BUILDING PERMIT TOWN OF QUEENSBURY No. 87-406 � !Z , WARREN COUNTY, NEW YORK Ricky L . Moon PERMISSION is hereby granted to w OWNER of property located at Nathan St . Street, Road or Ave. ^' - j Alterations to "A"r Frame Dwelling and in the Town of Queensbury, To Construct or place a Sewage Alteration 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. OWNER'S Address is RR #2 Lucerne Rd . Lake George , N . Y . 12845 a� 0 ri 2. CONTRACTOR or BUi LDE R"5 Name v r Same 0 a 3. CONTRACTOR or BUILDER'S Address 4. ARCHITECT'S Name r* 5. ARCHITECT'S, Address � cis r�r B. TYPE of Construction — {Please indicate by X) l I Wood Frame ( ) Masonry I 1 Steel ( l 7_ PLANS and Specifications Alterations to "A" Frame dwelling , finish interior , and No install sieptle system per plot plan , specifications and r application . rr� t' S. Proposed Use r�r One family dwelling to l" R **Additional information in old permit file 85-372 *5 . 0 0 10 . 00 February 1 , 88 $ PERMIT FEE PAID — THIS PERMIT EXPIRES 19 w a rt ilf a longer period is required an application for an extension must be made to the Building and Zoning inspector of the a town of Gueansbury before the expiration date.) p Dated at the Town of Queensbury this 1st Day of July 19 87 SIGNED BY L 'gsaG� �~ for the Town of Queensbury w Bu lid 1ng and Zoning Inspector n TQ BE COMPLETED BY BLDG . DEPT . 17 / Application No . gown ©j Queien .3hury Permit Issued 19 BUILDING and ZONING DEPARTMENT Permit Expires 19 - rn I Bay and Haviland Road, R. D. 1 Box 98 Zoning Designation ;11 --,r'p Queensbury, New York 12801 Variance No . Site Plan Revi No . JUN 2 91987 � f�7 - 3 d 7 Approved by BUILDING & 0C7E L?E:pT APPLICATION FOR PUILDING 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 he done in accordance with the description , plans and specifications submitted , and such special conditions as may be indicated on the Permit . - - .............. ---- __ The owner ofthis_propertyis _ �1� i__ a k lrcr P. O. Address , , uaer n *e A +2 tic �t�� [ Tel , Property Location : P614_ 04 Lr.D'� 6 Z::2 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 Tel . No . Name of builder Address Tel . Name of plumber ItID,d7s Address OR G ,oyr Tel . AVIle tLs rFtrMC Name of mason e'c Ay"040" Address _. Tel NATURE OF PROPOSED WORK : _� ZONING INFORMATION : _Construction of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED , _Addition to a building * drawp 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) Jg eoj ► y'C 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 . ,F of septic disposal area . * COMPLETE INFORMATION REQUIRED BELOW . size of property � * ft X_ 1 - - ft . * Existing building ( s) Size..3o ft PROPOSED BUILDING AND USE : * Existing buildings ) Use r' .+1:'-s72 *" Size of new structure t X ft Foundation-pier/slab�ra7�Elpartial/full Proposed building , distance from property line (circle one ) �. Front yard �' +X 110' ft Rear yard ,�� i'. � / (i ft No * of stories (habitable space) * Side yards *v � tfP ft and 450 x Ir ft Height ( grade to ridge ) . J' ft . If on corner , setback from side street Aro ft If residential , no . of families I No . of rooms ( excluding baths ) * OCCUPANCY INFORMATION No , of bedrooms L PRIMARY BUILDING - No . of bathrooms Primary heating system V'L.cc. Esc b'a" * -- -Ore family dwelling Two family dwelling Type of fuel rc N * Multiple dwelling / Number of units o . of fireplaces to be installed Permanent occupancy Will a wood stove be installed * ? * Transient occupancy Central Air conditioning? Q 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 th /� ^" '� * ACCESSORY BUILDING- Colonial Row Town House Det '�ts ed garage/one car/ two car/ car ( CIRCLE ONE PLEASE ) * Attached garage/oxxGcar/ two car/--car * * * * * * * * * * * * * * * * * * Private storage building ESTIMATED MARKET VALUE OF * �Otlier NSTRUCTION INFORMATION ON BUILDING SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET , TO BE COMPLETED ? Form BPA 4/86 and-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 % 11 1 . Gross floor area, 0 5l ' 2 . Type of heat %25- K 220t.,CZK. E740� . 3 . Is the building mechanically cooled ? T 4 . Percentage of area of windows and doors A . over 16 % Only 1 . Uo value of gross area of walls , roof/ ceiling and floors exposed to ambient conditions - SIQ lc.e -- 2 . Floor over heated spaces (io NO a . Are foundation walls insulated ? YES 1, NO 1 _ If YES , what is the R value ? ,' - 3 . Slab on grade NO a . If YES , what is the R value of insulation around perimeter of flooav ? 4 . - Is basement heated ? YES �J — a . R value of insulation ,r !K % ✓1 s 5 . Type of insulation i�V-� 475 B . under 16 % only 1 , R value of roof and floors exposed to ambient conditio s .� '2 2 -- 2 . R value of exterior walls ic� Q S t S 3 . R value of glazed area Jl f� .e-. 17 .z �► ram ; � zCd:, + 4 . R value of doors igV;&- (et4cmdca i 5 . R value of doors over unheated spaces $ 4T'7 /72r1A4,/e5'2 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 ) 9 . R value of heated basement/cellar walls ( below grade ) 10 . Type of insulation co Controls 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 1 . Sire of heat water or cooling carrying agent ape r 20 R value of pipe insulation ,Lp ; ) 17 S [, let F . Service Water Heating �1 1 . Performance efficiency_ A) ,Pdl Q ,IQA y PT� .-iva'j 2 . Temperature control setting maximum G . For Swimming Pool Only 1 . Maximum heating II' Telephone No . p F j - - - ( appli a is signature ) 4` TOWN OF QUFFNSBURX BUILDING & ZONING DEPARTMENT SFW?AGF DISPOSAL PERMIT APPLICATION 1, Owner ' s Name 9; Cj4v L yL't 6d ✓1 Address Telephone No . (4?w2l { 2 . Property location s2on y cys CLA6Q4 ;-e 3 . Name of person or firm responsible for installina system. f lc /e /woam { c /5%0 '01 1! C/4� . Telephone No . bDp " G f Address `R'1 4� vs. e« .� .e 12G'icsaCi� S' z A 4 . Number of bedrooms ( residential buildings only) 5 . Daily flow SfX7? gallons/day 6 . Septic tank capacity_ c4 gallons 7 . Topography : fla rolling , steep of slope 80 Nature of soil and. depth 9 . If ground water , bedrock or impervious material is apparent at what depth does it begin? 4!21! "ze? ft . 10 . Percolation test : A is required B XC is not required C If required what is the rate minutes/ inch 11 . Water suppl municipal well , other 12 . Type of system proposed : drywel the field , other Any contractor , corporation , individual , etc . engaged in the construction of a sanitary sewage disposal system who covers the same before inspection , does not have an approved permit , or varies from the approved application will be subject to a penalty of $ 250 as provided for in Section 6 . 010 of the Queensbury Sanitary Sewage Ordinance . Date sign&ture of applicant On separate sheet of paper submit a diagram of the proposed septic system with all dimensions , including distance from any structure , distance from property line and domestic water supply , etc . Include all dimensions of the system itself . Form 3 - 82 I TO4^7N OF QUFFNSBUF2Y BUILDING & ZONING DEPARTMENT SEWAGE DISPOSAL PERMIT APPLICATION 1 . Owner ' s Name TC / 4 Z. i4l o0 *n Address L dr rr Apr 07 /'{J4 +44C2 , J r,) Fe ( : ig t)~Q Telephone No . 2 . Property location 'S,`.r p a/ 3 . Name of person or/ firm responsible for installing system f 1cle ow-fom 5. C��/S2 .41 �XCQy. Telephone No . Address p5 '^ 1, vx. e�- +-ee �' 1 95C .2512 Cr me 4 . Number of bedrooms ( residential buildings only ) 5 . Daily flow ?� gallons/day 6 . Septic tank capacity eoo gallons 76 Topography : fla rolling , steep of s lope 8 . *Mature of soil and depth �'-�; ,��j gyp � -4- 9 . If ground water , bedrock or impervious material is apparent at what depth does it begin? ,�+'/p,(,/957 "2a ft . 10 . Percolation test : A is required B }�� is not required C If required what is the rate minutes/ inch 110 water suppl 7muicipal well , other 12 . Type of system proposed : drywel file field , other Any contractor , corporation , individual , etc . engaged in the construction of a sanitary sewage disposal system who covers the same before inspection. , does not have an approved permit , or varies from the approved application will be subject to a penalty of $ 250 as provided for in Section 6 . 010 of the Queensbury Sanitary Sewage Ordinance . J Date C y signb,ture of applicant On ' separate sheet of paper submit a diagram of the proposed septic system with all dissensions , including distance from any structure , distance from property line and domestic water supply , etc . Include all dimensions of the s-.> stem itself . Form 3 - 82 a THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY FNLG 41 STATE STREET, ALBANY, NE.'W PORK 12207 Dote t'lPRIL 29 p 1988 Application .NV . an file 088.500185 85 A ..�`� _ 5 0 1 ! THIS CERTIFIES THAT i only the electrical equipment as described below and intreducad by the applicant named an the above application n1amber in the promises ctf RICK 3`SC, ON * NATHON STaEETTr I1U>rEENSl3URYs N- aT YORK in the following location, ❑ Basement OKlst ,Fl. ® Snd Fl. OUTSIDE Section Block Lot was examined on 2 / 17 /83 and found to be in compliance with the requiremsenta of this Board. FIXTURE RXTURRS RANGES COOKING DECKS OVENS I DISH WASHERS EXHAl15T FANS OUTLETS RECEPTACLES SWITCHES 0mCAP40eWAWj FLV0tMeW I AMT. K. W. AMT. K. W. AMT_ K.W_ AAAT- K. W. AMT. H. P. 17 11 n DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS ISPECIALREOPTI TIME CLOCKS I ERLL UNIT HEATER'L MU61-OUTM WALIILERS AMT. K. W_ OIL H. P. GAS H. P. Att. j4r-:Gj AMT, AMP. AMT. A+ars. TRANS. AMT. H. P. SYSTEMS NO- OF MIST1 wMr. wwrrs 1 DRYE # 1U SERVICE DISCONNECT NO. OF S E R V I E AMr. AMP. IY1pE Ehr UE11 1 X RTV 7 1F 9W S .e 9W a�' 4W NO' PER rCGHO. OF cc C&41), PIQ. OF HI• LE NO- OF P�EUtRAiS QF P44EEUTUAL 1 150 Cb 1 x i 2 /0 1 1 / J OTHER APPARATUS. ELECTRIC ROOM hZATE RS : z - 2 . 5 kw 1— 1 . 0 KW 3-- . 7 5 FC`w.t 1-- . 5 K-W RICK IiUUN VATHON STREET QUEEN'SBURY' s NEW YORK 1 G801 239 BRANCH A"NAGER This certificate must not 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, UILDING and ZONING DEPARTMENT ay and Haviland Road, R D. i Box 98 -+Quee�ns�bury, New York 12801 BL) IL ? ING INSPECTOR ' S REPORT NAME LOCATION � , 1 permi t No Date YES* NO yI* * APPROVED - / Footing/Pier Forrns� Foundation Waterproofing Backfill Framing Roof ing Siding Masonry Veneer Rough Plumbing Relief Valves Ext . Po ches Finished lours interior im - Stairs & lings Cellar Drain Tile Concrete 'Floe s Plbg . Fixtures Gar . Fireproofi Door Closers Smoke Detectors Chimney INSULATION Foundation Floors Walls Ceiling FINAL ELECTRIC L INSPECTION DRIVE'WAy APPR AL Final Buildin Surveyr�_ d insP ection (Ca 1 when ready ) Next schedul Remarks- 05 C � ti r Building Inspector €,/86 and-Vl f tJ Ownn/ Q"eenjlury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. I Sox 98 Queensbury. New York 12601 BUILDING INSPECTOR ' S REPORT NAME I t Q C2 C LOCATION Date 3 / permit NO . U APPROVED* --*YES* NO Footing/Pier Forms Foundation waterproo f;L Backf it l KFraming Roofing Siding masonry Veneer 'ARnugh 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 ELE TRICAL INSPECTION DRIVEWAY PPROV"1, Final Building Survey Next scheduled inspection {call when ready Remarks- Alm t A %D / CA7-40- it in nspec r 6/86 and-vl �Jnwn nj Queerij " ry BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Oueensbury. New York 12801 SEPTIC DISPOSAL SYSTEM .INSPECTION AM NE _ �.� _- AC9 LOCATION DATE PERMIT NO9 SOIL TYPE - Sand - Loam - Clay - Percolation 'Test Required? YES NO Percolation rate - Min/Inch - TYPE of SYSTEM: ��-.�. Absorption field , total lenc�b..-- Length of each t h✓� Depth o nches S ' of gravel SEEPAGE PITS{N er of) Size- - ft. X t. Gravel size _ PIPING : Si RType Bldg . to tank Tank to list . box Dist . box to field/ 4^- Openings sealed'? NO Partial LOCATION/SEPARATIO Foundation to tan Foundation to abs rption ft . Absorption to to lime ft . Separation of p s ft. LOCATION Y ON PROPER one) Front - ear Left side - fight side COMMENTS : IC90166,A--L ✓'J "�. l - bc$T 1� © K.. SYSTEM USE APPROVED YES NO Bui ding nspec or O1/i3Ex0md ul BUILDING DEPT. COPY OF APPLICATION FORM 464EL. NEW 'YORK BOARD OF; FIRE UNDERWRITERS. FILE THIS COPY WITH BUILDING DEPT, WHEN REQUIRED. TEMP. >I HATE CITY OR VILLAGE 1 + r,. ; '� }Al t �,- # TOWNSHIP COUNTY �y£y ; Iz J ' .. A STREET AND NO. OR !' ROAD AND POLE NO, N42fiaoie, BETWEEN WHAT POLE NO-+ y CROSS STREETS ISWO PREMISES LOCATED? ' Jote SECTION BLOCK LOT OCCUPANT`S BUILDING NAME OCCUPANCY � OWNER'S NAME � �. `y�.-�f� �r7 TEL. # ''AND ADDRESS —[--•;-- 01= + 0•^w CURRENT OFFICE SUPPLIED BY FROM THEIR SUILDING NEW OL- Airport WORK DEFECTS lS NEW ADDITIONAL © REMOVED LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED Ne. of Fixtures & BRANCH OFFICE USE NUMBER OF OUTLETS Lamp Rwwptacles MOTORS HEATERS CIRCUITS ONLY Loer H.P. Wets A.W.G. Side Attaad+'t Switd. Pandmt Breckat No. Type Eaab Na Each No. gaups INSPECTION Cepina Wall RecspTs Out- side Sub- bow Btwr mmt 1st FL 2nd FI. " 3M FI_ ELI] REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: DO NOT USE THIS SPACE. This application is intended to ewer she above-listed equipment to be impacted but if at time of inspection then is found additional equipment not above listed, you are authorized males the kupsctian and adjust the fee to cover the additional equipment, as. provided by the applicant. SIZE OF r' / ELEfts PC SIGN TOTAL MAINS /' �',� FEEDERS PS WATTS CHARACTER / EXPOSED GAS TUBE SIGN OF WORK •��.` %- �(. ! ! f' / CONCEALED TRA NSf O RM E RE VA ,WORK TO BE / {NUMBER) PACITYI STARTED .i ,/` / COMPLETED SIZE OF SIGN SERVICE O R E D UNDERGROUND MAKER ENTERS �"I OF SIGN ILDiNG INSPECTION N REOU STEO ♦ ■ �r ,r+ PO SI AS NEAR AS i!/rl-^"l /� {�. N£yy OLD POSSIBLE AVOID DELAY BY GIVI FLIP L AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. PRINT NAME D A ESS DATE OF 6PAPt (CANT r APPLICATION STREET ADDRESS Y aiI1 TELEPHONE # 2 �� - .. ZIP n LICENSE NO. POST OFFICE /"' -r ( �' CODE +� +� (%" WHEN APPLICABLE Qe EL (nsV. 1/85) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING `- i x 4 i 1 f i E � ~