1987-397 1 `
CERTIFICATE C►F OCCUPANCY
TOWN OF QUEENSSURY
WARREN COUNTY, NEW YORK '
SOY 3 S1
[ 1 L1ate November 3 , 1987
•This is to certify that work requested to be done as shown by Permit No. 8 7�39 7
has been completed. MiC Fc y�•,n i 1 `� l �
This structure may be occup" as a �- e Family Du-0in�;
1Q lrl { Mj;fA S
Location Lot # 18 Michae42 Drive
OwnerWilliam VanNostrand
By Order Town Board
'I`OArN OF QUEENSBURY
Building & Zoning Inspector
�BUILDING PERMIT '
TOWN OF QUEENSBURY 1-d`
No. 87-397 z
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Mr . & Mrs . William Van Nostrand i
V
1
OWNER of property located at Lot # 18 Michaels Drive Street, Road or Ave. cc
in the Town of Ousensbury, 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 _ OWNER'S Address is Lot # 18 Michaels Drive
Sherman Acres l"
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Queensbury , N . Y . 12801
2. CONTRACTOR or BUl LDE R S Name leg
R+
Tim Chase z
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3- CONTRACTOR or BUILDERS Address
N
P . O . Sox. 62
Glens Fails , N . Y . 12801
d. ARCHITECT'S Name
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5. A R CH ITECT"S Address Co
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B. TYPE of Construction — (Please indicate by X) F
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( )o Wood Frame { ) Masonry { I Steel ( I
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7. PLANS and Specifications
No_ 24 ' x 42 ' one family dwelling as per plot plan , specifications
and application ., including septic system
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8. Proposed Use �ry
One family dwelling w
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$5 . 00 C/O ty
$ MOO PERMIT FEE PAID — THIS PERMIT EXPIRES January 1 , 19 88 ro
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the H
town of Queensbury before the expiration date.) .
Uq
25th June 87
Dated at the Town of Queensbury thiisd�� DDaayy7 of 19
SIGNED BY // /� C:l r 9Ti for the Town of Queensbury
Building and Zoning Inspector ,
c-�■ TO BE COMPLETED BY BLDG . DEFT . TOWN OF" C..Au EEi d` D� 1 ' „
Applic
1 [2 @ E W
tion
.._./[iwn D/ Q"eenjl"ry PermitaIssuedo + 19
BUILDING and ZONING DEPARTMENT Permit Expires 19 � JUN l 0 1987
Bay and Haviland Road, R. D. 1 Box 98 Zoning Designation
Oueensbury, New York 12801 Variance No. BUILDING & CODE EPT.
I q Site Plan Review No . „{ - c-i- 70? �
I ea� �7 -- / K7 ApproVed b
fi
APPLICATION FOR
BUILDING AND ZONING PERMIT le e 1140( �
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTIONe 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 ,
---------..........................---1 � W12 ____- ---' ___--------
The owner of this property is : T Q S cJ lL' w L3wti. �Js] S�rrsr.�
P. O, ,Address Tel .
Property Location : 40t k R c 'Tax Map No .
Street number or building lot number 6 64 GG 'k
Subdivision name (if applicable)
THE PERSON RESPONaIEsLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS :
P. Q� , :✓x �� 6 j ems. L�4 [ I S Na I zF4,0 3 y
Name P. O. Address Tel . No .
Nami? nf. }5vsi 1r3iar -SMalwn� Address Tell
Name of Address Tel .
Name of mason c , , � 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 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 configurationC "` �
LOCATION OF STRUCTURES AFFECTED. * of septic disposal area . S°
K COMPLETE INFORMATION REQUIRED BELOW * cr �
Size of property ft X uA ft . Ito`
* Existing buildings) Size ft X ftw f�r4, k
PROPOSED BUILDING AND USE : " Existing building ( s ) Use
Size of new structure .2.�ft. X.9 ft
Foundation-pier/slab/crawl/partial ull * Proposed building , distance from property line
(circle one)
No . of stories (habitable space) * Front yard 5-C) ft Rear yard ft
Height {grade to ridge} ft .
* Side yards '� c ' f t and J ft
_
If residential, no . of families o " t * If an corner , setback from side street
No . of rooms (excluding baths ) OCCUPANCY INFORMATION
*
Noe of bedrooms � � PRIMARY BUILDING -
Now of bathrooms I One family dwelling
Primary heating system I tecks
Type of fuel Two family dwelling
Multiple dWolling / Number of units
N99 of fi.replac es to be installed .�.:. : * Permanent occupancy
Will a wood stove be installed? ry n
Central Air conditioning? Transient occupancy*
* Business
BUILDING STYLEp - PRIMARY STRUCTURE * Industrial
Ranch ? Contemporary Log cabin * Other v
wed ranch Mansion Duplex * If addition , what will use be .
Split level Old style Bungalow "
Cape Cosa Cottage Other * ACCE SORY BUILDING-
Colonial Row Town House * tached garage/one car/ two car/ car
CIRCLE ONE. PLEASE ) * Xe
ttached garage/one car/ two car/ car
rivate storage building
ESTIMATED MARKET VALUE OF * ther
CONSTRLIGTIOAT �-
- -1 - - - - - - - - - - - -
INFORMATION ON BUILDING SPECIFICATIONS , ON REVERSE SIDE Or THTQ fiFxFETx TO BE cOMPLETEDI
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 Dot T44
2 . Type of heat � ti"G L.
3 . Is the building mechanically cooled ? 0
4 . Percentage of area of windows and doors tb
A . Over 16 % Only
1 . U0 �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 exposed to ambient conditions_
2 . R value of exterior walls #y�---`�i
3 . R value of glazed area +
4 . R value of doors r S%
5 . R value of floors over unheated spaces, � �
6 . R value of slab edge insulation - unheated slab N �.
7 . R value of slab insulation - heated slab I\f ) J
aw R value of heated basement/ cellar walls ( above grade ) is
9 . R value of heated basement/ cellar walls ( below grade ) � k
14 . Type of insulation Q 0 cu..
C . Controls „
1 . The-rmostat maximum heat setting 90
D . Duct Systems //^^
1 . Is duct system installed in unheated spaces '? YES (DO
a . If YES , R value of duct installation �� JJ
b . R value of duct in other areas
E . Pi in Insulation
1 . Size of hot water or cooling carrying agent pipe
2 . R value of pipe insulation
F . Service Water Heating e
1 . Performance efficiency
2 . Temperature control setting maximum Igo
G . For Swimming Pool Only
1 . Maximum heating (i
Telephone Na . ) Q 3Liq
( applicant ' s signature )
�./'ocvn n� �upens6urr�
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Oueensbury, New York 12801
SEPTIC DISPOSAL PERMIT APPLICATION
Owner ' s Name_ r m?�; 2; Tel ,
Address
Person/Firm i.nstallino. system , rv�
Number of bedrooms ( residential only)
Total daily flow : ( compute @ 150 cal . per bedroom per day ) -
Topography(.
=f1at - rolling - steep - ( circle one ) Degree of slope �
Nature of sails : sand- oam-clay- other- Depth ft .
Ground water- - at what depth?
Bedrock or impervious material- -at what depth?
Pe c lation Test Not realuied r Reauired -Rate min/inch ,
s c at r u Municipal Well - Other
IMPORTANT !
On a separate piece of paper , submit a diagram of the proposed septic
system with all dimensions ; including distance from any structure ,
distance from property lines and distances from any domestic water
supply or shore - line of lake , stream , pondor wetlands . Include all
dimensions of the system itself .
Description of proposed system :
Septic tank size ( gal _
Tile field- Length of each trench ft . Total field ft .
Size of stone # .-1 .� -
Seepage Pit ( s ) Number /Y f Size_ ( ftX_ '' ftyy Size of stone#
V
Any contractor , corporation , individual , Etc . , engaged in the
construction of a Sanitary Sewage Disposal System , who covers the
same before inspection , doves 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 Town of Queensbury Sanitary
Sewage Ordinance .
r 1
S gnature of Ap ant Date
01f86 and /v1
4003361 THE NEW YORK BOARD ,OF, FIRE UNDERWRITERS f
E UReAU OF : ELECTRICITY
September 9 � :, 198741 STATE: STREET: ALBANY. NEW YORK 12207
Vats Application No. on file I 019165—$7 A 693412
THIS CERTIFIES THAT
pray the electrical equipmw#se me.described below and intradtse*d by She Agv7neant n4ur ed an the Isbar.a application number in the premises Of
Mr . . & Mr�^s�. William�Cvan NoSt(rrand , Michaels Drive , . Queensbury , NY
in the followiro,E location; I xl Basement 3.....! /at Fi. ] FI and Fl. . .. outj!A:Lde '.Section 12 1 Block +7 Lori 8
was examined on 8/ 14/87 and found to be In compliance with the requirements of this Board.
gxTL1RE FIXTURES RANGES : COOKING !LOCKS OVENS I DISH WASHERS EXHAUST FANS
ACLrx SwICHRs
OUTLETS T INCAW1t5CENr I FLlK7et5CtMr I AMI. K. W. wMT. K. W. µ4T- k-W, wMT, K- W. wMT- T N. P.
18 43 21 1 6 . 51 1 fr
I I
IIRYERS FURNACE #MOTORS FUTURE AMMIANCR M501IRS ISPSCIALRWPT TIME CLOCKS �( . LIMIT HEATERS MUkri-WITMT piMMERS
SYSTEMS
AMT. K. W. OIL H. P. 4AS 11. F. AMr. - NO. A. W. Cs. AMT. LAM.►. AMT. LAMPS. TRAML• #MMt, H_ r, pp_ of FEET AM7_ WwTt$
i 'hex 3 if 1
SERVICE DiS CT No_- Cw It V I " C E
wMr. AMP. 7Y1't M[TER _ I ,e '.1W f JF 7W 8 X 7MAr 7.i' 4W "0. Of CC, CAPIG. Iv. W. G. rq. Car` �Hrt-Lim w, w. G. ..o. of nIELrTRw�s w. w. c.
EQUIP. rert . cc»�ro. or NI•LtG os r+turtwL
1 200 cb
OTWR A "ATUS:
kk
#--smoke detector
electric heaters 3 '2 . 0 kW '.
. .4 1 . 5 : . , kw ..
2 1r . kw
kw
1-smoke detector : ?
. . I•' .
. .I
'L1R1 . CYlaS2 BRANCH MANAGER
PO Box 62
Glens Falls', NY 12801
This certificate must not kIa altered in any manner) return to the 'off ire of the 8aard if incorrect. Inspectors may be identified by chair credentials.
��1 ,lown 01 Qmeen3iury
.;(,�Q BLOLDING and ZONING DEPARTMENT
• ii" _, Bay and Haviland Road, R.D. 1 Box 98
ueensbury, New York 12801
"I. BUILDING INSPECTOR ' S REPORT
b� NAME •� L/e^i '/ �r
LOCATION 1/ r1ti2?00N7
Date �'� Perm /
✓ = APPROVED - YES NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext . Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Ti
Concrete Floor
Plbg , Fixture
Gar , Firepro ing
Door Closersjr I
Smoke Deter rs
Chimney NL
INSULA,TIO
Foundatio
Floors
walls
Ceiling
FINAL EL CTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building, Survey
Next scheduled inspection ( call when ready )
Remarks
Suildin Inspector
6/86 and-vi
Jown o Queen36ury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R. D, I Box 98
Queensbury, New York 12801
BUILDING INSPECTOrRO S REPORT
NAME
LOCATION
Date; /_permit tarn . v' 9
✓ = APPROv.ED - YES NO
Footing/Pier Forms
Foundation
waterproofing
Back£ill
Lo Irrar ing
Roofing
Siding Okh
Masonry Veneer
Rough Plumbing
Relief valves
Ext . Porches
Finished Floors
Interior Trim T
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg . Fixtures
Gar . Fireproo ng
Door Closers
Smoke Detect s
Chimney
INSULATION :
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready
Remarks-
____
Building Inspector � J
6/86 and-vl
BUILDING and ZONING DEPARTMENT
Bay and Havifand Road, R.D. 1 Sax 98
pueensbury, New York 12801
BUILDING INSPECTOR ' S REEPPOOr,R�T,
NAME /7' •�ri�40-000
0
LOCATION 0- �+ IZ
Date Permit Now OPP
✓ - APPROVED - YES / NO
Footing/Pier Forms
Foundation
waterproofing
Backfill
eraming
Roofing
Siding
Masonry 'Veneer
Wugh 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 I PECTIUN�
DRIVEWAY "PKuv
Final Building Survey.
Next scheduled lnspe+ction (call when ready
Remarks-0
r
Building Inspector
6/86 md-vl
J7 BUILDING and ZONING DEPARTMENT
} Bay and Haviland Road, R. D , 7 Box gg
1 Oueensbury. New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME
LOCATION !9 ,
DATE �/ PERMIT NO. � �/
SOIL TYPE A - Loam - Clay
Percolatiost Required?
Percolation rate - Min/Inch �^
TYPE of SYSTEM:
Absorption field , total length
Length of each trench S1r
Depth of trenches yi r —_`.`
Size of gravel'_ � ^
SEEPAGE PITS4N of)
Size- ft. X _ t .
Gravel size '
PIPING : S Tape
Bldg _ to tankI or
Tank to dirt. box
Exist_ box to field
Openings sealed? YES NO artial
LOCATION/SEPARATIONS :
Foundation to tank ft.
Foundation to absorpt n t ,
Absorption to lot li
Separation of pits ft ,
LOCATION STEM PROPERTY (circle one )
Front - Left side - Right side -
COMMENTS :
G� s
SYSTEM USE APPROVED YES
Building Inspector
01/86 and vi
._./acun o/ Qu ee n j i"P t
BUILDING and ZONING DEPARTMENT
Bay and Haviiand Road, R.D. 1 Box 98
+Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION
Date IrD / / < Permit No .
✓ APPROVE
PPRDV YES NO cil
Footing/Pier Forms
k Foundation
Xwaterproofing
A Backfill
Framing
Roofing
Siding `
Masonry Veneer .._._.43
Rough Plumbing _
Relief valves__
Ext . Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg . Fixtures
Gar . Fireproofi
Door Closers
Smoke Detectors
Chimney
INSULATION
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL' NSPECTION
DRIVEWAY APPR7%r
Final. Buildin Survey
Next scheduled inspection (call when ready
Remarks-
oc, tA.1 A-C�L 5 -�:JI4a✓ID �I k L-
Gl 77 A T r ca'r-l.0 fo �'va.� T`0 rz6-
tc1�'q� PNA Lr C4 r*"rt .rfl(o
13
Building In pector
6/86 and-vl
�� Jvwn oueQr� �6ur�
I I BUILDING and ZONING DEPARTMENT
Bay and Haaifand Road, R. D. 1 Box 98
Oueenshury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAMEer _ G''
LOCATION 4aT I 11 i h G' a / Is I Al {.
Date `/� 'Permit No . �� rL
✓ = APPROVED - YES NO
FootingJPier Farms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
East . Porches
Finished Floors
Interior Trim
Stairs & failings
Cellar Drain Tile
Concrete Floors
Pibg . Fixtures hL
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- Ai 40
Building Ilygpedtoy
6/86 and-vi
CONSTRUCTION
TIM CHASE
P. 0. BOX 62
GLENS FALLS, NY 12801
TELEPHONE (518) 793-4862
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