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1987-504 I I � y r f, CERTIFICATE C]F «CCUPAN CY" TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK 2. 2> '69 Date November 23 , 14 87 87 -504 This is to certify that work requested to be done as shown by Permit No. has been completed. m onks Family i)werig This structure may be a uT iwn M s Der i l Atcatitst► i,© t l l Hi den Hills Owner By Schermeerhurn ' I - By Order Town Board TOWN OF QUEENSBURY Building & Zoning Inspector 1 i f r BUILDING PERMIT TOWN OF QUEENSBURY � No. 87-504 z 0 WARREN COUNTY, NEW PORK w PERMISSION is hereby granted to Rich Schermerhorn 1 OWNER of property located at Lot 11 Hidden Hills Dr . Street, Road or Ave_ 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 wfth the Town of Queensbury Building and Zoning Ordinance. r� 1 . OWNER'S Address is 1 Windsor Ct . tr] Gansevoort , N . Y . 12831 m rn 2. CONTRACTOR or BUILDER 3 Name Fi rr Same C' H F4A0RCHMCT*S NTRACTOR or BUILDEWS Address Same r O h 'Name r x r- a. CIA (D 5_ ARCHITECT'S Address 0 W N N 111 6. TYPE of Construction — (Please indicate by X) t7 *i h+- I gl Wood Frame ( ) Masonry { 1 Steal ( ) ro 7. PLANS aril Specifications No. 68 ' x 241 per plot plan , specifications and application , including septic syste;_z and attached two car era e . o B. Proposed Use PLANS IN DRAWER pne—Family Dwelling �c $5 . 00 C /o March 1 , 19 138 M $ 136 ` C10 PERMIT FEE PAID - THIS PERMIT EXPIRES fO {If a longer period is required an application for an extension must be made to the Building and Zoning inspector of t he � town of Queensbury before the expiration date.) 00 Dated at the Town of Queensbury this 6th Day of August 1987 for the Town of Queensbury SIGNED BY ` Building and Zoning 1 nspa+otor TO BE COMPLETED BY BLDG . DEFT . // Application No . a7 p \Ij , oiv t ril ueelt Lsu[rldf Permit Issued 19 JUL Fr C� BUILDING and ZONING DEPARTMENT Permit Expires 19 Bay and Haviland Road, R. D. 1 Sox 9$ Zoning Designation UI1poll v & GpDE PE�'T> Queensbury, New York i28{}1 Variance No . -�- ) lb. � Site P Review o . r� 4,V - Ap V ` y 3 APPLICATION FOR Jul` 4ililit 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 e description , plans and specifications submitted, and such be done in accordance with th special conditions as may be indicated on the Permit . TT ____ The owner of this property is : s _.S:JL_iC eor + . }' - / ? S3 Tel . ? 9S - csG75,' P . O . Address / +'17 0 ` f r�` : / S f, Tax Map No �/fy Property Location : Gof If "—�_ Street n er cr building lot number Subdivision name ( if applicable) di dGld- V /f S THE PERSON RESPONSIBLE4 FOR SUPERVISION OF WORK AS REGARDS BUILDING CODE S IS : Name P . O. Address Tel . No . Address , ' n c�s o r _.�Y 'f • Tel . 7F Name of builder , . e c" g Tel . � $� $ 8G �cs Name of plumbers v c� . , Address /' ' ��Addressu�__n�� ,�[ rv ✓ Tel . ' Ste* O Name of masonr�� r_ � I�Sr ! �� �- NATURE OF PROPOSED WORK : ZONING INFORMATION : iistruction of a new building A PLOT FLAN MUST Be PREPARED AND SUBMITTED , iiiii _Addition to a building drawn reasonably to scale and attached heretor Alteration to a building showing clearly and distinctly all buildings , (no change to exterior dimensions) whether existing or proposed and indicate all set-back dimensions from property lines . Give Other work (describe) --- street and number or lot number and indicate whether interior or corner lot . Show location FOR DEMOLITION PERMIT , STATE SIZE AND x of water supply and location and configuration LOCATION OF STRUCTURES AFFECTED _ * of septic disposal area . COMPLETE INFORMATION REQUIRED BELOW . Size of property JO / ft X / 5S 2 ft . Existing building ( s ) Size X ft . PROPOSED BUILDING AND USE : Existing buildings ) Use Size of new structure 65 ft x�ft " Foundation-pier/ slab/crawl/partial/full Proposed building , distance from properLy_. 7ift � ,J.,F._". f t (circle one) Front yard 3 5 ft Rear yard No . of stories (habitable space) .2 Side yards ft and Height ( grade to ridge ) '7 side street ft ft - * If on corner , setback from if residential , no . of families * OCCUPANCY INFORMATION No . of rooms ( excluding baths ) No. of bedrooms 3 PRIMARY BUILDING - No . of bathrooms * 'One family dwelling Primary heating system L&X. ; c- * Two family dwelling Type of fuel ) r � ^ kc - * Multiple dwelling / Number of units No . of fireplaces to be installed / Permanent occupancy Will a wood stove be installed?_ NCr Transient occupancy Central Air conditioning?J „A10 Business Industrial BUILDING STYLE, PRIMARY STRUCTURE � Other Ranch Contemporary Log cabin � If addition : what will use Ise? Raised ranch Mansion Duplex " Split level Old style Bungalow * ACCESSORY BUILDING- Ca e Cod Cottage Other car Town House �' Detached garage/one carj tw Colonial Row wo car oar ( CIRCLE ONE PLEASE ) * Attached garage/one ca Pr "VatE: Storage bu.ildin ESTIMATED MARKET VALUE OF ''F' Other CONSTRUCTION BE COMPLETED ! INFORMATION ON BUILDING SPECIFICATIONSr ON REVERSE SIDE OF THIS SHEETr TO Form BPA 4/86 and-vl BUILDING, PERMIT APPLICATION CONTINUED BUILDING SPECIFICATIONS ; r Type of construction , wood frame , fire safe , etc . 4!! Q/ E ���� f will any second-hand or ungraded lumber be used? If so , for what ? Foundation wall material /Y7q Thickness d! eo Depth of foundation below grade (to bottom yr of footing ) 1+ Will there be a cellar? Ye.5 Heated or unheated . Floor sq . footage I000 s ft Will there be a basement? _Will any portion be used as living space ? q ( If so , what Portion? sq . ft , _ - Type of use? '� . Type of roof - sloped flat/shed/other Material of roof Size , wood studs "'x "' spaoing.. /6_"'o . c . length 9' ft , Joists ( floor beams. ) 1st . floor ;2 /p '" spacing / � '*o , c . span 12 ft . Joists ( floor beams ) 2nd . floor ._ _.._"'X /GO '" spacing c . span_ -ft . Overlays (ceiling beams ) "'x spacing "o . c . span ft . Roof rafters "'X spacing o . c , span ft . Roof trusses (pre-engineered) spacing 2 —'"o . c . span - _ft . Exterior wail finish ��� � y (tor, f � Of what material? Interior wall finisho,jl1� C 5�te r� If a garage is to be attaiched , describef materials -t be used for FIRE SEPARATION : ---� d LV f' '�.IQ 'SL r d" e" a Y"1 C1 �. f '�" 73`!.•.�._ f �' C�'�O'7 f+�'-i n a�L. "'� f7 (r L' r Is Cf there to be an opening between garage and dwelling?—,Le-f_ If so will a Fire-rated door , enclosure , and self-closing device ttb,��e provided? _ ,�leS Will a flue-lined chimney be installed? r&,, Height above roof ft , Depth of chimney foundation below grade 7 " ft . Depth of fireplace hearth .2 ftd in , Water supPlY - Municipal or private well u ,0t SEPTIC SYSTEM _ Distance from ANY private well ( includi g adjoining properties �p ft . (A separate application is necessary for any Ar�epTair or new installation of septic system) Town of f Warren R F F D A Y 1 T STATE OF NEW YORK County of 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 allprovisions 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 - �c;-,�+ .�� ___- � wner , owner ' s agent , arcnztectocontractor day of ,�C.__} f y' 19� C7 , 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 SQ 2 . Type of heat 3 , Is the building mechanically cooled ? a 0 4 . Percentage of area of windows and doors A . Over 16 % Only 1 , U value of gross area of walls , roof / ceiling and floors exposed to ambient conditions 2 _ Floor over heated spaces ( YESN 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 [7 B , Under 16 % Only 1 . R value of roof and floors exposed to ambient conditions. 'lF _ 040 f 2 , R value of exterior walls 5 3 , R value of glazed area , 4 , R value of doors A /r3 5 , R value of floors over unheated spaces /ss 6 , R value of slab edge insulation - unheated slab A 7 , R value of slab insulation - heated slab AV g , R value of heated basement/ cellar walls ( above! grade ) 9 , R value of heated basement / cellar walls ( below grade ) e ' /o 10 , Type of insulation r;j6e.. f Ulas� Co 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 ba R value of duct in other areas E , Piping Insulation !/ 1 . Size of hot water or cooling carrying agent pipe_ c1—� 2 . R value of pipe insulation F , service Water Heating n 1 . Performance efficiency_ lF 0 2 . Temperature control setting maximum /E/ G , For Swimming POOL Only j Maximum heating }� Telephone N o . �/4 c3 � ' /-" --�I ( applicant ' s signature ) APPLICATION FOR SEPTIC DISPOSAL PERMIT DATE F }7 LOCATION OF PROPERTY FOR INSTALLATION Owner's blame: / # CA 5;7 �C-YV) a ,I sr 0 CA/ ��T-selephone; _ % � �f ^ Af:)6 --7V Address: _ / tt'l i in r,/ S' o A', i -�ci tl 5 tf V o o r /V - /1-0�. - A2 8" � I� Installer's Name: CJl C i S { cry, ,r1 �� r Telephone: Number of bedrooms (residential only) Total daily flaw (compute @ 150 gal per bedroom) Topography: circle one: Flat Rolling Steep Slope %" of slope Soil Nature: circle one: Sand Loam Clay Other / Depth: feet Ground Water: At what depth? © feet Bedrock or Impervious Material: At what depth? _ feet Percolation test: circle one: not required required / rate min. inch. Domestic water supply: circle one: Municipal Well Other _ IF domestic water supply is a Well: Separation: Watersupply* from Septic absorption feet PROPOSED SYSTEM: Septic Tank _/64 Q _ ,gal. (minimum size: 1 ,000 gal.) TILE FIELD: Each Trench feet / Total system length feet SEEPAGE PIT(S) : Number of / Size each feet by feet Size of stone to be used # / Depth or Thickness feet IMPORTANT ...Please...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: 1 .) 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 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 $Z50.00. 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. 1 have read the regulations above and agree to abide by these and an 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) 792-5832 SETTLED 1763 HOME OF NATURAL BEAUTY . . . A GOOD PLACE TO LIVE I �Jnwn O/ Qu ee" .f t) " ry BUILDING and ZONING DEPARTMENT Bay and Haviland Road. R. D. 1 Box 98 Queensbury, New York 12801 SEPTIC ISPOSALL YSTI INSPECTION NAME , / +� woe LOCATION ff r,� / DATE I r f PERMIT NO. ?1L SOIL. TYPE - nd - Loam - Clay - Percolation T t Required? YES NO Percolation ra - Min/Inch TYPE of SYSTEM : r7�Gf Absorption field , total a th Length of each tre h Depth of trenches Size of gravel_ SEEPAGE PITS4Number o ) Size- ft. X f Gravel size PIPING : iz pe Bldgw to tank ec— Tank to dist _ ox Dist_ box to field/pit openings sea ed? YES NO artial LOCATIbN/SE ARATIONS : l Foundation o tank ft. Foundation o absorption t . Absorption to lot line %kt . Separation of pits ft . LOCATION YSTEM ON PROPERTY (circle cane) Front - r Left side - Right side - COMMENT SYSTEM USE APPROVED / YES No BuiIdi p or 01/86 and vl y ILDING and ZONING DEPARTMENT y and Haviland Road, R.D. 1 Box 96 Queensbury, New York 12801 BUILDING INSPECTORTS IREPORT LOCATION Date Permit No . / G ✓ - APPROVED - YES NO Footing/Pier Forms Foundation Waterproofing Backfi.11 Framing Roofing Siding L� Masonry Veneer Rough Plumbing Relief Valves Ext . Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg . Fixtures Gar . Fireproofi g Door Closers Smoke Detecto s Chimney INSUEATI ON Foundation Floors walls Ceiling FINAL ELqCTRICAL INSPECTION Ain. al VEWAY PPROVAL Bui ng survey Next - scheduled inspection (call when ready ) Remarks- _Fr ki Building Inspector 136 and-vl �lnwn o p ueenshur BUILDING and ZONING DEPARTMENT , r Bay and Haviland Road, R.D. 1 Box 98 Oueensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME LOCATION DATE /! / eoe/ PERMIT NO. sd SOIL TYPE - Sand - Loam - Clay -r Percolation Test Required > YE NO Percolation rate - Min/Inch TYPE of SYSTEM: Abs ption field , total. 1 n�g�h Lengt of each trench Depth o renches size of rtavel_ SEEPAGE P TSfNumber a Size- t. X _ Gravel size PIPING : Size Type Bldga to tank Tank to dist. b Dist. box to fie /pit Openings sealed? YES NO Partial LOCATION/SEPA IONS : Foundation to ank f t. Foundation to bsorptto ftA Absorption to lot line ft. Separation o pits ft. LOCATION YSTEM ON DROP TY (circle one) Front Rea Left side - ight side - CCMMENTS : Cy/ ' C' �• SYSTEM USE APPROVED YES Or Building Inspector 01/86 and vl J6 LI,'y7 BUILDING and ZONING DEPARTMENT (14 P. 4 Air � /r Bay and Haviland Road. R. D. 1 Box 98 6 ,90 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME r z� LOCATION Datekz�_ f - Permit No , -Z�527 4/ ✓ = APPROVED - YES NO Footing/Pier Forms Foundation Waterproofing 4�kfill raining Roofing Siding Masonry Veneer. v3augh 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 APPROV Final Building Survey Next scheduled inspection (call when ready* ) Remarks- Bux ding rffspector 6/86 and-vl f { f .J'cawn o/ Queens Miry BUILDING and ZONING DEPARTMENT jo Bay and Haviland Road, R. D. 1 Box 98 1� Queensbury, New York 12801 UILDING INSPECTOR ' S REPORT NAM p LOCATION Date s r�''C�fy Permit No . � /�'tjG�Y ✓ = APPROVED - YES NO Footing/Pier Forms ✓Poundation "atorproofinq vE3ackfi3l Framing Roof ing Siding Masonry Veneer Rough Plumbing Relief Values Ext . Porches Finished Floors Interior Trim Stairs & Railings _ Cellar Drain Tile - Concrete Floors Plbg . Fixtures u� Gar . Fireproo£in 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- ------------------------ Builds g nspector 6/86 and-vl �£lWlt O� �4lPPft3 �u/"r� BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME e LOCATION ' Date! f� -2- Permit No . ✓ APPROVED - YES NO Footing/Pier Forms oundation aterproofing ckf:L l l Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext . Porches .. ....................... Finished Floors Interior Trim Stairs & Railings Cellar Drain Til Concrete Floors Plhg . Fixtures Gar . Fireproo ngL. Door Closers Smoke Detect rs Chimney INSULATION - Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final,. Building Survey Next scheduled inspection ( call when ready ) Remarks- R Building Inspector 6/86 and-vl 4 a W#1 O/ Qi "eie I'1 J i"r iy BUILDING and ZONING DEPARTMENT k9 Bay and Hawiland Road, R. D. 1 Box 98 Queensbury, New York 12861 BUILDING INSPECTOR ' S REPORT NAME &i (- LOCATION DatelJ 'l 9727Permit No . ✓ = APPROVED - NO Doting/Pier Forms undation Waterproofing Backf ill Framing 1 Roofing Siding Masonry Veneer o Rugh Plumbing Relief Valves Ext . Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile �� Concrete Floors Plbg . Fixtures Gar . Fireproof g Door Closers Smoke Detect s Chimney INSULATION Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROV Final Building Survey Next scheduled inspection (call when ready ) Remarks- Building Inspector 6/86 and-vl BUi LDI NG DEPT. COPY OF APPLICATION FORM "-E L, HEW YO RK BOARD OF FIRE UNDERWRITERS. FILE THIS COPY WITH BUILDING DEPT. WHEN REQUIRED. 3 DATE CNTY an { 4 t VILLAGE �I +t_ ! t �k t'k.. i 1 �J TOPI NSHIP V. x it COUNTY STREET AND NO. OR ROAD AND POLE NO. 11+ c: 1 I I POLE NO BETWEEN WHAT TWO CROSSSTREETSIS PREMISES LOCATED? SECTION BLOCK LOT OCCUPANT'S 17 ` BUILDING NAME ,ir `} r C_ / 7 �i C_ / i s It r" 'U`[MCCUPANCY /r lam` e a-'! r 1/ "'L/ . 1 OWNER'S NAME ,r} AND ADDRESS , . <: ../y rJ - x J / , i t SUPPLI !':. u D - . BY FROM THEIR .'�; /�� ,1 t t, /� .� OFFICE BSV ILpING - DEFECTS NEW O OLD ElIWORK NEW ADDITIONAL ❑ REMOVED ❑ LIST BELOW ALL EQUIPMENT WHICH YOU INS ALLED NUMBER OF OUTLETS =V E MDTORS HEATERS 4m^x H OFFICE USE # « ONLY tion Sftle Atmwt HJr. Watq A.W.G. ComingWa11 Rscap*% Seriath lYrMdNrs Bracical No. Tysxe Each No- Each Nam- amd1w INSPECTION skjo sNN S le Samoa Bsr. went lyt FI_ 2nd Ff. 3rd FR. REMARKS: LIST OTHER ELECTRICAL DIEV ICES NOT SET FORTH ABOVE; DO NOT USE THIS SPACE. This application rs intended to cover the abov*4istrd spuilwxtent to be inspactad but if at tune of invammctieel there is foonA etldiliosyl ealo iprryant not above listed, you are au/harizsd to Ntwks That irgysetiow and acljuae the Fie to cwres the additiestN squ4fsnarst, as provided by the alMlicern. SIZE OF ELECTRIC SIGN TOTAL MAIN$ FEEDERS LAMPS WATTS CHARACTER EXPOSED GAS TUBE SIGN OF WGRK CONCEALED TRANSFORMERS OF VA WORK TO BE (NLWABERI ICAPACiTYl STARTED COO PLETED SIZE OF SIGN SERVICE OVERHEAD UNDERGROUND MAKER ENTERS BUILDiNY OF SIGN INSPECTION REQUESTED ON OR AS NEAR AS POSSIBLE NEW 0 OLD AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION, ALL SPACES DATE OF l�MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. PRINT NAME A114p ADDRESSNAME OF J y APPUCA N_ RE APPLICANT /�1` + £' .� �',t :� /,' ^a /r r : ..'L,/ ,/\ OF APPLICANT. PPLICA l � / J OF APPLICANT STREET ADDRESS ,y'Ll -' !{_1 S I �'7F TELEPHONE CITY OR ' ZIP LICENSE NO, POST OFFICE : " {. } i `-. yl '1C- " T- .ref J . CODE WHEN APPLICABLE Ae EL (REV. ,Ise) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING