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1987-673 CERTIFICATE OF OCCUPANCY TOWN OF QUEENSSURY WARREN COUNTY, NEW YORK /i Date July 29 19 � 'This is to certify that work requested to be done as shown by Permit No. 87-673 has been completed. This structure ma be occupied as a One k ami],y Dwe l l in g Location Queens Lane Clwtser Viu-Jo Contractors Inc . By Order 'Town Board TOWN OF QUEENSBURY Building & Zoning Inspector BUILDING PERMIT � TOWN OF QUEENSBURY � No. 87-673 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to yin-Jo Contractors Inc . �a I OWNER of property located at Lot 45 Queens Lane Street, Road or Ave. in the Town of Queensbury, To Construct or {glace 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 1237 Central Ave . s Albany , N . Y . 0 a 2. CONTRACTOR or BUILDER 'S Name n Same 0 r7 H W n 3. CONTRACTOR or BUILDER S Address cp 0 a tt w 4. ARCHITECT'S Name 5. ARCHITECT'$ Address O 6. TYPE of Construction — (Please indicate by XI .p I X1 wood Frame I I Masonry 11 Steel I I fo m 7_ PLANS and Specifications to No 28 ' x 54 ' per plot plan , specifications and application including t 03 septic system, and attached two car garage . B. Proposed Use One Family Dwelling m I 143 . Ofl ' $ PERMIT FEE PAID — THIS PERMIT EXPIRES May 1 , 19 88 r. (if a longer period is required an application for an extension must be made to the Building and Zoning inspector of the G town of Queensbury before the expiration date.) tzj Dated at the Town of Queensbury this 8th Day of October 1987 SIGNED BY i7/ /62'.-'4c� - for the Town of Queensbury Building and Zoning I nspector .. . TO BE COMPLETED BY BLDG . DEPT . F I I 9LP � Ca l 1v C'� Application No. SEA! 3 4 1987 �lpwr� peteen36ur� Permit. Issued 19 BUILDING and ZONING DEPARTMENT Permit Expires 19 Bay- and Haviland Road, R.D. 1 Box 98 zoning Designation_ ©ueensbury, New York 12801 Varianc a 640 y 1� Site P n Re is No . f _ �/� r 1 ' Appr q0 APPLICATION FOR iL ✓ 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 trh-e Permit . --- The-owner of this property is : J J`! w • f P. O. r C_7c`/zJ ��x' �f/� /U 1 Tel . %. . O. Address I 7�- �C , J Jx Tax Ma No . Property Location b 1' Street number or building lot number Subdivision name (if applicable) - TM PERSON RESPO14SIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS : Name Po Ow Address Tel . No . r^ / Name of builder f,, . _ a i>,h ;iL �Address x __ Ic c} h5 - c,� Lam. f ! Tel , __7z'_ Name of plumber Address1��`` Tel , Name of mason /: '� �r✓r � r r ddress Tel NATURE OF PROPOSED WORK : * ZONING INFORMATION : .Construction of a new building " * A PLOT PLAN MUST BE PREPARED AND SUBMITTED4t Addition to a building * drawn reasonably to scale and attached hereto , Alteration to a building * showing clearly and distinctly all buildings , �wwww(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 configuration LOCATION OF STRUCTURES AFFECTED* of septic disposal area . * * COMPLETE INFORMATION REQUIRED BELOW . * size of property 4G7 ft X A3Cd ft . * Existing building ( s) Size ft X ft . PROPOSED BUILDING AND USE : * Existing buildings— )u Size of new structure Z ft X f Foundation-pier/slab/crawl/Partial ull� * Proposed building , distance from property line (circle one ) ] * Front yard ft Rear yard ft No , of stories (habitable spac Side yards Height (grade to ridge) 4a ft . * Z ft and t. ft If residential, no. of families ;"� rJ� * If an corner , se asetback from side strE+et ft No . of rooms (excluding baths ) ;j77,e. * OCCUPANCY INFORMATION No. of bedrooms �x� '!� * PRIMARY BUILDING Now of bathrooms - Primaryheatingsystem G * One family dwelling Type of fuel '`� * Two family dwelling Now of fireplaces to be installed r�,d/a� * Multiple dwelling / Number of units Permanent occupancy a wood stove be installed? Central Air conditioning? r. _ * Transient occupancy * Business BUILDING STYLE, PRIMARY STRUCTURE Industrial Ranch Contemporary Log cabin Other Raised ranch Mansion Duplex * If addition , what will use be7 Split level Old style Bungalow Ca_ s Cod Cottage Other * ACCESSORY BUILDING- Row Town house * Detached garage/one car/ two . car/ car CIRCLE; ONE PLEASE } * =k Attached garage/one car, -two caar74` car Private storage building "�'— _ ESTIMATED MARKET VALUE OF * Other CONSTRUCTIOPT$ INFORMATION ON BUILDING SPECIFICATIONS . ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED ? Form BPA 4/86 md-vl BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATI{Ns : Type of construction , wood frame , fire safe , etc . d4/� Will any second-hand or ungraded lumber be used? If so , for what ? 4otic7 Foundation wall material d i/,r��'+�� �v,�u G� , Thickness t? `r Depth of foundation below grade (to bottom of footing } _-- rCf, / , 's� 5- r Will there be a cellar? Heated or unheated? Floor sq , footage sq ft Will there be a basement? Will any portion be used as living space? doy0 { If so, what portion? sq. ft , - -- Type of use? Type of roof - slope Fla shed/other Material . of roof 51r�Hfr�,v' r, rCrE p �,yc�� S�y4E Size , wood Stu d8 - "x ..__...■' spacing l�/�'•o . c . length ft , Joists ( flaor beams) Ist . floor -"X�r -" spacing -"o . c . span Joists ( floor beams ) 2nd . floor "x -" spacing�"o , c , span ft . Overlays (ceiling beams ) "X " spacing "o. c * span. ft . ` Roof rafters "X it spacing o c . span ft Roof trusses (pre-engineered) s cing,�"o . c . span f . Exterior wall finish 5�1�1. � � . Of what material Interior wall finish•. <"zie If a,9prage in to be at ached , describe materials to be used for FIRE SEPARATION . �� To tnere to be an opening between garage and dwelling?- �,/, -. . if so will a Fire-rated- door, enclosure , and self-closing device be provided? ,gs Will a flue-limed chimney be installed? Height above roof ft , �— Depth of chimney foundation below grade Depth of fireplace earth��ft . in , Water supply unicipa r private well SEPTIC SYSTEM _ from ANY private well ( including adjoining properties ft , (A separate application is necessary for any repair or new installation of septic system ) Town of Queensbury Warren War County of Warren A F F I D A V I T STATE OF NEW YORK . ,'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 tie and complete statement of all proposed work to be doneion the described premises and that all provisions 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 Signaturu�2 . ,h Owner , owner ' s dent , arcnx r ect, oontr ctor _ Notary Public, Warren County, N , Y . SPECIAL CONDITIONS OF THE PERMIT .& TOWN Or QUEENSBURY WARREN COUNTY , NEW YORK Application fora BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK STATE ENERGY CONSERVATION CODE A permit must be obtained before beginning work . ANSWER ALL of the followings 1 . Gross floor area 2 . Type of heat 3 . Is the building mechanically cooled ? r/f• 4 . Percentage of area of windows and doors f A . Over 16 % Only 1 . Uo 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 ? 309 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 wallsL ` 36 R value of glazed area /0- Z- 5 4 . R value of doors -7- .' :1 -- --.. _ 5 . R value of floors over unheated spaces 6 . R value of slab edge insulation - unheated slab 1) ,14 7 . R value of slab insulation - heated slab +'/� y 8 . R value of heated basement/ cellar walls ( above grade ) f f= 9 . R value of heated basement/cellar malls ( below grade ) .~ to . Type of insulation G-/^ tdr-' C . Controls ` T Thermostat maximum heat setting D . Duct Systems 1 . Is duct system installed in unheated spaces ? YES rT6� a . If YES , R value of duct installation b . R value of duct in other areas E . PI in% Insulation � rr 1 . Size of hot water or cooling C rying agent pipe 2 , R value of pipe insulation �/ F . Service Water Heating Y. d Performance efficiency 2 . Temperature control setting maximum G . For Swimming Pool Only 1 . Maximum heating Telephone VNo . _ /' - /L (( pap,licant ' s signatre ) , •'' '" "� "CrAl Awry APPLI CAT ION FOR SEPTIC DISPOSAL PERM I T &VILVItarp and tON81yo CHEPARTMEMy may sno Haviland ptood. A.O. 1 Box 93 _ Dufcns!►ury. fMRr► York Y2�D� DATE LOCAI lON OF FROPERTY FOR ] NS7A LLATION OWNER ' S NAME ADDRESS7. TEL INSTALLERS NAME TEL Number of bedrooms {reaidential only} Total daily flow ( compute $ 150 gal ,per bedroom) Topography = I`'1at' - Rolling - Steep slope - (circle one) of slope Sol l nature : (#'Und '�L Loam - Clay -- Other Depth f t . J' Ground water -At what depth? x4` % fte Bed-rock or impervious snaterial - At what depth? Percolation test - `Not required - Required - -Rate min-inch_ Domestic water supply Municipal =- Well - Other Separation - Watersupply ( i +well) from Septic absorption ft . Proposed System : Septic tank fA l ` gal . { Minimun size , 1000 gal * ) ii 'E = ; e2 (' - rnc ?-, trer: ch ft . Total. St• stem lear. th ' < ' ft . Seepace pit ( s ) N7tuy Der of Size each f t x f t Size of stone to be Lse ;? * Depth or thickness ! r r r r r r ♦ } • tir ! r w r r • r r w w ! w • w r • • w r • w ! w w ♦ r 2 WiP[} R7ANT ' ' On a separate piece of paper , subunit a diagram of the proposed system With All dlViernSiona Shown ; including distance from any structure , distance .from property lines and from ANY DOMESTIC WATER SUPPLY or shore - line of lake , atreamepand or wet -lsndle. w Include all dimensions of the system , itselfo r r + ♦ + r r ♦ r r r r r w w ♦ w r w * w w • r w r r ♦ r r • ♦ r r r r 1 f: F : ) • c` I •: e" .i ' {: ;= u �^ :• 1. : G7: 7 �. E _rr � L7•E' E TiGt of Oki t F +k: c Gn: :. GG } ' C & t o c ?- : ac t v i C cr. d c 7 2 rvqui rFr* Cnitr cf The Tos.+n o{ Cuf eysrtury Scnitcr;'r Sei, r} c i. � cpGSG1 f1} dir, ps� oC . { - .t117YCt '✓ r! Pf 'r C)n : .�• 2 ! � � ?'^ C•1: C G a_ [ /� CIx DS / 8b a+ d /vI a Section II Septic Syste+.m Tnslsectiarsss A . All applicationd for septid eye alteration or repair , a tedm installation , s rea�uirad by the Town of - Oueenzbrary Sanitary Sewage Ordinance# shall be submitted to the Buildxna Department at least 24 hours before start of Construction and shall include a plot plan sh6wing ; 1 ) the proposed location of the system 2 ) location and distad d nce to lot lines 3 } loco t iOn anistance to structures 4 ) location and distance to any Water supply 5 ) size and dimensions of all tanks , distribution . boxes , tale fields Ana /or drywells Be t'O system shall be covered before i nspectic.n and approval by the Building Inspectoro railure to comply with this r+eQuirement way result is the uncovering of the system by the installer and a `Fine of up to $2500000 CO An approved copy of the plot plan shall be available an the Constructionsite. Failure to produce said plot plan at tjwke of inspection'na,y result in en Immediate work stcp"ga. Do Should unforeseen problems during construction Prevent proper installation , alteration or repair of an approved system , a new proposal must be submitted to the Queer+ sL� ury Builrixnv e�artinent before further construction , r � /awn IQ �6cer� BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME LOCATION !J 7� �/'v� �J/w'•'. 5 , Q Date� �/��� Permit No . r = APPROVED - 'YES NO Footing/Pier Farms Foundation Waterproofing Backf ill Framing Roofing Siding Masonry Veneer. Rough Plumbing Relief Valves Ext . Porches Finished Floors Interior Trim Stairs a Railings Cellar Drain Tile Concrete Floors Plbg . Fixtures Gar . Fireproofing Door Closers Smoke Detectors Chimney INSULATION : Foundation Floors Walls Ceiling FINAL ELEqrRICAE INSPECTION DRTVEWAY A PROVAiti . Final Building Survey Next scheduled inspection (call when ready ) Remarks- Buil n In pector 6/86 and-vl MIDDLE DEPARTMENT INSPECTION AGENCY, INC. 9w Haddon Ikyenuie, Cdlungswood, N-d- 09108 rrt� Datu Ju rte 14 , 19 is 3 (Certlflez that the electrical equipment listed has been examined and is approved as being in accord with the National Electrical Code, applicable governmental, utility and Agency rules. Owner: Vix1go Construction Occupancy: 3awe11in Occupant_ Sir�.ble Family y y R,]u yE'.i2S1'k t..ir £ yy�$',�-L'e7�1 CO )4 a g to r[�fi�ale counts The ei�trical.#gk+ipment and insiailathon mspa i rd this Location. Lot 45 l�l eeris 1 a �' date If additional equipment should be imroduced or aiterations made to e Kisting system this certificate Prism be null and void. and application for i ns pec lion 9no Uld be 3Ubmitted Is For"pity to this AgenCy- Equipment: 9 5 of t lets s 60 Receptacles , 20 ixtur'es f Holder of this ce riot Cate shoutd prase nt name to his property insu re n ce carrier 200 1irap Service ; 4 =ippli-aaCe5 lageni or cc m pan y)as evidence of sedifi cat ion of electrical eq ul pmert t ap proved as specified. F'Kelly Electic :Dillow Road No . 15 - 020710 Glens Lolls , 1`iY 12301 J Fwtn Wl. 7W EL I-I flown of Queernsbury BIJILDING and ZONING DEPARTMENT y and Haviland Road, R.D. 1 BOX 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME V%h T S 4 s '-- LOCATION e!p ref7 � ,yce�� f5W Date , /� Permit No ool" APPROVED - YES NO Footing/Pier Forms Foundation Waterproofing Backfill �Q-Framing Roofing Siding Masonry Veneer , Rough Plumbing u Relief Valves Ext . Parches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plug . Fixtures Gar . Fireproofing Door Closers Smoke Detectors Chimney INSULATION Foundation Floors Walls Ceiling FINAL ELECTRI AL INSPECTIONr DRIVEWAY APPRO AL Final Building Survey Next scheduled inspection (call when ready ) Remarks- AS uxld In pector 6/86 and-vl �../vwn v� �ueenshaer-ear BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME LOCATION f �1` ;-FS r c � DATE 1 -2 I PEWIT NO., SOIL TYPE - Sancl - Loam - Clay - Percolation Test Required? YES - 10 Percolation rate - Min/Inch TYPE of SYS Absorption field , total le gth Z 5� Length of ea h trench Depth of tre ches ' Size of grave '_ — SEEPAGE P ITS # er _ Size- Grav sa.ze PIPING . Size Type t e Bldg . to ank ��#', PLt Tank to list . tc " Dist . box to f ' ld/ _ Openings seal ? Y NO Partial LOCATION/SEP RATIONS : Foundation o tank 0 ft- Foundation o absorptio t- Absorption to lot line frpf� Separation of pits ft- LOCATION SYSTEM ON Pk)PERTY (circle one) Front - ar - Left side - Right side - COMMENTS : SYSTEM USE APPROVED ES NO iL Hui ding Inspec r 01/86 and vl All out" of Queen36ure� /ry BUILDING and ZONING DEPARTMENT fC/ Bay and Flaviland Road, R. D. 1 Sox 96 Queensbury, New York 12801 BUILDING I N SPECTOR ' S REPORT NAME LZ LOCATION Date Permit No . ✓ = APPROVED - YES NO Footing/Pier Forms V,F'oundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext . Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg , Fixtures Gar . Fireproofin Door Closers Smoke Detectors Chimney INSULATION : Foundation Floors Walls Ceiling FINAI. ELECT." AL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection (call when ready ) Remarks- J� , Building Inspector +6/86 and-vl q1 all 4 01 ueens urea ` w BUILDING and ZONING DEPARTMENT ' ✓ Bay and Haviland Road, R. D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME LOCATION r'�5� f•+`rG''' � XG �"� Date /G' �;� / � "" Permit No . Iv' APPROVED - YES NO oating/Pier Farms Fours da t ion Waterproofing Backfill Framing Roofing Siding Masonry VenM Rough Plumb Relief Val Exit , Porch Finished FInterior T StairARa3 ails gs Cellain Ti e Concrloors Plbg , ures Gar . roofi g Door rs Smokeecto s Chimn rr�s Lrx Found Floor Walls Ceili FILIAL RICAL INSPECTIONDRIVEPROVALFinalding Survey Next scheduled inspection ( call when ready ) Remarks- Building In pector 6/86 and-vl BUILDING DEPT. COPY OF APPLICATION FORM 46-EL, NEW YORK BOARD OF FIRE UNDERWRITERS. FILE THIS COPY WITH BUILDING DEPT, WHEN REQUIRED, TELIP s DATE CITY DR _ ter' / .. VILLAGE --r .'` f F..._.r [.- F I`c COUNTY Ai r—f. rkl �r j STREET AND NO. OR ,.-, `' ROAD AND POLE NO. • :�. `�_ l / J ! i BETYaEEN WHAt TWO £ POLE P THE LEYS IED7 OCCUPANT'S BLOCK LOT NAME BUILDING OWNER'S NAME OCCUPANCY� ,• !AND ADDRESS TEL. SYMPLIED B f{fj .' ::' � .:P"�" .`-� f r'f � ,',!l' FROM THEIR /''-/1z �' ��„' OFFICE BSUH.DHIWORK NEW If"`I.., OLD IS NEW ADDITIONAL II^^--�� DEFECTS 1_f REMOYEp LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED No. of Flauleve 6 NUMBER OF OUTLETS Lamp Raptaesm MOTORS HEATERS BRANCH ae CIRCUITS OFFICE USE Bide AtzaAr't ONLY Calli.rll aMaM Rrpp"1s SwIII Pendant Bracket No, Type E� No. E� No. Ace up.' INSPECTION side SWr Iraaa mr.t fat Ff_ 2nd Ff.. Sod FL REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORT" ABOVE: 00 NOT USE THIS SPACE, This hop ication is intended to cmw the abcv hstad agoipmarnl to be inspected but it at lima Of i you Ana aolltorized to male the A s pec5on and rrsPaasion Ill is found additional epuipmant I Ober fisted, ad]tlRt xha fee i4 EOtrar the wdditional aquipnNnt, as proridad by Iha ipIPIkCaM. 512E OF MAINS ELECTRIC SIGN TOTAL FEEDERS LAMPS WATTS CHARACTER EXPOSED GAS TUBE SIGN OF WORK CONCEALED TRANSFORMERS OF WORK TO BE VA STARTED INUMBER I ICAPACkTV Y COMPLETED SIZE OF SIGN SERVICE OVERHEAD UNDERGROUND ENTERS ,..s MAKER {LDI OF SIGN INSPECTION REQUESTED ON OR AS NEAR AS POSSIBLE NEW OLD AVOfD DELAY 8Y GIYfN6 FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETU R NEO. DATE OF r•�' PRINT NAME AND A RE,S�rr,,l APPLIC IONNAME OF APPLICANT �' ' '� L._. ? ,i' -! -' i [_�f` ,fc=.. /�,,.: : . _ F SIGNATURE /` 1 J d'a. OF APPL CAN.Ts.�f_ STREET ADDRESS %+^l jr CITY OR J / TELEPHONE POST OFFICE 'ram �J / f . / :::. .i y`. CODE = LICENSE No. WHEN APPLICABLE as EL (REV. 1/86) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING 20 ' { or e 1 ' ter' T � n 3 � qa + 3 � fo VA everrc V �,.l v n �/�'r�� -�1 s gv c v GcJd �'2� n! G' 4-e,.41.7 sV, Al. s!_ +1 =. SG.�4 L G"' / •• S'`ca �i',4 Te"' = �E'"F'T.' 25'. !9 S �, V©nDus en & Ste ves LAND SURVEYORS , GLENS FALLS , NEW YORK N. Y. STATE LIC. NO; 35617 x