1987-740 G
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSSURY
WARREN COUNTY, NEW YORK
I
n@@Umber 23 , iq 87Date
1,
This is to certify that work requested to be done as shoam by Permit No.
87- 740
has been completed.
This .fracture tray be occupied .n. a
One Family Dwelling
1 LKrti- *8 Queens Lane
Location
Colonial Construction
owner
I
By Order Town Board
{ OrOW N OF QUEENSBURY
or
Building lS► Zoning lmPector
I
4
BUILDING PERMIT
r i
TOWN OF QUEENSBURY No. 87-740 z
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Colonial Construction ua
0
1
OWNER of property located at Lot 48 Queens Lane Street, Road or Ave. `c
1
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.
1 . OWNER'S Address is P . O . BOX 242
Bolton Landing , N . Y . c3
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2. CONTRACTOR or BUI LVEWS Name '
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3. CONTRACTOR or BUILDER'S Address rt
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address ru
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6. TYPE of Construction — (Please indicate by X) M t�
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( x) Wood Frame ( I Masonry ( I Steel { ? rt ro
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7. PLANS and Specifications
No 28 ' x 52 ' per plot plan , specifications , and application including
attached 2 car garage and driveway permit ...+
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8. Proposed Use CD
One-Family Dwelling "t
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$5600 CIO
May ay 1 , 88
$ PERMIT FEE PAID — THIS PERMIT EXPIRES 19
(if a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Ousensbury before the expiration date.l
04
30th October 19 87
Dated at the Town of Queensbury this Day
of
SIGNED BY ,r C-� _ ' _' t for the Town of Queensbury
Building and Zoning Inspector
TO BE COMPLETED BY BLDG . DEPT ,
Application No .
-�'
�] ( WN CIF .r
QJt- . rVSci ;
_Down a/ Queenlj+b/ "ry Permit Issued 191�4 �r
BUILDING and ZONING DEPARTMENT Permit Expires 19 (] V `;y�
Bay and Haviland Road, R.D. 1 Box 9$ Zoning Designation Variance �r
Queensbury, New York 12801 variance No . 00T8 198f
Site Plan Review No . 'OU
/] �� ' Approved by : D!JILUi
APPLICATION FOR
�J d�
PU I LD I N6 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
tion , plans and specifications submitted , and such
be done in accordance with the descrip
special conditions as may be indicated on the Permit .
- ..................
_____-- _ .......... -------------.
The owner of this property is : r� J� � ` _______ _____...._ _
F . O. Address �. ,,�!�v1 : %- �-' ...?.:);Y. Tel .
x
Property Location " sfl f � A) Tax Map No .
Street number or {{building lot number
Subdivision name ( if applicable)
THE PERSON RESPONSIBLE FOR ;SUPERVISION OF WORK AS REGARDS BUILDING CODES
rr IS .
Name P . O. Address Tel . No .
Name of builder—_- ` Address
Name of plumber - J] Address Tel '
Name of mason_ Jam ` Address Tel .
NATURE OF PROPOSED WORK : * ZONING INFORMATION :
t` 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 configuration
LOCATION OF STRUCTURES AFFECTED - * of septic disposal area ,
COMPLETE INFORMATION REQUIRED BELOW .
Size of property 10 Q ft X 22 0 ft '
* Existing building ( s) Size _ ft X - t-
*
PROPOSED BUILDING AND USE : * Existing building ( s ) Use - -
Size of new structure e ft x 7�ft -
Foundation-pier/slab/crawl artial ull * Proposed building , distance from property line
* r �1' £t
( circle one ) Front yard S[ ft Rear yard . _� ��
No . of stories (habitable space)
,� Side yards _ � +� '' ft and 'L � ft
Height ( grade to ridge ) 2, ft ' if on corner , setback from side street — ft
If residential , no . of families_
No . of rooms ( excluding baths ) S0 * OCCUPANCY INFORMATION
No , of bedrooms - - �� * PRIMARY BUILDING -
No , of ]bathrooms �- _ 1"Y
One family dwelling
Primary heating system {` ! * Two family dwelling
Type of fuel 091 c Multiple dwelling / Number of units
Now of fireplaces to be installed /
p .* Permanent occupancy
Will a wood stove be installed? Transient occupancy
*
Central Air conditioning? Business
*
BUILDING STYLE, PRIMARY STRUCTURE Industrial
other
Ranch Contemporary Log cabin If addition , what will use be?
Raised ranch Mansion Duplex '�
Split level old style Bungalow
Cape Cod Cottage
Ether ACCESSORY BUILDING-
_
0 oni~' a�_• Row Town House * etached garage/one car/ two car/ car
CIRCLE ONE PLEASE )
* Attached garage/one car/ two car/� -..car
* * * * * * * w * + * Private storage building
ESTIMATED MARKET VALUE OF " Other
CONSTRUCTION $ _ ^ 3j '
_ - _�
INFORMATION ON BUILDING SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET , TO BE COMPLETEDI
Form BPA 4/86 and-vl
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS :
Type of construction , ivc[5od fram fire safe , etc . VjCT-0 j: f: "Oleo'
Will any second-hand or ungraded lumber be used? If so , for what ? 4 ��
Foundation wall material G ff,P. Thickness
Depth of foundation below grade (to bottom of footing )
Will there be a cellar? Y& _5 Heated or unheated? 4Ir►" �J,FF % Floor sq_ footage sq ft
Will there be a basement? Will any portion be used as living space? Ale.?u
( If so , what portio;y? sq. ft . - - Type of se?
Type of roof sloped Jflat/shed/other Material of roof '71P (,r $ {
Sine , wood studs_� •'X�„ spacing- „ram . c . length ft .
Joists ( floor beams) Ist . floor _ �� "X .L +1 IF
spacing j span t .EZ-
Joists ( floor beams ) 2nd . floor J.. "X �► -"' spacing_ 'o . cm span_,e
Overlays ( ceiling beams ) "X spacing '"o . c . span ft ..R �r� btS r
Roof rafters " X 10 spacing ---.o . c . span.._._ ft .
Roof trusses (pre-engineered) spacing "'o . c . span 7 ft .
Exterior wall finish Of what material ?
Interior wall finish � ,{ � — 0 if a garage »two be attached , d Abe mate ' als to be used for FIRE SEPARATION :
Vp
Y c7 e' -
Is there t be an opening tween garage and dwelling? If so will a Fire-rated
door , enclosure , and self-closing device be provided? ey.*f
Will a flue-lined chimney be installed? 1. ,5 Height above roo - , ft . �-
Depth of chimney foundation below grade -- --- ft .
Depth of fireplace hearth .----- ft .
Water supply - Municipal or private well 4f t C•.-�
SEPTIC SYSTEM _ Distance from ANY private well ( including adjolhing properties ' ft ,
(A separate application is necessary for any repair or new , installation of septic system )
Town of Queensbury T T� Lr
County of Warren A F I C 1 D A V T STATE OF NET 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 true and
complete statement of all proposed work, to be done on the described premises and that all
provisions of the BUILDING CODE , THE ZONING O and all othedand
pertaining to
the proposed work shall be complied with, ether spe ified or not , hat s h work is
authorized by the owner .
SWORN TO .BEFORE ME THIS Signature -t ---_-_- er , owner ' agen arcnitect, contractor
day of
Notary Public , Warren County , N . Y .
IF * * * * * * * * . * * IF * * * * * OF * * * * * * * * * * * * * * * * * * * * * IF
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 ;2 L7
2 . Type of heat, A �A A-Ire J" e �
3 * is the building mechanically cooled ? 4 /�
4 . Percentage of area of windows and doors 1
A . Over 16 % Only
T . Uo value of gross area of walls , roof /ceiling and floors
exposed the ambient conditions
lrr,.
2 . Floor over heated spaces YES N¢ ''
a . Are foundation 'wwalls insulate YES NO
1 . If YES , what'`:Ls the R v ue ?
3 . Slab on grade YES
a . If YESO, what is the vbrkue of insulation around
perimeter of flop
4 . Is basement heate YES NO
a . R value of nsulation
5 . Type of in lation
B . Under 16 % Only
1 . R valu of roof and floors xpos � to ambient
bient conditions_
2 . R value of exterior walls Q
3 . R value of glazed area
4 . R value of doors
5 . R value of floors over unheated spaces /C - 40
f, . R value of slab edge insulation - unheated slab
7 . R value of slab insulation - heated slab le !
84 R value of heated basement / cellar walls ( alcove grade ) 040- IV
9 . R value of heated basement /cellar walls ( below g/rjade )
10 . Type of insulation "•'
C . Controls f� f/� ' Of
� � e �
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 . Size of hot water or cooling carrying agent pipe � 4
2 , R value of pipe insulation f�
F . Service Water Heating /^t
1 . Performance efficiency (r
2 . Temperature control setting maximum
G . For Swimming Pool Only
1 . Maximum heating -
Telephone No ,
pplicant Is sign tune )
,."")A
APPLICATION FOR SEPTIC DISPOSAL PERMIT
DATE /A[! /
LOCATION OF PROPERTY FOR INSTALL TION K Z(,o t C' ¢ Q
Owner's Name: ej !t /* Telephone. j t'
Address. /, 0. .7 f) .G�' Z11
r .
Installer's Name. Telephone: "
Number of bedrooms (residential only) T / p�Total daily flow (compute @ /'150 gal per bedroom) (�+ V ( � t4/]D
Topography: circle on Flat Rolling Steep Slope % of slope ` -
Soil Nature: circle one• and Loam Clay Other / Depth: feet
Ground Water: At what depth? Q +�/�'- feet
Bedrock or Impervious Material: At what depth? ��,� .. 1 e feet
Percolation test: circle on�ot required required / rate in in. inch.
Domestic water supply: circle one one unlcipal ell Other
IF domestic water supply is a Well.
Separation: Watersuppiy from Septic absorption
PROPOSED SYSTEM. Septic Tank 16 60 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
,,,Pleaseo.oLIST NEW EQU PMENT TO BE INSTALLED
* * * * * * * * s * sss * * * * * sss * * * * * * * * * * * * * * * * * * ss
(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, the 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 $250.00.
Co 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 regulaticros above and agree t e by these and all requirements
of the Town of Queensbl<ay Samitarg Sew C7rxli>Aan e.
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
at"I v/ Queen Gray
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R. D. 1 Box 98
Queensbury, New York 12801
44 BUILDING/ INSPE�aCTOR ' S REPORT
N ME (` D / OY1..-t�G • -f C�tz pS �". �3, S
LOCATION r Q Y'"e" J C.G{�
Date � 2-- / * T Permit No .
✓ = APPROVED - YES NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
F rami n g
Roofing
Siding
Masonry 'Veneer
Rough Plumbing
Relief Valves
Ext . Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Til
Concrete Floors
Plbg , Fixtures
Gar . Fireproo ing
Door Closers
Smoke Detec rs
Chimney
INSULATION
Foundatio
Floors
Walls
Ceiling
FINAL IECTRICAL INSPECTION --
DRIVEW Y APPROVAL
.PFinal uilding Survey
1
Next scheduled inspection ( call when ready )
Remarks- C do
7i
r
Huilding Inspector
6/86 and-vl
0 ,RPE4 CAD 124--*0 to"
--+'e' W" o/ 'Qu ee►l 3 b u ry
BUILDING and ZONING DEPARTMENT
Bay and Havifand Road, R. D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME
LOCATION ( e--6- q
DATE/ PERMIT NO,, / 71
SOIL TYPE - Sand - Loam - Clay -
Percolatai.o Test Required? YES - NO
Peroolatio ate - Min/Inch
TYPE of SYS EM;
Absorption f ' eld , to 1 length 2 ,c(-o
Length of ea h tren
,Depth of tren hes -
Size of gravel
SEEPAGE PITS4N of)
Size- ft . ft.
Gravel size
PIPING : Size T
Bldg . to tankr
Tank to list . x
Disto box to f eld
Openings seal ? ES O Partial
LOCATION/SE RATIONS
Foundation tank ,ft.
Foundation o absorpti n ft .
Absorption o lot line ft .
Separation of pits ft.
LOCATION YSTEM Chi P OPERTY (circle one )
Front - e r Left side% - Right side -
CC MMEN
SYSTEM USE APPROVAd ' ng
S NO
Inspector
01/86 and vl
nwrr o uQens6Ury
BUILDING and .ZONING DEPARTMENT
Bay and Haviland Road, R. D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME 000vk gov /'"�„ _
LOCATION1
Date 11 Permit No .
APPROVED - YES NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
LAF'fami ng
Roofing y
Siding
Masonry Ve eer
'ugh P1 ing -_•_, '
Relief Val es
Ext . Porche _ -
Finished Fl rs
Interior Tri
Stairs & Rail n
Cellar Drain T e
Concrete Floo s
Plbg . Fixtur s
Gar . Firepr ring _•••_ � . ""' �_`
Door Closer
Smoke Dete tors
Chimney
INSULATI
Foundat ' n
Floors
Walls
Ceilin
FINAL E CTRICAL INSPECTION
DRIVEWAY APPROVAL,
Final .Building Survey
Next scheduled inspection (call when ready )
Remarks-
yr r d I
Building Inspector
6f86 and-vl
..Dawn 01 Queenjg"ry
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R. D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION
Late / Permit No . F''1 WC,)
✓ = APPROVED - YES NO
Footing/Piet Forms
Foundation
Waterproofing
Backfill ^-
Warning
Roofing
Siding
ml,rbonYy Veneer
ugh Plumbing
Relief Valves
Exit , 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 APPROWil.
Final Building Survey
Next scheduled inspection ( call when ready )
Remarks- 0
Building Inspector
6J86 and-vl
_lour" ouv�" f6ur�
BUILDING and ZONING DEPARTMENT
Bay and Haviiand Road, R- D_ 1 Box 98
C?ueensbury, New York 12801
SEPTIC � PO L SYSTEMINSPECTI
NAME
LOCATION Gl r°'ra' ,fr P
DATE / PERMIT NO,
SOIL TYPE - Sand - Loam - clay -
Percolation Test Required? YES - NO
Percolation rate Min/Inch
TYPE of SYSTEM:
Absorption field , total ength
Length of each trench
Depth of trenches '
Size of gravel_
SEEPAGE PITS4Number of)
Size- ft. X ft ,
Gravel size -
PIPING : Size pg
Bldg . to tank Y
Tank to dirt . box
Dist. box to fiel z
Openings sealed? Y NO P rtial
LOCATION/SEPARATI S :
Foundation to t f ft.
Foundation to orption ft .
Absorption t line ft_
Separatio o its ft.
L.00ATI TEN ON PROPERTY (circl one)
Front R Left side - Right si -
' / ,r/ P KJ
SYSTEM USE APPROZPE YES N
Bui3 ng Inspec o
01/86 and vl ��
BUILDING and ZONING DEPARTMENT
Bay and H nd Road, R. D. 1 Box 98
ee bur New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION
Date 4Yf'7 Permit No . 7 - f G'
� ���...�� ✓ = - NC3
�'F'ooti APPROVED Yng/Pier 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
Plbg . Fixtures
Gar . Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION :
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVA
Final Building Survey
Next scheduled inspection ( call when ready )
Remarks-
K Vo
04�
Building Inspector
6/86 and-vl
L7 V 1 BUILDING and ZONING DEPARTMENT
v Bay and Haailand Road, R. D. 1 Box 98
Oueensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME 6 06
LOCATION
Date A//457 /S5 7` Permit No .
✓ = -
Footing/pier Forms APPROVED YES NO
Foundation
Watyerproofing
ckfill
Framing
Roofing
Siding j
Masonry Veneer
Rough Plumbing
Relief Values
Ext . Porches
Finished Floors_
Interior Trim
Stairs & Railings
Cellar brain Tile
Concrete Floors
Plbg . Fixtures
Gar . Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION :
Foundation
Floors
Walls
Ceiling
FINAL, ELECTRI AL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection ( call when ready )
Remarks-
fix
4 it/4
l I f I
f
Building Inspector
6/86 and-Vl
./own n/ Qieeensbury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R. D. 0 Box 98
Oueensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME � �.P�
LOCATION
Date/ / 3 f Permit No .
✓ = APPROVED - a"Rg NO
oting/Pier Fortes
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Vene _
Rough Plumbin -
Relief Valves
Ext . Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
plbg . Fixtures
Ga.r . Fireproofing
Doer Closers
Smoke Detectors
Chimney
INSULATION :
Foundation
Floors
Walls
Ceiling
FINAL ELECT CAL INSPECTION
DRIVEWAY AP ROVAI.
Final Build ng Survey
Next scheduled inspection ( call when ready )
Remar s-
C (Jl --Cri C rz i't� rz,
�r
Building Inspe for
6/86 and-vl
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