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1987-787 f w CERTIFICATE OF C: CUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Daft A r1l 15 , 19 88 . t � - - ►► 9 This is to certify that work requested to be dome as shown by Permit No. 8 7_ 7 8 7 has been completed. 'Phis structure may be occupied as a !� One Family Dwelling Location O Hidden 111119 �Y OwnerSt#zphen M . Kelly By Order Town Board TOWN OF QUEENSBURY 700�0' Building & Zoning Inspector 4 BUILDING PERMIT TOWN OF QUEEN5BURY No. s7- 7s , WARREN COUNTY, NEW YORK o PERMISSION is hereby granted to Stephen M . Kelly c w OWNER of property located at Lot #96 Pleasant Lane Hidden Hills 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 with the Town of Queensbury Building and Zoning Ordinance. t. OWNER'S Address is Gn Sam 15 Willow Rd . rt ro Queensbury , N * Y . 12801 m 2. CONTRACTOR or BUILDERS Name Same N 3. CONTRACTOR or BUILDERS Address x o 4. ARCHITECT'S Name � *r a No ro r7+ x 'v S. ARCHITECT"S Address N fb (A to Fyy r r* B_ TYPE of Construction — (Please indicate by X) ro A Wood Frame i ) Masonry I ) Steel i 1 7. PLANS and Specifieartions No_ 271 x 651 as per plot plan , specifications and application including septic system and attahced two car garage . B. Proposed Use One Family Dwelling . 0 ro $5 . 00 CIO � 122 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES June 1 , 19 $$ (If a longer period is required an application for an extertsion must be made to the Building and Zoning inspector of the town of Queensbury before the expiration date.) ro Dated at the Town of Queensbury this 25th Day of November 19 87 t y� oc SIGNED BY 7 r / /t - we'00-� for the Town of Queensbury Building and Zoning Inspector TO BE COMPLETED BY BLDG . DEPT . i r;PIN N, C) Ff !F 4� CCam']� // Application No . 19 ��� `lowrt ©/ Queenjhurcy Permit Issued BUILDING and ZONING DEPARTMENT Permit Expires 19 L NOV 1311987 Bay and Hawifand Road, R.I7. 1 Box 98 Zoning Designation Queensbury, New York 12801 variance No . F l3i '' ,. zr , tuw r ': ;E : , L- 117 site Plan Review No . } 110 Approved ! APPLICATION FOR G� y G BUILDING P.ND 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 the Permit . -------- --�____-__-__- The owner of this property is : A , m * Tel P . [?. Address Location : (Irj y ` Tax Map No . Property �y r� 4 Street number or building lot numbe02- r Subdivision name ( if applicable) f j'' .Q' THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK� AS REGARDS BUILDING CODES ISa // Tel . No . NameAddress _ of builder F Address Tel . Name of lmber Tel * 1 � Address Name of mason Address_ yrZ . 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 configuration LOCATION OF STRUCTURES AFFECTED . of septic disposal area . APP * COMPLETE INFORMATION REQUIRED BELOW . Size of pr L�operty-4 ft ft . Existing buildings) Size ft X ? uC ft . PROPOSED BUILDING AND USE : * Existing buildings ) Use Size of new structure /� 7 ft X 40 6ft 45* Foundation-pier/slab/crawl/partial/full * Proposed building , distance from property line ( circle one ) .�,,, �, Front yard �+® ft Rear yard ,-.3tS ft No . of stories (habitable space/) Side yards ^ /'> ft and Q Alf f � Height ( grade to ridge) 4A ft . If on corner , setback from side street ft If residential , no . of families f * OCCUPANCY INFORMATION IcNo . of rooms ( excluding baths) 7 No, of bedrooms PRIMARY 'BUILDING - . No _ of bathrooms * One family dwelling Primary heating systemrn Two family dwelling Type of fuel GB106 Multiple dwelling / Number of units No . of fireplaces to be installedh. f Permanent occupancy Will a wood stove be installed? Aldo Transient occupancy YCentral Air conditioning? �A„Z&l ^ * 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 ACCESSORY BUILDING- Ca e Cod Cottage Other car Twal onia Row Town House Detached garage/one car/ two car/ - ( CIRCLE ONE PLEASE ) * Attached garage/one car/ two carj car � _Private storage building ESTIMATED MARKET VALUE OF * �Other CONSTRUCTION INFORMATION ON BUILDING SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET , TO BE COMPI Form BPA 4/86 and-vl c BUILDING PERMIT APPLICATION CONTINUED _ BUILDING SPECIFICATIONS : �'` Type of construction ,ructio , wood frame , fire safe , etc . , �.7 Will any second-hand or lumber be used? If so , for what ? Foundation wall material 4010 to . Thickness f/ Depth of foundation below grade (to bottom of footing ) ill there be a cellar? He ted or unheated? ,/A Floor sq. footage sq ft1 "' . ill there be a basemen ? ill any portion be used as living space ? ( If so , what portion? sq . ft . - - Type of use? -- Type of roof - sloped/flat/shed/other S Material of Size , wood studs "'X it spacing "a . c . length G ft. Joists ( floor beams ) lst . floor "X IF 4 _ s Pacin g .� "o . c . span ./� ft . Joists ( floor beams ) 2nd . Boor �' "X p �" spacing "'o . c . span�� ft . Overlays (ceiling beams ) "X " s acing '"o . c . span ft * Of rafters "'X IF spacing . O . C . span ft . of trusses (pre-engineered) spacing "'o . c . span _ft . xteriar wall finish /a✓ r r7 -7 _ Of what material? Interior wall finish If a garage i/s� to be attached , de cri a materials to be used for FIRE SEPARATION : Is there to be an opening between g r ge and dwc ing? p _ If so will a Fire-rated door , . enclosure , and self- closing device be provided? Will a flue-lined chimney be installed? Height aboire roof ft . Depth of chimney foundation below grade ft. Depth of fireplace hearth ft . in . Water supply - Municipal or private well SEPTIC SYSTEM _ Distance from ANY private well ( including adjoining properties ft . (A separate application is necessary for any `r'epair or new installation of septic system) Town of f Warren A F F I U A V I T STATE OF NEW YOR.K 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 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 hat such work. is authorized by the owner . 00 SWORN TO BEFORE ME THIS Signature - - -- -------- Owner , er " s agent , ar ire day of 19 _ ontractor - Notary Public , Warren County , N . Y . * * * * * * * * « * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * SPECIAL CONDITIONS OF THE PERMIT : $y--------------------------------------- A 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 : ,p 1 . Gross floor area / ii 2 . Type of heat._ 3 . Is the building mechanically cooled ? 4 . Percentage of area of windows and doors '1 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 ? 3 . Slab on grade YES NO a . If YES , what is the 1R value of insulation around perimeter of floor ? 4 . Is basement heated ? YES NO a . R value of insulation 5 . Type of insulation Be Under 16 % only 1 . R value of roof and flo rS� s exposed to ambient conditions _ value of exterior walls 1�- 114. • 3� 3 _ R value of glazed area . � 4 . R value of doors 5 . R value of floors over unheated spaces 6 . R value of slab edge insulation - unheated slab 71 R value of slab insulation - heated slab 8 . R value of heated basement/ cellar walls ( above grade ) - 9 . R value of heated basement /cellar walls ( below grade ) --"" r^ 10 . Type of insulation '� t �� �, I- 1:1Ss C . 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 �r 8 . Piping ion 1 . Sizee of of hot wager or cooling carrying agent pipe 2 . R value of pipe insulation F . Service Water Heating. _ 1 . Performance efficiency ' �o 2 . Temperature control setting maximum G . For Swimming Pool Only 1 . Maximum heating Telephone No . ( a0pplicant ' s ig ure ? / %Yown d( QeAW&*y APPLICATION FOR SEPTIC DISPOSAL PERMIT DATE LOCATION OF PROPERTY FOR INSTALLATION Aa ;04 - Y4 Owner's Name : � ''sd' �� Telephone: 2 Address: _ Z ,5 Installer's Name: �'h s� e _ Telephone: 7 . a� — Number of bedrooms (residential only) Total daily flow (compute @ 150 gal per bedroom) ifs 6T Topography: circle one: Flat Rolling, Steep Slope r'o of slope _ Sail Nature: circle one Sat Loam Clay Other / Depth: feet Ground Water: At what depth? feet Bedrock or Impervious Material: At what depth? _ A/ _._. feet Percolation test: circle one: not required required / rate min. inch. Domestic water supply: circle one: unicipa well Other IF domestic water supply is a Well: Separation: Watersupply from Septic absorption _�� feet PROPOSED SYSTEM: Septic Tank gal. (minimum size: 1 ,000 gal.) TILE FIELD: Each Trench feet / Total system length feet SEEPAGE PIT(S): Number of �t / Size each feet by feet Size of stone to be used # f Depth or Thickness . _ feet ,,r IMPORTANT ...Please...LIST NEW EQUWMENT 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: l .) 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. Sbould 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. I have read, the regulations above and agree to abide by these and all requirements Of the Town of Queensbury Sanitary a Disposal 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 VaUILDING and ZONING DEPARTMENT y and Haviland Read, R. Q. 1 Box 98 Queensbury, New York 12801 D I NGINSPECTOR,' $ REPORT NAME LOCATION Date PerrLGmi"ct` No . ✓ = APPROVED - YES No Footing/Pier Farms Foundation Waterproofing Hackfill Framing `( Roofing )( Siding Masonry Veneer Rough Plumbing ,,K Relie aloes X E;xt . Po hes FiniShe d. lacers jCInter1 T im xStairs & Ra Zings Cellar Drain Tile C oncrete Floo 5 ,X Plbg . Fixtures J( Gar . Fireproof-. ADoor Closers ,,Smoke Detectors f( Cbirnney INSULATION Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APP OVAL,Final Builds g Survey Next scheduled inspection ( call when ready ) Remarks �L � L ,� r� S i�iI +12r.5+lS- /l!•G . /�,+r�L+�'L3 � �7r�12. 1�rL�•�^'1 D .C . �f �P ►� tll�`� tiuildi g Inspector 6/86 and-vl �f�rr Own 0/ ' V BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Oueensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME f/ LOCATION . / 5;yc��'.-��Z_ �� Date� / Permit No . �� ' '�—� ........ �- Footing/Pier Forms APPROVES? - YES NO Foundation Waterproofing Backfill Framing Roofing siding Masonry neer Rough Pl ing -- Relief Val s Ext . Porche Finished Fl rs Interior Tri Stairs & Rail ' ngs Cellar Drain ile Concrete Floor Plbg . Fixtures Gar . Fireproof Door Closers Smoke ,Deter rs Chimney WSULATIO Foundati n Floors Walls Ce.i.lin FINAL LECTRSCAL INSPECTS - 3 DRIVEW APPROVAIt _ Final Building Survey— -- Next scheduled inspection (call when ready ) Remarks- and-vl Build ng Inspector 5/86 ' , ,��� �vwrlr e-r� �ctperr.�6urr� BUILDING and ZONING DEPARTMENT and Haviiand Road, R. D. I Box 98 Queensbury, New York 1280I BUILDING INSPECTOR ' S REPORT NAME LOCA7IC]N do Date � �- Permit No . ✓ =Footing/Fier Forms APPROVED YES . NC7 Foundation waterproofing Backfill Laming Roofing Siding Masonry Vene r Lfiw<gh Plumbin Relief Valves Ext . Porches Finished Floors Interior Trim Stairs & Railing Cellar Drain Tile Concrete Floors Plbg . Fixtures Gar . Fireproofing Door Closers Smoke Detectors Chimney INSULATION : Fo'un da tion Floors Walls Ceiling FINAL ELECT CAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection (call when ready ) Remarks- 0 // -1 L W6 Ff?( i AeI'pil�' and-vBui ng Ins cto E/$� I awn n/ �ises►+ sd urr� BUiLDING and ZONING DEPARTMENT Bay and Haviland Road. R. D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME_ LOCAT ION r dy ' ' DATE !rJ � / tl a PERMIT ANo . SOIL TYPE - Sand - Loam - Clay Percolation T t Required? YES - NO Percolation ra e - Min/Inch TYPE of SYSTEM: Absorption field , total length AD � Length of each tre h [3- - 3 ar Depth of trenches ' Size of grave]:_ SEEPAGE PITS{Number o _ Size- ft. X _ f Gravel size PIPING : Si a Type Bldg . to tank - Tank, to disc. box � Distv box to fie d/ Openings sealed . Ndr Partial LOCATION/SEPA TIONS : Foundation to tank 4I(] ft, Foundation t absorption �r�IDft . Absorption o lot line ft . Separatio of pits f . Iow SYSTEM ON PROPERTY (circle One) Front - ear - Left side - Right side - NT . SYSTEM USE APPROVED YES NO 10 Buil ing I sp for 01/86 and vi /r" S _Jc�urrt o Queens bury EIUIL�DING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Oueensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME LOCATION Date Permit No . ✓ APPROVED - YE NO �5otingfPier Forms Foundation Waterproofing I3ackfi 11 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 Detector Chimney INSULATION : Foundation Floors Walls Ceiling_ FINAL EIEC RTCAL INSPECTION DRIVEWAY A ROYAL Final Building Survey Next scheduled inspection ( call when ready ) Remarks- Building Inspector 6/86 and-vl y BUILDING and ZONING DEPARTMENT I Say and Haviland Road, R. D. 1 Box 98 I Oueensbury, New York 12801 BUILDING INSPECTOR ' S R�rE, P--GIRT nor NAME ,-�c,..t,,""z- L O C A T I O N nor Date .�� ,/� i Permit 'No . �'/- / ✓ = APPROVED - Yq NO C.�ooting/Pier Forms Foundation Waterproofing r Backfill Framing Roofing Siding masonry Veneer No Rough Plumbing Relief Valves Ext . Porches Finished Floors Interior Trim stairs & Railings Cellar Drain Tile Concrete Floors Plbg . Fixtures Gar . Fireproofing Door Closers orroonnon Smoke Detectors Chimney INSUI ATION : Foundation Floors Walls Ceiling FINAL, ELECTR.ICA INSPECTION DRIVEWAY APPROVA Final Building, Survey Next scheduled inspection (call when ready ) Rema rk.s- Building Insp ctor 6/86 and-vl C MIDDLE DEPARTMENT INSPECTION AGENCY, INC. 900 Haddon Avenue, Collingswood, N.J_ 06105 G Date vC tc;U 2 i T 1 Ccrtifle5 that the electrical equipment listed has been examined and is approved as being gin accord with the National Electrical Code, ap plicable governmental , utility and Agency rules. 5 Owner: �3 t e,?hen Ke 1 i y Occupancy, Di.lc I i OccuPant: s=e This ceryhcate covers the electrical equipment ann insiahation :nspzc:ec '1-.-S \ Cale If addllkpnal equipmenx Should be introeo Cad or alterah Ons made is Juhl ,R e%I51n1g 21 Inin certificate Shall be MU14 afld void. and aPpliGahun for Equipment ! )u r t e t:3 j G: 0 Recep tz-zc j es j JIB r Z e ? inscecrion should i submitted promptly to Irma Agency S ervi ar= j ,;iy7p 11.,pr1C es HOldet Of this certificate shou#d present same 10 his properly Insurance carrier (agent Or C O m pan y)&S evidilinCe 01 Certd I Ca I tan Of elechicai eq u I p men I ap p r ovetl as Specified. C Applicant: �tLe ? 1y lectr� c I111ON4 Roc -d No . �Gletas c^ ilea ;:Y 12301 J Fenn No. 70$ EL 1+4.3 f 0� vtn f ri I �X� v`rhrr� WEIZXIO / 10 .i /doo i AZ• Tlkr11< 1o,�v1i'Na f„J f Oct s ✓� any I G 30' SErf3.4cY- LINE MAP REFERENCE HIDDEN HILLS SUBDIVISION MADE FOR RALPH & MICHAEL WOODBURY BY VonDusen A Stoves DATED MARCH 26 , 1986 FILED SEPTEMBER 22 , 1986 IN MAP CABINET A , SLIDE 44 9� I e F_- e M \ S iSy � Ga LaT 17,502.58 Q. FT. r 38S _ o APPROVED FOR SEWAGE DISPOSAL \ \\ NEW YORK TATE DEPARTMENT OF HEALTH. o P.E. / SANITAIkY ENGINEER DATE - Q PLOT PLAN MADE FOR S TEPHEN K'EL L Y •�,•,r.AJ TOWN OF QUEENSBURY WARREN COUNTY , NEW YORK '�A��lp .� SCALE I = 30' DATE :MARCH 29 , 1988 VonDus en Steves LAND SURVEYORS, GLENS FALLS, NEW YORK N.Y. STATE LIC. NO. 35617 73 S - 7Z.