1987-777 ' CERTIFICATE OF CJ1"`CU ".A►.N'+CY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 19
This is to certify that work requested to be done as shown by Permit No. 87- 777
has been completed.
This structutF y be occupied as a One Family Dwelling
Location I�t ig Bay Rd .
Omer David. & Karen Hamell
BY Order Town Board
TOWN OF QUEENSBVRY
Building & Zoning Inspector
BUILDING PERMIT
H
TOWN OF QUEENSBURY �
No. 87- 777 '-
WARREN COUNTY, NEW YORK
z
o
PERMISSION is hereby granted to David & Karen Hamell .
OWNER of property located at 513 Big Bay Rd .
Street, Road or Ave.
ti
in the Town of Queensbury, To Construct or place a Addition to One—Family Dwelling r
at the above location in accordance to application together with plot plans and other information hereto filed and w
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance_
1 . OWNER'S Address is Same
tv
2. CONTRACTOR or BUILD 0ER'S Name .�
Same r'-
fY+
3. CONTRACTOR or BUILDER'S Address
fU
tb
m
4_ ARCHITECT'S Name H
f�
5. ARCHITECT'S Address
to
Y
w
B. TYPE of Construction — (Please indicate by X) ay
F+-
Ot7
{ V Woad Frame ( ] Masonry { I Steel ( 1
A�
`C
7_ PLANS and Specifications
Q..
No. 35 ' x 40 ' as per plot plan , specifications and application .
4 -
8_ Proposed Use
Addition to one family dwelling
cn.
$5 . 00 CID ti
$ 10 . 20 PERMIT FEE PAID - THIS PERMIT EXPIRES June 1 , 19 88 �
{If a longer period is required an application for an extension must be made to the 8uIIdF
town of Ctumnsbu before the a ng al►d zoning inspector of the o
r'Y sgpiration data.Y
C2Oth November
Dated at the Town of Queensbury this Day of 19 $7 �
y7 / { Iv
SIGNED BY _ / /G for the Town of Queensbu
Buildingand zoning Inspector
5
TO BE COMPLETED BY BLDG . DEPT .
Application No .
,✓nulr� o fleert�6ttr� Permit Issued 19 tyi � Ott C
BUILDING and ZONING DEPARTMENT Permit Expires 19
Bay and Haviland Road, R. D. 1 Box 98 zoning Designation
Oueensbury, New York 12801 Variance No. ;
Site Plan Review No . 1y0U 2 0 1987
Approved y
APPLICATION FOR At<_
RUILDING 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 the Permit .
______________ ________ _____________________ _-______-_-_____.________-__--__. .-
The owner of this Iproperty i�s�: i AV16 ,5 4MELL. {I'yA.09 '�! L ��,�'* (..L
P. O. Address 1r3 L7ld' r _L� Cx �ICf G k'4 �A �Lr � � /�e! ",✓ Tel <"geii 5�
Property Location : Tax Map No .
Street number or building lot number
Subdivision name ( if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS :
I}AVIb S I-JAMALL_ S54oy
Name P . O. Address Tel . No .
Name of builder E1' ,5 �/ Address Tel .
Name of plumber Address Tel .
Name of mason Address Tel .
NATURE OF PROPOSED WORK : ZONING INFORMATION :
Construction of a new building A PLOT PLAN MUST BE PREPARED AND SUBMITTED ,
3_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 ft X zc!ce) ft .
Existing building ( s ) Size ��ft X �, g ft .
PROPOSED BUILDING AND USE : Existing building ( s ) Use A A66. SPACE.
�tSize of new structure .7j ft X.,,Y�Dft
Foundation-pier/slab/crawl/partial/full Proposed building, distance from property line
(circle one )
* Front yard 30 ft Rear yard ft
No . of stories (habitable space ) / �-
Height ( grade to ridge ) ft '
� _ ;I fp * Side yards �► y7, _f t and t., f t
.-- If on corner , setback from side street ft
If residential , no . of families I
No . of rooms ( excluding baths ) . OCCUPANCY INFORMATION
No. of bedrooms
f PRIMARY BUILDING
No * of bathrooms -
Primary heating system &L44.A,t One family dwelling
Two family dwelling
Type of fuel Multiple dwelling / Number of units
No . of fireplaces to be installed &� permanent occupancy
Will a wood stove be installed? ,m Transient occupancy
Central Air conditioning? Zyyfw
Business
BUILDING STYLE, PRIMARY STRUCTURE * Industrial
Ranch Contemporary Lo cabin * Other '
Raised ranch Mansion y Duplex If addition , what will use be?
IJ/
Split level Old style Bungalow
Cape Cod Cottage Ot er * ACCESSORY BUILDING-
Colonial Row Town House * _Detached garage/one car/ two car/ car
( CIRCLE ONE PLEASE ) Attached garage/one car/ two car/ car
* * * * * * * * * * * * * * * * * * Private storage build '
ng
ESTIMATED MARKET VALUE OF Other. RY
CONSTRUCTION
INFORMATION ON BUILDING SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED !
Form SPA 4/86 and-vl
BUILDING PERMIT APPLICATION CONTINUED
BUILDING SPECIFICATICNVS :
Type of construction , wood frame , fire safe , etc .�
Will any second-hand or ungraded lumber be used? If so , for what? ZY6
Foundation wall material CONLf,PT &&Oc k 'Thickness -
Depth of foundation below grade (to bottom of footing ) A
Will there be a cellar ? "yj Heated or unheated? WgrAr Floor sq. footage ", g�db sq ft
Will there be a basement? 40 Will any portion be used as living space? ]r&
( If so , what portion? ZZ* sq , ft . - - 'Type of use? 1,/(//
Type of roof - sloped/flat/shedfather Slp�o�� Material of roof yWaW /�'+i 97:44
Size , wood studs_ " XT1y, spacing "o . c . length �ft ,
Joists ( floor beams ) lst . floor 7 ^"X ed'" spacing, _"o . c , span A5� €t ,
.joists ( floor beams ) 2nd . floor` " XJ " spacing Aje "o . c . span..2-__fL .
Overlays ( ceiling beams )
//_ "X_ "' spacing "o . c . span_ __fft .
Roof rafters 7 " X ram" spacing_Z _o . c . span ft ,
Roof trusses (pre-engineered) spacing " o . c . span ft .
Exterior wall finish /�� /- // Of what material? tSpz;;�
Interior wall finish
If a garage is to be attached , describe materials to be used for FIRE SEPARATION :
Is there to be an opening between garage and dwelling? #3 If so wi a Fire-rated
door , enclosure , and self-closing device be provided?
Will a flue-lined chimney be installed? Height above roof _- M2 €t .
Depth of chimney foundation below grade ft .
Depth of fireplace hearth„_. �ft , (p in ,
Water supply - Municipal or private well ►f/li„//[/,0,¢
SEPTIC SYSTEM _ Distance 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 R D R V I T
County of Warren 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 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 cified or not, and that such work is
authorized by the owner .
SWORN TO BEFORE ME THIS signature __--
Owner , own Is agent . arcnir-ect , contractor
clay of 19
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
2 , Type of heat (r- F
3 , Is the building mechanically cooled ?
4 , Percentage of area of windows and dvors �. /,/ . 25 Cr
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 ?
30 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
50 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 lFj►
3 , R value of glazed area
4 , R value of doors /
59 R value of floors over unheated spaces ( 1 ' RiS'Tlntt'
6 , R value of slab edge insulation - unheated slab. f
7 . R value of slab insulation - heated slab hjjX') -
-ti
8 , R value of heated basement / cellar walls ( above grade )
9 , R value of heated basement/ cellar walls ( below grade ) Jz__.. C.
10 . Type of insulation p4 ? -
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
E . Piping Insulation
1 . Size of hot water or cooling carrying agent pipe
2 , R value of pipe insulation
F , Service Water HeatingC
1 , Performance efficiency � Ls
2 . Temperature control setting maximumvc_
G , For Swimming Pool Only
1 . Maximum heating
Telephone No . j A 4VA I
( ppl ' cant ' s s '3 nature )
APPUCAT70N FOR SEPTIC DISPOSAL PERMIT
DATE // " / I / v7`
LOCATION OF PROPERTY FOR INSTALLATION
Owner's Name : ]y,q-1�f� ,. , WME� � r 1, L Telre-phonea � C6 �"
Address: 513 leI�G- L?�" 5 �f ,fJ� L)C w
Installer's Name: &5T/l Telephone:
Number of bedrooms (residential only)
Total daily flow (compute (ZD 150 gal per bedroom) tf.�
Topography: circle one: lot olling Steep Slope $'o of slope
Soil Nature: circle one• Sand Loam Clay Other / Deptheo r feet
Ground Water: At what depth? o9 feet
Bedrock or Impervious Material: _Att what depth? —� f - feet
Percolation test. circle one: Hoff require required / rate min. inch.
Domestic water supply. circle on 1Viunici al ell Other
IF domestic water supply is a Well:
Separation: W atersupply from Septic absorption _�^ feet
PROPOSED SYSTEM: Septic Tank 1000 . 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 # l Depth or Thickness feet
* * * * * * * * * * * * * s * * * * * * ac * * * * * * * * * * s s * * ale * * * * *
IMPORTANT
...Please...LIST NEW EQUIPMENT TO BE INSTALL.ETa
EL
(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 $2 So.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.
I have read the regulations above and agree to abide by these and all requirements
of the Town of Queensbury Sanitary ag ce.
y�
Signature ofr responsible
� person: �
Date: T
Town of Queensbury
Building and Cade Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832
SETTLED 1763 . . . HOME OF NATURAL BEAUTY . . . A GOOD PLACE TO LIVE
TOWN OF QU£ENSSURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY , NEW YORK 12804
TELEPHONE ( 518 ) 792- 5832
BUILDING INSPECTOR' S REPORT
REQUEST FOR INSPECTION RECEIVED
RAMIE_ f/r cif -e
LOCATION +-/ -
DATE PEIIMIIT # .
TYPE*OSTRUCTURE / /
RECHE{KF +' : APPROVED
�'- " N/Al YES I NO
FOOTINGS/PIERS
MONOLITHIC POUR FO
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPOMlSISL
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS FOLLOWING
THE PLACEMENT OF THE CONCRETE_
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATIO WALL POUR
REINFORCEM T IN PLACE
FOUNDATION/ MPROOFING
BACKFILL APP VAL
ROUGH PLUMBING
PLUMBING VENT/ V IN E
PLUMBING UNDER S B
FRAMING : old
JACK STUDS/HEADE
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS /MAIN BEAM ':
FIRESTOPPING ,
WALLS
CEILING
FIREWALLS
HEATING ROUGH— IN
INSULATION:
FOUNDATION WALLS IN E IOR R—
FOUNDATION WALLS EXTERIOR R—
FLOORS R—
WALLS
CEILING R—
DUCT WORK OR PI ING IN UN EA ED
SPACE
REMARKS :
5
ARRIVE
DEPART
I PECTOR
BUILDING DEPT. COPY OF APPLICATION FORM 46-EL, NEW_YORK SOA D OF FIRE UNDERWRITERS.
THIS TIS COPY WITH BUILDING DErlor }NIiEI�I �IRF�P•
/ • ,B DATE }J. -
CITY OR y f /'! 1� �r �l TOWHtsl4tP COUNTY
VILLAGE L
STREET AND MO. OR C POLE M
ROAD AMD POLE NO.BE
CROSS STREETS Is
PREMISE L TED? �r i,.# �' 'c•a" ECTIf.IN BLOCK LOT
BUILDING
NAME OCCUPANT'S �`., - fi i i r OCCUPANCY .
OWNER'S NAME , t f h : TEL. ,1k ' s •.
AND ADDRESS - r
'CURRENT OFFICE
SUPPLIED Al I1 FROM THEIR
By BUILDING �I DEFECTS
NEW L^� OLD � IWORK MEW El ADDITIONAL O REMOVED Q
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
Ha of FlxtanaS lc BR' OFFICE USE
NUMBER OF OUTLETS Larne Raxeptaclw, MOTORS HEATERS CIRCUITS ONLY
aOo Ah•t Sw1uh P"KuwR Breeet No. Type Each lil • Eaah H.P. IlIhm * - ~avow INSPECTION
Ceiling Slide #r
Wee ReeapTa
ssidlim
E..iw
here
Baer
m.rrt
Iat FL
21W F1.
Srd FI_
REMARKS. LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: 00 NOT JIBE THIS SPACE`
This application iS intended to CWrer the ebo listed eguiPneot W M Inspected but it at tuna of inapeC"iaei tllare is fearrrd addi-uooal o0japirrwtl not ebetlle fisted,
you are euthoriaed W make the irspactloo and ■djoss the feen mover the the +dditional eguipnWeit. N p"mmond by tho aPPlitr aaL
ELECTRIC SIGN TOTAL
SIZE: OF FEEDERS LAMPS WATTS
MAINS
CHARACTER EXPOSED GAS TUBE SIGN
OF WORK ONC EALE.D TRANSFORMERS OF VA
OJTARIBCD
W TO BE CNUMBERI ICAPACITYI
COMPLETED --I SIZE OF SIGN
ERS OVERHEAD UNDERGROUND MAKER
OF SIGN
LDING
PECTION REQUESTEDOR AS NEAR AS r^ NEW OLD
SILE
AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES DATE o
MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. APPU ON
PRINT NAW AND jyFf'DDRE$ ,r ,/� SIGNATURE
NAME
r ci 1 '" I yJL.�--Y' /1► OF APPLICANT
STREET ADDRESS
,r ' -' TEL
CITY OR 1'- Lr•- zip ODE + ^j C/f� / LICENSE NO-
f i :7 J YYHEN APPL!r_A<�t E
POST OFFICE
ae Ei. (Rev. +/ae) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING
k`
I
1
r 6CN
� r
IZ- �