1987-833 i
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date May i4 , 19 88
This is to certify that work requested to be done as shown by Permit No&
has been completed.
one Family Dwell ng
This structure may be occupied so a
I..acation
.0�R;D Peggy Ann Lick .
1lav1d Howard
Oavlf ker
By Corder Town Board
TOWN OF QUEENSBURY
Building & Zoning Inspector
BUILDING PERMIT �
TOWN OF QUEENSBURY �
No. $7-833 z
WARREN COUNTY, NEW YOR K `D
N
David Howard i
PERMISSION is hereby granted to
RD # 2 Peggy Ann Rd .
OWNER of property located at 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�
f. OWNER'S Address is
Same µ
a.
x
0
E
2. CONTRACTOR or BUI LDE R'S Name H
Martin Mosher
3_ CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
r.�
f
ro
oQ
w
5. ARCHITECT'S Address *C
C
6. TYPE of Construction — (Please indicate by Xi ¢
f 1 Wood Frame ( 1 Masonry f 1 Steel i }
7. PLANS and Specifications
Q
No. 34 ' x 44 ' as per plot plan , specifications and application including roc
septic system and two car attached garage .
w
8. Proposed use One Family Dwelling
E
ro
$5900 c/o N
$ I15 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES July 1 , t988
ov
IN a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of aueensbury before the expiration date.}
Rated at the Town of Queensbury this 8th Day of December �, 87
SIGNED BY / / / ,'Oew LC • 4 for the Town of Queensbury
Building and Zoning Inspector ..
To HE COMPLETED BY BLDG. DEPT.
TC)'dVN 0F QUEENS ,
own o reeerxal6te// ry Application No.
r _
Permit Issued 19 R irJ L7
BUILDING and ZONING DEPARTMENT Permit Expires 19 D
r 7
Bay and Maviland Road, R.D. 1 Box 98 Zoning Designations DEC � #
Queensbury, New York 12801 Variance No. 1
987 .
Site P Revie -DI'NC- & C400E_ DEPT,
APPLICATION FOR
BUILDING AND ZONING PERMIT
A PERMIT MUST BE OBTAINER BEFORE BEGINNING CONSTRUCTION . ANSWER ALL OF THE FOLLOWING .
The undernlgoed 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 : �y
P. O. Address Tel . —rT "
Property Location : �6 Tax Map No . /_�f
Street- numb&3F Vr building lot number
Subdivision name ( if applicable)
THE PEVAqN RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS :
I5 4 ` .
Name P . O. Ad r Tel . No .
` n
Name of builder &,ALL /Address k) 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 .
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 .
Ok * Size of property ! (' o ft X ft .
* Existing building s) Size ft X ft .
* . . - , .
PROPOSED BUILDING AND USE : * Existing building ( s ) Use
Size of new structure ��r ft X ft
Foundation-pier/slaGb/crawl/partia fu 1 * Proposed building , distance from property line
(circle one ) ft
No . of stories (habitable s ace) ^ * Front yard ' ft Rear yard
Height (grade to ridge) Side yards ft and ft
ft If on corner . setback from side street ft
If residential, no. of famlll-es
Now of rooms ( excludinc baths ) * OCCUPANCY INFORMATION
No , of bedrooms ' PR Y BUILDING -
Now of bathrooms * one family dwelling
Primary heating s stern �✓ u * ' Two family dwelling
Id
Type of fuel [ 7 Multiple dwelling / Number of units
No . of fireplaces to be installed * Permanent occupancy
Will a wood stove be installed? OF * .
Transient occupancy
Central Air conditioning?, YI.A ^ Business
BUILDING STYLE, PRIMARY STRUCTURE * Industri l
* Other '
Ranch Contemporary Log cabin If addition, what will use be?
Raised ranch Mansion Duplex � .
Split level Old style Bungalow * "`
Cape Cod Cottage Other * ACCESSORY BUILDING-
Colonial Row Town Mouse * ' Detached garage/one car/ two—car/ car
( CIRCLE ONE ]PLEASE ) " Attached garage/one car/ two cajW car
Private storage building
ESTIMATED MARKET VALUE OFF Other
CONSTRUCTIONOQ -� r~
INFORMATION ON 80ILLIING SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET, TO VE COMPLETED I
Form BPA 4/86 and-VI
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS :
`type of construction , od frame fire safs, etc .
Will any second-hand or ungra ed lumber be used? If so, for what?
Foundation wall material 21 Thicknestoos
Depth of foundation below grade (to bottom of footing }
too
Will there be a cellar?-�V' ( Heated or ate 9 pioor sq. footage c sq ft
Will there be a basemenE7 �ill any portion be used as living space?
( If so, what port ' sq . ft . - - Type of uses?
Type of roof 51 ad layyyt/shed/other Material. of ro f
Siee , wood studs 40x / ,�
spacing_-- o _ c . length ft .
xoists ( rloor beams ) 1st , floor -�0X spacing /fe ',o . o . span 07 ,ft
i .
Josts ( €loor beams] 2nd . floor 41 r` spacing "o . c , span ft .
Overlays ( coiling be
ams } Fix to spacing "o. e . span ft,
Roof rafters 'rX " spaaing� o . c . span�fto
Roof trusses (pre-engineered) spacing "o . e . span ft _
Exterior wall finish f1�4 pe�f what material?
Interior wall finish4y���
If a garage is to 4e attached , describe materials to :-be used for FIRE SEPARATION :
Is there to be an opening between garage and dwelling? € so will a Eire_-rated
door , enclosure , and self-closing device be provided? ,ram.
will a flue-lined chimney be installed?. Height v aboe roof ft .
Depth of chimney* foundation below grade ft .
Depth of fire plac h�'ft .
Water supply unici a or private well
SEPTIC SYs*rLM _ Distance from ANY private well ( including adjoining properties ft .
(A separate application is necessary for any 1rlepTair or new 'Installation of septic system)
Town of flu ry
County of Warrenarren A F F T D A Y 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 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 that such work is
authorized by the owner . J
SWORN TO BEFORE ME THIS Signature __
day ofi2d l9
Owner, owners agent , arcnasect,, contractoY
Notary Public , Warren County , N . Y .
A W * * t * * * w , * * to * : * * t * * * * * * Ar #r Ar Ar yr * tk * * : Ar * * tk it k IF to Ar ,r tt tk s
SPECIAL CONDITIONS OF THE PERMIT :
_—_—
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
1 . Gross floor area I( �}
2 . Type of heat
3 . Is the building mechanically cooled ?
�
4 . Percentage of area of windows and doorsu1U'
A , Over 16 % Only
14 W value of gross area of walls , oof / ceiling and floors
exposed to ambient conditions
2 , Floor over heated spaces CYE%S NO -
a , Are foundation walls insulated ? +OYES NO
1 . If YES , what is the R value ? � ZL'� Teti
3 , Slab on grade YES NO
a , if YES , what is the value of insulation around
perimeter of floor ? III
4 . Is basement heated ? YES GDO �
a . R value of insulation
I �
5 . Type of insulationp
B , Under 16 % Only
1 . R value of roof and fl ors exposed to ambient conditions _
. .'70
2 , R value of exterior walls l
3 . R value of glazed area l +
4 . R value of doors . � " �
5 . R value of floors over unheated spaces
f , R value of slab edge insulation - unheated slab
7 , R value of slab insulation - heated slab
s , R value of heated basement / cellar walls ( above grade ) - �v
9 , R value of heated basement /cellar walls ( below grade ) L- � �
1O . Type of insulation
C . Controls l
1 . Thermostat maximum heat setting
D , Duct Systems
1 , Is duct system installed. in unheated spaces ? NO
a . if YES , R value of duct installation
b . R value of duct in other areas
E , Pining Insulation
1 . Size of hot water or cooling carrying agent pipe
2 , R value of pipe insulation
F , Service Water Heatingl� S
1 . Performance efficiency �j r'
2 . Temperature control setting maximum l `
G . For Swimming Pool Only
1 . Maximum heating
Telephone No .
( applicant s signature )
1
APPLICATION FOR SEPTIC DISPOSAL PERMIT
DATE
LOCATION OF PROPERTY FOR INSTALLATION
rr
Owner's Name: - ,Lf4 Telephone: . /Z `I
Address:
Installer's Name: Telephone: 01 2 ?`
Plumber of bedrooms (residential only) �) _
Total daily flow (compute @ 150 gal per bedroom)
Topc graphy: circle one Flat Rolling Steep Slope °10 of slope _!
Soil Nature: circle one: San Loam Clay Other / Depth: feet
Gaound Water: At what depth? feet
Bedrock or Impervious Material.: At what depth? i feet
Percolation test: circle one: not required equire / rat in. inch.
Domestic water supply: circle one Muni ell Other
IF domestic water supply is a Well:
Separation: Water-supply from Septic absorption — feet
PROPOSED SYSTEM: Septic Tank L 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 (c feet
IMPORTANT
...Please...LIST NEW EQUEPMENT TY3 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
50 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 $254.0o.
C. An approved copy of the plot plan shall be available on the construction
site. Failure to produce said plot plan at time of inspection may result
in an immediate work stoppage.
D. Should unforeseen problems during construction prevent proper installation,
alteration or repair of an approved system, a new proposal must be submitted
to the Queensbury Building Department before further construction.
I have read the regulations above and agree to abide by these and all requirements
of the Town of Queensbury Sanitary Sewage Disposal C Wdinauce.
Signature of responsible person;
Dater
Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832
SETTLED 1763 . HOME OF NATURAL BEAUTY . . A GOOD- PLACE To LIVE
Y
F o5 a THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
to 41 STATE STREET, ALBANY, NEW YORK 12207 ^] i^� Q
Date *'�a y� 2 3 r 1 09 8 8 Application No, an fide 0 0 4 6 14 { B igr. A f 1 ? 9 G �.J
THIS CERTIFIES THAT h�
Only the electrieal equipment no close *bed below and Introduced b the applicant non on Clue aboow application number in the premiiows of
I]ave Floward 1>a Tay ,inn Rd . Glens rzal s ; '-Tew York
outside
on the following location: Fi Basement lot Fl. YCI 2nd Fl. section Block L.ot
won examined on 5 " 1 d ^ 88 andfound to be in compliance with the requirements of this Board.
FIXTURE ECRTACLES SWITCHlS HXTURES RANGES CO0ILING DECKS 4VEN5 DISH WASHERS EXHAUST FANS
OEt'tLRTyy.B +y ,�T 1MC►JJpE$OENT FLUORESCENT V AMT, K. W. AMT. K. W- AM K.W. AMT. K. w. AMT- M. P.
1SD 3 -1 1. 3
DRYERS FURNACE MOTClRS FUTUEE APMANCE FEEDERS IS06CIAL REC'PT TIME CLOCKS y UNIT HEATERS +t'►YLTI-OUTUIT DIl MPARS
SYSTEMS
OILw- P. GAS M. P. MP
T. NO. . 0. AMT. AMP. AMT. AS. TRANS. AMT. N. P. NO. OF FEET ,+uAT. WATTS
SERVICE I115CONNECT NO. or S E R {., V 1 C E
MST. AMP. TYPt .memo 1 Je 2w 1 X '9'rr 8 X 3W 3 .a IW Ma CIF ccdCONn. OF C[CaND. NO, Of WaG OIF�HI i4FG NO, OF MEUTRAlS A- W. 6. `
1. 00 c b x 4 0
OTHER APPARATUS: 2 . g tl C i
1 - smoke detector
Sa1x+ W . Corhouse a-
11 potter �Rc3 . /
r:,an '~evoor t r NY 12831. y BRA14CH MANAGER
c7 Per.
This certificate must not be altered in any manner, return to the office of the Board if incorrect. Inspectors may be identified by *Wlr credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. _ IL
�J'own o/ Queenji "rty
BUILDING and ZONING DEPARTMENT
Say and Hawi#and Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME `� r✓/ C tlfe,_,y .� .�
LOCATIONf�rQf
Date-4 c $ / Permit. NO o I
APPROVED - y NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
(tough Plumbing
Relief Valves
Ext . Porches
Finished Floors
Interior Trim
Stairs & Raili s _
Cellar Drain le _
Concrete Flo s� ---
Plbg . Fixtu S
Gar . FireP ofing
Door Clos s
Smoke Det Ctors
Chimney
INSULATI N :
Foundat on
Floors
WaI. 1s
Ceiling
FINAL ELECTRICAL, INSPECTION
DRIVEWAY APPROVAL
inal Building Survey
£Text scheduled inspection (call when ready )
Remarks- /,
Funding Inspector
6/86 and-vl
.Down o� �ueerzn36ure�t
} 40 BUILDING and ZONING DEPARTMENT
ay and HaviIand Road, R. D. 1 Box 98
Queensbury, New York 12801
1 "
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME
LOCAT ION Ztlj
DATE PERMIT NO . f
SOIL TYPE - an Loam - Clay --�
Percolation Test Required? YES
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorpti n field , total length
Length o each trench
Depth of Tenches
Size of g vel
SEEPAGE PI S4Number of)
Size- f X �ft .
Gravel size FV-off.
PIPING : Sizer Type
Bldg . to tank
Tank to dist . x
Dlst. box to fi d/pit -
Openings Seale _ ~ NO Partial
LOCATION/SE RATI
Foundation o tank I4 ft.
Foundatio to absorpt ' on ac ft .
Absorpti to lot line ,e'i, ft-
Separat ' n of pits cAe7 ft-
WCAT"- OF SYSTEM ON P OPERTY (Circle one)
Rear - Left side - Right side -
C S :
SYSTEM USE APPROVED YES NO
Building Inspector
01/86 and vl
BUILDING and ZONING DEPARTMENT
ZL
y and Haviland Road, R. D. I Box 98
Queensbury, New York 12801
DING INSPECTOR ' S REPORT
NAME
LOCATION
Date_:: Permit 60 . [7
✓ = APPROVED - YES NO
Footing/Pier Forms
Foundation
waterproofing
Z S��kfill
Framing G
Roofing
Siding
�M onry Veneer _
gkh Plumbing
Relief Valves _
Ext . Porches
Finished Floors
Interior Trim
Stairs s Railings
Cellar Drain Tile
Concrete Floors
Plbg , Fixtures
Gar _ Fireproofi g
F>oor Closers
Smoke Detecto
Chimney
INSUTATION :
Foundation
Floors
x walls
PCei1in(3
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final B%iilding 'Survey
Next scheduled inspection ( call when ready )
Remarks -
Fiuilding In'specFtor
G/86 and-vl
eA1
} C�
AJIP fowrr o/ Queensl�iurt�t
BUILDING and ZONING DEPARTMENT
` Bay and Haviland Road, R. D. 1 Sox 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION
Date ,/ / f '� permit No . O(
✓ = APPROVED - Y NO
�oting/Pier Forms
t ,oundatlon
waterproofing
E3ackfill
Framing
Roofing
Siding
Masonry Ven er
Rough Plumbi g
Relief Valves
Ext . Parches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg . Fixtures
Gar . Fireproofin
Boor Closers
Smoke Detector
c'hirnney
INSULATION :
Foundation
Floors
Walls
ceiling
FINAL F.I E TRICAL INSPECTIO
DRIVEWAY PPROVAL
Final Building Survey
Next scheduled inspection (call when ready )
Remarks-
'-. }G✓ �'� � S
II
Building I spector
6/86 and-vl
f lrIr )
._fawn a/ Queen .fi* t4ry
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R. D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
fox
LOCATION p G
Date f_ r ermit No . - ,
f ✓ = APPROVED - NO
`footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext . Porches
Finished Floors
Interior 'Prim
Stairs & Railings
Cellar Drain Tile,Y
Concrete Floors - --
Plbg . Fixtures
Gar . Fireproofin
Door Closers
Smoke Detector
Chimney
INSULATION :
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection ( call when ready )
Remarks-
� <
Building InkPK for
6/86 rnd -vl
BUILDING DEPT. COPY OF APPLICATION FORM 46-EL, NEW YORK BOARD OF FIRE UNDERWRITERS.
FILE THIS COPY WITH BUILDING DEPT. WHEN REQUIRED.
TES # DATE �
CITY VILLAGEOVVMSFifP
er.! .. -..' . COUNTY jo
STREET AND NO. OR i"
ROAD AND PDLE NO_ i-
BETwEEM WHAT Two
CROSS STREETS IS 1 _ ... ! ..,.. ."/
PREMISE TED?
SECTION_ BLOCK OT
OCCUPANT'S ---1
NAME '' BUILDING
i1WNER"S NAME
f:.t „- - �.eCf✓+.'�.:. OCCWA ICY !� u.d_ C " /J- - `�•r•-i�..fc. - '
AND ADORESS .• / .
S'IJPPLIED
BY FROM THEIR OFFICE
BUILDING ff--1f DEFECTS
IS NEW OLD tJ IWDRK NEW ADDITIONAL REMOVED C
LOST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETS No. of Flxtww & BRANCH
Local- iLanw RoamimptaclN MOTORS HEATERS CIRCUITS OFFICE USE
tlast Caiun1 Sit" Attach't gt - "-P. ONLY
wan Raeals'la Salit Pendant Bracket No, Type Each Ms lflfreq A.YVCG.
E■eh No. Below INSPECTION
Ort-
Sub-
flda
bNa
now
titan[
list Ff.
ZnUd FI
3rd FL
REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: DO NOT USE THIS SPACE.
This application is lntanded tar ca w the aboae-listad eclimmipawiwiflWbat inspected but if st tuna of ineprcNon the, fs found additional i
Y� are itu o rawal to make the in a'4e ftmenx not abate listed,
specxion and adjust the fee to cower the additional equiPstsent. as ps--'_' yy the appKcant..
SIZE OF "' ELECFRiC SIGN
MAINS (yam [,,asw :+""�",y^'(�,� FEEDERS LAMPS WTOTAL
ATTS
CHARACTER f EXP4DSED GAS TUBE SIGN
OF WORK fut-�#J` CONCEALED TRANSFORMERS OF VA
WORK TO BE (NUMBERI iCAPACITY)
STARTED e2 �Ct;MNPLETED
SIZE OF SIGN
If TERSE OVEflHEAD VNDEIiG$plllND !MAKER
ILDfNG P OF SIGN
EnF. EC TION REQUESTED
ON OR AS NEAR AS
POSSIBLE NEW OLD
AVOID DELAY BY GIVING FULL A ACCURATE INFORMATION. ALL SPACES ,i
MUST BE FILLED IN OR APPLICATION
DATE OF
MAY BE RETURNED- /
PRINT NAMNAME OF E/,,jA N/�D�/ADD ESS APPLICATWN^—'-y
APPLICANT ^' 7 "' r o" t4w� /e 19 SIGNATURE
OF APPLICANT
STREET ADDRESS 0 TELEPHONE #'
CITY OR // y
POST OFFICE r ~�'� - CODE ll'-3' WHEN APP LICENSE LICABLE
46 I:L (R"N 1/815) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING
pE-;�.q
y
.J
� II
5
AIAP 0� A AMP6- Lori
DA V r D A. 4 Dr A n n rE NOWA ZD
ToGRJnJ 44-)Aee6-AJ ooca iry Al v.
3o ' DAIS' Ti/NE 30 ,
VAnDusert 4 Srz vr.5
(AND 5i rc/f /C oe $ C1 L" S F,W CZ S , /✓• V