6022 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date G� I I c 19 A.
V
This is to certify that work requested to be done as shown by Permit No.
has been completed.
This structure may be occupied as a 0 ._ /i=Y11 r lc � in j•
LOCAtiOU
•
Owner —DC)II
By Order Town Board
TOWN OF QUEENSBURY
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Building & Zoning Inspector
CR[ATIV[ "INSTA" PRINTING, GLENS FALLS. N• 12601 1518)797.5656 1
= BUILDING PERMIT
•
TOWN OF QUEENSBURY No. 6022
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Donald Sokol
OWNER of property located at Lot 56 Helen Drive (St. No . 38) Street, Roador 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 t�
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
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1. OWNER'S Address is �
to
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0
2. CONTRACTOR or BUILDER'S Name
George Senecal Builders, Inc .
3. CONTRACTOR or BUILDER'S Address
• 57 Helen Drive
Glens Falls , N. Y.
4. ARCHITECT'S Name
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5. ARCHITECT'S Address
to
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6. TYPE of Construction—(Please indicate by X) ~
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(X)Wood Frame ( ) Masonry ( 1 Steel ( 1
17)
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7. PLANS and Specifications
O
No.
28 'x64 ' per plot plan, specifications and application
submitted including two-car attached garage and septic
system_
8. Proposed Use
One-Family Dwelling
0
$5 . 00 C/O Paid
$ 180. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES 'March 1 1930
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the N.
town of Queensbury before the expiration date.) I—
Dated at the Town of Queensbury this 1 0 th Day of August 19 79
SIGNED BY /Jj � for the Town of Queensbury
Building nd Zoning Inspector p
,
TOWN OF QUEENSBURY- '/ • t (Space inside block to be filled in by
WARREN COUNTY, NEW YORK •Building Inspector)
Application for Application No. :
. 1'crntit Issued 19. .
BUILDING AND ZONING PERMIT l'vruiit Expires. l!
/.i iiinn District
. \ oliic• „I \Vi rk%
THREE (3) Copies of a PLOT PLAN, Drawn to scale .\1'1 " •`I 1i
showing ,the actual dimensions of the lot to be built i:cnia Kf
upon, The-exact size, and location on the lot of the
building::.=#S-;'•be erected or altered MUST BE SUB-
MITTED
.WITH THIS APPLICATION.
TOWNqo , z76 OF QUI=ENSBURY
s(U DATE E, f 4 D
A PERMIT;,-MUST BE OBTAINED BEFORE BEINING WORK J AUG 'f" G. fl7fl
ANSWER ALL OF THE FOLLOWING. L / Kr l";P.M.
The undersigned hereby applies for a permit to do the following work A.M.which will be. done'in accordance with the description, plans and ipecifi- 718,19t1'i I at 112.13. 14. 15.19
cations, and such special conditions as may be indicated on the permit. it
. .
The owner of this prol,mrty is:
INA',I,E1 P.O.ADDRESS)
The person responsible for supervision of the work:insofar as the Building Code and the Zoning Ordinance apply is:
.G.. .6.,c:.: - A/. (1.�, /. ./��.). /d�.R.s, ..�is 6:q. .f/.6l,env. 4.. .�/ 5. .Fi�.%/s, A/•Y
(NAME) AR AD„,De
RE..S)
Name of Builder. . .$-../9 M. • • :.- Address
Name of Plumber Address
Name of Mason Address
Lot Number Unit Estimated value of proposed work 5 . 96> 6.60.
Name of Village . 2u /e-,F.A S ( u A y
Name of Street ,4.EA.k/.V. • R /• V C L�P,0 Side.of street: north 0, east-.❑, south awest g
J5/(-. � Nearest Cross St
reet 4"//V r2/.C. X Distance from this cross street-- " Ft.
/ Property is north ❑,south Ca,east f,west 0 from Cross Street
If on Corner, which corner, northeast ❑-, northwest ❑, southeast /lg. southwest
(Designate by marking with an •`X'• in the correct space.)
NATURE OF PROPOSED WORK OCCUPANCY
Cli Main Building
Construction of a new building. One-family dwelling �
❑ Addition to a building. Two-family dwelling 0
0 Alteration to a building. family apartment house ❑
El Demolition of a building. Store building ❑
.scar attached garageX.
Other:
Accessory Building
One-car.detached garage ❑
❑ Other work. Describe: Two-car detached garage
Private chicken house ❑
Private storage building " , ❑
Other:
ZONING SPECIFICATIONS. Fill in for new building,or addition to existing building, or a change of occupancy.
Indicate on the plot plan street names, the location and
size of the property, the location, site and setbacks of pro-
posed buildings,and the location of all existing buildings.
NORTH Show proposed building(s) in dotted line and existing
lluilding(s).in solid line.
Size of property ,2.o. . ft. x . . . ./5 O. . ft.
Size and use of existing buildings, if any
I
s w Size of proposed building • . • ft.x 6 4/ ft.
• Height (from grade to ridge) . ia9a ft.
Front yard - 4/5 ft.
Side yards 2(21. ft. and 4/0 ft.
Rear yard 7'7 ft.
SOUTH If on corner,setback from side street L/d• • • ft..
Note: All distances are net, as measured from street side
• line to nearest part of building.
(OVER) • .
7-73—M
(cont'd.) -
BUILDING SPECIFICATIONS.,
Kind of construction: Wood frame, fire safe, etc.?.\/✓Q a J T /9 m e
Will any second-hand lumber be used? A/0 If so, for what7
Material of foundation walls . 1.0. X/4a. . . L'.OfCRef /3/ CK ' Thickness
Depth of foundation walls below grade �� Continuous foundation?
Will there be a cellar? ye-S' If so, material of cellar floor 4/ C'Q 21 C:/Q e,l'
Type of roof: Sloped or flat? . . .640,/a-e..D Material of roof -AS? .
Size,wood studs "x 1/", spacing /Ca."o.c., length ft.
Size, floor beams, 1st floor 2 " x /C)", spacing - /CD."o.c., span 1 ft.
Size, floor beams, 2nd floor " x ' spacing "o.c., span ft.
Size, ceiling beams 2" x ", spacing /Co"o.c., span c` ft.
Size, roof rafters or beams �" x .", spacing /lp"o.c., span /f ft.
Exterior finish ./gp. 9.a.d-. ./(Sf3TT-Al With what material?
Finish of interior walls '/2" Sbee%..zo.c..4
If garage is to be attached, of what material is wall between garage and main building to be constructed?
Is there to be an opening between wage and building?
Kind of heating system ./ .Elir C!m p Oil burner or coal?
Will a flue-lined chimney be provided? . Depth of chimney foundation below grade
Height of chimney above roof
Will there be a fireplace? . .y:f S Depth of fireplace hearth
Will a toilet be installed?
Will a kitchen sink be installed and connected to water supply? )/e
Water supply (public water supply or pump) ,J.C.1. .0 /.0
Distance of cesspool from any private well feet
Will drainage system be provided with required traps, cleanouts, and vents? . . .y S
AFFIDAVIT
Town of Queensbury
County of Warren
State of New York
I swear that to ttr liar of my know,edge and belief the statements contai•• .f,': application,toga with the plane and specification sub-
mitted, are a true and co.e.plete statement of all proposed work to be .> e describedm d that all provisions of the BUILD-
ING CODE,THE ZONING ORDINANCE,and all other laws pertaini"_ e proposed:1;0r a complied with,whether specified or not,
and that such work is authorized by the owner.
Sworn to before me this Signature ...
t// // /. E/ NE AGE T,ARC ITECT,CONTRACTOR
v.day of.. ..... 19./��
NOTARY PUBLIC, WARREN COUNTY, N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
•
By
TOWN OF OUEENSBURY
BUILDING AND ZONING DEPARTMENT
BAY AND HAVILAND ROADS, R. D. 41 .
GLENS FALLS, NEW YORK 12801
APPLICATION FOR A PERMIT TO CONSTRUCT, ALTER OR ENLARGE
A SEWAGE DISPOSAL SYSTEM WITHIN THE TOWN OF OUEENSBURY
OCCUPANT'S NAME a 6 ADDRESS
TELEPHONE OWNER'S NAME (_<#74,7007
p
ADDRESS NUMBER OF BEDROOMSJ
GARBAGE GRINDER? ,4 C1 (YES OR NO) TOPOGRAPHY: FLAT, ROLLIr?n, STEEP, SLOPE ,
GENTLE SLOPE, OTHER
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NATURE OF SOIL: CLAY, SANDY, LOAM, GRAVEL, ROCKS, ETC. 29,0D j"
PERCOLATION TEST WATER SUPPLY: P'IUNICIPA , WELL, OTHER
DIAGRAM OF PROPOSED SEPTIC SYSTEM
4":16\
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OTHER PERTINENT INFORMATION
IT IS HEREBY AGREED THAT IF THIS APPLICATION AND PLANS ARV APPROVED,
INSTALLATION OF SEWAGE DISPOSAL FACILITIES WILL BE F IN ACCORDANCE
WITH DETAILS SHOWN.
DATE i //o/ SIGNATURE OF APPLICANT /////
LAKE GEORGE PARK COMMISSION APPROVAL:
(signature
(date)
TOWN OF QUEENSBuRY
Building_ Department
Inspectors Report Date
NameO�C p
Location s ,uk
Permit No. (p 0 ,2 Weather
Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing
Sheathing �)
Roof Felt L!
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs &Railings
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic. Approval
Floors
Insulation Foundation '
Walls
Ceiling . .
Building Inspector
REMARKS
TOWN F QUEENS•BURY
Building Department
Inspectors Report Date 2 =8c)
Name .1S-.%9 W01
Location Ate-l e v J)e
Permit No. // (_7 O a t Weather
• Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Fin /
Finalal Survey /41q
Framing •
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railings
Cellar Dr. Tile
)('
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval •
• Floors
Insulation Foundation
Walls
Ceiling
JL.412
Building Inspector
REMARKS
A e %Se,- - A
TOWN OF QUEENSBURY.
Building- Department
- Inspectors Report Date /D 3— l
Name _ce,-, 1 • , a d l
Location p/e,„) T
Permit No. Co o a a Weather
Remarks
Excat'ation
Footing Forms 1
Footing & Piers
Foundation •
Cement Coat
Waterproofing
Backfill
Final Survey 1
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves jC
Wall Board / •
Ext. Porches
Finished Floor /
Interior Trim / N\
Stairs & -Railings
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval —�
Floors
Insulation Fou.ndati.On -
Walls
celiinq " F
•
Building Inspector
REMARKS
/e2d '
•
TOWN OF E N URY
Building. Department
Inspectors Report ;,ate
Name .0
Location
Permit No. tip, 6 a 9., 'Weather
Cher
Remarks
Excaation
Footing Forms
Footing & Piers �T
Foundation
Cement Coat ^�-
Waterproofing
Backfill
Final Survet%
Framing
Sheathing L__
Roof Felt
Roofing _
Siding
Masonry Veneer
Rough Plbg. �_ ^
Relief Valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railing
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing _
Door Closers
Chimney
Water Meter Inst.,
Septic Approval
Floors
Insulation
Cei--
„57;
Eu l ing Ins octor
REMARKS
I .
TOWN. OF QUEENS-BURY
Building Department
•
Inspectors Rnpor, Date 7-21`
Name
Location e/`C )
Permit No. = 1 0. Weather
6 O•P a Per Cunt • Remarks
Complete
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Rough Htg.
Relief Valves
Wall Board
I Ext.Porches
Finished Floor
Interior Trim
Stairs&Railings. •..,
Cellar Dr.Tile
Concrete Floors
Plhg.Fixtures
Gar.Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval `
Building Inspector
REMARKS
4
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