5504 _ .
/t1
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date Algrm 4,2 1971'
is is to certify that work requested to be done as shown by Permit No.
has been completed.
This structure may be occ pied as a 2-)
Owner .7 -
By Order Town Board
TOWN OF QUEENSBURY
•
Building & Zoning Inspector
•
CREATIVE ••INSTA•• PRINTING. GLENS FALLS. N Y 12801 15181793-5658
.
BUILDING PERMIT
TOWN OF QUEENSBURY No. 5504
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Martin Mosher
rt
OWNER of property located at Lot 41 Helen St. (St. #4) Street, Road or Ave. H'
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 `n
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. n
1. OWNER'S Address is
R. D. #3 Upper Sherman Ave.
Glens Falls, N. Y.
2. CONTRACTOR or BUILDER'S Name
Same
3. CONTRACTOR or BUILDER'S Address
Same ti
r
4. ARCHITECT'S Name
H
ID
H
5. ARCHITECT'S Address CD
Ll)
ft'
6. TYPE of Construction—(Please indicate by X)
Cr)
( NI Wood Frame ( ) Masonry ( 1 Steel ( ) *
qrk
7. PLANS and Specifications A
24 'x64 ' per plot plan, specifications and application
No. submitted including sewage system and two-car attached
garage_
8. Proposed Use •
One-Family Dwelling
•
$5. 00 C/O Paid
$fin, n0 PERMIT FEE PAID —THIS PERMIT EXPIRES May 1 19 79
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.) I-'
C7
Dated at the Town of Queensbury this 4th Day of October 19 78
SIGNED BY for the Town of Queensbury
Buildingind Zoning Inspector
L4
TOWN OF QUEENSBURY (Space inside block to be filled in by
WARREN COUNTY, NEW YORK . ' Building Inspector)
Application for • 1)plication No.
P� Permit Issued 19-
BUILDING AND ZONING PERMIT Permit Expires. Ig
/Amin District
\ aim. „I Work$
THREE (31 Copies of a PLOT PLAN, Drawn to scale .\I)I,r„\t•(l by
showingthe actual dimensions of the lot to be built ItcrnarKr .
upon, Te exact sire, end location on the lot of the
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION.
L/ I d G-k- j l 97 F �{ (v-
TO-TOWN OF QUEalssI ,'SS U. �{
/ DATE
BEGINNING WORK ,' b fllj
A PERMIT MUST BE OBTAINED BEFORE � OCT � 1978
ANSWER ALL OF THE FOLLOWING.
The undersigned hereby applies for a permit to do the following work A.M. P.M.
which will be done in accordance with the description, plans and specifi- 7I819I10I11112)1I2I31415I6
e e & a < < i t & e. a e.
cations, and such special conditions as may be indicated on the permit.
A
The owner of this ruperty is:
. '1,4 ,` ,..i . .* . . . . . /g Xi •, G I / Cry". . .
(NA''.E) IP O.ADDRESS)
The person responsible for •supervision of the work insofar as the Building Code and the Zoning Ordinance apply is:
"/ "''' `� •
A0.1E) .
Name of Builder. . . ��,. •' '- •' •--s"� Address (P.0 ADDRESS)
Name of Plumber. . Address
Naei-te of Mason. . . . Address
5� Ro
Lot Number P Estimated value of proposed work$ . �-'� • i
Name of Village -�- Gib✓?s--?. � .''s• ,
Name of Street . .�,.r. . .rS.� x Side of street: north 0, east , south O. west 0
Nearest Cross Street t• Distance from this cross street ' G D • Ft.
Property is north ❑,south ,tg,east [i, west 0 from Cross Street -
If on Corner,which corner, northeast ❑, northwest ❑, southeast 0, southwest
(Designate by marking with an "X" in the correct space.)
NATURE OF PROPOSED WORK OCCUPANCY
of Construction of a new building. Main Building
❑ Addition to a building. One-family dwelling
❑ Alteration to a building.
Two-family dwelling CI
Demolition of a building. -family apartment house ❑
Store building ❑
. . . -car attached garage
Other:
• Accessory Building
• One-car detached garage ❑
❑ Other work. Describe: •
Two car detached garage Cl
Private chicken house ❑
Private storage building El
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, size and setbacks of pro-
posed buildings,and the location of all existing buildings.
NORTH Show proposed building(s) in dotted line and existing
buildings) in solid line.
-1,; _. .
Size of property / D ft. x �$ ' ft.
Size and use of existing buildings, if any '
la 4
w Size of proposed building 4-�a ft.x . . 4. .'. . ft.
' i Height(from grade to ridge) o? D ft.
glaFront yard "4/•.c- ft.
yards ards o7,5-- ft. and . . . D ft.
•
,.C--- ' Rear yard 'D ft.
•
SOUTH If on corner,setback from side street ft.. ..
Note: All distances are net, as measured from street side
line to nearest part of building.
(oven)
7-73®M
(cont'd.)
BUILDING SPECIFICATIONS.,
Kind of construction: Wood frame, fire safe, etc2 •t•- .L_. .✓� '.-s•
Will any second-hand lumber be used? . . 0. . . . . . . . If so, for what
Material off foundation walls /O `' , e.i-*� Thickness
Depth of foundation walls below grade y Continuous foundation fit
Will there be a cellar? If so, material of cellar floor "
Type of roof: Sloped or flat? . .� - •1•-. Material of roof . . .�",/4 xi lid .�-� !"
Size,wood studs o2 " x ", spacing . . . .,/. .� "o.c., length P ft.
Size, floor beams, 1st floor o2 ,"x lea ", spacing / S "o.c., span .. ft.
Size, floor beams, 2nd floor " `/� ", spacing / ` . . ."o.c., span / ft.
Size, ceiling beams ,.-.!-✓.� -e:=+t--/ ", spacing o/ 171 "o.c., span '.lv ft.
Size; roof rafters or beams ...ri�i—4--L.�J x ", spacing e2 •7,/. . ."o.c., span .?. 4. . . ft.
Exterior finish . . . . �.�.• With what material? . . .P.--t�
_ �.✓
Finish of interior walls
If garage is to be attached, of what material is wall between garage and main buialding to be constructed?
Is there to be an opening be ween garage and building? ` '
Kind of heating system . . . Oil burner or coal?
Will a flue-lined chimney be provide .� . Depth of chimney foundation below grade 4
Height of chimney above roof
Will there be a fireplace? Depth of fireplace hearth / m
Will a toilet be installed?
Will a kitchen sink be installed and connected to water suppl ? -
Water supply (public water supply or pump) . . . . . . . . . . . . . . . feet
Distance of cesspool from any private well
Will drainage system be provided with required traps, cleanouts, and vents?
Town of Queensbury l AFFIDAVIT
County of Warren
State of New York
I swear that to th• of my knowledge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, are a true and co.uplete statement of all proposed work to be done on the described premises and that all provisions of the BUILD-
ING 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. y
Sworn to before me this Signature L7 ) `-2
_'
OWNER.OWNER'S AGENT,ARCHITECT.CONTRACTOR
day of 19
NOTARY PUBLIC. WARREN COUNTY. N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
•
•
• By
TOWN OF QUEENSBURY
BUILDING AND ZONING DEPARTMENT
BAY AND HAVILAND ROADS RD #1
GLENS FALLS, NEW YORK 12801
APPLICATION FOR t+ PERMIT TO CONSTRUCT, ALTER OR ENLARGE
A SEWAGE DISPOSAL SYSTEM WITHIN, THE TOWN OF QUEENSBURY
OCCUPANT1 S NAME ADDRESS /e,C_ . 4 5• ....
TELEPHONE l�st, G JNERQ S NAME ��1-2 .
ADDRESS •' '*(y/ �CLc�ti , _ - NUMBER OF BEDROOMS__'
GARBAGE GRINDER? /2,k/ (YES OR NO) TOPOGRAPHY: FLAT, ROLLING, STEEP, SLOPE,
GENTLE SLOPE, OTHER Laic „ � .
NATURE OF SOIL: CLAY, SANDY, LOAM, GRAVEL, ROCKS,
PERCOLATION TEST WATER SUPPLY: PFiUNICIPAL? WELL, OTHER
DIAGRAM O1 PROPOSED SEPTIC SYSTEM
art
--7;?
OTHER PERTINENT INFORMATION ,1D2 7C J4.4
/71/ /7;47,
IT IS HEREBY AGREED THAT IF THIS APPLICATION AND PLANS ARE APPROVED,
INSTALLATION OF SEWAGE DISPOSAL FACILITIES WILL BE MADE IN ACCORDANCE
WITH DETAIL SHOWN.
DATE I/ , / SIGNATURE OF APPLICANT %-A4_16-2:
LAKE GEORGE PARK COMMISSION APPROVAL:
signature?)
TOW OF QUEENSBURY•
Building Department
Inspectors Report Date 3 //.(///
Name
' /
Location ; i: ?' �--/ C�,�= ✓,
Permit No. it Weather
Per Cent
Complete Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat /� f
Waterproofing
Backfill �✓
Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding (� •
Masonry Veneer
Rough Plbg.
Rough Htg.
Relief Valves
Wall Board
Ext.Porches ;
Finished Floor \\<:"
Interior Trim _ y
Stairs&Railings 6�� � a
•
Cellar Dr.Tile
Concrete Floors �r
Plhg.Fixtures
Gar.Fireproofing 4,0=0"-
Door Closers
Chimney
Water Meter Inst.
Septic Approval
��f�' Building Inspector
\ reA 5 "° L-� REMARKS •
TOWN OF QUEENSBURY-
Building Department.
Inspectors Report Date 7
Name A-1jisAw,- -
' Location . k 53(.- Lc 7- `•W
Permit No. .-S o Weather
Per Cent
Complete Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat -
Waterproofing
Backfill
• .Final Survey f
Framing / ()Y
Sheathing
Roof Felt
Roofing
Siding •
Masonry Veneer
Rough Plbg. � (J 4_
Rough Htg.
Relief Valves
Wall Board
Ext.Porches 2\c,
Finished Floor
Interior Trim _
Stairs&Railings
Cellar Dr.Tile
Concrete Floors
Plbg.Fixtures .
Gar.Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Building Inspector
REMARKS
TOWN OF QUEENSBURY-
Building Department
Inspectors Reit Date /j-/-7P
Name floc'
• Location .//1) Lo/ 49 Vi
Permit No. 6-3" it Weather
Per Cent
Remasics
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
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
Building Inspector
/000 REMARKS
6'1 -5-ePLIC
TOWN OF QUEENSBURY'
Building Department
Inspectors Report Date
Name h03A'e
Location Zak
Permit Nos5-cl T Weather
Per Cent Remarks
Complete
Excavation
Footing Forms (� _
Footing & Piers
Foundation.
Cement Coa\
Waterproofing
7)<Ar
Backfill
_Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding •
Masonry Veneer
Rough Plbg.
Rough Htg.
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
Building Inspector
REMARKS
J nn v1,
1
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