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1682 CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date KJOVOIA-4(171 19-7D- This is to certify that work requested to be done as shown by Permit No. has has been completed. This structure may be occupied as a a h v I i Location Owner By Order Town Board TOWN OF QUEENSBURY - e• Building & Zoning Inspector BUILDING PERMIT TOWN OF QUEENSBURY No. 1682 WARREN COUNTY, NEW YORK cD PERMISSION is hereby granted to Jeffrey L. Kelley OWNER of property located at Lot 520 Westland Avenue Street, Road or Ave. '-' in the Town of Queensbury,To Construct or place a Dwelling Sewage System `< 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. 1. OWNER'S Address is 25 Westland Avenue Glens Falls, New York 12801 2. CONTRACTOR or BUILDER'S Name John Cifone 3. CONTRACTOR or BUILDER'S Address 89 Cooper Street Glens Falls, New York 12801 4. ARCHITECT'S Name 5. ARCHITECT'S Address 6. TYPE of Construction— (Please indicate by X) ° r Wood Frame ( ) Masonry ( )Steel ( ) p ci- 7. PLANS and Specifications O No.701X34' as per plot plans and specifications submitted enc. sewage system co 8. Proposed Use N ci- CU N One-Family Dwelling Sewage System C/O Pd. 5.00 $ 70.00 PERMIT FEE PAID -THIS PERMIT EXPIRES 11-1- 19 72 (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.) Dated at the Town of Queensbury this 18 Day of Apri 1 19 72 SIGNED BY J2,e)-1 142 �4 fo the Town of Queensbury Building and Zoning Ins ctor 1 i2/i TOWN OF QUEENSBURY (Space inside block to be filled in by WARREN COUNTY, NEW YORK • Building Inspector) Application for Application No. Permit Issued Pi. . BUILDING AND ZONING PERMIT Permit Expires 0 . 19 - ZoitintCDistrict • • • Value of Work S THREE (3) Copies of a PLOT PLAN, Drawn to scale •\i'I "`c'(l by . showing the actual dimensions of the lot to be built Remai k. upon, The exact size, and location on the lot of the building to be erected or altered MUST BE SUB- • MITTED WITH THIS APPLICATION. TOWN OF QtJEENSBUZY . . .PiAs`�. . . 2.1tigiz. . �D1C6E .E. .J11. ,)/= �"Pi/O� A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK 13.pv W. ANSWER ALL OF THE FOLLOWING. A.M. U• 462���a. P.M. . The undersigned hereby applies for a permit to do the following work ,711141.2111141168911.0 . 123 • 5l which will be done in accordance with the description, plans and specifi- A. cations, and such special conditions as may be indicated on the permit. The own r of this property is: . 3.el=P. !ICY. . . 1-... .K Ii .� . . . . . . . . .,ten. S. [�.� F+st-!. .v�. ./.Qci-•..'�L *.. 5, A4 (NA`4E) (P.O.ADDRESS). The person responsible for •supervision of the work insofar as the Building Code and the Zoning Ordinance,apply is: � . 1 .1L. .1. . . . . . 4. . .4UCsfLRf�': .. . . .t `.4�VS. .�gLL),. Al..i,. . . +� (NAME) • (P.O.ADDRESS) Name of Builder 1 0+i n1 t Font Address . .n9 �Io,,, . gr. . .G C. !vs.Fia,c.5,. Az v Name Of Plumber Address Name of Mason Address Lot Number. . 5120 . . . Unit . .Sact:.!Z, Estimated value of proposed work$ " 3 S COO- 00 Name of Village 't-)c - OF 0 i-'C=?=./•15.7 vz / Name of Street . . . C.,.r:E S4A9A//.J. . ./44-ems Side of street: north 0, east 0, south D. west X Nearest Cross Street . .2Pc:,..... .7.''. ./ ct/a D Distance from this cross street .QN O"aw Win- Ft. Property is north X,south ❑,east El, west ❑from Cross Street If on Corner, which corner, northeast ❑, northwest IZ, southeast ❑, southwest • (Designate by marking with an "X" in the correct space.) • y� NATURE OF PROPOSED WORK OCCUPANCY ' J� Construction of a new building. Main Building ❑ Addition to a building. One-family dwelling ❑ Alteration to a building. Two-family dwelling . . ❑ ❑ Demolition of a building. -family apartment house El Store building ❑ -car attached garage . ❑ Other: • Accessory Building One-car detached garage El ❑ 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- NORTH posed buildings,and the location of all existing buildings. Show proposed building(s) in dotted line and existing 1111101 l;uilding(s) in solid line. i motI Size of property . . . /SCE. . . . . . ft. x /2- ft. • • ti0` Ia 1__ ___ __ c F. Size and use of existing buildings, if any F Ca I "w �Z© w kl I _ �+ Size of proposed building . . .?..C. ... . ft..x 3�/ ft. J Height (from grade to ridge) '/7 ft. 0 Front yard 3. ft. I SS" ,.fo I Side yards 6 0 ft. and - iz Q ft. 'I141�5rJiw.Vr) i 'c. Rear yard s ft. SOUTH If on corner,setback from side street . . . .60 ft.. .. Note: All distances are net, as measured from street side line to nearest part of building. (OVER) (cont'd.) BUILDING SPECIFICATIONS., Kind of construction:6;ood frame fire safe, etc.?. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Will any second-hand lumber be used? . . . .0v0 If so, for what? Material of foundation walls 2 x 10 . . .73.1 o.c.V. Thickness . . . i.O++ Depth of foundation walls below grade 6 8" Continuous foundation? . .y.a.. . . Will there be a cellar? . . . .t/C.S If so, material of cellar floor . . .C oN.CaarC. .5L✓.,�:/'3. Type of roof: Sloped or flat? . . . .S`op.0 Material of roof . . . . /2 -Frei?$. . w/.2yo, .%goy. /a c/&/,�- Size,wood studs 2 "x V ", spacing /6, "o.c., length 9• ft. Size, floor beams, 1st floor 4 "x /o ", spacing /4 "o.c., span ./3 ft. Size, floor beams, 2nd floor " x ", spacing "o.c., span ft. Size, ceiling beams 2 "x Cr., ", spacing /4 "o.c., span /7 ft. Size, roof rafters or beams "x ", spacing . . . . . . ./.4. . . ."o.c., span 3 ft. Exterior finish With what material? Finish of interior walls Sf/..0 . Cf.c./C. . yiv.c3./9/iA.,cU...-.4.. If garage is to be attached, of what material is wall between garage and main building to be constructed? . . . . . . . ./r�/. . .lv/!1!. . .X2.."/4 7e.4).0.040. ."9/1/.a. . jZ •Zl7/e.c?G/c, Is there to be an opening between garage and building? . . . . y.er-a �W�. , /./.t4-. .Z? .,a.. Kind of heating system O/.�. . ig! . .I//= it urnee or coal? Will a flue lined chimney be provided? . . .e,/ Depth of chimney foundation below grade . . . 7:�U.`.�. . . . . . ' Height of chimney above roof 4'20 " Will there be a fireplace? tile. Depth of fireplace hearth . . .2-' G-•" Will a toilet be installed? (7 Will a kitchen sink be installed and connected to water supply? . . / ,.: Water supply (public water supply or pump) . . . . 0.v.c, ►a►.5. /'3c,1i7.-+Fe ,6c,/ 72-,. S.spp/cr Distance of cesspool from any private well feet Will drainage system be provided with required traps, cleanouts, and vents? t j 4-6 Town of Queensbury AFFIDAVIT County of Warren ss. 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 sub- mitted, are a true and complete 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 th proposed work shall be complied with,whether specified or not, and that such work is authorized by the owner. Sworn to before me this Signature i.,E • WNS AGENT,AR ITECT.CONTRACTOR day of 19 NOTARY PUBLIC.WARREN COUNTY. N. Y. SPECIAL CONDITIONS OF THE PERMIT: • By • TOWN OF QUEENSBURY WARREN COUNTY, NEW 'FORK Application for A PERMIT TO CONSTRUCT, ALTER OR ENLARGE A SEWAGE DISPOSAL SYSTEM FOR A PRIVATE RESIDENCE WITHIN THE TOWN OF QUEENSBURY Mail or bring this application to: Building 8 Zoning Department Queensbury Town Office Building • R.D. 1 Bay Road Glens Falls, New York 12801 • This application for a Sewage Disposal Permit must be accompanied by a plot plan drawn reasonably to scale showing all dimensions , the size of the lot, the location on the lot of the water supply and sewage system. • 1. Name and mailing address of applicant: • . Elf&zf • . 2s 6 raw c ; A.4, . /zPo/ 2. Specific location of property: �. STREET -AND' NUMBER . _ 3. Ap lication is for: (New constructions of private dwelling . Alteration- or- .enlarge.m.e.nt of,.existing sewage disposal system. 4. Description of building: a. number of bedrooms b. garbage grinder (OOR NO) 5. Topography: (flat, rolling, steep 6lope, gentle slope, etc. ) 6. a. Nature of soil. (Describe to a depth of 5 feet if tile • field is to be used or 10 feet if leaching pits are proposed, giving thickness of various strata such as top soil, clay, loam, sand, gravel, rock, etc. ) E•5r evei:..‘s 5.4'c , /y aft of24: v,e ,e," b. How determined? • 7 —sr /2,r.�.,,�c ����r CC k 7. a. Soil percolation test made by (Refer to Part III , Bulletin 1 , N.Y.S. Department of Health) b. Percolation test notes submitted? (YES OR NO1 8. Proposed sewage disposal system indicated on attached plan or sketch? (YES OR NO) • 9. Date when construction will commence /74w/( It is hereby agreed that if this application and attached plans dated or any amendment or revision, thereof, are approved, installation of sewage disposal facilities will be made in accordance with the details thereof as shown on such approved plans. • Installed By: Contractor Sign t e f applic t Owner - i k