6033 a.
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date'
OCT: ' 4 7_ci
This is to certify that wor requested to be done as shown by, Permit No.
has been completed.
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This structure may be occupied as a O} -f//?l•`/ <>'J-e///
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Location / / : )r7)/l
Owner 719 /1""))� /`,1' g/
By:Order Town Board
TOWN OF QUEENSBURY
Building & Zoning Inspector
•
CREATIVE "INSTA" PRINTING. GLENS FALLS. N Y 12801 I5 1 817 9 7-5 6 58
BUILDING PERMIT
TOWN. OF QUEENSBURY
No. 6033
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Martin C. Mosher
•
OWNER of property located at Lot 66 Helen Drive (St. No. 58) 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.
1. OWNER'S Address is
4 Helen Dr.
Glens Falls, N. Y.
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2. CONTRACTOR or BUILDER'S Name
Same
3. CONTRACTOR or BUILDER'S Address
Same
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4. ARCHITECT'S Name cn
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5. ARCHITECT'S Address - 2 N
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6. TYPE of Construction—(Please indicate by X) . (D
) Wood Frame ( ) Masonry ( ) Steel ( )
7. PLANS and Specifications
26 'x64 ' per plot plan, specifications and application
No. • submitted including sewage system and three—car
attached garage.
8. Proposed Use 0
CD
One—Family Dwelling
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$5. 00 C/ 0 Paid ~-
$ 80. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES i March 1 19 80
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the C7
town of Queensbury before the expiration date.)
F-'
Dated at the Town of Queensbury this 15th Day of August 19 79 N
SIGNED BY �' for the Town of Queensbury
Building and Zoning Irfspector
TOWN OF QUEENSBURY t (Space inside block to be filled in by
WARREN COUNTY, NEW YORK Building Inspector)
Alication for Application No.
PP ('rrmit Issued 19. .
BUILDING AND ZONING PERMIT Penult Expires. . IQ .
i:'.ning. District
• \ : henI Work.%
THREE (3) Copies of a PLOT PLAN, Drawn to scale •\i'i"r„`NI by
showing the actual dimensions of the lot to be built Rciu:ii•KS.
upon, The exact size, and location on the lot of the •
. building to be erected or altered MUST BE SUB- _
MITTED WITH THIS APPLICATION.
/� cy/ //' �-- 97.2 TOWNR O�,F QUEENSBURY
9 1 DATE
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK . AUG '1 51979 ��7
ANSWER ALL OF THE FOLLOWING. A.M. 8Pv✓ re-e- rp,M,
The undersigned hereby applies for a permit. to-do the following work 7 1 8 1 9 110111112)112131415N
e , � , , . e . e
which will be. done in accordance with the description, plans and specifi- . . e , )y
cations, and such special conditions as may be indicated' on the permit. Cl(7
•
T e owner of this property is•.
lNA'E) (P.O.ADDRE / /2,A0/
The person responsible for�i `��_su pei of the work insofar as the Building Code and the Zoning Ordinance apply is:
(NAME) • (P.O ADDRESS)'
Name.of Builder.'. . --.•. . .. . . . . . ._._ . :. . . . . ... . • • ... . .Address
Name Of Plumber `'� ' • - Address
Name of Mason Address
Lot . .Number. �.�U� aEsti�d��of proposed work 3 •y U 0 O O-
Name of Village
14,4
Name of Street Side of street: north ❑, east Cl, south O. west
Nearest Cross Street Distance from this r.ross street o?02--0 Ft.
Property is north 0,south X,east i i, west 0 from-Cross Street
If on Corner, which corner,northeast ❑, northwest ❑, southeast ❑. southwest
(Designate by marking with an "X" in the correct space.)
NATURE OF PROPOSED WORK OCCUPANCY . ..
Construction of a new building. Main Building
❑ Addition to a building.
One-family, dwelling IF='
❑ Alteration to a building. Two-family dwelling ❑
El Demolition of a building. -family apartment house ❑
Store building ❑
. . . .-car attached garage SK
. . • 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, size and setbacks of pro-
posed buildings, and the location of all existing buildings.
NORTH Show proposed building(s) in dotted line and existing
' lzuilding(s).in solid line.
Size of property . . .'. .t -i • • . ft. x / 7 0 ft
�� Size and use of existing,buildings, if any
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in
s I iLlw
Size of proposed building d Z.. . ft.x 4/ ft.
Height (from grade to ridge) /s ft.
Front yard ' ' 7' ft.
•
• • • Side yards it ft. and ' /1 ft.
Rear yard 61 a 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.; .
(OVER)
7-73—M. •
(coned.)
BUILDING SPECIFICATIONS., lam!
Kind of construction: Wood frame, fire safe, etc. 1/. ,L --2 . . .• • •T "''`. . . . . . . . . . . . . . . . . . . . . . . . . . . . . •
Will any second-hand lumber be used? `-"Y1-0 f so, for what
Material of foundation walls Pa c- Thickness
Depth of foundation walls below grade 6 2 ', Continuous foundation? . . . .
� y
Will there be a cellar? `�� . , If so, material of cellar floor _
Type of roof: Sloped or flat. Material of roof . . . A.e-sg. .,.; n
Size,wood studs .. " x V ", spacing . . . ./4v. . . . . ."o.c., len th '• ft.
Size, floor beams, 1st floor v� x /0 ", spacing / to "o.c., span /..3 ft.
Size, floor beams, 2nd floorY A " x /0 C'spacing . . . . /. "o.c., span . . . . .% ' ft.
Size, ceiling beams /✓ 4 " " x ", spacing a- , "o.c., span ?? ft.
• Size, roof rafters or beams . .T✓.eu.4e%. . " x ", spacing . . . � .+"Z. . . . ."o.c., span 4, ft.
a
Exterior finish <r mWith what material? 4-2/6 O
Finish of interior walls
If garage is tp be atta , off what material is wall between garage and main building to be constructed?
.
of b
Is there to be an opening between garage and building? tl'1.4 • .
Kind of heating system . . . . . Oil burner or coal? /
Will a flue-lined chimney be provided? .-. J / Depth of chimney foundation below grade 4 0
Height of chimney above roof. . . . . . . . . . . . .a. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .�. . . . . . . . . . . . . . .. . . . . .
Will there be a fireplace? .:` Depth of fireplace hearth ��
Will a toilet be installed?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Will a kitchen sink be installed and connected to water supply?
Water supply (public water supply or pump) . . .
Distance of cesspool from any private well feet
Will drainage system be provided with required traps, cleanouts, and vents?
AFFIDAVIT
Town of Queensbury
County of Warren
State of New York
I swear that to tb bard my knowledge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, are a true and co.i.•lete 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. — �/
Sworn to before me this Signature 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 ;a PERMIT TO CONSTRUCT, ALTER OR ENLARGE
A SEWAGE DISPOSAL SYSTEM WITHIN THE TOWN OF QUEENSBURY
OCCUPANT°S NAME ADDRESS _ Q L 4
TELEPHONE_ 79 d - / 2 se OWNER'S
ADDRESS _ ( -m_NUMB ER OF BEDROOMS
GARBAGE GRINDER?_> (YES OR NO) TOPOGRAPHY: FLAT ROLLING, STEEP, SLOPE,
GENTLE SLOPE, OTHER
NATURE OF SOIL: CLAY, SAND , LOAM, GRAVEL, ROCKS, ETC.
PERCOLATION TEST WATER SUPPLY: MUNICIPAD WELL, OTHER
DIAGRAM OF PROPOSED SEPTIC SYSTEM
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OTHER PERTINENT INFORMATION
1.T IS HEREBY AGREED THAT IF THIS APPLICTION AND PLANS ARE APPROVED,
INSTALLATION OF SEWAGE DISPOSAL FACILITIES WILL BE MADE IN ACCORDANCE
WITH DETAILS SHOWN.
DATE e/,c/7JsIGNATuRE OF APPLICANT
LAKE GEORGE PARK COiM1MISSION APPROVAL:
(signature)
(date)
TOWN Cr VEE;XSMNRY
WARREN COUNTY, NEW YORKC
Application for: BUILDING PERMIT IN COMPLIANCE WITH TEE NEW YORK
STATE ENERGY CONSERVATION CODE
A permit must be obtained before,. beginning work.
Answer all of the following: I
1. 'Gross floor area 0 l 7,: S - •
2. Type of heat ���V s�.�~c
3. Isthe building mechanlically cool� < �ed7
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4. Percentage of area of Lindoor s sand; doors._/./
o •. A. .. Over 16% only '
1. Uvalue of
o gross areas of walls, roof/ceiling and floors , ;,•-,.:' ••;: ."�
�:T exposed to ambient conditions
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,ct o 2. Floor over hearted spaces Yes No
a. Are foundations walls, insulated 'Yes No
1. If Yes, what is the R value
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PT 3. Slab on grade Yes No
/1) • a. If Yes, what is the R villue of insulations around perimeter
of floor? ' '
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� �re"� `� 4. Is basement heated Yes No
a. R value of 'insulation . .
.
5. Type of insulation
Y . Under 16% only
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1. U value of roof and floors exposed to: ambient conditions.
2. U value of exterior walls
3. U value of glazed area -167
4. U value of doors '
5. U value of floors ever4heated lbpaces...- o t
6. R value of slab edge insulation-unheated. slab
7. . R value of slab insulation - 1heated slab. . .
8. U value of heated basement/cellar walls (above grade)
9. R value of heated •.basement/cellar wails. (below grade)
10. Type of: insulation. . ��-.� �� S �h ✓ • �td'�-f "�
C. Controls
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1. ' Thermostat maximumheat setting �i; .�- i
D. Duct slystems
1. Is duct system Iinstallac1 iia unheated areas Yee I ��
a. If Yes, R value of duct installation
b. R value of duct in other areas
E. Piping Insulation
1. Siuo of hot water or cooling parrying agent pipe
2. R value of pipe insulation)
F. Service water Heating 1 '
1. Performance efficiency . ,
2. Temperature control setting maximum 0WQ
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G. For shimming pool only '•
1. Maximum heating' i 1
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S ' np.Thlarscfisc.scmMcm/IR nit WINK>apxJan ng.mJac PIR ilLMWm 7111‘ m nsRmm m lig m7s1.7111WILIUip.)sv*m i.okW./IlkW RIRfimJIIRW.,.�
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THE NEW YORK BOARD. OF FIRE' UNDERWRITERS T
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BUREAU OF ELECTRICITY
�r_; 41 STATE STREET,ALBANY,NEW YORK 12207
Date L':•. ;.iit?..".-; ,, .I'• r, C• Application No.on file 4 : . .+ A iY
-c THIS CERTIFIES THAT 1r.r
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of ra
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-< in the following location; 0 Basement 0 1st FL. 0 2nd FL. ,) _,''.'•_":_ Section Block Lot ;J U a
was examined on and found to be in compliance with the requirements of this Board. a . _,
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS ;
OUTLETS RECEPTACLES SWITCHES INCANDESCENT FLUORESCENT MERCURY AMT. K.W. AMT: K.W. AMT. K.W.- AMT. K.W. AMT. H.P. i5'
VAPOR ,r.
PY-
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS !Y
SYSTEMS
7 'AMT. K.W. OIL ' H.P. , GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. 'AMPS. TRANS. AMT. H.P. NO.OF FEET -AMT.- WATTS Y
_. . . i�
,��j SERVICE DISCONNECT NO.OF 4i' S,',..' ' E R V I C E ;r.,
J� AMT. AMP. TYPE EQ��p i,e 2W 1,B"3W 30 3W 3,9'4W NO,OPER gCOND. OF CG COND. NO.OF HI-LEG OF.HI-LEG NO.OF NEUTRALS OF NEUTRAL '�'
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OTHER APPARATUS:1 '
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COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
TOWN OF-QUEENSBURY
Buildnijj Department
Inspectors keport Date /0
Name d
Location /v 6'6 Ate'j¢ ¢�—
Permit No. 6,0 3 3 Weather
Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing J
Sheathing '
Roof Felt C�
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 4_/ '
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors .
Insulation Foundation
Walls
•
` ://1/1- 2
Ceiliri
Building 1? pector
REMARKS
X-ICj -e Q I},(4 l f
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•
TOWN OF QUE S .v•
Building Department
Inspectors Report Datt ,
Name '(1`l 0 5 Il C►-
Loccation
Permit No. (D 0 Wezther
Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill L
Final Surveil
Framing I J
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves
' Wall Board
Ext. Porches
Finished Floor
Interior Trim j
Stairs & :Tailing_ i
Cellar Dr,. Tile
. Concrete Floors
Plbg. Fixtures
Gar. Fireproofing i •
Door Closers
Chimney
Water Meter Inst. .
Septic Approval C97(
Floors'1
Insulation FT-t-ndet_Lc
Walls 12 "6 SAelAz
Bu_l L-"ng .Ins.)2cto_
REMARKS
CP„,(4174X(V4.--61
•
•
TOWN OF UE N I
Building- Department
hmpedtors ReportLoate Z
Name ILI® �aP
Location. i oT n �i
Permit No. %heather^
•
a 33 Remarks
Excavation
Footing Forms
Footing & Piers •
Foundation
Cement Coat ; ... •
Waterproofing (
Backfill •
Final Survey �a _
Framing
Sheathing
Roof Felt 1
Roofing --__�_�_—__�.•_
Siding
' Masonry Veneer
—.__
Rough Plbg.
Relief Valves
Wall Board . i •
Ext. Porches 1
Finished Floor
Interior Trim 1
Stairs & Railing: 1 '
Cellar Dr. Tile 1
Concrete Floors 1 _
Plbg. Fixtures •
Gar. Fireproofing i _
Door Closers 1 `—^
Chimney
Water Meter Inst. 1
Septic Approval • i f._r__.•e„__�.
Fl o s ' 1
Insulation
. 1Y//:ali
III
E7.211ding I ..s.psctor
•
REMARKS
TOWN OF QUEENSBURY
Building Department •
Inspectors Report Date' Al`29
Name "74:j 1--
Location 4 A
Permit No. ,a a 3 3 Weather
Per Cent Remarks
Complete
•
Excavation
Footing Forms
Footing & Piers C/
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
REMARKS
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