6889 ., .
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C/O Pa id
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CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY i
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WARREN COUNTY, NEW YORK
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19e.: I
Dare I ai
This is to certify that,work requested to be done as shown Ilyi, Permit. No. (.02':
,
has been completed. 1.
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This structure may be occupied as a MS- :':' F.:2ff 417a1:46' ' tie (((o
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By Order. Town Board
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TOM& OF QUEENSBURY
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Building & Zoning Inspector
,
1,
CREATIVE ••INSTA" PRINTING GLENS FALLS N Y 12801 1518)793-5658
(
BUILDING PERMIT
TOWN OF QUEENSBURY No. 6889
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Martin C. Mosher
OWNER of property located at Lot 65 Helen Drive (St. No. 56) 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-
1. OWNER'S Address is
15 Greenway North
Glens Falls, New York
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2. CONTRACTOR or BUILDER'S Name
CD
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same
3. CONTRACTOR or BUILDER'S Address
same
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4. ARCHITECT'S Name p
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N rn
(D UI
rt
5. ARCHITECT'S Address
O H
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6. TYPE of Construction—(Please indicate by X) N
(})Wood Frame ( ) Masonry ( )Steel ( ) (D
7. PLANS and Specifications 28 'x6 0° per plot plan, specifications
No. and application submitted including two—car
attached garage and sewagesystem.
8. Proposed Use 0
One—Family Dwelling
p)
$5. 00 C/O Paid ~
$157 . 00 PERMIT FEE PAID —THIS PERMIT EXPIRES December 1 19 81 "C
(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.)
F-'
fJ
Dated at the Town of Queensbury this 18th Day of May 19 81 N
SIGNED BY 6 .�-ru for the Town of Queensbury
Building and Zoning Insp ctor
TOWN OF QUEENSBURY (Space inside block to Ix filled in by
WARREN COUNTY, NEW YORK • Building Inspector)
• for Application No.
ApplicationPermit Issued 19.
BUILDING AND ZONING PERMIT Permit Expires. lg. .
Z iinu. District
\ aloe OI Work
THREE (3) Copies of a PLOT PLAN, Drawn to scale \1)1"."‘c•(1 b
showing the actual dimensions of the lot to be built Remark(
upon, The exact size, and location on the lot of the
building to be erected or altered MUST BE SUB- •
MITTED WITH THIS APPLICATION.
y DATE D ,_ V E - n��If/Jn E flA PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK
ANSWER ALL OF THE FOLLOWING. MA'Y 18 1981 • 1
The undersigned hereby applies for a permit to do the following work D� rem rCt
which will be done in accordance with the description, plans and s ecifi- A.M. 'fy '
P.M.
cations, and such special conditions as may be indicated on the permit. .7I8I9I1GI1i)12J1I2I3I4J5I6
td 1 viC
The owner of this propertyiss:
(NA.•.) -I-',, (P-0.ADDRESS)
The person responsible for supervision of the work insofar as the Building Code and the Zoning Ordinance apply is:
C - -'r.�---Q�-salt,,
(NAME) )P.O.ADDRESS)
Name of Builder ` `n-/_—, Address
Name of Plumber \--54-"3-71-4----- Address
Narne of Mason Address
'Si'• Lot Number •'`� Unit Estimated value of proposed work S 6,s —0 '
66 Name of Village a Gt✓c.-- /c-
Name of Street . .) rem'. • Side of street: north 0, east ❑, south ❑. west
Nearest Cross Street f44iz% -e. Distance from this cross street �-'' Ft. -
Property is north 0,south TO east i i,west 0 from Cross Street -
If on Corner, which corner, northeast 0, northwest ❑, southeast 0, southwest
(Designate by marking with an "X" in the correct space.) •
NATURE OF PROPOSED WORK OCCUPANCY
Construction of a new building. Main Building
El Addition to a building. One-family dwelling
Two-family dwelling El❑ Alteration to a building. -family apartment house CI
of a building. Store building ❑
-car attached garage 0
Other: •
Accessory Building
• One-car detached garage' ❑
❑ Other work. Describe: Two-car detached garage El
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-
4 posed buildings,and the location of all existing buildings.
NORTH Show proposed building(s) in dotted line and existing
-Wv r'?7'' — l;uildings) in solid line.
Size of property /10 ft. x / ' D ft
Size and use of existing buildings, if any
e . m Size of proposed building . . .c2C'• • ft.x d ft.
Height(from grade to ridge)
0 ft.
Front yard cj-Z, ft.
ISide yards a O ft. and /S ft.
Rear yard (. 0 ft.
- SOUTH If on corner,setback from side street ft..
Note: All distances are net, es 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. ..„2/Ot—a---le-- L� "-`�
Will any second-hand lumber be used? `emu' . � �/If so, for what
Material of foundation walls /D ' �� L Thickness
Depth of foundation walls below grade L 2 O Continuous foundation? . .
Will there be a cellar? . .-1-Cam If so, material of cellar floor 1!' ` .�6L.
Type of roof: Sloped or flat? . ,/a 4-' Material of roof ad....."--/-
Size,wood studs " x ", spacing 6 "o.c., lengtre-‘)
et ft.
Size, floor beams, 1st floor v. " x • /0 ", spacing / "o.c., span / ft.
Size, floor beams, 2nd floor Z." x / D ", spacing . . . ./ '`. ."o.c., span /" ft.
Size, ceiling beams a " x (rp% ", spacing 7 6 "o.c., span / ft.
Size, roof rafters or. beams " x O ", spacing / "o.c., span / ft.
Exterior finish � With what material?
Finish of interior walls ' `�i!,� �.-
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 garage and building? i w •
Kind of heating system '�" Oil burner or coal? .
Will a flue-lined chimney be provided? 7- Depth of chimney foundation below grade . . . .(✓ .O. ..,
Height of chimney above roof oe
Will there be a fireplace? Depth of fireplace hearth / t'
Will a toilet be installed? -Y-5( .
`G 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?
Town of Queensbury / AFFIDAVIT
County of Warren
State of New York
1 swear that to th-bjaof my knowledge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, are a true and co.0 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. �J!7
Sworn to before me this Signature OWNER.OWNER'S AGENT.ARCHITECT. ONTRACTOR
day of 19 .
NOTARY PUBLIC, WARREN COUNTY. N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
•
By •
TOWN OF QUEENSBURY MARTIN C. MOSHER
BUILDING AND BONING DEPARTMENT 15GREENWAIINGMY
BAY AND HAVILAND ROADS, R. D.#1 GLENS ALLa y1280I
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 IK'AILE • ADDRESS
-..'ELEPHONE 7. 9-2 - OWNER S NAME 4) e, •
ADDRESS.J7 NUMBER OF BEDROOMS 7/
GARBAGE GRINDwR2Li(20- (YES OR NO) TOPOGRAPHY: (F114 ROLLING, STEEP, SLOPE,
GENTLE SLOPE, OTHER.
NATURE OF SOIL: CLAY( NIA) LOAM, GRAVEL, ROCKS, FTC.
PERCOLATION TEST WATER SUPPLY: (1;-ICIP24) WELL, OTHER
DIAGRAM OF PROPOSED SEPTIC SYSTEM
OTHER PERTIDENT INFORMATION
IT IS HEREBY AGREED THAT IF THIS APPLICATION AND PLANS ARE APPROVED,
IKSTALITTION OF SEWAGE DISPOSAL FACILITIES WILL BE MADE IN ACCORDANCE
WITH DETAYLS SHOWN.
DATEV-)1 /d.?: Zid7/ SIGNATURE OF APPLICANT C -
LERE GECRGE ?A COMMISSION APPROVAL:
(signature)
(date)
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 . Gross floor area 2/ _ 7 �(',�_ /�
2 . Type of heat fir, / �?�re--%4",a c%
3 . Is the building mechanically cooled? ///O
4 . Percentage of area of windows and doors ,//cam
A. Over 16% Only
1 . Uo value of gross area of walls , roof/ceiling and floors
exposed to ambient conditions
2 . Floor over heated spaces YES NO
a. Are foundation walls insulated? YES NO
1 . If YES , what is the R value?
3 . Slab on grade YES NO
a. If YES , what is the R value of insulation around
perimeter of floor?
4 . Is basement heated? YES NO
a. R value of insulation
5. Type of insulation
B . Under 16% Only
1 . R value of roof and floors exposed to ambient conditions
2 . R value of exterior walls /9--//�
3 . R value of glazed area
4 . R value of doors r
•
5. R value of floors over/heated spaces /—/j
6. R value of slab edge insulation - unheated slab
7 . R value of slab insulation - heated slab
8 . R value of heated basement/cellar walls (above grade)
9 . R value of heated basement/cellar walls (below grade)
10 . Type of insulation ,‘? _r ,&Gr r jr.;eejs
C. Controls v
1 . Thermostat maximum heat settinger
D. Duct Systems
1 . Is duct systlem installed in unheated spaces? YES CN�
a. If YES , R value of duct installation
b. R value of duct in other areas
E . Piping Insulation
1 . Size of hot water or cooling carrying agent pipe
2 . R value of pipe insulation
F. Service Water Heating
1 . Performance efficiency ' S��%�=j
2 . Temperature control setting ma`acimum `/ Q
G . For Swimming Pool Only
1 . Maximum heating
Telephone No. 7Ra -
(applicant ' s signature)
4A.�9.'.lk 94.A�.C"..),A).AJJASJAA AJ.A...C3.A).A).A.J..A).A).AXAAA2AS.AA AA.2).AJ.A).Al..AaAaA).A).A).A).AaVA)VAJ...A),IPAx,A).,A).AA.)OA).A).A),2..Aa.A),2C.. 1.).�J.Via 2),,
"k, THE NEW YORK BOARD. OF FIRE UNDERWRITERS .r•
1; -I BUREAU OF ELECTRICITY ,J! '
i. � �
! ' � 41 STATE STREET,ALBANY,NEW YORK 12207
�I Date L§��''."' '_ . 20 it Application No.on file e.e - 0 e A " ci 1 j- ` Y'Al -
1 THIS CERTIFIES THAT '.
�, only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of ,Y
• I
j' in the following location; ❑ Basement �:❑ 1st Fl. :.CI � •J 2nd Fl. , .r; V .- , Section Block Lot ,�
• II was examined on 9• L. ``1k�I and found to be in compliance with the requirements of this Board. ,y .
4
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS ;�'
�' ECEPTACLES SWITCHES MERCURY
OUTLETS INCANDESCENT FLUORESCENT VAPOR AMT. K.W. AMT. K.W. AMT. K.W.. AMT. K.W. AMT. H.P. '>'
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS ,� `�
SYSTEMS .,
'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_,l"
-
SERVICE DISCONNECT NO.OF .L 'i.10' ' '.5.',.7 E R V I C E ;r
�i AMT. AMP. TYPE METER
1,B'2W 1,B'3W 3,2'3W 3,B'4W NO,OPER COND. OF CC.COND. NO.OF HI-LEG OF HI--LEG NO.OF NEUTRALS OF NEUTRAL t
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, OTHER APPARATUS:
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• -C� 1,...!:",..._. ii '.iT '-�r -
�1 ,. . .. ,~ '.�'n'_II. BRANCH MANAGER 'Ii
-_ , Per . . Y
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COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. . _
TOWN OF QU•EENSBURY
Building Department
Inspectors Report Date ,PJ1/19,0
Name XV. /"ve®���%�
Location C/V .)
Permit No. (X `i Weather
Remarks
Excax>a t on
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves
Wall Board yA
Ext. Porches
Finished Floor
Interior Trim r
Stairs & Railings
Cellar Dr. Tile
Concrete Floors r
Plbg. Fixtures
Gar. Fireproofing
Door Closers _.
himey Water
Waterr Meter Inst.
Septic Approval
FlOors
Insulation Foundation
Walls
Ceilin
Building Inspector
REMARKS
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date ', /Name I.or
Locati n/
Permit No. -A"'d? ` Weather
Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing •
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg. �f $(7--jel
Relief Valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railings
Cellar Dr. Tile i ---
Concrete Floors
Plbg. Fixtures / \
.Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation
Walls
Ceiling
tiTBuilding Inspector
REMARKS
TOWN OF QUEENSBURY
Building. Department
dnsperters Repo Date -3 ,(9/
Nome Xlev ek-
Location . .,/ o
. Permit No. /0 8.8 7 Weather
•
• Remarks
•
' Excatation •
Footing Forms
Footing & Piers
Foundation
• Cement Coat
•Waterproofing •
Backfill ,
• Final Survey
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 Focindatiori
Walls
Ceiling
Building Inspector
•
•
REMARKS
, - 4.1 AA 'CI .
TOWN OF QUEENSBURY
Building Department
I .
Inspeetora Date 6 —2- 6f
Name g
e a,, . . .
Location L` /- cl J - - k1v_.
Permit Na (,-•A' c' ? Weather
Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing -12:::,;-/1.)a/7.
Backfill � i
Final Survey �,� �/�
Framing
Sheathing
.Roof Felt_____.- ,
Roofing
Siding ' Z.)
Masonry Veneer
Rough Plbg.
Relief, Valves f
Wall Board �.�
Ext. Porches K
Finished Floor \ /
Interior Trim
Stairs & Railings A
Cellar Dr. Tile /
' Concrete Floors
Plbg. Fixtures f` \\
Gar. Fireproofing
/ \ .
Door Closers/
Chimney E
Water Meter Inst.
. Septic Approval
Floors
Insulation • Foundation •
Walls _
Ceilin
• Building Inspector
• REMARKS
/'ec' . /C. % i .
• TOWN OF QUEENSBURy
Building Department
Inspectors Report Date �/ -ate
Name /tJv
Locatie /6 /, /-)
. Permit No. Ct7 S 37 Weather
Remarks
•
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat' •
Waterproofing en r
Backfil1 Or
Final Survey
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 Foun tiori
. Walls
Ceiling
Building Inspector
REMARKS •
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date
Name V' tf_;=<ii,,
•
Location j el- 475 Alet',;? t);�
Permit No. 'pro,t9.-- `:� Weather
Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
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
•
Building Inspector
REMARKS
M4R77N°C MOSHER
16 GREENWAY NORTH
GLENS PALLS` NY 12801
•
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