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CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
4
Date
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
Location
Owner (-101-(..2.:SenJe()&- I "RUA\CIS CS" S .tv\r
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoning Inspector
A
CREATIVE ••INSTA• PRINTING. GLENS FALLS. N Y 12801 (5181793 5658
k BUILDING . PERMIT
TOWN OF QUEENSBURY 5915
- No.
WARREN COUNTY, NEW YORK •
. PERMISSION is hereby granted to George Senecal Builders, Inc.
OWNER of property located at Lot 76 Helen Drive ($n'ts-S> Street,Road or Ave.
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in the Town'of Queensbury,To Construct or place a One—Family Dwelling o
. at the above location in accordance to application together with plot plan's and other information hereto filed and• _
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approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
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1. OWNER'S Address is 57 Helen Drive 0 m
Glens Falls, N. Y. o
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2. CONTRACTOR or BUI LDER'S Name • •
H.
Same H
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3. CONTRACTOR or BUILDER'S Address .
Same H
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4. ARCHITECT'S Name
5. ARCHITECT'S Address
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6. TYPE of Construction-(Please indicate by X) • . *
(X)Wood Frame '( I Masonry ( )Steel ( ) N
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7. PLANS and Specifications i'
26 'x64 ' per -plot -plan, specifications and application d
No. submitted including sewage system and two-car garage q
under.
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8. Proposed Use
One-Family Dwelling
$5. 00 C/O Paid o
. Si 6( _ 00 PERMIT FEE PAID —THIS PERMIT EXPIRES January 1 19 80 (1-)if
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the FI
• town of Queensbury before the expiration date.)
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Dated at the Town of Queensbury this 25th Day of • June 19 79 H
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SIGNED BY �� �( a < for.the Town of Queensbury
Build' g and Zoning Inspect./ I s. m
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TOWN OF QUEENSBURY
(Space inside block to lx. filled in by
WARREN COUNTY, NEW YORK . Building Inspector)
Application No.
Application for 1,,,,..„0 is:,,,ed ,q.
BUILDING AND ZONING PERMIT Permit Expires. . IQ .
Y.onilt . District
• \ Ate ot Work i
THREE (3) Copies of a PLOT PLAN, Drawn to scale Ap1 (1 by
showing the actual dimensions of the lot to be built RenlarKs-
upon, The exact size, and location on the lot of the
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION.
• - • To '
Wi`l OF' QUEENSBURY
•DATE
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK .E1 E ° ElfiVIE 3
ANSWER ALL OF THE FOLLOWING. JUN 2 2 ij/9
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 specifi- A 7181911.0)1.1112)11213141576.
Acations, and such special conditions as may be indicated on the permit. i , . . . . , ., , ,• 0/0•
T ., owner of thiseproperty is: . /
. .eC)RCe._ . . 'e._.r\.e c c%_... . .c.Ii. 6.-e_R.S) . -.1-1.--• .c_.•. . .5. /.-/C tefv-. . .DR... .67cAls. /./s,At -i.
(NA'AE) (P.O.ADDRESS)
The person responsible for -supervision of the work insofar as the Building Code and the Zoning Ordinance apply is:
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CT.MS•ZeiA.-. . . -X\e_Co._\.. .1.&_ .% 8:e_._( ,, .5.7 /./e_/:e^i. .D ... .
(NAME) , (P.O ADDRESS),
Name of Builder. . . -..".•''C..),-M-4?-.-- • , -: Address
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Name of Plumberk Address
•Nathe of Mason k, Address
Lot Number "7 CO Unit Estimated value of proposed work S E-c:7- i c..)".c).C2,.A , •
Name of Village . . .),-Q e-r•--•N-.. • s--) c;-y
Name of Street 14 e....\.-e._(-4 r-1:2)...s _.i .\.) •••_._ Side of street: north 0, east Ff, south 0. west 0
Nearest Cross Street ti‘e._‘. .P.:i.C_K S IV; Distance Iron! this -ross street . Ft.
Property is north pl,south CI,east ri, west [11 from Cross Street •
If on Corner, which corner, northeast [1.1-, ruirt 6 ti Ei, southeast U. southwest
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• (Designate b,y..,narking with an "X' in the correct space.)
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NATURE OF PROFt EDWORK
A . OCCUPANCY
/),_ Main BuilOing
0 Construction of a ew lritoling.
C) Addition to a. ,iildnyi. One-family dwelling
0 Alter ilf. Wfding.
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. Two-family dwelling 0
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E De itii it of a building. ,, . . . . . . .-family apartment house
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Store building 0
L. , . . a . . .-car attached garage (-, bt h
- Other:
. . Accessory Building
One-car detached garage 0
fl 'Other work. Describe' . • .
Two-car detached garage • El
Private chicken house . E
Private storage building . 0
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-
NORTH
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posed buildings,and the location of all existing buildings.
Show proposed building(s) in dotted line and existing
luilding(s) in solid line.
Size of property /60 ft. x . . . . /70. . . ft.
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Size and use of existing buildings, if any
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XIII 41 Size of proposed building . . . . . 22 f '. ft.x . . . . . . -/. . ft.
Height (from grade to ridge) . . ft.
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Front yai-d - . • I/a ft.
Side yards /E"ft. and /. R-- ft.
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Rear yard 9 5-- ft.
SOUTH Hon 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 •
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BUILDING SPECIFICATIONS., - \
Kind of construction: Wood frame, fire safe, etc.?.�J�>c� • ... • ��---
Will any second-hand lumber be used? .N CC) If so, for what?
Material of foundation walls . . . . . Thickness
Depth of foundation walls below grade Continuous foundation?
Will there be a cellar? •>' If so, material of cellar floor . / ��. . .0 C v.--?�.C. T
Type of roof: Sloped or flat? . . Material of roof \.\
Size,wood studs dam" x H", spacing l Ca ."o.c., length • ft.
Size, floor beams, 1st floor c&" x 10', spacing ‘L-4? "o.c., span ft.
Size, floor beams, 2nd floor " " spacing "o.c., span ft.
Size, ceiling beams " x ", spacing l L "o.c., span ft.
Size, roof rafters or beams off" x (Q", spacing I Lla"o.c., span ft.
Exterior t'E- Cc C.. • • • With what material?
Finish of interior walls !
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? ' /� .
Kind of heating system . . .C.(.�C. .\.�?\ Qs_ 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? . \/ .S 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) . .(31�.
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
I swear that to tt-s,,1 of my knowledge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, are a true and co.e.�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.OWNERS AGENT.ARCHITECT.CONTRACTOR
day of 19
NOTARY PUBLIC, WARREN COUNTY, N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
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By
TOWN OF oTTEENSBURY
BUILDING AND ZONING DEPARTMENT
BAY AND HAVILAND ROADS, R.D,f1
GLENS FALLS, NEW YORK 12801
APPLICATION FOR A PERMIT TO CONSTRUCT, ALTER OR ENLARGE A SEWAGE
DISPOSAL SYSTEM WITHIN THE TOWN OF OUEENSBURY-UP A NT'S NAT. _-5 ADDRESS -r j , t',, c;-)R;c f f' ez is_A /s
TELEPHONE 7 9.3- )/C) ! OWNER'S NAME
ADDRESS NUMBER OF BEDROOMS
GARBAGE GRINDER? /\( (YES OR NO) TOPOGRAPHY FLAT a ROLLING, STEEP,
SLOPE, GENTLE SLOPE,, OTHER
NATURE OF SOIL: CLAY, SANDY, LOAM, GRAVEL, ROCKS, ETC,D=9/0 %W
PERCOLATION TEST WATER SUPPLY. MUNICIPAL, •TELL, OTHER
DIAGRAM OF PROPOSED SEPTIC SYSTEM
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OTHER PERTINENT INFORMATION
IT IS HEREBY AGREED THAT Tr THIS APPLICATION AND PLAMS ARE APPROVED,
INSTALLATION OF SEWAGE DISPOSAL FACILITIES WILL BE MADE IN ACCORDANCE
WITH DETAILS SHOWN.
DATE SIGNATURE OF APPLICANT
LAKE OEORGE PARK COT/MISSION APPROVAL:
signature
(data)
THE NEW YORK BOARD. OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
F., 41 STATE STREET,ALBANY,NEW YORK 12207
Date Application No.on file _. - -
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THIS CERTIFIES THAT A -
so
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
in the following location; ❑ Basement -❑ 1st Fl. ❑ 2nd Fl. • • Section Block Lot •
was examined on -- and found to be in compliance with the requirements of this Board.
r FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT MERCURY 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
'AMT. K.W. OIL ' H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H P SYSTEMS AMT.- WATTS
NO.OF FEET
•
t SERVICE DISCONNECT NO.OF S E R V I C E o
AMT. AMP. TYPE METER 1.e'2W 1 0 3W 30 3W 3 0 4W NO.OF CC.COND. A.W.G. NO.OF HI-LEG A.W G. NO.OF NEUTRALS A.W.G.
EQUIP. PER.B' OF CC.COND. OF HI-LEG OF NEUTRAL
i OTHER APPARATUS: -
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BRANCH MANAGER a"i
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Per
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TOWN OF QUEENSBURY
Building Department
Inspectors Report Date g—/S= Jam)
Name .. 're)//9 ' r../4 .
Location ,C •7 / V
Permit No. 5-9 /.5 Weather
, Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey g,ed W
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 n
Insulation Foundation .
Walls
• Ceiling •
•
Building Inspector
REMARKS
TOWN OF QUEENSBuRY
Building. Department
Inspectors Report Date; .7 S'
Name
Location i / 76
Permit No. 'S ? /S Weather
• Remarks
Excavation •
II
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 p-
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers Ae
Chimney
Water Meter Inst..
Septic Approval
FlOOrs
Insulation Foundation
Walls'
Ceiling
• Buildi nspector
J REMARKS
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TOWN OF QUEENSBuRY
Building Department
Inspectors Report Date!. /- rgb
N 5 e,)ecq/
Location sty f 7y- . c/wrf✓ . •
. Permit No. 5`' 15 Weather
Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
. Waterproofing
Backfill
Final Survey
Framing //q
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
Car. Fireproofing
Door Closers p,�/:f5" " ,A
Chimney
Water Meter Inst.
Septic Approval
Floors '
•
Insulation Foundation '
Walls '
' Ceiling
' Building Inspe or
REMARKS
TOWN OF QUEENSbURY
Building Department
Inspectors Report IDat / O/c/2 '
Name >
Location
Permit No. ,6 / /5 eather _
Remarks
Excavation
Footing Forms
Footing & Piers
' Foundation
Cement Coat
Waterproofing
Ba ckfi l l
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. /j5
Septic Approval
FlOors
Foundation '
Insulation Walls
Ceiling
Buildin Inspector
REMARKS
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TOWN OF QUEENSBURY
Building Department
Inspectors Report Date -7.9
Name /
Location .A.../J
Permit No. S`! /4 Weather
Per Cent • Remarks
Complete
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
' Waterproofing
Backfill
efe
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 �1
Cellar Dr.Tile
Concrete Floors
Plhg.Fixtures
Gar.Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Builiing Inspector
REMARKS
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OWN OF QU�EENS•BURY:
Building Department
Inspectors Report ` Date
Nan trt'4 /
Location .//c,
Permit No. 59/S Weather
Per Cent •
Complete Remarks
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
REMARKS
I
TOWN OF QUEENSBURY
, Building- Department
I, �`3
Inspectors Report Date•
Name �it7 Csa�
Location 74 .4.FJ
Permit No. Weather
No.
Cent i,
5 J 1 5 Complete li Remarks
•
Ej ;
ion
Fo I.
& vion ,
' Cement Coat
Waterproofing i'
Backfill •
-
.Final Survey
Framing 1!
Sheathing L'
• Roof Felt - /*.
Roofing
Siding Masonry Veneer-i, Rough Plbg. " •
• Rough Htg.
Relief Valves :/
Wall Board
•
Ext.PorchesIII
Finished Floor ;1
Interior Trim
Stairs&Railings
Cellar Dr.Tile i,
Concrete Floors I, •
Plhg.Fixtures I• ,
Gar.Fireproofing
Door Closers I;
I, Chimney I'
Water Meter Inst. 1' •
•Septic Approval h
di
I, I uilding Inspector
REMARKS
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