5748 C/n Paid,
CERTIFICATE OF OCCUPANCY
1:
TOWN OF QUEENSBURY
, • • ,
WARREN COUNTY, NEW YORK
• . 4
•
Date LY/11 1i77
This is to certify that work requested to be done as shown by Permit No.
has been completed.
Thu -Tti 3.2 7 *IkriA ICJ s structure may be occupied as a 1 Life((
- ck r(2.•• 43 _ .a
Location -
Owner 01 Q$ 11....d.r.c
By brder Town Board
TOWN OF QUEENSBURY
•
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Building & Zoning Inspector
1:7•.,
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CREATIVE "INSTA- PRINTING. GLENS FALLS. N Y 12801 1518)793-5658
i.
BUILDING PERMIT
TOWN OF QUEENSBURY No 5748
• WARREN COUNTY, NEW YORK
fj
PERMISSION is hereby granted to • Martin C. Mosher
OWNER of property located at Lot 4 3 Helen Drive (St. No. 8) Street, Road or Ave. �.
o
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 Drive
Glens Falls, New York
2. CONTRACTOR or BUILDER'S Name
Same
•
3. CONTRACTOR or BUILDER'S Address •
Same ti
rf-
4. ARCHITECT'S Name W
fD
•
(D
5. ARCHITECT'S Address
t7
fi
6. TYPE of Construction—(Please indicate by X) •
'•
1 Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
• 26 "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
N-
$ 120. 00 PERMIT FEE PAID—THIS PERMIT EXPIRES Nov. 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 CJ
town of Queensbury before the expiration date.)
(D
Dated at the Town of Queensbury this 24th Day of April 1979
SIGNED BY `'' 6? 7 Q for the Town of Queensbury
Buildingding a g I mpector e'
OF
TOWN QUEENSBURY (Space inside block to Ix filled in by
WARREN COUNT, NEW YORK • Building Inspector)
•
Application for Application No.
Permit Issued 19.
BUILDING AND ZONING PERMIT Permit Expires. lg. . .
Zoning. District
. \ aloe id Work j
THREE (3) Copies of a PLOT PLAN, Drawn to scale -\1)I„-(,`('(1 hV•
showing the actual dimensions of the lot to be built Itcniar)Cf
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�tJN OF QUEENSBU Y
�� !ll/ : �7 ATE/9 7, REGEHE "-A'
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK `. I9fJ APR 2 .1
ANSWER ALL OF THE FOLLOWING. A.M. I ! --- Fee ?P'M.
9 8
The undersigned hereby applies for a permit to do the following work 7. . . , . .101112 j I 6
1234. . . . ,5 a
which will be done in accordance with the description, plans and specifi-
cations, and such special conditions as may be indicated on the permit. e_Wo i
The owner of this property is:
. . .' .)'L(k.!. c„.i ' - �� i- •7 ,e ✓ 0_, . . ..�� �rtQ/ a-L4/ %J . /2'�O i
(Na.^E) (P. ADDRESS) / /
The per-so responsible for •supervision 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
Narhe of Mason Address
Lot Number "/"/�• • . . Unit Estimated value of proposed work$ . .6.o D,0O
cc_e.
Name of Village -
///7-� tv• �c1 6-t.-.[_�w��<cch....
Name of Street . . / F�- L.•/• . . JCiA•t.LGC- Side of street: north 0, east , south O. west" 0
Nearest Cross Street . /U .- [�F-' Distance from this cross street . . . . Ft.
Property is north 0,south >!,east i,, west ❑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
Construction of a new building. Main Building
i Addition to a building. One-family dwelling
"K.
❑ Alteration to a building. Two-family dwelling ❑
❑ 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 ❑
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
building(s) in solid line.
Size of property /" ft. x 7 6 ' ft.
Size and use of existing buildings, if any
•
. w Size of proposed building ft.x ft.
• Height(from grade to ridge) 0 0 ft.
Front yard y ft.
_J Side yards /' ft. and A- ft.
�
1,_,-. ' a Rear yard s.4— ft.
SOUTH If on corner,setback from side street ft.. ..
,,
Note: Ill distances are net, as measured from street side
line to nearest part of building.
(OVER)
7-73-
(cont'd.)
BUILDING SPECIFICATIONS.,
Kind of construction: Wood frame, fire safe, etc.7
Will any second-hand lumber be used? IlA If so, for what2
Material of foundation walls . . . , . p t.• Thickness
Depth of foundation walls below grade . . . 6, 0 j• Continuous foundation? . . .I ✓
Will there be a cellar? . �v� If so, material of cellar floor . . . .y "
Type of roof: Sloped or flat? Material of roof
' spacing /�
Size,wood studs x ", s acin "o.c., length ft.
Size, floor beams, 1st floor "x . /. C2 ", spacing / 6 "o.c., span . . . .l ft.
Size, floor beams, 2nd floor . . . . . . '. ." x . /0 ", spacing / 4 . . . ."o.c., span /. ft.
Size, ceiling beams " x • £• • • • •", spacing "o.c., span ft.
Size, roof rafters or beams
s" "x . . .7/f-� 4. . . . .", spacing a "o.c.,span ft.
Exterior finish . . . .. n* - .1-.>+l• • • cf�.. 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 . . Oil burner or coal?
Will a flue-lined chimney be provided? . ' • • • • • Depth of chimney foundation below grade . '
Height of chimney above roof a
Will there be a fireplace? . . Depth of fireplace hearth / 6
• Will a toilet he installed?
Will a kitchen sink be installed an connected to wate pply?
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
I swear that to th-becrof my knowledge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, are a true and cnuAolete statement of all proposed work to 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 !ice �//�
' � (
OWNER,OWNER'S AGENT,ARCHITEC .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 ',j
OCCUPANT'S NAME � ADDRESS 'i6? AL( • ii
TELEPHONE % 9 - / o OWNER'S NAME >nd1/27,'_i �iti,.
ADDRESS q ke NUMBER OF BEDROOMS `V
GARBAGE GRINDER? -O (YES OR NO) TOPOGRAPHY: (LAT)ROLLING, STEEP, SLOPE,
GENTLE SLOPE, OTHER
NATURE OF SOIL: CLAY, SANDY: LOAM, GRAVEL, ROCKS., ETC.
PERCOLATION TEST WATER SUPPLY: MUNICIPAL, WELL, OTHER 7,,,,
DIAGRAM OF PROPOSED SEPTIC SYSTEM
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, _ _ �•�
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(VIZ ti.Q�G►,G
OTHER PERTINENT INFORMATION
IT IS HEREBY AGREED THAT IF THIS APPLICATION AND PLANS ARE APPROVED,
INSTALLATION OF SEWAGE DISPOSAL FACILITIES WILL BE MADE IN ACCORDANCE
WITH DETAILS SHOWN.
DATE a SIGNATURE OF APPLICANT
LAKE GEORGE PARK COMMISSION APPROVAL:
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Application for: , BUILDING PERMIT IN COMPLIANCE. WITH THE NEW YORK
- - STATE -ENERGY CONSERVATI.ON CODE
A permit must be obtained before beginning work.
Answer all of the following:
1. Gross floor areao • •)� �• e • • • • • o • ovo • • e • oao • • o • • • • oo • • v • oo • e • • • MOO
L. Type of heat• • • •gls �be • ovOe • o • • 000 • o • e •o • • • oe• •• • or • • • • e • • • • • • oe
3. Is the building mechanically cooled? oo • o . 00 . o • •o • ee • • • • • e • • • • o • • • mo
4. Percentage of area of windows and domes a m . a .1 i te� c . e e e • e . e • e • m
A. Over 16% only
1. Uo value of gross area of walls, roof/ceiling and floors
' exposed to ambient conditionsee • e • • e • ee • • 0 • • e0000a • 0 • 0 • . • ea
0 • e • e 0 0 • • e 0 • • • 0 o • • • 0 • • 0 e 0 0 0 0 . 0 0 0 0 . 0 0 0 0 a o e • e • 0 0 0 • • • • e 0 • • • • • 0
2. Floor o =r! heated spaces Yes No.
a. Are oundatio' s .wa1':� :_ : ; .slated es No
1 0 I Yee, w e• • • • • e • • • o • • o a o • o e a . e • •
3. Slab on--g-ra 4------- - No -
a If yes he : R vblue of ins around perimeter
o7 flPor' • o • e e o v o e • e o o • o e • • •o • o • o • a • • • moos
4. Is basesm'-.' le tea`
.` -. va7lua . f wsulaiLione0o • • oao . o0e • r • • • • • • • oeoe • 0 . • • • o • •
5. Type of ineulat on
B. Under 16% only •. '
1. U value of roof and floors exposed to: ambient conditions
• OOOOO o 0 0 • • • • • •'• e •.• o oo e • • o o a OOOOOO o• o • •
2 • EY valise of exterior • • i• OO 004b26041000000 • 000 OOOOOO
30 U value of glazed area. . . o e • e e • e .• • • • e• v e o e • e o o • • • e 0 e •
4. U value of d�'��g o m a v • o o v • •.�o a v • • OOO 0 OOOOOOOOOOOOOO o e o o • o • o
L_
5• U value of floors overeated spaces e • . ;' _.. - • • e .�o:e
6. R value of slab edge insulation-unheated slab e e • • •e 2 • e •
7. R value of slab insulation - heated slab
8. U value . of heated basement/cellar walls (above grade) e 4/4
9. R value of heated .basement/cellar walls (below grade) • /W-
10 d /1 n/�/p� rJ/ Ll /�J)/��, py�
. Type of insulations. • e 6aVa G•5'd e'o0 e • fa`e.,�e4i8 S�.'d• • • • • o oa •
C. Controls - -
1e Thermostat maximum heat .Bie ngo00 • r 0 •.o• • a'o • 000 • • • • • • • e •
D. Duct systems
1• Is duct system installed in unheated areas Yes No
a. If Yes, R value of duct installation • e e • • . e
b. R value of duct in other areas • • o . •e e o •
E. 'Pipin3 Insulation
1. Si.s,<e of hot water or cooling carrying agent pipe.0 _ . . . .
2 R value of pipe insulation a . a m . a e • C 0000 • 00 • 0 S a 0 000000000 as
F. Service water Heating /614 0
1 :-
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THE NEW YORK BOARD, OF FIRE ;UNDERWRITERS •
--<. BUREAU OF ELECTRICITY
:<<,' 41 STATE STREET,ALBANY,NEW YORK 12207
-0 Date ,L. ._•` Application No.on file !--;
�,
�� THIS CERTIFIES THAT A 4
-<" onlythe electrical equipment as described below and introduced bythe applicant named on the above application number in thepremises
-< PP PP of
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�: in the following location; CIBasement CI1st Fl. :CI 2nd Fl. Section Block Lot
Iwas examined on ; and found to be in compliance with the requirements of this Board. P
- 4
�; FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS i t.
RECEPTACLES SWITCHES •• MERCURr ›'
j, OUTLETS INCANDESCENT FLUORESCENT VAPOR AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
�i ` 'IA
liii
-6 DRYERS' FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS P
SYSTEMS 4
4 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
4 .
T
C ._ 5-
2 :-.
j: SERVICE DISCONNECT NO.OFMETER S E R V I C E r
�, AMT. AMP. TYPE EQUIP. 143.2W 1,e'3W 3,B'3W 3 A 4W NO,OPER COND. OF CC COND. NO.OF HI-LEG OF-HI--LEG G. NO.OF NEUTRALS OF NEU G.TRAL Y
-(, OTHER APPARATUS:
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it BRANCH MANAGER
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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 A, A 1-4?
-7222 NameJ�f?� �
Location ' %?J 3 1c14�42» /�
Permit No. 57 it-8 Weather
Per Cent
Complete Remarks
Excavation ,^�
Footing Forms ' "7,
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
/64t.S �kC,
i II
TOWN OF;QUEENSBURY
Building Department
Inspectors Re•,,,rt Date t6 " J2-- 7 d
Name/4a '� a�
Location A49,20 ) L?Y 4.r/ L/ it
Permit No. 3-7 /5Y Weather II.
Per Cent Re `
Complete•
II
Excavation II
Footing Forms ii
Footing & Piers II
Foundation 11
Cement Coat 1
Waterproofing �1
Backfill - �1
.Final Survey 11
II.
Framing
Sheathing it
Roof Felt
Roofing 1�
Siding '1
Masonry Veneer / . 1
Rough Plbg. f 1
Rough Htg. 4 1
Relief Valves
Wall Board 1
Ext.Porches }
Finished Floor
Interior Trim 11
Stairs&Railings it
Cellar Dr.Tile 11
Concrete Floors I'
Plbg.Fixtures 11
Gar.Fireproofing
Door Closers '1
Chimney i
Water Meter Inst.
Septic Approval L✓ it
Building Inspector
REMARKS
•
•
•
TOWN OF QUEENSBURY
Building Department
Inspectors Report - Date /2/7.9
Nam
Location 4 3 ,�}�ft#.• G)
Permit No. S 7 S Weather
Per Cent •
Complete • Remarks
Excavation
Footing Forms • ii •
Footing & Piers
Foundation
Cement Coat I11
Waterproofing
Backfill �I
Final Survey
Framing L� 0 K
Sheathing i1
Roof Felt �{.
Roofing
Siding
Masonry Veneer
Rough Plbg.
Rough Htg. v ii
Relief Valves.
Wall Board
Ext.Porches
Finished Floor
Interior Trim
Stairs&Railings jl
. Cellar Dr.Tile
Concrete Floors
Plhg.Fixtures
Gar.Fireproofing �!
Door Closers
Chimney I„
Water Meter Inst. I�
Septic Approval jl
je///6/
Building Inspector
REMARKS •• ;f
•
•
.
•
•
•
TOWN OF QUEENSBURY
•
Building Department
Inspectors Rep�ff Date
Nan:
Location _ / ,u ' �o �7`•S
Permit No. hA 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 TileNN:\
Concrete Floors
Plbg.Fixtures
Gar.Fireproofing
Door Closers
Chimney '
Water Meter Inst.
Septic Approval
Building.Inspector
REMARKS
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