5393 •
c/o Pa-1,J
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
cr:N.LIiie:•.: (2/ 171
71:1)
' 19 '
This is to certify that work requested to be done as shown b Permit No._ Ck
has been completed.
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t
This structure may be occupied as a t PIA'? ( (
Location
Owner
Vd(47+.'-"-- - ii kb 1 .
• By Order Town Board
TOWN OF QUEENSBURY
/22
Building & Zoning Inspector
lj
k7144,1a.A.,
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CREATIVE -INSTA" PRINTING GLENS FALLS. N Y 12801 15181793-5658
1 -> BUILDING PERMIT
TOWN OF QUEENSBURY No 5393
WARREN COUNTY,.NEW YORK
PERMISSION is hereby granted to Robert F. Cubbins
OWNER of property located at Lot 100 Helen Street (S..rid 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 op
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
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Fi
1. OWNER'S Address is
.Meadowbrook Road F.]
• Glens Falls, New York 12801 •
'
it
2. CONTRACTOR or BUILDER'S Name
i7
N.
Martin C. Mosher
3. CONTRACTOR or BUILDER'S Address
R. D. #3
Glens Falls, New York
4. ARCHITECT'S Name
0
rl
5. ARCHITECT'S Address H
o.
N .
H.
6. TYPE of Construction— (Please indicate by X) CD`
(X)Wood Frame ( ) Masonry ( 1 Steel ( ) En
r -
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7. PLANS and Specifications
No. 28 'x56 ' per plot plan, specifications and application
submitted, including sewage system and 2-car attached O
8. Proposed Use
N
• 'iJ
One-Family Dwelling
N
$5. 00 C/O Paid '-c
$ 50. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES March 1 19 79 C7
(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.) •
1..�
F-'
Dated at the Town of Queensbury this 14 t h Day of Align s t 19 78
SIGNED BY / ,2 1, C/Zstet,21 for the Town of Queensbury
Building aid Zoning Inspector ./ `��
TOWN OF QUEENSBURY t (Space inside block to Ix filled in by •
WARREN COUNTY. NEW YORK • Building Inspector)
• A lication for Application No. ;
pP permit Issued - 19. .
BUILDING AND ZONING PERMIT l'ormit Expires. 19 .
/.IJnine District
\ u l uc• of work,
THREE (31 Copies of a PLOT PLAN, Drawn to scale \l'Io) ed by
showing the actual dimensions of the lot to be built ki'niar)(5-
upon, The exact size, and location on the lot of the
building to be erected or .altered MUST BE SUB- __,____
MITTED WITH THIS APPLICATION.
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�-�i.4t '. .//. :i97 TOWN OF QUEENSBURY
DATE. Hpn D
A PERMIT MUST BE OBTAINED _BEFORE BEGINNING WORK , �? .. V�4M
• ANSWER ALL OF THE FOLLOWING. • v �JG 11 1978
The undersigned hereby applies for a permit. to do. the following work 1 A.Me P.M.
which will be. done in accordance with the description, plans and specifi- .
cations, end such special conditions as may.be indicated on the permit. ,,._7181911.011.1.11111213141516_. _. ..- 7c A 1 1 1
The owner of this property is:. .
/4� (NA'.;E •
(P.O.ADDRESS)
The rson responsible for supervision of the work"insofar as the Building Code and the•Zonin Ordinance apply is:
A� a i.,,. , e,. 22-,-- L Al .� 1.-v,� �,. P.0 A -.-1 4— . . . . . : . . -c cat!}'+o—tc-4,4
(NAME) //
. Name of Builder... . . . . Address
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Name of Plumber Address
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Name of Mason
'O Address
Lot Number • • Unit Estimated value of proposed work i : La--a .
4--a
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• Name of Village . . .
Name of Street . .4--e....144--) Side of street: north 0, east 0, south O. west X
Nearest Cross Street . v Distance from this loss street .a/ - -/� Ft.
Property is north 0,south ,east [1, west ❑from Cross Street"
If on Corner, which corner, northeast 0, northwest •❑, southeast 9. 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
❑ Alteration to a building. Two-family dwelling ❑
❑ Demolition of a building. -family apartment house ❑
. Store building ❑
. . . . -car attached garage 'El'
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Other:
Accessory Building
. One-car.detached garage . Li
0) 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 /`� ft. x /7o ft. •
Size and use of existing buildings, if any
- F `71..n't.e-
s W Size of proposed building . . .aP • • ft.x -6 ft.
Height (from grade to ridge) . . 0 ft. .
e Front yard L~� ft.
Side yards /5 ft. and /J ft.
. 1. J ,,a,-. . Rear yard to 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.,
Kind of construction: Wood frame, fire safe, etc.' ,.-2vt-rc-A--X., �� L)
Will any second-hand lumber be used? '71u If so, for what2
��
Material of foundation walls /O 4 .&T & Thickness
Depth of foundation walls below grade ' d Continuous foundation? . .`. .
Will there be a cellar? If so, material of cellar floor 4 " . r'��c., —,=-4-
Type of roof: Sloped or flat? -e--/Z�-ti Material of roof . . 4.4+--t-/.". . .....Vv-i-y--&-..-)
Size,wood studs aZ "x 177 ", spacing . . . .l . . . . . ."o.c., length f• ft.
Size, floor beams, 1st floor (p• " x /, ", spacing / , "o.c., span /9' ft.
Size, floor beams, 2nd floor oZ " x ./ ", spacing . . . ✓ �. ./lo. ."o.c., span /Lit ft.
Size, ceiling beams " x ", spacing . . . . /.(' "o.c., span /-1 ft.
Size, roof rafters or^beams a " x .c ", spacing / ' "o.c., span ./V ft.
' Exterior finish . l,�t/?-LcJ• . .ef.triz. 4,—KA._.,6� With what material?
Finish of interior walls ��r ..-/-✓
If garage is to be attached/pf what material is wall between garage and main building to be constructed?
Is there to be an opening between garage and building? LA-0
Kind of heating.system . . GG.22Lr:e Oil burner or coal?
Will a flue-lined chimney be provide�� . Depth of chimney foundation below grade �o
Height of chimney above roof . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .�
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) . ----C.
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 tr. be.a of my know,edge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, are a true and co. olete 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. � ,
� zti�z
Sworn to before me this Signature 2 ( ' ' ^^ -w
OWNER,OWNER'S AGENT,ARCHITECT.CONTRACTOR
day of 19
NOTARY PUBLIC. WARREN COUNTY..N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
•
By
• TOWN OF QUEEN:BURY
BUILDING ^a ZONING DEPT.
. QTJEENSBURY TOWN OFFICE BUILDING
BAY 84 HAVILAND ROADS, RD 1
GLENS FALLS, NEW YORK 12601
APPLICATION FOR A PERMIT TO. CONSTRUCT, ALTER OR ENLARGE
A SEWAGE DISPOSAL SYSTEM WITHIN.THE TOWN OF QUE ENSBUR.YO .
C CMPAN 1 e S NAME JiG 4,- T' • B i�;L E�:S ?.Clc c.4� % /' 1.,
x'�i •t+me, c�ra....rr....,_.n - Yia�'asa aeasctcrl .<..e--,. a:=�ta.:•.v�c
. TELEPHONE
ra.sxR9'0 es.:.mi�nasns a:nsr..Rnr�.-:zs:ra-;,
AD zESSXj,t1 At-o ,dLc��,✓. /' • NUMBER OF BEDROOMS V-JJv'
cG-acsL ++�-"'_'-'-c9 az4uDrtsR :.r'W.`�et:iR>'1'S]SdU'IL'x_VC1'h._�af�..`:
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GARBAGE GRINDER? 7"2- Ores OR NO) TOPOGRAPHY: FLAT, ROLLING,NG, MEP
am- �s:aateaaaau-s:.�.•tiR
SLOPE, GENTLE SLOPE, OTHER _Y �._ ...R�. .
NATURE OF SOIL: CLAY, SANDY, LOAM, GRAVEL ROCK,, [Co_ j!--47,./r.. �.. .� +Rv,eRe2 .d'vR.cn
PERCOLATION TEST WATER. SUPPLY: MUNICIPAO WELL, Oh '-
®+.9ev+��tIIs.C:aC3tAum�,te�csiQC:W� •���•R>=.•.Syr r..r.m ...t£•.e1.��i1at rc RL�tr�Y.[+iRveKnrvtrr:la�Lrw'9vScttrvfen-RlvriaLa3lumvCM..'NPRaarm"F.ar+--.�..n.3sK.iuiRxS_Ct.Q�a¢: 'i::.
DIAGRAM OF PROP OLED SEPTIC SYSTEM
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CTHER PERTINENT INFORMATION fDZ) 51- -' d,o2c, —�
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II n+YYz.✓eII [4D,'Rm".S!'-pG+:trsY 6.H:i�lt,,:1�i eta Raam�[ , sia^>.:itGt'eiLt¢ -I EY.salvESClaa '.ffiL:T_..ti.4"t®taea'laG`+,�..'avwv't�.r�L-6i0s a.
6s1II3,LVSRSS"_>t�AlOLboM—"tA>faOrG'�7.v.++emr�'S».a2fB.Mgt®aa.[.t.•tesea�neab�Da:.ad+cfaII'rSa'h r�� wb.tiJ'�nLse2mW19RarcttatR:m.�•..Rem¢oaO6'�a aID^.Ci.�eNaC-Yernaatt`M-tlCYR.a.¢awi'..:
aeiitVLeYY'+a wtv-sttioc.o... seduce eranrs ...saP1aoC•e.29aLLtDtsomarls=tarsc-,.. ratYatX.acal..o.ma:lvl:'tmarr Vmute.r^r-..:0io:am.mats raarilaa¢ntw.032ScmVaa,Rani]-GtAtacm V.C...•a.L.....:acZIM.'lRtr
IT IS HEREBY AGREED THAT IF THIS APPLICATION AND PLANS ARS APPROTI a
INSTALLATION OF SEWAGE DISPOSAL FACILITIES, WILL BE MADE IN ACCORDANCE
tra H DETAILS SHOWN,
PERMIT FEE IS ` 5,00
ref„-�•.r.�iaaa.�..ta���m ..�Y.�
Ds3 .- 2� 7 SIG aATURE OF Al' L:i1 AN`To C •
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,44,4-_: !44.44.41..-a,lA94..1,<..1.4- -444, J,:4-1-7414-194.iAa.taL1.AJ.9.ea7,4.1.a!Ca�44.e..CL..-Ai...0..0 ..Cx!la..layla7..0..AC..iyA•J...cAlactJ._Catlwa..17.Ia:tJ.:47..I. ,J_,kAl.�.tte.s.J.).
THE NEW YORK BOARD. OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY 9
41 STATE STREET,ALBANY,NEW YORK 12207
1 Date Application No.on file
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
j in the following location; ElBasement El1st FL 2nd Fl. Section Block Lot is
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 FLUORESCENTilf
MVAPOR AMT. K.W. AMT. K.W. AMT. K.W.. AMT. K.W. AMT. H.P. i
IV
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS m
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
; 1 4.
" SERVICE DISCONNECT NO.OF S E R V I C E
METER NO,OF CC.COND. A.W.G. A.W.G. A.W.G.
7 AMT. AMP. TYPE EQUIP. 12W 1,0'3W 3,0'3W 3,0'4W pER B' OF CC.COND. NO.OF HI-LEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL ,
4
4
OTHER APPARATUS:
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a9
BRANCH MANAGER
liPer
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
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TOWN OF QUEENSBURY
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Building Department
Inspectors Repo C' t�4)�1 k '5 Date `2-/ y- 7r{�
NamewrV
Location -j Yic,K S/ a /aG
Permit No. C, 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 1 -
'///X/
Cellar Dr.Tile
Concrete Floors
Plhg.Fixtures /
Gar.Fireproofing l�i
Door Closers 6�J
Chimney
Water Meter Inst.
Septic Approval
Building Inspector
REMARKS
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air / Z_7-0i-7?
TOWN OF'QUEENSBURY
Building Department
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Inspectors Rep Date /'� /' 7d
Name 1,4 S Y i' •
Location ./Y ,Pst) S LvJL f
Permit No. .S 3 9 :3 Weather
Per Cent 1.
Remarks
•
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing li'
Backfill
_Final'Survey
Framing
Sheathing
Roof Felt
Roofing
Siding.
Masonry Veneer u ' •
Rough Plbg.
Rough Htg.
Relief Valves •
Wall Board
'Ext.Porches
Finished Floor
Interior Trim
Stairs&Railings
Cellar Dr.Tile
Concrete Floors
Plbg.Fixtures i;
•
Gar.Fireproofing
Door Closers
Chimney •
Water Meter Inst.
Septic Approval i!
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Building Inspector
REMARKS;
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Drjuk/ • .
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TOWN •OF•QUEENSBURY- • •
Building Department
Inspectors Report .. Date Jo--23= '
Name /11,0 ,e!" ( w b J 1 n S 'I
Location . He-kit) 5 : 20/A'd
. Permit No. „S"-"3 7 3 Weather
Per Cent
Complete • Remarks
Excavation
' Footing Forms
Footing & Piers
Foundation 'I
Cement Coat •
Waterproofing
•
Backfill
Final'Survey
Framing lJ
Sheathing
• Roof Felt •
Roofing i'
Siding 1
Masonry Veneer• •
•
Rough Plbg.
Rough Htg.
Relief Valves •
\ /✓
Wall Board • •
Ext.Porches •
Finished Floor
Interior Trim
Stairs&Railings
Cellar Dr.Tile
Concrete Floors '
ir
Plhg.Fixtures
Gar.Fireproofing
Door Closers t. •
Chimney
Water Meter Inst.
Septic Approval
Building Inspector
REMARKS !i
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TOWN- OF C UEENSBURY•
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Building' Department
Inspectors�,Reeport Date (-lU
Name ,/7"/65' i`- `fee47 t l ih)
Location /,c) _sr/ JoA/00
Permit No. Weather
J I Per Cent Remarks
Complete
Excavation /J
i Footing Forms ;� ,
Footing & Piers ///I
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
Cf2. (19
Building Inspector
REMARKS