6277 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date j i( 19K6
This is to certify that work requested to be done as shown by Permit No. 6)77
has been completed.
This structure may be occupied as a
C 64.1:t ,Lvei/47
Location iy /41.
T har:
Owner
By Order Town Board
TOWN OF QUEENSBURY
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Building & Zoning Inspector
CREATIVE "INSTA PRINTING. GLENS FALLS. N Y 12801 181131793-S688
BUILDING PERMIT
TOWN OF QUEENSBURY No. 6277
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Hal PhaTtl
F✓
OWNER of property located at Lot 68 Helen Drive (St. #62) 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 incompliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
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2. CONTRACTOR or BUILDER'S Name
CO
• Richard Chase
1-1
ID
3. CONTRACTOR or BUILDER'S Address • N
37 Bonner Drive
Glens Falls, New York
4. ARCHITECT'S Name fD
U]
rt
5. ARCHITECT'S Address •
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6. TYPE of Construction—(Please indicate by X)
( X Wood Frame ( ) Masonry ( ) Steel ( )
7. PLANS and Specifications
24'x68 ' per plot plan, specifications and application �o
No. submitted including two-car attached garage and sewage m
system.
8. Proposed Use Sv
One-Family Dwelling H
t7
$5. 00 C/O Paid
$ 96. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES November 1 1g80
(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.) L.R
Dated at the Town of Queensbury this 7th Day of La7(! )April 19 8 0
SIGNED BY y�/--66' gfor the Town of Queensbury
Building and Zo�ng Inspector
•
TOWN OF QUEENSBURY '- (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 Permit Expires. PI. . •
- Z(niint District
• \ .aloe nl Work,
THREE 13) Copies of a PLOT PLAN, Drawn to scald'
showing the actual dimensions of the lot to be built k nrirXf'
upon, The exact size, and location on the lot of the
building. to be erected or altered MUST BE SUB- ,
MITTED WITH THIS APPLICATION. '
TOWN OF QUEENSE•Urc
• DATE . RIECEIJNE
WORKr D
A PERMIT MUST BE•OBTAINED BEFORE BEGINNINGAPR 11yti0 v
ANSWER ALL OF THE FOLLOWING. 4 �.9 r,U�l Ce� `6 %U
A.M. • e°t//. P.M.
The undersigned hereby applies for a permit to do the following work • 7I8�9'10�11�12'1 2 3 4 5 6
which will be done in accordance with the description, plans and spocifi-. . c 1 .1, 1, 1 , 1,
cations, and such special conditions as may .be.indicated:on the permit.
The owner of this propert is:
H•4/ • P(NA'E1 (P.O.ADDRESS)
The person responsible for -supervision of the work insofar as the Buil:ding:C.6de and the Zoning'Ordinance apply is:
(NAME) • (P.O ADDRESS)'
t
Name of Builder Address-. , .
Name of Plumber
( i Address
I Address
Name of Mason d
Lot Number �.�• • ..,Unit ,.),Estimated value of proposed work f '��C7v 0
Name of Village t�C... .,..-t-S Co1
Name of Street � �`�•� I`' `� Side of.•street: north ❑. east ❑, south ❑, west S,
r ii
,l('®a` Nearest Cross Street 'it k w ` c- (c- Distance from this -ross street 3 G' < Ft.
ii'' Property is north g,south 0,east 5,west ❑from Cross Street.
If on Corner,which corner, northeast 0, northwest ❑, southeast C 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• 0
❑ Demolition of a building. - • - • - . -family apartment house D.
Store building 0
• -car attached garage ❑
Other:
' • Accessory Building
One-car,detached garage . 0
Q Other work. Describe: 0
Two-car detached garage
Private chicken house . 0
•
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 buildings) in .dotted line and existing .
Ile,t,v trt c.IC huilding(s).in solid line.
Size of property . . .1 PO ft. x 1 ,5 d ft.
s Size and use of existing buildings, if any
F H
�lW
lJit m Size of proposed building 0 41 ft.x ,G ft.
i f_2� Height(from grade to ridge) . ft.
Front yard ._ -z D / ft.
• Side yards / S ft. and / ft.
. . Rear yard / ( G ft.
7 lOUT H If op 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
(cont'd.)
BUILDING SPECIFICATIONS., f/
Kind of construction: Wood frame, fire safe,etc.?. . . . . • • • • • • • . . . . . . . . . . . . . . . . . . . . . . . . • •
Will any second-hand lumber be used? . . .h. . 71!.J. . If so, for what? i
Material of foundation walls 1- �uv 6 s- '. Thickness
Depth of foundation walls below grade 5 //.2 Continuous foundation?
Will there be a cellar? "-e If so, material of cellar floor
Type of roof: Sloped or flat?� S I o ►' v.. &. Material of roof r.- s fp R-- I 5 k i i_. j . ,S
Size,wood studs - "x `f ",spacing ,,/ "o.c., length 55 • ft.
Size, floor beams, 1st floor - 2' "x / L ",spacing .. , . . /.G. .• "o.c.,span /2 ft.
Size, floor beams,2nd floor "x /c7 ",spacing / "o.c.,span / ... . . ft.
Size, ceiling beams 2- „x spacing / G "o.c.,span /0. . . . ft.
Site, roof rafters or beams fr "x ",spacing "o.c., span ft.
Exterior finish �' S ' "`'� r_ With what material? /J7/71--5 a/Li 'f`C-
Finish of interior walls . • • S i-..e.e-f r-v (C-•
If garage is to be attached, of what material is wall between garage and main building to be cons ed?
Is there to be an opening between garage and building? Q S
Kind of heating system i'�('.-c-(--i-` G Oil burner or coal?
Will a flue-lined chimney be provided? Depth of chimney foundation below grade
Height of chimney above roof. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . .f
Will there be a fireplace? s'--5 Depth of fireplace hearth /
Will a toilet be installed?. .. . . . . . .. `F-.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Will a kitchen sink be installed and`connected to water supply? �� E S
Water supply(public water supply or pump) '13,. ) ( G e--, 14-l--eI-
Distance of cesspool from any private well feet
Will drainage system be provided with required traps,cleanouts, and vents? \l 4- 5
AFFIDAVIT .
Town of Queensbury
County of Warren
State of New York
I swear that to tr. Ocj s of my knowledge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, are a true and co.,. lets statement of all proposed work to be done on the described premis all es and that ovi ions of the BUILD-
ING CODE,THE ZONING ORDINANCE,and all other laws pertaining to the proposed work s I be complied 'th,whether specified or not,
and that such work is authorized by the owner. �-) T��`K /
Sworn to before me this Signature ,‘WWtf.OWNERS AGENT.ARCHITECT.CONTRACTOR
day of 19
NOTARY PUBLIC, WARREN COUNTY. N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
•
•
By
TON OF OUEENSBURY
BUILDING AND ZONING DEPARTMENT
BAY AND HAVILAND ROADS, R.D. 01
GLENS FALLS, NEW YORK 12801
APPLICATION FOR A PERMIT TO CONSTRUCT, ALTER OR ENLARGE
A SEWAGE DISPOSAL SYSTEM WITHIN THE TOE? OF OUEENSBURY
OCCUP '°S NAME /V/2 / r I") 1-1r t'N ADDRESS 7 9 :2 V --�
l �
TELEPHONE OWNER.'S NAs '
ADDRESS 6 1 ��ti r NUMBER OF BEDROOMS
GARBAGE GRINDER?. (YES OR NO) TOPCCRAPHY: F� , ROLLING, STEEP, SLOPE,
GENTLE SLOPED OTTER
NATURE OF SOIL CLAY; 6i4i) L PM, GRAVEL, ROCKS, ETC.
PERCOLATION TEST WATER SUPPLE'o i3iVICIP ` , WELL, OTHER
DIAGRAM OF PROPOSED SEPTIC SYSTEM
J ba SO
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Y
•
OTHER PERTINENT INFORMATION
IT IS HEREBY AGREED ED THAT IF HIS APPLICATION AND PLANS ARE APPROVED,
INSTALLATION OF SEWAGE DISPOSAL FACILITIES WILL BE MADE IN ACCORDANCE
WITH DETAILS SHOWN.
DATE S! N TURE• OF APPLICANT L
LAKE GEORGE PARK 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:
r
1. Gross floor area /e�II d
2 . Type of heat �� � c, l_ � (
3 . Is the building mechanically cooled? IL) 0
4 . Percentage of area of windows and doors /O
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 19
3 . R value of glazed area
4 . R value of doors
5. R value of floors over heated spaces • e_ 1 3
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 �i�c �S 5 V' 1�
C. Controls •
/ C
1 . Thermostat maximum heat setting �
D. Duct Systems
1 . Is duct system installed in unheated spaces? YES NO
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
2 . Temperature control setting maximum
G. For Swimming Pool Only
1 . Maximum heating
Telephone No .
P C
(applicant ' s signature)
JA ..i tia .. a�a1.A.11 c�-144.).ti).).).,.),•���a�ati��atix��.�xtia���ati�ti�c�tia4.)...a.�x,�).-1..�.4,4.- �A.tia..... ),a.�a��,,a�a.�a��...a4-1-1. a.., a�a).�
am, . r
t, THE NEW YORK BOARD OF FIRE UNDERWRITERS r
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BUREAU OF ELECTRICITY 'r
: '1 r
41 STATE STREET,ALBANY,NEW YORK',12207 ' 'r
Date Application No.on fileA rj ,, ram• r
THIS CERTIFIES`THAT h3 �I y
T
1 only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of y
in the following location; ❑ Basement ❑ 1st Fl. ❑ 2nd Fl. Section Block Lot ,
_< was examined on d . and found to be in compliance with the requirements of this Board. ;T
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS ;:
b' OUTLETS RECEPTACLES SWITCHES INCANDESCENT FLUORESCENT MERCURY
VAPOR AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P: >'
-<' I-
..4 ,t
,c, T
..4 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS ,r
' 'AMT. K.W. OIL H.P. GAS H.P. AMT: .i NO.. .y, ;,A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET 'AMT.SYSTEMS - WATTS ;i
"P n ;v .
'...‹j SERVICE DISCONNECT NO.OF S E R V I C E ;T
- AMT. AMP. TYPE EQU�p 1.9'2W 1,B'3W 3,¢'3W 9,0'4W NO.OPER gCOND. OF CC COND. NO.OF HI-LEG OF.H'LEG NO.OF NEUTRALS OF N W.
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OTHER APPARATUS: i
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i1 0
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r•f �_. +,_-; 3).i., w r,i _ BRANCH MANAGER ,�r.
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�+ l Per - •- ,:
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ifLY YY Y Y 1 Y iYYY YYY,eYYYY Y Y 'Cr Y'Y Y Ye YY - Y'1 lginlit"i Y
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
TOWN OF QUEENSBURY
Building Department
Inspectors Report - Date _
Name
Location ; �� [
Permit No. (a.a Weather
Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat 9/(/;)
Waterproofing
Ba ckfi ll
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
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1 /it/FG
TOWN OF - i ce,
Building Department
Inspectors Report Date - )
Name/f��s • (i ( P A g m ")
Location ,VelrN CQZ
Permit No. Co a -7 7 Weather, .
Remarks
Excavation
Footing Forms
Footing & Piers l
Foundation f -
Cement Coat
Waterproofing j .
Backfill
Final Survey -----
Framing
Sheathing
Roof Felt
Roofing
Siding _!.
Masonry Veneer
Rough Plbg.
Relief Valves
Wall Board
Ext. Porches
Finished Floor 1
Interior Trim I _
Stairs &Railings
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney •
Water Meter Inst. - _ _
Septic Approval
I F 1Ccrs
FOI.rjda.tioJn •
Insulation
jCeii.;'n • f
Building InsJ_ic t_c.:
•
REMARKS
/ ôo7 ram ,
.
r74 /
TOWN OF QUEENSBURY
Building. Department
Inspectors Report
Name 1*
Location . T 68 / . %z 51 C y-
. Permit No. - a 7 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
TOWN OF QUEENSBURY
•
Building Department
Inspectors Re Date /4 - ?&
Name
Location tor-6 8
Permit No. (c, a '77 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 •
•
•
Buil ing Inspector
REMARKS
TOWN OF QUEENSBURY
Building Department
•
Inspectors Report Date 7- =5PC)
Name AGJ P11
Location 142430.4_Permit No. Weather
6 a 7) Remarks
Excas,ation
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
BuildingTspector
REMARKS
A
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A
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