5639 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
DateLc`'I e /3
� 19
3uLi7-7
This is to certify that work requested to be done as shown by Permit No. Ems`
has been completed.
This structure may be occupied as a �//// `e44.f
(V/?'"-. GY'
Location
Owner
p ( :I . f r r
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoning Inspector
CREATIVE ••INSTA'• PRINTING GLENS FALLS. N V 12E01 15181793-565S
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 5639
WARREN COUNTY, NEWYORK •
PERMISSION is hereby granted to Robert W. Weaver, Jr.
•
OWNER of property located at Lot -71 Helen Drive 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 0
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. 10'
1. OWNER'S Address is
6 E Manor Drive
Glens Falls, N. Y.
m
2. CONTRACTOR or BUILDER'S Name
Same
n
3. CONTRACTOR or BUILDER'S Address
Same •
4. ARCHITECT'S Name
• 0
rt
5. ARCHITECT'S Address
•
6. TYPE of Construction— (Please indicate by X) (p
( XWood Frame ( ) Masonry ( )Steel ( ) C
7. PLANS and Specifications C'
No. 66 'x28 ' per plot plan,- specifications and application
submitted including sewage system and two-car attached
garagc
8. Proposed Use
One-Family Dwelling o
m
$5. 00 C/O Paid
$ 71. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES July 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
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 21st Day of December • 19 78
SIGNED BY62.E 5),Z,V,
for the Town of Queensbury
Building and Zoning Inspector 4
TOWN OF Q UE w'N BURY
BUILDING LDING & ZONING DE'3'.� TNENT
BAY & HAVILAl`fD. ROADS RD t1
GLENS FAI1S, NEW YORK 12801 •
APPLICATION FOR A PERMIT TO CONSTRUCT, ALTER OR-ENLARGE
A SEWAGE D` SPC SA SAYS 'M WITHIN THETOWN OF f T-r'-}�� �5 yR�Y
l I 1 .+.1 4.jS �`VY�P GY ��J.Yl1�I.Y���113.
e-jA L yate'Sf \ .
NAME fiDDRESS_L
TELEP ONEJ ,2Z d a C WNE :"S NA NE
ADDRESS NUMBER OF BEDROOMS
aARBAt"E GRINDER? (YES ()cal()cal> TOPOGRAPHY: (' Liii) ROLLING, STEEP, SLOPE,
GENTLE SLOPE, OM ER
NATURE OF SOIL: GUY, °• 3D 9. OA���, GRAVEL, ROC1 J ETC.
PERCOLATION TEST WATER SUPPLY: OTUNIdanqUELL, OTHER
DIAGRAM OF PROPOSED SEPTIC SYSTEM
OTHER PERTINENT YT INFORMATION
ATION
•
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 _....�..� SIGNATURE OP APPLE
LAU GEORGE PARK COMIS S I ON APPROVAL:
•
•
TOWN OF QUEENSBURY ' (Space inside block to be filled in by
WARREN COUNTY. NEW YORK • Building Inspector)
A lication for Application
PP I'crmit Issued 19-
BUILDING AND ZONING PERMIT l'i.rmi( Expires. . 1g
i.(Jflln District
\ Ali(' nl Work,‘
THREE (3) Copies of a PLOT PLAN, Drawn to scale •\11)1'"‘(•(1 by
showing the actual dimensions of the lot to be built hi'n,:ii')(S' •
upon, The exact size, and location on the lot of the •
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION.
6 • 'TOWN OF QUEENSBLJF3Y
DATE H 2 3 u." -gP4 1-d
I I I I'
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK 0IA Gf 1918
ANSWER ALL OF THE FOLLOWING. -
P.M.
• A.M.
The undersigned hereby applies for a permit. to do. the following work " I8,19�l0I11I12)1I2I3I415�6
which will be. done in accordance with-the description, plans and specifi- . ,7• '
cations, and such special conditions as may be indicated,on the permit. , -
The owner of thi pro rrt is: /
(NA E)
The person responsible for supervision of the work-insofar as the Building Code and the•Zoning Ordinance apply is:
:. i
(NAME) (P.O ADDRESS),
\1
Name of Builder. '. Address fus n ✓ � Address G 0 tic,/C
Name of Plumber. . .�. . . .. ���'•S � '
Name of Mason qf+-i Address G U 0'0
Lot Number. . . . Unit Estimated value of proposed work 5 . .3.. 1
5( ci Name of Village
&" G6 Name of Street 1*£,.L.Z . . s Side of street: north 0, east 0, south 0. west .a"
1.�
Nearest Cross Street ) Xe . Distance from this gross street 7 ?� Ft.
Property is north j<south ❑,east [1, west' 0 from Cross Street
If on Corner, which corner, northeast ❑, 2tthwest)], southeast Q. southwest
(Designate by marking with.an "X" in the-correct space.)
NATURE OF PROPOSED WORK OCCUPANCY
1`� Construction of a new building. Main Building
•
dwelling
❑ Addition to a building. One-family,
❑ Alteration to a building. Two-family dwellingc
❑ Demolition of a building. .-family apartment house ❑
Store building ❑
. . . . 7. . .-car attached garage •
Other:
• • Accessory Building
One-car,detached garage . • ❑
'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
• Iuilding(s).in solid line. , . "
1
•
Size of property / 5 ft. x / �'a ft.
Size and use of existing,buildings, if any
- F .
s m Size of proposed building . . . . ,.6 . ft.x . . . . . . . . ft.•
Height (from grade to ridge).. . . Z • • • • • • • • • . ft.
Front yard• ' � ', It.
Side yards " 3 5 ft. and • Z T ft.
•
Rear yard ? 7 ft.
• SOUTH . If on corner, setback from side street . . . .3 5— ft.. ..
)Tote: All distances are net, as measured from street side
- line to nearest part of.building.:
•
(OVER) _ 1 t' G `
7-73—M ,__ - - `�-r3 )
(cont'd.)
BUILDING SPECIFICATIONS.,
Kind of constructi•in: Wood frame, ire safe, etc.?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Will any second-hand lum,•r .e used? ^ �? If so, for what 7�
Material of foundation walls CJ NC- l �2 Thickness
Depth of foundation walls below grade Contt nuous foundation? vE 5.
Will there be a cellar? `v`Z 5 If so, material of cellar floor . . . .C.--0 /12.c .t`. >.
Type of roof: .loses..r flat? Material of roof . . ..4-S 1 1 Prl -/ /.!u .C..... .C . . .
Size,wood studs -.?...-- "x ", spacing 1 C "o.c., length V . . . ft.
Size, floor beams, 1st floor ' " x VU ", spacing , "o.c., span / y ft.
Size, floor beams, 2nd floor . . . . . ...... . . " x f 0 ', spacing / 6 "o.c., span . . . .,/ . . . . . . ft.
n ' x ", spacing ' °."o.c., span P
Size, c beams •7U' I)ss• �' �• ft.
Size, roof rafters pp ms x ", spacing "o.c., span ft.
Exterior finish L. ► e, With what material? jO N `' i
Finish of interior walls. . . . . .`�....... . ./ Q c"/-‹.
If garage is to be attached, Rf what material/ifi wall betpeen garage and main building to be constructed?
.;�:Z 5
Is there to be an opening b tween gara and building?
Kind of heating system B-4� �V tti J Oil burner or coal?
p
Will a flue-lined chimneyrovid ? (-) Depth of chimney foundation below grade . "/1= 7
_
Height of chimney above roof. . v
Will there be a fireplace? 7 5_ Depth of fireplace hearth < F- 7
Will a toilet be installed?. . . . . .Y�. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Will a kitchen sink be installed and connected to water supply? U4' =5
Water suppl (public wate upply or pump)
Distance of cess o rom any private well il.)/ feet
Will drainage system be provided with required traps, cleanouts, and vents? KZ'S
Town of Queensbury AFFIDAVIT
County of Warren
State of New York
I swear that to th bea'r of my knowledge and belief the statements contained i • applicatio ,, ther with the plane nd specifications sub-
mitted, area true and co.e.plets statement of all proposed work to be do n the described re tees and that all? mono of the BUILD-
ING CODE,THE ZONING ORDINANCE,and all other laws pertaini to the p posed work all be complied with bother specified or not,
and that ouch work is authorized by the owner.
Sworn to before me this Signature
R.0 E S A ENT.ARCHITE .CONTRACTOR
day of 19
NOTARY PUBLIC. WARREN COUNTY,.N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
By
--p....y..laf, J..C.__".la cC4....4n.,.._Ca").A. .IA..)...%.,,,I. C.n.l c" .4.. c6..sti.A:A.A..ln"A.a%J....1.4.4_.m...A)J.c"."CJ....IJ.....A. 1.A.ail A.A.e.CAS,,,....Ca�,!.A.,,,la�..._l%a..!.. /).,!. •
THE NEW YORK BOARD. OF FIRE UNDERWRITERS ,r
BUREAU OF ELECTRICITY '.
rT•.: 41 STATE STREET,ALBANY,NEW YORK 12207 '
Date - Application No.on file " " e ,
A t
THIS CERTIFIES THAT 'r
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of :r
in the following location; .El Basement D. 1st Fl. El 2nd Fl. .- --• - ''-:"1 = Section Block Lot '
14
); was examined on • ' • - and found to be in compliance with the requirements of this Board. ;•
a'
FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT MERCURY '
VAPOR AMT. K.W. AMT. K.W. AMT, K.W.. AMT. K.W. AMT. H.P. :•
14
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS 4
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 EET •AMT. WATTS ::
-� _ j
SERVICE DISCONNECT NO.OF S E R V I C E ;i
AMT. AMP. TYPE METER 1�6'2W 1 A'3W 3.B'3W 3,B'4W NO;OPERC COND. OF CC.COND. NO.OF HI-LEG OF HI-'LEG NO.OF NEUTRALS OF NEUTRAL
T
T
OTHER APPARATUS: •
>a
f
V T.
T
1 1
Yr
' _ . 77(:!50.-•-•-,+•-•a-Z2-4—•%-.7:
''. BRANCH MANAGER 4
5. T'
y Per
}
y
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
I
' 'I
TOWN Or C -k-cNSBURY- .
-Building- Department I •
. Inspectors Report . Date d "�
r .
Name O i' �'
' Location : f'ef� s,
• SIP Permit No. b- "3oj Weather
Per Cat Remark,
Complete
i,
Excavation '
Footing Forms
1 Footing & Piers
z(/;1
o
Foundation
Cement Coat
Waterproofing
Backfill •
Final Survey
Framing
Sheathing \
Roof Felt • \ ''
Roofing
1( :e2
Siding
Masonry Veneer
- Rough Plbg.
Rough Htg.
Relief Valves ii •
Wall Board 1
Ext.Porches I'
Finished Floor .—
Interior Trim
Stairs&Railings 1.....0 ..--
Cellar Dr.Tile
Concrete Floors 7I'
Plhg.Fixtures iir......„,..,.,--(...9 , ' .
Gar.Fireproofing
Door Closers
Chimney 1'
Water Meter Inst.
Septic Approval
5-.: /j-- :
Building Inspector
•
REMARKS
6., -.,6.,.,1 __... 6 i,, h ,'.
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date � �Qj'-75
Name. / k,,.4ri'- .
Location • 110r✓ _s74
Permit No. 510 3 9' 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
li
TOWN OF QUEENSBURY"
Building Department !;
Inspectors: Report Date 3-
Name A ,
Location , /I� 4°/'A) 1-o r 7/
Permit No. . (G 3 9 Weather
Per Cent
Complete Remarks
Excavation
Footing Forms )
Footing & Piers ,J I
Foundation /
/
Cement Coat
Waterproofing ,.
Backfill
Final Survey /
Framing
Sheathing f
Roof Felt
Roofing
Siding i
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
5/.
Building Inspector
REMARKS
TOWN OF QUEENSBUR'Y
Building Department
Inspector,,Report Date "" 7%
Nam tueoc)Lt-
Locationt���'/�
Permit No. �"( c7 Weather
Per Cesit •
Complete Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey l /
Framing .. .�,r
%
Sheathing r,:
•
Roof Felt f
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
9 r REMARKS
7
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