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744
CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK r`/'�'!}�/f'�f l '�`''•��j Date. a 744 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 _ . DW ling Location 26 Jerome Ave . Carter White C"►wner By Order Town Board PrOWN OF QUEENSOURY Buiiding & Zoning Inspector BUILDING PERMIT TOWN OF QUEENSBURY No. 744 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Carter Wh1te OWNER of property located at 26 'Jerome Ave * Street, Road or Ave. in the Town of Oueensbury, To Construct or place a Dwelling at the above location in accordance to application together with plot plans and other information hereto filed and Y approved and in compliance with the Town of Oueensbury Building and Zoning Ordinance. t. OWNER'S Address -is 31 Webster Ave . R� Glens Falls , N . Y . nr 2. CONTRACTOR or BUI LDERS Name Gaston La Fond a CONTRACTOR or BUILDER 'S Address 10773 Feeder Dam Rd . S . Glens Falls , N. Y . rn 4. ARCHITECT'S Nance 'L-1 Same y 0 rn 5_ ARCHITECT'S Address Z>, Same c 6. TYPE of Construction — (Please indicate by X) 1 'Wood Frame ( AAasonry I I Steel i 1 7, PLANS and Specifications 2610 * ' X 46 r 8 t t AS per plot plan . No 8. Proposed Use CDw e l l i n g $ 10 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES September 30 i9 70 11f a longer period is required an application for an extension must be made to the Building and Zoning inspector of the town of Oueensbury before the expiration date.] Dated at the Town of ueensbury this 29 ---Day of April 1970 SIGNED BY for the Town of Queensbury Bui Iftand Zoning Inspector TOWN OF QUEENSBURY { space inside Mock to fw iillecl in by WARREN CCiLiNT` F, NEW YORK Building Inspe( lorl % for Application No . . . . . . Application �'� -� 1'er)nit . BUILDING AND DOMING PERMIT Pt'1-=11il Expires . . . . J., ,n ill Y Di_�1rit t A� Y Ailed of %Viwk b THREE ( 3 ) Copies of a PLOT PLAN, Drawn to scale showing the actual dimensions of the lot to be built ltc'>>f:11 k upon, T6a exact size, and location on the lot of the ff// building to be erected or altered MUST BE SUB- MITTED WITH THIS APPLICATION, TOWN C QUEENSGUnY A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK i0 ANSWER ALL OF THE FOLLOWING. The undersigned hereby applies for a permit to do the following work which will be done in accordance with the descrip+ion, plans and specifi- cations, and such special conditions as may be indicated on the permit. ,The owner of this roper is: - (NPG} (P.O. ADDRESS) The rso respnnsi :f pervision of the work insofar as the Building Code and the Zoning Ordinance apply is:. . . . - , NAME} . - . . . . . . . . . , - . (P.O- ADDRESS) . - - . . . . . . . . . . . . . - .--^ n -. . . . . . ly . . . . - . . . Name of Builder . . Address /p n ? 3 - . /. �perer4,,^ .026l, - S to. Name of Plumber . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . . Name of Mason . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address Lot Number . . , , . . . . . • . Unit . . . . . . . . . . . . Estimated value of proposed work $ . . .T ' 47 . - Nameof Village . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Street • c fo. pp . . . L'� .F. . . . , . . . . . . . Side of street: north. �, east ❑ , south C3 . west ❑ Nearest Cross Street . . . . . . /4 Distance from this cross street . . �/ d. 4*. . . • . - - . . - . Ft . Property is north ❑ , south P1. east i 3 , west 0 from Cross Street If on Corner, which corner, northeast 0 , northwest ❑ , southeast ❑ , southwest (Designate by marking; with an "X" in the correct space.) NATURE OF PROPOSED WORK OCCUPANCY Construction of a new building. Main Building Li Addition to a building. Clue-family dwelling Two-family dwelling L1 Alteration to a building. ❑ ❑ Demolition of a building. � � -family apartment house ❑ Store building � . . . . . . . . -car attached garage ❑ Other: . . e e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Accessory Building One-car detached garage E__1 C� Other work. Describe: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Two-car detached garage 0 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- NORTH posed buildings, and the location of all existing buildings. Shaw proposed building(s) in dotted line and existing buildings) in solid line_ Size of property . . .lie�'jQ . . . . . , . ft. x . �. d. . . , - . ft. Size and use of existing buildings, if any . . . . . . . . . . . . . . Size of proposed building , 'lo . . `� ft. x ft. Height (from grade to ridge) . . . . . . . . . . . . . . . . . . . . . ft. Front yard „ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ft, Side yards . . . . . . . . . . . . . . ft. and . . . . . . . . . . . . . . . ft. Rear yard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ft. sourN if on corner, setback from side street� . . . . . . sire • . . f� Note: All distances are net, as measured Pram street side line to nearest part of building. roveRI BUILDING SPECIFICATIONS. (cont'd.) Kind of construction. Wood frame, fire safe, etc.? . . . . Will any second-hand lumber be used? . . . . . . . . If so, for what; . . Material of foundation walls . . . ? .`. ?l. S5' , V . ./,6 .'' . - Co.✓. ��rrc, �' - - - . . . . . . Thickness . . . . . . . . . . . . . . . . . . . . . Depth of foundation walls below grade . . . . f . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Continuous foundation? . . . . . . . . Will there be a cellar? ° . If so, material of cellar floor . . —Ve-0 e t pay! . . Type of roof. Sloped or flat? . . . � Q,d- „ , . . Material of roof . . ,,..91/13 ?4` Size, wood studs . . . . . . . . . . . . rQ. . . . . . x y- . . . . . " spacing " length �S'. . - s cin f!4' - - . . . . . . o.c., len h . . . . . . . . . . . . . ft- Size, floor beams, 1st floor - - . . -7. . . . . . " x . . . . . I'A? - . . . . . . ", spacing . . . t .k} .� . . . . . . ^o.c span Size, floor beams, 2nd floor . , . . . , . - . " x . . . . ./. t . . - . . . . '", spacing . . / . - ° �. . : 'o.c., span . . . /Lq , . - - - . . ft. Size, ceiling beams . . . . . . . - . . 4� . . . . . " x . . . . G? . . . . . . . . to, spacing " - - p g . . /.(� - . . . - . . . o.c., span . . . f. b . - . . . . . . ft. Site, roof rafters or beams - . . . c . . - - . " x . . . . lv- - - - . . . . . 'V I spacing . . y! (Q. . . . . . . . . ..a-c., span . - ,3 r?. . . . . . . . ft. Exterior finish . - . . . 4 �1 + #�' 6}. . . . . . . . . . . . . . . . . . . . . . . With what material? - 1"otsoov , 7,— Finish of interior walls . . . If garage is to be arttached, of what material is wall between garage and main buij4ing to be constructed? . . rW. o .R Q . - . . F. ?�r9-!rl-� Is there to be an opening between gars and building? . . /tl©. . . . . . . . . . . . . . . . . . . . . . . . . A . . . . . Kind of 'heating system . . . , `cs? . . o - ? . .. i . . . . c > -r or --- ? Will a flue-lined chimney be provided? . � ' . . . . . . Depth of chimney foundation below grade Height of chimney above roof. . . l� . . . . . . . . . . . . . . . . . . . . . Will there be a fireplace? . . .X0.. ;-ter. . . . . . . . . . . . . . . . . Depth of fireplace hearth - - - , ,�41. - . . . . . . . . . . . . . . . . . . . . . . . Will a toilet be installed? � . . . . . . . . . . . . . . Iq '- . . Will a kitchen sink be installedrand connected to water supply? . . - �' r� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Water supply (Public water supply or pump) . . . . . y�.v xx ' . . . . ... . . . . . . . .. . . . . . . . . . . . . .# . Distance of cesspool from any private well . . . - . - . . . Rr . . . . e-" a:-l. F e- . , . . J64 .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . feet Will drainage system be provided with required traps, cleanouts, and vents? . . . . . -'>e' . . . . . . . . . . . . . . . . . . . . . . . . . Town of Queensbury AFFIDAVIT County of Warren SR. State of New York I swear that to ate beet of my knowAadge and belief the statements contained in this application, together with the plans and sperafcatioos sub* mitts d, are a true and complete statement of all proposed work be do ING CODE, THE ZONING ORDINANCE, and a!1 other lawthe pjvIvased e on the deartt-hed�premises and that an whether specified a � of the BUILDo, ebe and that such work is authorised by the owner. Sworn to before toe this s4nature ... . .cT q ... .. ......... . OWNER. OWNER-S RGE 4" ARCNITE CT. CONTRACTOR .. ...........j. ./..�...y. ..... .. ...... ......day ....................... .. .--.r. ...... . 19.. ...... L.M. W R6N Co TY. N. Y. ... .. SPECIAL CONDITIONS OF THE PERMIT-. LD DATEFI. AP - spa By ... ........ . ...... . ........ .. .. (cont'd.) BUILDING SPECIFICATIONS., Kind of construction., Wood frame, fire safe, etc.? . . . . [. o°. '? . . , r P'4 ^' � . . . . . . . . . -Will any second-hand lumber be used? -�'r . . , . . . . . If so, for what? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . » . . . . . . . Material of foundation walls . . . 15r':. ),g'. LV :".`+i'. Ark .`: . . �d ti' . . �S'�a �.'�- . . . . . . . . Thickness . . . . . . . . . . . . Depth of foundation walls below grade . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Continuous foundation? . . . . . . . . . . Will there be a cellar? `t- If so, material of cellar floor . . .+ ' r� A. . _ �_t 7C. . . . A ee` . . . _ . . . . . . . . ,y Type of roof-. Sloped or flat? . . . . Material of roof . , 4 U ` , . . tr �f'' '�e'? Size, wood studs ;�. . . . . . . . . . . . . . . . " x . . . . . . ' . . . . . . ", spacing . . . ,/le? .'.` . . . . ."o c., length . . . . . '. ' » » » . ft. . Size, floor beams, 1st floor . . . . .oz . . . _ _ " x . . . . . . . ", spacing _ . . l.h . . . . . , . ."o c», span . . . . ./. '✓-r . . . : . . ft. Size, floor beams, 2nd floor . . . =7. . . . . . " x . . . . J 0 . _ _ . . . . ", spacing . _ J Ago`,�, , : : , »"o..c., span . . . /Ca . . . , , . . ft. Size, ceiling beams . . . . . . . . . . qa& . . . . . " x - - - ee . . . . . . . . ", spacing . . . . . ."o.c., span . . . / F+ . . . . - . . . ft. Sire, roof rafters or beams . . _ . J=;?4 , . . . . " x . . . . 06. . . . . . . . . ", spacing . . , » , ,"o.c», span . . ,3 �'. . . . . . . . ft. Exterior finish . , . . ,C-0 L. w ee A W< . . . . . . . . . . . . . . . . . . . . . . With what mlaterial? Finish of interior walls _ _ . : V1 . . . e.� L. 4--'. . . . . . . . . . , , . . . . If garage is to be attached, of what material is wall between garage and main buUA ng to be constructed? �'✓. 0 a. z> W . . . .Fe'059. n-A-. . » » . . . . . . . . . . . . . . . I . . . I . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . » . . . . . . . . . . Is there to be an opening between age and building? - - Aer:a. . . . . . . . . . . . . . . . . . I. . . . . . I » - » » , . . . . . . . . . . . . » . . . » Kind of heating system . - _ //c9T" . gl . . , , . . . . . . . » . ? . . . 4!5;�Jo9x: .%. .. . . . . . . . » W » , . . . . . . Will a flue-lined chimney be provided? Depth of chimney foundation below grade . . ./7. »'�. . . . . . , , , . Height afchimney above roof. , . f rr_ . . . , . , » , , , , » . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A . » » . . . » _ . _ . _ , , , , , Will there be a fireplace? . . .Ye. ;,I�. . . . . . . . . . . . . . . . . Depth of fireplace hearth . . . . /'��`. . . . . _ . . _ . . . . . . . . . . . . . . . . Willa toilet be installed? : . . �' a cr` . . . . . . . . .. . . . . . '. . . . . . . . . . . . 0 . 1 _ _ . _ . . . . . . . . . . . . . . . . . . . . . _ _ . . . . . . . . . . , Will a kitchen sink be installed'and connected to water supply? . l`yI. vo' . r . . . - .. . _ . . . . . . . . _ . Water supply (public water supply or pump) . . . . . .w ' . . . . : . . . . . . . . . . . . . . . . . . Distance of cesspool from any private well . . . . . . . . . e4x `_ . . . . `, e.. . . . . d`7G' . . - . » » . . . . . . . . . . . . . . . . . . . . : . . . feet Will drainage system be provided with required traps, cleanouts, and vents? - - . . 'o' g . . . . » . . • - Town of Queensbury AFFIDAVIT County of Warren saw State of New York I swear that to the beat of my knowiodige and belief the statements contained in this application, to�ethar with then ,�♦a� and open i aationh sub- mitted are a true and oomplaw statement of all proposed work w he on the described premtaes sad that an of the RunmD ING ♦LODE THE ZONIN ORDINANCE, and all other lawn pertain o the p work be t1t, whether r spawf�d or note, and that aitc� work is authorised by the owner. Sworn to before me this Signature . R.....� .... N ......TO.Ig.........•.............. OWNER, QWNERS AtiENT. ARCHITECT, CGfNTRACTOR .......... ..day o .. ....r....,... 19........ W^Pfiptam GQ . N. V.. .... SPECIAL CONDITIONS OF TgE PERMIT: I^ ti, N �.. 1970 FA " i r OR N7�1 .................. ................. .. r CERTIFICATE OF INSURANCE [I} Hartford Fire Insurance C rmpany New York Underwriters Insurance Company THEHARTFURD m Hartford Accident and Indemnity Company ® Northwestern Underwriters of Citizens Insurance Company of New Je:aey INSURANCE GROUP m Citizens Insurance Company of New Jersey m Twin City Fire Insurance Company nnwrrowo cO. xrGrGyr This is to certify that the company designated Co. Code herein by Co. Code has issued to the named insured Named Insured and Address the policies enumerated below. Gaston C . La Fond 10779 Feeder Darn Road Sooth, Glens L" allas New York The policies indicated herein apply with respect to the hazards and for the coverages and limits of liability indicated by specific entry herein, subject to all the terms of such policies. Coverages and Limits of Liability Hazards Policy Effective Expiration Ro Iiy Injury Liability Property Damage Liability Number Date hate each Person each accident each accident aggregate General Liability Premises-Operations Q 1 5 22905 `i / 2? / 70 ?/7/$Q $ 20 r000 $ ,000 $ 1Q,000 $ 25 r000 Elevators $ 1000 $ 10006 ro00 xxxx Independent Contractors $ ,000 S ,000 $ M)u $ r000 Products-Completed $ ,000 $$ 7000 S ,000 $ r000 Operations Aggregate:_ $ ,000 xxxx xxxx Contractual-as described below $ row $ 000 $ 000 $ 000 Automobile Liability Owned Automobiles Q 1 C 522905 4/ 27 /?Q 7 /7/7 Q E 20 000 $ 40 o00 $ 1f? 7000 xxxx Hired Automobiles Q 1 C 522905 ���I { �71'��— S 000 S t000 $ lQ—,000 XXx?, Non-Owned Automobiles 01 C 522905 4/ 27 / 70 7 /7/70 $ 20 ,000 $ 40 ,000 $ 1G r000 xxxx Workmen"s Compeneation Compensation -- Statutoryand i Employers' Liability 011*1 125094 4/ 27 /70 717 /70 Now York. Employers' Liability — $ 1OO ,000 Umbrella Liability $ 10000000 Location and description of operations, automobiles, contracts, etc. (For contracts, indicate type of agreement, party and date.) Building contractor Town of Queertsbury If policy is canceled, iQ clays cJ o G. Liapes wntten notice will be given to : .down Of L i ce Bldg . Bay Road Glens Falls New York 12801 L3ate 4/ 27/70 By.. ... ... ... ... ... .... ... .. . . an �_... . ..... ?!a..... nE...,..,.., .. Authorized Re s talir e Forl[er 0-2106-3 Printed in t7. S. A. 6 '64 Gsi 12T�4Jlt�T� TOWN OF OUEENS BURY ,¢ vim C 0fEgvF APR, 2 7 1970 A.M. P.M. 718191 gIi1I2{ 11213 } 41516y r']�b v DATED APR 2 9 1970 1 r ; BUILDff tG & ZONING l�pR rUWN OF 'QULE+INSSURY b 1 r' x i a N M 11 I 3 1 ' {