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8644 C/o Paid CERTIFICATE OF OCCUPANCY TOWN OF +QUEENSSURY WARREN COUNTY, NEW YO►RK Date 19 �� .Ci (- This is to certify that work requested to be done as shown by Permit No. 8644 has been completed. This structure may be occupied as a One—Famlly Dwe l l i n Location IX Owner Kathy Forth By Order Town Board '1'OWN OF QUEENSBU Ry Building & Zoning Inspector C NE ATW[ "�NSTA-- nRINTIMp IwLENq iY1LL5 N v Y�O� Y3 � e�]9l363! BUILDING PERMIT TOWN OF QUEENSBUR'"1f' No. 86, 4 ,E WARREN COUNTY, NEW YORK x ps PERMISSION is hereby granted to Kathy Worth OWNER of property located at Big Day Road Street, Road or Ave. in the Town of Queensbury, To Construct or place a rt One-Fancily 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. t . oWNER'S Address is 5g3'� Jahn St . Hudson Falls , New Stork 2. CONTRACTOR or BUl LDE R'S Name W r- Tony Jones W w 3. CONTRACTOR or BUILDER'S Address will. iam St . Hudson Falls , New Stork 01 4. ARCHITECT'S Name S. ARCHITECT'S Address 6. TYPE of Construction — (Please indicate by X) { ) Wood Frame ( I Masonry I ) steel { ) (D 7. PLANS and Specifi '4"' x3 6 r per plot plan , specifications and application tion zy 03 No. submitted including sewage system . N- I� 8, Proposed Use C'1 One-Family Dwelling (D $ 5 . 0b C/O Paid $ 77 . 00 PERMIT FEE PAID - THISPERMIT EXPIRES February 1 1985 � {ff 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 18 th Day of July 1984 _ _ SIGNED BY a • ����� _ for the Town of Queensbury Building and Zoning Inspector `C... TOWN OF Q`► EENSBURY ISpace inside block to he lilted in b% WARREN COUNTY. NEW YORK Building Inspector) Application far tii+s>li, .Issli ..Tl. II PP 1 c'1 ,1T 11 S1YIli`il BUILDING AND ZONING PERMIT I',•11„ ii F %pires 11 :Mlle• I +I 11 r1T"� � �+' THREE 131 Copies of a PLOT PLAN, Drawn to scale \ i '1 " , 1\ e•,l h�' showin the actual dimensions of the lot to be built 1t, nl.lrkf upon. The exact size. and location on the lot of the }wilding to be erected or altered MUST BE SUB. MITTED WITH THIS APPLICATION, TOWN OF QUEENSBURY — / — nA ,! ' . -� ,Z �1 fATIir A PERMIT MUST BE OBTAINED BEFORE BEGINNING 'WORK � 1 1984 ANSWER ALL OF THE FOLLOWING. U 7 The undersigned hereby applies for a permit to do the following work 419& which will be done in accordance with the description, plans and specifi. '? FLI l cations, and such special conditions as may be indicated on the permit. The owner of this property _ INA The person respesnsibitii' for supervision of the work insclfar as the Building Code and the Zoning Ordinance apply ih_ .�0,/�V. . . . . , , V . Q tk�t2_ •r.?. . . . . . . . . . . . . . . �! c7 ta.a'r` t t !r rs, + . . j N,A hAE} {P C7 AL1 L7 K,ESSI Name of Builder - . . 7 i . . . d [ of e Address . . . . . . - - . . . . . . . . . . . . . . . . . . . . . Name of Plumber . . . . < r . . . . . . '! . . . . . . . . . . . . . . . . . . . . . Address . . . . , . . . . . . . . , Name of Mason Address t . . 4 p !D . . . . . . . r Lot Number . , . . . - . . . . . . Unit . . . . . . . . , . . Estimated value of proposed work S . . . f. aJ Name of Village . Name of Street .!:1I.P !.:�-.! ty . . . . . . . . . . . . . . ' . . . . . . . . . Side of street: north 0 . east ❑ . south ❑ . west Ea, NearestCross Street /.I,da ✓. . PA.r6 . . . . . . . " " • • " . . . . Distance from this cross street ^'0c, 4"+7 - l't • Property is north W`, south ❑ , east i J , west 0 from Cross Street If on Corner, which corner, northeast [aj northwest [3 , southeast ❑ . enuthwest (Designate by marking with an "X" in the correct space.) NATURE OF PROPOSED WORK OCCUPANCY Construction of a new building. Main Bundling f� Addition to a building. One-famiiv dwelling Alteration to a building. Two family dwelling [D Demolition of a building. -family apartment house Store building � - . . . . _ . . -car attached garage 0 Other: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - . _ , . Accessory Building One-car detached garage 0 Other work. Describe. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Two-car detached garage Private chicken house El ' " ' ' ' ' 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 sire of the property, the location, site and setbacks of pro- NORTH posed buildings, and the location of all existing buildings. r+. 3f v r7ra Show proposed building(s) in dotted line and existing $uilding(s) in solid line. Size of property . . ./. 47 Q- . . . . . . ft. x . . l . "z. . . ft. r Size and use of existing buildings, if any * Y - w Size of proposed building 2 ft. x . . . °. ft. L Height (from grade to ridge) . . . . � .S' . . . . . . . . . . ft. Front yard ft. Side vards . , . .? � . . . . . . . . ft. and . . - . , • . . , . . . . . . ft, Rear yard . . . !f '. . . . . . . . . . . . . . . . . . . . . . . . . . . ft. SOUTH If on corner, setback from side street . . . > v • • • • . . • • it. Note; All distances are net, as mcilsured from street side line to nearest part of building- tovEn} 7 -73 —M (cont'd.) BUILDING SPECIFICA►TIONS4 I•-- Kind of construction: Wood frame, fire safe, etc.? . tot! !' Will any second-hand lumber be used? . . . . . ./LJ If so. for what? . . . . . . . . . . . . . . . . . . . . . . . . . , Material of foundation walls . . . . . . . ''t..! G " w /�. , , , , I . , , . . . Thickness . . . . . `r ' Depth of foundation walls below grade . . _ , . . . . , Continuous foundation? , . . . . . 't:f. . . . . . . . . . . . . . . . . . . . Will there be a cellar? . , , . {` - , . . , - - If so, material of cellar floor . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . Type of roof: Sloped or flat? . . . . 5 G 5":: % . . . . . Material of roof . . R#-e'•�f F . , . , . . . . . . . . . . . . . . . . . . . . . . . Size, wood studs . . . . . . . . . . . . . . . x . .`^f . . . . . . . . . . . ", spacing . . , A Sr. , . . . . . "a,c,, length . . . . . . . . . ft_ Size, floor beams, 1st floor , . . . . . , X. d I -: . . . . . ", spacing . . . . . , + ,. .. . "o.c., span . . . . . . . . . . . . . . Size, floor beams, 2nd floor . . . . . . . , . " x . . . ", spacing . . , . . . ,f" Y. . . . . "o.c., span . . . , ft. Size, ceiling beams . . . . . . . . . , . . �. . x . . _ . . . _ . . . . , spacing . . . .t )!! . . . . . "o.c., span . . . , .� Side, roof rafters or beams . . . . . . . . . , . " x . . . . . . . ", spacing , , . . "o.c., span ft. Exterior finish . , . . _ �" ' ��'t� . . , . . . . . d- . ',+' . . . . . . . . . . . With what material ? _ . . . . . . . . . . . . . . . . . . . . . . . . Finish of interior walls . . . . . 1`��t.+ r `, - !? F . . . . . . . . . . , . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , , 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 . . . . - I'- ".': 'C ' r A� R .44�. . . . . . . . . . . . . Oil burner or coal ? . . _ . . . . . . . , . . _ . . . . . . . . _ . . . . > Will a flue-lined chimney be provided? . . . . . . . . . . . . . . . Depth of chimney foundation below grade . . . . . . . . . . Height of chimney above roof . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . , . . , . , . . . . . . . . < < _ . . . Will there he a fireplace? . , , y �7 . . . . . . . . . . . . . . . Depth of fireplace hearth . . . . _ , , . . . . . . . . . . . . . . . . . . . . . . . . . Will a toilet be installed? . . . ./. . r . . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Will a kitchen sink be installed and connected to water supply? . . . , ,k� 1=. .S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Water supply ( public water supply or pump) . _ , . /J LP. ! . L .J` . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . Distance of cesspool from any private well . . . . . . . . . . . . . . . . . . . . . feet Will drainage system be provided with required traps, cleanouts, and vents? - .'1�..!' . -<j . . . . . . . . . . . . . . . . . . . . . . Town of Queensbury AFFIDAVIT County of Warren State of New York 1 swear that to it. b 4 a of mY knowledge and belief the statements contained in this application, together with the pimps and apecificatims sub- mitted, area true and ax..i. lobe eLtement of all proposed work to he done on the described ptcmtsea a that all } ions of the BUILD- ING CODE, THE ZONING ORDINANCE, and all other laws pertain' posed woe shall ptted with,rwhether specified or not, and that such work is authorized by the owner. Sworn to before me thin signat /) NER, OWNER'S AGENT ARCHITECT. CONTRACTOR dayaf. ... . . . . . ...... . ... . . .. . . . ... . . . . . . . .. . . . _. . . .. 19. .. . . .. . ... . . . . . . NOTARY PUBLIC. WARREN COUNTY, N, Y, SPECIAL +CONDITH3NS OF THE PERMIT- By .. . . .. . . ...... .. .... . . . . ._. . . _ __. . . _ .. . . . ._ .. . . . ... . . .. .... . ... ........ .. .. TOWN OF QUEENSSURY WARREN COUNTY , NEW YORK Application for : BUIEDING PERMIT IN COMPLIANCE WITH THE NEW YORK STATE ENERGY CONSERVATION CODE A permit must be obtained before beginning work , ANSWER ALL of the following : _ 1 , Gross floor area Zto 2 , Type o f heat :: t AG � J` ft S( f, 3 , Is the building mechanically cooled ? Z7 4 , Percentage of area of windows and doors A . Over 16 % Only 10 Uo value of gross area of walls , roof / ceiling and floors exposed to ambient conditions 2 , Floor over heated spaces ES NO a . Are foundation walls insulated ? YE �M `��► 1 , If YES , what is the R value ? 3 , Slab on grade ES 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 BOW „i �Under 16 % Only — ��. W 1 . R valm of roof and floors exposed to ambient conditions 2 , R value of exterior walls 3 . R value of glazed areas 4 . R value of doors 5 . R value of floors over unheated spaces 6 . R value of slab edge insulation - unheated slab � � / E 74 R value of slab insulation - heated slab tom~ 80 R value of heated basement/ cellar walls ( above grade ) 90 R value of heated basement / cellar walls ( below grade ) ��' 10 . Type of insulation C . Controls 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 As b , R value of duct in other areas E . Flipin Insulation > 1 . Size of hot water or cooling carrying agent pipe4✓ diY 2 , R value of pipe insulation F , Service Water Heating I . Performance efficiency 2 . Temperature control setting maximum G , For Swimming Pool Only 1 . Maximum heating �/� i/+ I eee Telephone No . ( applican s signature ) TOWN of OUFFNSBURY BUILDING & ZONING DEPFRTMENT SFV7AGF DISPOSAL PERMIT APPLICATION 1 . Owner ' s Nam ei �f' /` /f +E.�©et... �'/j- Address ./ �. t�- �- .� T" . /71 � d' f ice44 ._g. Tel ephone No . 2 . Property location Ccq1t-^w9 &wL a ,rz !!:�!e I +p�3W/4 dd lf-oa . o:;AA7'1Z- 3 . Name of person or firm responsible for installincar system 04 . J . ,, zv Telephone No . Address c " r ,Y- •� �- / /= 4 . Number of bedrooms ( residential buildings only ) 5 . Daily flow gallons/day 6 . Septic tank capacity f, 0—vcD JCL gallons 7 . Topography : flat , rolling , steep % of slope Be Nature of soil and depth -- 9 . If ground water , bedrock or impervious ma erial is apparent at what depth does it begin? ft , 10 . Percolation test : A is required B %Pc� is not required C if requ Te- d what is the rate minutes/inch 11 . Water supply . municipal , well , other /+o f r'/,h i 12 . Type of system proposed .* drywell , the field ., other f Any contractor , corporation , individual , etc . engaged in the construction of a sanitary sewage disposal system who covers the same before inspection , does not have an approved permit , or varies from the approved application will be subject to a penalty of $ 250 as provided for in Section 6 . 010 of the Queensbury San iyttary Sewage Ordinance ., v DatezV �G eNZ sign Lure of applica t On separate sheet of paper submit a diagram of the proposed septic system with all dimensions , including distance from any structure , distance from property line and domestic water supply , etc . Include all dimensions of the system itself . Form 3 - 82 Tz lL.� AJ TOWN OF +QUEENSBURY Building- Department Miraewe �'T tr r a„ 7-H c ! P+e.�r:t No. Weartl�er Remarks Excavation Footinia Forms Fcotlng & Piers Foundation Cement Coat Waterproofing BacRfill Final Surve prauri.n ,Sheathin Roof it Roofi Sidin Masonz. vj veneer Rou h P ? hdnr- wall Board Ext . Porches Finished Floor Interior Trim Stairs & Railin s Cellar Dr . Tile Concrete Floors plbq. Fixtures Gar . Fire roofin boar closers Chimne water Atet+er Inst . Septic A roval Floors _. Foundation Insulation walls _... ceilin Bez rlding Inspector I , REMARKS J / TOWN OF QJEENSBURY BuIldiag- Department In"N"*MS Date 7,/.2 4/�S y Name � a Ano pernakNo. Weather Remarks Exca0pa tj on Foot-in Forms Footing & Piers Foundation Cement Coat Water raofin Backfill Final surve Framing + rhea thin Roof Felt Ro0jeIng Siding Mamonrg Veneer Rough P3 Relief Valves Wall Board Ext .. Porches Flni died Floor Xnterior Trim Stairs & Railings Cellar Dr . Tile Concrete Floors Pl . Fixtures Gar . Fire roofin Door Closers Chimney Water Meter Inst . Septic Apozoval Floors Insulation Foundation Walls cal IS rkq Building Inspector REMARKS TOWN OF QUEENSSURY Buildia=- Department iorpackw* Repast Daft NM=W Larer4# M i Permit No. Weadar Remarks ExcatYa tson Foratirr Forms Footilr B Piers Foundation r.--" Cement Coat Waterproofing Baohfi I I Final Surve Frami Sheathin Roof Fel It Roofin Siding Masonr IVeneer Roucth PI Relief Valves Wall Board Ext . Parches Finished Floor .Interior Trim stairs & Railings Cellar Dr . Tile Concrete Floors P l FixtUres Gar . Fireproofing c or Closers C�ti.mne Water Meter Inst . Septic Approval IIIIII Floors Foundation Insulation Walls — Ceili Building Inspector REMARKS TOWN OF QUEENSSURY Building- Department Man Peroait No. _,_� w�.t�r Remarks sxcatYa tion Footin Forms Footing & Piers Foundation Cement Coat Water roofin Bacxfill Final Surve Faramin sheathing Roof' Fel t Roor-ing Siding masonry Veneer Rough Plbgq Relief Valves Wall Board Xxt . Porches Finished Floor Interior Trim Stairs Rallis s Cellar Dr . Tile Concrete Floors P.Zbga Fixtures Gar . Fireproofing Door Closers Chimney water Meter Ynst . 3e tic A-pproval Floors Insulation Foundation walls ceiling—� Building Fnspector REMARKS BUILDING, DEPT. COPY OF APPLICATION FORM 46-ELo NEW YORK BOARD OF FIRE UNDERWRITERS, r- FILE THIS COPY WITH BUILDING DEPT. WHEN REQUIRED. TEMP. DAr£ - CITY OR Zvi LLAGE srREEr AN N 11. 09 TOWNSHIP ROAD AND POLE NO, COUNTY 8ETWEEN KIIII TWO r- v �. CCREO STREETS - PD ND. OCCUPANT'S T ON 'r Io NAME BUILDING L K LOT AOWI:ND A ^S ILIA �"f"f Oil OCCUPANCY rp C: -AND ADORES / .*'" '+ SUPPLIED K TEL. FROM THEIR 101TO . IS NE11111111111 OFFICE OLD ❑ WORK IS DEFECTS LIST BELOW ALL EQUIPMENT WNFCH YOU IhISTgLLE NEW ADDITIONAL ❑ RESWOV£D ❑ NUMBER OF OUTLETS No. of Pictures A t Lamp Receptacles Morons HEATERS &RANCH Skies Attash't CIRCUITS OFFICE USE We" Rec P*q Switch Fsndwst Bracket No. Type HI Wales ONLY Out- Nn Each M° At .W,G aicb INSPECTION sac. loops Iat Fl, 2nd PI 9rd Fl. REMARKS- LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: Do NOT USE THIS SPACE- Tha aPWication is into Y radstl to tors thi plgya..Fisred atlllipnle..t iaplactrsl but if • tw are autkarizW ea make the insParrtlon and adjust the tee to wer t time of i St2E OF co tha adtktional equipinrot, a pr"ffP*I thI is found additi mai •WiPrrlant not above Iicted, . MAINS by the applicant• FEEDERS ELECT R acsIGN CHARACTER LAMPS TOTAL OF IMORK EICPOBED 40AS TUBE $IGN 'WATTS WORK TO BE CONCEALED TRANSFORMERS OF STARTED {NUMBER} VA E TVK:E DV ERHEAp COMPLETED 512E OF SIGN TCAPACITYI ENTERS UNDEROROUNp I OINrt' MAKER INSPECTION REQUESTED OF SIGN ON OR A I NEAR AS POSSIBLE: LD AVOID PECAN D Gl VING FULL AND ACCURATE INFORMATION. ALL SPAG ES MUST BE Ft LLLLE0AME OF 1N OR APP�ICAT� MAY BE RETURNED. PRINT NAME AND DRESS APPLICANT r / BATE OF _ STREET ADDRESS / - APPLICATION L r � ) CITY OF _ T£L£PHOIV FIC E #k r 2 4LIgoI,�� E / ' r� w. . CIP ODE . � C- ICENSE fVp_ 46 EL (REv. lea al 1Mgf Eft APPLICABLE A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING PLot go 91' ',,,m � 10r in �� t4{PP e T Y a asa�!► CO A30 z Pie re `. 'VI