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1989-746 CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY i WARREN COUNTY, NEW YORK Date December 20 19 89 This is to certify that work requested to be done as shown by Permit No. has been completed. i 1 This structure may be occupied as * Ji ^gip Fam11Y— adul ar C.7 P i n e l l o Road t.oGariOnhard ------ C hb By Order Town Board TOWN OF QUEENSHURY s Director of Bldg. do Cade Enforcement i . . BUILDING PERMIT TOWN OF QUEENSBURYio No. 139-746 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to RICHAR❑ PASHRY -ter OWNER of property located at Rn#4 ROM 180 PT NFI 1 O ROAD Street, (toad or Ave. in the Town of Queensbury, To Construct or place a S T NCI F FAMI I Y MODULAR 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 SAME 2. CONTRACTOR or BUI LDE WS Name s Or+ -C 2r7 a. n 3. CONTRACTOR or BUILDER'S Address —" "S fl. MUNCY , PA . 4. ARCHITECT'S Name coo 6. ARCHITECT'S Address o x w on r_. 6_ TYPE of Construction — (Please indicate by X) CD ( 1(Afood Frame i 1 Masonry S ) Steel 1 I 0 7. PLANS and Specifications c au No. 26 ' x 48 ' Single Family Nodular as per plot plan , specifications , and applicaitongXXXXXXXXXX Existing septic and two car garage . 8.7TNr. se THE ATTACHMENT OF THE TWO PARTS MUST BE APPROVED BY A d LICENSED PROFESSIONAL ENGINEER. crn $ 144 00 PERMIT FEE PAID — THIS PERMIT EXPIRES April 1 19 90 (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.) cq Dated at the Town of Queensbury this 9 1 Cz t Day of September 19 $9 SIGNED BY for the Town of Queensbury Buirding and Zoni spector Towx OF r,ZUEExsBVRY REViE WED BY �C kf FEE PAM is /r . PERwr NO. BUILDING PERMIT APPLICATION Gam, •-�' A PER1YtTP MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. NO INSPEC4 MS WILL BE MADE UNTIL APPLICANT HAS RECEIVED A VALM BUILDING PERMrr. y All applicants spaces on this application NTIUST tee completed and the signature of the applicant MUST appear on the reverse side of this application. The owner of this property is: k f ch "b r d P 3 h io EI P.O. Address TeL Property Location k Ly' 3`z��( �i ne r,, Tax Map No. 14L7I lie 67 Has there been any split of this property since October 1 . 1988 ? / X :S If yes Planning Board Review is necessary . yes no SUBDIVISION NAME, IF APPLICABLE LOT NO. THE PERSObf RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS: t MATURE OF PROPOSED WORK : * ESr'.MATED MARKET VALUE OF Construction of a new building * CONSTRUCTION: S Addition to a building * COMPLETE INFORMATION REQUIRED BELOW: Size of property / 4 � ft x eft. Alteration to a building * Existing Buildings( 3 ) Size _ d,�j 'ft. x ft. (no change to exterior dimensions) * Proposed building - distance from property line: Other work (Describe) ' Front yard '7.5� ft. Rear yard ft. * Side yards j�5 ft. and G'3 ft. GROSS AREA OF PROPOSED STRUCTURE * If on corner, setback from side street ft. sq' * OCCUPANCY INFORMATION * 2nd Floor. ' sq. ft. » Primary Building - Other Floors sq. ft. • .`.One Family Dwelling (not cellar Orbasemen"U� . Two Family Dwelling TOTAL FLOOR AREA L4 8 sq. ft. " Multiple Dwelling/Number of units Size of new structure �.f�, -ft x _ ` F) ft. * Business Foundation-pier/slab/era.wllpartfal iuLl " Industrial (circle one) -Jv • Other • No& of stories (habitable space) I ,� Height (grade to ridge) � ft. * If addition, what will use be? It residential, no. of familles�_ No. of rooms(ezcluding baths) ; „ • Accessory Building � No* of bedrooms �i " Detached Garage QNEAtWQ 'ar 25X '�" I AJi� No* of bathrooms 3L r ~ Primary heating system e jery� • .�Attacheed Garage QNE/TyMQ Car Type of fueel_ zu,�IJ " Private storage building No. of ftreplaces to be installed Other Will a wood stove be installed Central Air conditioning _ O V* ER a BUILDING PERMIT APPLIC .kTIfJv CONTINUED - BUILDING �PEC' IFICATIO *4S; Type of construction, wood frame, fire safe . etc. (n/'on L7 Will any second-hand or upgraded Itember be used? If so, for what ? nC' Foundation wail material % dMCri inr K. Thickness /401 Depth of foundation below grade ( to t3ottom of footing)Will there be a cellar ? r.1Tti Heated or unheated? ( u 1,)eC,1,.t & r-� Floor sq. footage J ;" qp, ;y ft . Will there be a basement ?sz ,� ,s—Will any portion be used as living space ? ,/( L2 (If so, what portion? sq ft . Type of use? Type of roof - lope flat/shed/other :Material of roof Size, wood studs Z. "x..�" spacing " o.c. length ft , Joists ( floor beams ) 1st floor ,? "x /�S " spacingP 6> '10.c. sDa n ft. st (fl or s) 2nd ' s acing o. c. span ft * v s cei ms ) "x " spacing " o. c. span ft . "x spacing o, c. span ft. Roof trusses (pre-engineered) spacing ' o. c, span ft. Exterior wail finish 4,/4 ,:20 k Z �9 1,P1A16 of what material? ZZ /f L Interior wall finish i' If a garage 1's to be attached, describe materials to be used for FIRE SEPARATION: Is there to be an opening between garage and dwelling ? cfi - If so will a Fire-rated door, enclosure, self-closing device be provided? Will a flue-lined chimney be installed?�l� -Height above roof ft, Depth of chimney foundation below gradeft. Depth of fireplace hearth-ft . in, Water supply - Municipal or private well SEPTIC SYSTEM Distance from ANY private well (including adjoining properties 3 .mil ft. (A separation application is necessary for any repair or new installation of septic system) NAME OF 'BUILDER PV y) k,<� ADDRESS R1 I kkc)rL TEL. NO. 885 - LiC)50 NAME OF PLUMBER - F�ADDRESS West, (YUrn. . 4:�d' . FFFF,TEL, NO. NAME OF MASON PfLtj r�� -auDG1�_enCC ADDRESS yJLtd = r) 05t. TEL. NO.�U - '� L3 � NAME OF ELECTRICIAN60b 1 (LI,rrie. r ADDRESS U�. ebt, IYI P dt TEL. NO. f712 - L DECLARATION To the best of my knowledge and belief the statements contained in this application, together with the plant and specification[ submitted, area true and complete statement of ,all proposed work to be done on the described premises and that all provisions of the BUILDING 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. Signature ARJ2A,4x L) Owner, owner's agent, architect, ontraatoe SPECIAL CO'NDMONS OF THE PERKrr: BY 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 : 1 . Gross floor area / Z q e 2 . Type of heat f C-- r^ 3 , Is the building mechanically cooled ? / v 'D 4 . Percentage of area of windows and doors /a Ca A . Over 16 % Only 1 . U 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 roofand floors exposed to ambient conditions _ 2 . R value of exterior walls 3 . R value of glazed area 4 . R value of doors c 5 . R value of floors over unheated spaces_ f 6 . R value of slab edge insulation - unheated slab 7 . R value of slab insulation - heated slab S . R value of heated basement / cellar walls ( above grade ) 9 . R value of heated basement/ cellar walls ( below grade ) 11j 14 . Type of insulation C . Controls [� 1 . Thermostat maximum heat setting ^ '1' T 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 P001 - Only 1 . Maximum heating /y f, _ Telephone No . ( applicant ' s signature OWN or QUEENSBUR- r CAPPLICATION FOR SEPTIC DISPOSAL PERMIT DATE LOCATION OF PROPERTY FOR INSTALLATI©Id (' gj _<�f I 0 r Owner's Name: R � fr1 d h Y_] Telephone: Address: Installer's Name: T 1 hone' Number of bedrooms (residential only) Total daily flow (compute Cd 150 ga a bedro m) Topography: Circle one: Flat fling teep Sl pe of Slope Soil Nature: Circle one: Sa d Loa Cla Other /Depth: Feet Ground Water: At wha de h? Feet Bedrock or Imp va s ate r 1: hat depth? Feet Percolation est: Circle e: not required required rate min. inch. Domestic wat su ly: ircle one: Municipal well Other if domestic er sup ly is a well: Separation: ater s ply from septic absorption feet PROPOSED SYS Septic Tank gal. ( minimum size: 1 .000 gal.) TILE FIELD: Each Trench feet/Total system length feet SEEPAGE PIT(S): Number of / Size each feet by feet Size of stone to be used # /Depth or Thickness feet I have read the regulation on the reverse side of this sheet and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. SIGNATURE OF RESPONSIBLE PERSON: DATE: OVER e Septic System Lnspections : A . All applications for septic system installation , alteration or repair , as required by the Town of Queensbury Sanitary Sewage Ordinance , shall bu submitted to the Building Department at least 24 hours before start Of construction and shall include a plot plan showing : 1 . ) the proposed location of the system 20 ) location and distance to lot lines 3 . ) location and distance to structures 4 , ) location and distance CO any water supply* S . ) size and dimensions of all tanks , distribution boxes , tile fields and /or drywells B . Nu system shall be covered before inspection and approval by the Building Inspuctor . Failure to comply with this requirement may result in the uncovering; of the system by the installer and a fine ut up to $ 250 . 00 . C . An approved copy of the plot plan shall be available on the construction site , Failure to produce said plot plan at time of inspection may result in an immediate work stoppage . D , Should unforeseen problems during construction prevent proper installa— tion , alteration or repair of an approved system , a new proposal must be submitted to the Queensbury Building Department before further construction , Town of Queensbury BUILDING and CODES DEPARTMENT Say and Haviland Roads Queensbury , New York 12804 TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS Q Y' NEW TELEPHONE (5 8 ) Y 0 792-5832 BUILDING INSPECTOR' S REPORT REQUES91Fop INSPEC ON RECEIVED ���-- NAME LOCATION DATE . i' f — PERMIT # APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR ORms OOFING FOU'NDATTONJDAMP- BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN INSULATION- FOUNDATION FLOORS WALLS CEILING _ ,r FINAL INSPECTION : CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/STEPS STAIRS-CLEARANCE & RAI 5 PLUMBING FIXTURES/RELI F VA VE�__ -- INTERIOR TRIM/PRIVACY DOORS -- FINISHED FLOORS GARAGE FIREPROOFING DOOR CLOSER (S) SMOKE DETECTORS FINAL ELECTRICAL INSP CTION FINAL APPROVAL OF CO STRilCTION� A SIGNED CERTIFICATOF OCCUPANCY MUST BE OBTAINED FROM THE B LDING DEPARTMENT B FORE THESE PREMISES ARE OCCUPIED ? REMARKS : INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS / QUEENSBURY. NEW YORK 1280t / TELEPHONE (518) 792-5832 . BUILDING INSPECTOR' S REPORT.3 i S REQUEST FOR SPECTTON RECEIVED �___---.--- NAME LOCATION r DATE •-- PERMIT # � . APPROVED _ ,,d✓ r�J ES NO FOOTINGIPIERS MONOLITHIC POUR FORMS F-O UNDA T IO N/DAMP—PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUG —IN INSUZATION: FOUNDATION FLOORS s WALLS SLING INAL INSPECTION: a CHIMNEY HEIGHT ' ROOFING SIDING EXTERNAL PORCHE /ST'W STAIRS—CLEARAN & PLUMBING FIXTU ES/RELUF. VALVE INTERIOR TRIM PRIVACY r?OORS FINISHED FLO S GARAGE FIRE OOFING DOOR CLOSER S) SMOKE DETE TORS FINAL ELECT CAL INSPECTION FINAL APPRO AL OF CONSTRUCTrON: fOBTAINED SIGNED C RTIFICATE OF OCCUPANCY MUST BE F OM THEBUILDING DEPARTMENT BEFORE ESE PRE SES ARE OCCUPIED+ REMARKS: f,/�� A/0 SPE OR T ( IL CODES OF QU COD S[3RY �BUILDING AND ES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW' PORK 12809w TELEPHONE ( 518 ) 792-5832 BUILDING INSPEZTOR' S REPORT REQUEST FoRorINSPECTION RECEIVED _ NAME LOCATION DATE !� /l� PERMIT # i' / 7 APPROVED YES NO FOOTINGIPIERS MONOLITHIC POUR FORMS FO ATION/DAMP-PROOFING ACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: g CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/ST iS STAIRS-CLEARANCE & I _ ~ PLUMBING FIXTURES/ ELI` VALVE INTERIOR TRIM/PR ACY ISQt7RS FINISHED FLOORS GARAGE FIREPR ING DOOR CLOSER (S) .SMOKE DETECTO S FINAL ELECTRIC L INSPECTION FINAL APPROVA OF CONSTRUCTION A SIGNED CE IFICATE OF OCCUPANCY; MUST BE OBTAINED FR M THE BUILDING DEPARTMENT BEFORE THESE PREMI ES ARE OCCUPIED! REMARKS: INSPECTOIR Nptional Headgµarte% , . 9W Fladdon 'Ave., Collingswood, Iif,J- 08108 ,. Elate: �. City, Town or Township. County��+"�� State 4 x r Location IAddrees f Locat enRuraLAreatP ease Att'hch Directions)JC gritJ# 4ccnupieci As Bu3ldmg Pl ' 01d0 Occupant Work Area in Building Floor A for: Whin Service or: Read for In Fee Remitted'- $ ` ' Cash Check I +f:0, M.D.I.A, 'son lea lllaa s$!re s5na 173n 80oe xxso x5ea x75° 3eee ` Number of Rouyn W=ring C7u leCs` Elect. Beat = , : "'. Switches P. Service 5cfrface Unit l]nhwr Darr s hanger- .. Lighting Water Heater Air Conditioner. ID ryer ' humtp . . Receptacles Oven i3blrbage Disposal Wiring and Controls for Burners Number a 0#ik ur i4rFwp.'RecefrtaCle$ Fractional H,P. Vent.Fans Other Equipment•. =r: : MOTORS H.P, 1�,, 1J 'W, 11a 1!5 1!4 '1J3 112 3J4 1 lWa 2 9. . 5{ 7�1x 10 15 20 25 30.' 4Ati ! dR 73 ,:I00 Lid y Mark Number of Each Size Applicant^s - . License # Pefirr+lt Signature T/A ! itilliy: EMATjqjINj r APplica P ross:d ECitY1 `[ istatel 4Zi�r3 Service Request #- r Phone # leotaici�rt : !S#+Tt RECEiuEd: DATE 1NSPE ~Ll , Correct Location : 'Same as Above Q or: f -. Red Notice Label 0 Rough Wiring Outlets Surface Unit 'Oven rL Switches Ran r5sp Receptacles we r Heater Jvesh' r Fixtures his Coniiiti ' ner' : 17ryer, Amp. Service E uipment Burner, 1l r_ i'g &"Caritrols for Ainp. Rece tacle Amp. Service Conductors Pump fit Fins' M07L7RS H.P, 1/20 1(12 1{SO 1/6 1{S 114 1/3 2 7% 10 15 20 25 3 5 j - L j Mark Numller of Each Size Elect. Heat nOO lob saoo lsso sa°o i�so zoo° :xs° aeon aM6 sage ' rr LL Q RW Progress: Ire. Q LKD Contractor ] [] CFT Violation : Work Comp, 0 Inc, . F1 CASH Q L1A Owner fFe CHIC P 0 Pf A Municipal x �� ?. .I,,P Other Side Q titilrty _,r* .��s a.,� dog 4 Y , t Lin_ AV .4401icw- 0 _ rr Cut in Card []' Temp #d Date c - t,� . , :s.1 � g :# Final # i?ate . . %APPL_i C/R'Y df4 JF0 riM NHS, 256 EL'T1l54 _ . TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT 1p BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 1280& TELEPHONE (518) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIV D NAME 94 n" CX LOCATION DATE -�) R 1 PERMIT # -- APPROVED YES .lowo, ( w, OTING1PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL APPROVAL f ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING J, EXTERNAL PORCHES STEPS t STAIRS-CLEARANC & RAILS PLUMBING FIafTU ES/RELIEF VALVE _ INTERIOR TRIM PRIVACY DOORS FINISHED FLOQkS GARAGE FIRE OOFING DOOR CLOSERS) SMOKE DETEQ'TORS 11 FINAL ELECTR CAL INSPECTION FINAL APPROVAL L OF CONSTRUCTION i A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: RI11 # INSP TOR SELECT BUSINESS FORMS (649) 22a-7775 RS APPLICATION FOR ELECTRICAL INSPECTION PLEASE BEAR DOWN YOU ARE MAKING (4) COPIES / MIDDLE DEPARTMENT INSPECTION AGENCY, INC. National Headquarters 900 Haddon Ave„ Collingswood, N.J. 0$i08 Date: .., City, T own or Township County. Yre P'l —state Location/Address bK T 1 �l� �� �If Lofted in Rural Area - Please Attach Directions] Pole # Owner �Jf-3�•4�`�LLIn k / Permit Occupied As - Building: New DC Old Occupant // Work Area in Building Floor #, etc. ) : for: Wirin Lj Service or: tap �#' W* Ready for Inspection : Fee Remitted - $ Cash 0 CheckEer M.O. Q Make Payable To: M.D. I.A. 500 1 75o xgeo xzso xsoo x7so xoao xxso xsao x7so 3oaa Number of Rough Wiring Outlets Elect_ Heat Switches —Crit? Lighting Amp. Service Surface Unit Dishwasher Range Receptacles Water Heater Air Conditioner Dryer Pump Number of Fixtures Oven Garbage Disposal Wiring and Controls for Burner Amp. Receptacles Fractional H.P, Vent Fans Other Equipment: MOTORS H,P, 1/2 1/12 1/14 1/B 116 1/4 1/3 1/2 3/4 1 l+fa 2 3 5 7xls 14 15 24 25 30 44 54 75 140 Mark Number of Each Size Applicant`s y� Signature �r License # Permit # TIA Utility Applicant's Address: NAME OFFICE LC+CATI¢N (City) [41-e-eD t r (State) } (zip) 103IR04 rvice Request Phone # 4V Electrician : a x DATE RECEIVED: PATE INSPECTED: Correct Location : Same as Above = or: Red Notice Label Rough Wiring Outlets Surface Unit Oven Switches Range Garbage Disposal Receptacles Water Heater Dishwasher Fixtures Air Conditioner Dryer Amp. Service Equipment - Burner, Wiring & Controls for Amp. Receptacle Amp, Service Conductors Pump Vent Fans MOTORS H.P. 1/:W 1/12 1 1/14 1/0 1 1/6 1/4 1/3 112 3/4 1 1 11/2 1 2 1 3 1 5 1 7112 1 14 1 15 1 24 1 25 30 4o 50 1 75 144 Mark Number of Each Size 11 Elect. Heat LA 5110 id° laoa 125o xsoo x75o 200o xxsa xsao x7so 3000 bA ED R W Progress: Inc. 0 L K D 0 Contractor [] CFT Violation : Work Comp. Q Inc. 0 CASH Q L/A Owner Fee L GHK/A Due MO alk IPA Municipal INV # Date : Other Side 0 Utility Applicant Owner Cut in Card C] Temp # Date �ruapGrrntaa air^_wiarc Svc II II MORSE ENGINEERING 99 LOWER DIX AVENUE OLEN$ FALLS, NY 12901 December 19 , 1989 Queensbury Building and Codes Dept , Queensbury Town Offices Bay at Haviland Road , Box 98 Queensbury , NY 12804 RES Modular Home Inspection - Pashby , Qby . Bldg . Permit # 89-746 Gentlemen : Please be advised that Morse Engineering conducted an on-site inspection of a one-story modular dwelling on December 14 , 1989 , at the property of Mr . & Mrs. Richard Pashby at Box 380 , Pinello Road , Queensbury , New York . The inspection included visual examination of the foundation for possible damage during placement of the modular sections as well as inspection of the center beam connections and vertical column supports . FOUNDATIONS O.R . - # 10 inch CMU wall , no visible cracks in wall or voids in masonry mortar . No visible or apparent foundation leaks . CENTER BEANO O.R. - Level and straight (6) 2 x 10 connected at 4 feet . O . C . with 9116 inch bolts . COLUMNS: O*Km - Each 3" column plumb with 3/ 8" steel plates top/bottom and 9 feet O . C . New York State DHCR Model Approval Data : Insignia Serial Number ; 36724 Manufacturer : Premier Builders Plan Approval Number : NY0483 Manufacturer Serial Number : 03-0981169AB Date of Manufacture : September 13 , 1989 Should you have any questions regarding this inspection, please contact me at Morse Engineering . Yours truly , MORSE EN RING 40 r Mackk A . Dean Senior Codes Specialist MADtpl cc : Mr . & Mrs . Pashby RICHARD 8 , MORSE , P. E. Phone ' ( 518) 792 - 5382 cn cx x 0 / >ago 2 � .c > r cn a0i Qj y� N xz em Cc 3 w a 4 a s p - _.._ csc7 cJOZ.....,� .-------r—#---•_-_.__ � i W �' y �, o � ",OpK 6�-/d b w Q p