7004 CERTIFICATE OF OC+CUPAN'CY
TOWN OF QUEEN58URY
WARREN COUNTY, NEW YORK
Date ! � � 19
This is to certify that work requested to be done as shown by Permit No. 70404
has been cAmnpleted. rg
This structure may be occupied as a
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoning Inspector
e
CRE kT1YE ••IM1t/l" ♦MNTaMG GLEM3 FALLS IY ' IS•OI 1}�E�lf 3-{Ibbq
BUILDING PERMIT
TOWN OF +QUEENSBURY No. 7004
WARREN COUNTY, NEW YORK _
a
Barber Daniel Re tj
PERMISSION is hereby granted to Da D
r•
Bay' Road Street, Road or Ave.
OWNER of property located at ~
in the Town of +Qusensbury, 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 W
Building and Zoning Ordinance.
approved and in compliance with the Town of CSueensbury g Cr
fD
[AE
dress is Re Do # 1
Glens Falls , New York
OR or SUI LDEWS Name
same
W
OR or BUILDER 'S Address
:U
0
Cv
same
'S Name
TT Address
r C7
6. TYPE of Construction — IPlease indicate by 'X) [1
12q wood Frame I } Masonry I ] Steel I }
h'•
I--A
7_ PLANS and specifications 30 * x38 * per plot plan , specifications and
application submitted including sewage system _ �
No. fp
F—'
a. Proposed Use
One-FamilY Dwelling
$ 5 . 00 C/O Paid 82
s133 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES February 1 19
IIf a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of ClueensburV befoce the expiration date.I
Dated at the Town of Q.ueensbury this 27th Day of JUl Y 79 81
SIGNED BY � �+ e7 C „�� — for the Town of Queensbury
if Building and 204 1nspe r
7+C)1VIl/ N OF QUEENSBURY ` (Space inside block Itr be fillexl in b%
WARREN COUNTY, NEW YORK Building fnxpracsrw-1
Application for Permit+h,mit Iii,1, di,.
Permit �,t14K1 i g
BUILDING AND ZONING PERMIT Ve'e inie ENpires
4441mok District
\ ;fleet• r .l l\'< Irk
THREE ( 3 ) Copies of a PLOT PLAN. Drawn to scale
showing the actual dimensions of the lot to be buift ite'eTe;frkS
upon, Tha exact size. and location on the lot of the
but"Iding to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION.
'5- d _ -1 / T�]C)>WN I/LI�7nF QLJE:Ei{}�{/N] S1I e13U [RYYy �
IE
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK � lu' � 2- / 1981
ANSWER ALL OF THE FOLLOWING. A.M. $� v -C P.M ,
The unudarsigned hereby applies for a permit to do the following woclt ' �yl F y
w ich will be done in accordance with the description, plans and spocifi. 7MsI$] ;q�. x12� 31 .0 0 a
cations. and such special copAitions as ay be ind` ted on fhe permit. ALG��? Y► QC
The owner of this propertg i . . , � . /��//] (�./+��]
. . {NA •". 1 , ee.. - fD i1. A.❑a7 EES 1 -
The person responsibie for supervision of the work insofar as the Bu il d i;W-Cocle and the Zoni Ordinance apply i%:
{NAtft {P�x1 AddRE551
Name of Builder . , - . . , - - - . Address . . . • . . . . . . . . . . . . . . . 1. . . _ . . . - . - . . . . . _ _
IC , . . .
Name of Plumber . . . . . . . . . . • . . . Address . . . . . . . .
Name of Mason . . . . . . . . . . . . . . . . . �. , - - Addresv . . . . . .
Lot Number , . . . . . . . . . - Unit . .//.t� . . . . Esti tea value of pro red work f •�'' Cr �: �✓
. . . { \i . � . . I . . . . . . .Name of Street Side of street: north ❑, east . D , south ❑ . west ❑
Nearest Cross Street . . . . . . . . . . . . Distance frons ttiir: ^ross street . . . . . . . . . . . . . . . . . ft
Property is north ❑ . south ❑ . east I , 'west ❑ from Crass Street ,
If on Corner. •which corner, northeast U , northwest ❑ , southeast ❑ . southwest
(Designate by marking with an "X" in the correct space.)
NATURE OF PROPOSED WORK OCCUPANCY
_f Main Building
L�C]L Construction of a new building. one-family dwelling
Addition to a building. Two-famiiv dwelling
Alteration to a building. - . . . -family apartment house
0 Demolition of a building. Strom building
-car attached garage ❑
Other- . . . . . . . . . . . . . . . . . .
Accessory Building
One-car detached garage �
Q Other work. Describe: - . . . . . . . . . . . . . . . . . . • . Two-car detached garage
Private chicken 'house
. . . . . . . . . . . . . . . . . . . . �
. • . . . , . Private storage building
. . . Other: . . . . . . . . . . - .
ZONING SPECIFICATIONS. Frill 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 Vacation of all existing buildings.
No" r" Sbow proposed building(s) in dotted line and existing
tauilding(s) to solid lino.
Size of property . . . . . . _ . . . . . . . .
Size and use of existing buildings. if any . . . . . . • •
fe' Size of proposed building . , . . . ft. x - . ft.
meight (from grade to ridf;e) .
'r . , .
Front yard ft-
Side
_ . . �+' : G . .
Side yards ft» and . . . . . . . . . . . . . . . ft.
Rear yard . . . . . . . . . . . . . . . . . . ft.
so U T µ If opt corner, setback from side street . . . . . . . . . . . . . ft.
Note, All dista vices are nett as measured from street side
j line to nearest wart of buifdixg.
ry ry i4VSet1
{coont'd.)
BUILDING SPECIFICATIONS.,
le
Kind of construction' Wood frame, fire safe, etc ? . . . . .
Will any second-hand lumber be used? . . . f so, for w ,�
Material of foundation walls . . . . . . . . . . . . . . c?�? � . . Thickness . - , . L . . . - . . . . . . . .
Depth of foundation walls bed de . . - - • - . . . . . anti ous foundation? . . . . . . . . . .
Will there be a cellar? . . . . -�CJ If soterial of cellar Haar
Type of roof,. Sloped or flat? - . �y,./�.'.� atenal of roof . . . . . . . . . �^
Size, wood studs . . . x . . . ,� . spacing . . . . . "o-c-, ength . . ft.
Size, floor beams, 1st floor . . . . . . " x . . . . . . 1 . ✓ - ". apar<tng . . . . .�/? /� - . . . "o.c., span
Size, floor beams, 2nd floor . . . . ". spacing - . . . �, . . -"o.c., span . . . . . . . . . ft.
Size, ceiling beams . . . . . . . . . . . rc�+. . . " x . . . . ", spacing . . . . "a.C., span , . G , ." . . ft.
Sije, roof rafters or beams . . . . - t'. " . . . . . ", spacing . . . . . Zee . . . . . "o.c-, span . . f.�. . . . . . . . ft.
Exterior finish . . . . � -�••� /•/� With what material? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Finish of interior walls . . .
If garage is to be attached, of what material is ail between garage and retain bukWng to be conlstructed?
Is there to be an opening betweery.g Idi,ng? . . . . . . . . . . ./ '�.=6 �✓ . , . , , . . . . . . . . . . . . . . . . . . .
Kind of heating system . . . . . . # _' . . . . . . . Oilbtgrner or coal? . . . . . . . . . . . .
Will aflue-lined chimney be provided? . . {.� . . . - Depth of chithnley foundation below grade . . . . . . . . . . . . . . . .
Height of chimney above roof . . . . . . . . . /. t ,+ .� x . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Will there be a fireplace? - . . . . , . . . . . . ..�'. . . . . . Depth of fireplace hearth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Will a toilet be installed? . . . . . . . . . . . . ~+ . . . . . . . . . . . . . . . . .
Will a kitchen sink be installed and connected to water supply? . . . . . . . . • • • • •
Water supply (public water supply or pump) . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . . . .
Distance of cesspool from any private well . . . . . . . . . . . . . . . . . . . . . . . . . . . . G . . ,..+"r . , , . . . . . . . . . . . . . . . . . . . . feet
Will drainage system be provided with required traps. cleanouts, and vents? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
AFFIDAVIT
Town of Queensbury
County of Warren
State of New York.
I swear that to it 1k +of my knoyiedge and belief the statements contained in skis spplieatiun, the oLana and apecifcatsorns sub*
mitted. are a true and ao.",pleta statement of all proposed work to ba desweri a t a of the BUILD-
ING CODE, THE ZONING ORDINANCE, and all other Lowe pertsirung to whethenr specified or �•
and that such work is authorised by the owner. r
Sworn to before me this Signature .. .. . .. . . -
OWNJER• 6 ER'S AGERT, ARcml CT. CBh ACTOR
dayoE.. . . ... . . ... .. ... . .. . . . . . . .. . . . ... . . .... .... . . .19. . .... ..
NOTARY PUBLIC. WARREN CoUFfTY. N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
By .. . .... ..... .. .... .. . ..... .. . .. ..... .__. . .. . .... .. .... ...
]FOR A -trr . 10 CC7PS
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—
TOWN OF C AJEENS SU RY
Buildinng� Department
In""m6we Pww Date 4j
Nawn!
Permit. Nw 7 . C3 WO&th4w
Remarks
ExcatYa t on
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
BacJc7111
Final Surve
Framing
Sheathing
Roof Felt
Roofi
MasonrLy veneer
Rou h PI
Relief Valves
Wall Board
Ext _ Porches
Finished Floor
.Interior Trim
Stairs & Railings
Cellar Dr . Tile
Concrete F.ZOOrs -
PjbCjw Fixtures
Gar . Fire roofin
Door Closers
Chimne
Water Meter Inst .
Septic Approval
Floors
Foundation —+
Insulation Walls
Ceili
Building nspectar
REMARKS
THE NEW YORK BOARD OF FIRE UNDERWRITE
BUREAU OF ELECTRICITY'' -
41 STATE STREET, ALBANY, NEW YORK 12207 T
Date TharCh 30 , 19S2 Application No. onfile 497037 R1 ; +THIS +CERTIFIES THAT
only the elactricol equipiraent as described bRrlow and introdaacvd by the spplia�rrr�t Hamer! an the atone appGFcatioTa aaes ofDaniel R . .Barber , Nottlxig ,am Drive , GIO::Tis falls , Newin the allows location; Pt BaxePnent 0Ut `Sidsf ng � lst FY. � 2nd Fl. Section was ezominerd on 3 / 2 g / f j 2 aredfaund to be in compliance with the requirensents o
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
E"ACLES SVOTCHES
OUTLETS OW-ANDESCEi%rri PLUORESCENfT v AMT. K. W. AMT. K. W, AMT. K.W. AMT. K. W, AMT. H. P.
' 46 IL 23 2 F'L;.
dd DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SO4MAL RECTT TIME CLOCKS I UNIT HEATERS MULTI-OUTLET DUALMERS
AMT. X. W. OIL H. P. GAS H. P. T. NO. . G. AMT. AMP. AMY. AMPS. TRANS. AMT, H, P. SYSTEMS AMT. WATTS
NO. OF FEET
1 Il yer • l fi� _
r
SERVICA DISCONNECT No. OF S E It V I C E
AMT, AMP. TYPE EGUEIf 1 Jr zw 1 J' S1Y 8 .s' ]Vv 3 X iW NO, a ERCA.rCOND. OF CC W.
NO. OF H�.LEG w• NO. oP NEUTRALS of A.
Wi ' L
l 200 CB 1 x 1 11 / 0 1 2 / 0
OTHER A"MATLM
1 Smoke Detector
1. 15 amp GFC1 Breaker
OTSFECTI
Daniel. R . Barber �aR
1 1D #r 1
Glens Falls , New York 12301 BRA ER
Per '
COPY FOUR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED 1N ANY MANNER. _
TOWN OF QUEENSSURY
8uildias Department
juspecoms Datc f 'AU--
Name���e MRJ&
Pe r mR No.
Wcr
Remarks
Excar,Ya ti.an
Footincr Farms
root In & Piers
Foundation
Cement Coat
water roofin
Backfill
Final Surve
Framin
Shea thin
Roof Felt
Roofin
Siding
Masonr Veneer
Rou h Pl
Relief valves
Wall. Board
Sxt . Parches
Finished Floor
Interior Trim
stairs 6 Rai.lin B
Geller Dr . Tile
Concrete ]doors
P1 Fixtures
Gar . Fire roofin
Door Closers
Chi one
Water Meter Inst .
Septic A royal
Floors
Foundation _
.Insulation Mails
Ceilin
Building rnspectar
REMARKS
TOWN OF QUEENSBURY
Building Department
ie"seCbeT��R.opmt Date
Name - ^'r t7f+f A i.0 BED _
i..ocalio�s
p Na. O C+ Weather
Re=.r)cs
8xcatya ti on
Footing FOXIMS
Footinci 6 Piers
Foundation
Cement Coat
Water roofin
Backfill
Final Surve
Framin
Sheathing
Roof Felt
Roofin
Siding
Mason-I Veneer
Rots h PI
Relief Valves
Wall Board
Ext . porches
Finished Floor
Interior Trim
Stairs & Railings
Cellar Dr . T-Ile
Concrete Floors
Pl Fixtures
Gar . Fire roofln - -
Door Closers --
Chitane
Water Meter InstII,
se tic Amrxro.val
Floors
Foundation
Insulation _— -
Wa 3V
ceilin
J Building Inspector
REMARKS
a
i