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8909
f i j CERTIFICATE OF OCCUPANCY i TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date �. .4 19 1_ This is to certify that work requested to be done as shown by Permit Iris._ has been completed. This structure mav be occupied as a ta I+ ? tt LAocat on Qwn3 r. T By Order Town Board TOWN OF QUEENSBURY Builotf g & Zoning Inspector I CIIIE^T*VE 'IMSTA PMIMTIMG. GUWNS FAL"5 N V }2401 ID IdIiS 3-O{S! BUILDING PERMIT TOWN OF QUEENSBURY No. 8909 WARREN COUNTY, NEW YORK ' 0 w PERMISSION is hereby granted to Richard and Bernard Rouge , OWNER of property located at _ Upper Sherman Avenue Street, Road or Ave. tj Clj in the Town of Queensburyr To Construct or place a One—Family Dwelllnq to rD 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. {y +-t sZ 1 . OWNER'S Address is RD # 2 Fort Edward , New York 0 LO .si rD 2. CONTRACTOR or BUILDER'S Name _ Lamplighter Homes 3. CONTRACTOR or BUILDER'S Address RD # 2 Fort Edward , New York m 4. ARCHITECT'S Name f-1 C!] r� (Fd{ 5. ARCHITECT'S Address 0 0 C CEr B- TYPE of Construction — (Please indicate by X) N. ( wood Frame ( ) Masonry ( } steel i ) 7. PLANS and Specifications 26rx481 per plot planr . sp+ecifications and No. ,application submitted including sewage system . C? 8. Proposed Use THE ATTACHMENT OF THE TWO PARTS MUST BE APPROVED BY A LICENSED PROFESSIONAL ENGINEER . One-Family Dwellin I� r- $ 5 . 00 C/o Paid $ 94 ` OO PERMIT FEE PAID — THIS PERMIT EXPIRES prune 1 19 $ 5 v � {If a longer period is required an application for an extension musk be made to the Building and Zoning inspector of the town of Queensbury before the expiration date.) F- N Dated at the Town of Queensbury this y,3, Oth Day of November 1984 t5 SIGNED BY _for the Town of Queensbury - --------- Building and Zoning inspe�-ctrj TOWN OF 'QUEENSBURY Space inside block to be tilled in bN WARREN COUNTY. NEW YORK Building Inspt"fir} Application for \,a,ai ( rti[trr No. }'rrr�rr( Is.ur•+rl 1+7 BUILDING AND ZONING PERMIT 1` 115i3 H.xhit 117 % � �rzrrr;: i )+strut \ ,r � �ss• tit \1'„rl. ,� THREE ( 3 ) Copies of a PLOT PLAN, Drawn to scale showing the actual dimensions of the lot to be built it[ ns:rrJGS upont Tate exec+ size, and location on the lot of the building to be erected or altered MUST BE SUB- MITTED WITH THIS APPLICATION, TOWN OF QUERNc�;F?! - ` . A PERMIT MUST BE OBTAINED BEFORE BEGINNING 'WORK N o V � .� 19t4 LU ANSWER ALL OF THE FOLLOWING. The undersigned hereby applies for a permit to do the following work AM" j �i" �`k3}�1'� � • 'S- which will be done in accordance with the description. plans ands acifi- 718191-01 T ! 2ANN131 ` 15 f 6 cations, and such special ca. ditions as may be indicated on the permit. Y The of /r+il�s 41 prsa ty is. f� �a f ,•le�e' . INR" _S J IP d. ►+DbR E$$1 I The ,rJe]r ' n '' irefor so ,r ion of the, ` ork insofar as the Building Cody an the Zoning Ordinance apply is: . . /J�"'�.` G.'. .e'st'!`. ,f ,�!'J-•? . . :—`x.}"r"ra - . G_r-s. . DDL, ,- . . . . . . . . - . � {HJ►M } IP 4 ADDRESS) ' Name of Builder . . . '�li�'d r . A r , . - . . . - - . Address . . . . ddd Name of Plumber . . . . . . . . . . . . . . . . . . . . Address . . . Name of ;Mason. , , . . . . . . . . . . . . . . . . . . . . . - Address C� L.ot Number . . . . . . . . . . . . Unit . . . . . . . . . . . . Estimated value of proposed work $ . . . . . . . . . . . . . . . Nameof Village . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Street . � 2 �/.�x' + 7 + /T . . . . . . . . . . . . . . . Side of street : north 0 . east 12Csouth O . west C1 Nearest Cross Stree' C . . 46? . . - . . . . . . . . _ . . . . . Distance from this gross street let - . . . . Ft. Property is north © . Scout Pu . east i i , west © from Cross Street If on Corner, which corner, northeast G t . northwest qEcsauthea C} . anutt�wese ( Designate by marking with an "7{" in the correct space-1 NATURE OF PROPOSED WORK OCCUPANCY Construction of a new building. Main SuRding I_I Addition lobe building. One-family dwelling 0 Alteration to a building. Two-family dwelling 0 M Demolition of a building. Family apartment house Store building L� -car attached garage Other: d I I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Accessory Building One-car detached garage I J ❑ Other work. Describe: . . . . . . • . . . . • • • • • . . . . Two-car detached garage 13 Private chicken !souse . . . . . . . . . � 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. Show proposed building(s) in dotted line and existing %uilding(s) in solid line. t^ e s Size of property !� x , . C ft. 90 Size and use of existing buildings, if any . . . . . . . . . . . . . 0 '' Size of proposed building . .©s .+ ft, x . . . J• • . . ft. ac, ' Height (from grade to t} e) . . . y/��a . . . . . . . . . . . . . . ft. Front yard . . . . . . r •' . . . . . . . . . . . p. ft. Side yards . . . . . /r %'� - . . . , ft. and . ✓• . ft. Rear yard . . . . . . . . . . . . . . . . . . . . . . . . . . . SOUTH If on corner, setback from side street . - . J`f • • • ft. , - Note: All distances are net, as measured from street side litre to nearest part of building. ry •� (OVER) f 7 J"'M (cont'd.) BUILDING SPECIFICATIONS., Kind of construction : Wood frame, fire safe, etc.? . . . /�' � Will an second-hand lumber be used? . . . Q _ . . If so. for what? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . y � yy � Material of foundation walls . . . . . [�c"�r lay . . +f t � . . . . . . . . . . . . . . . . . . . . Thickness . . ./00 . . . . . . . . . . . . . . Depth of foundation walls below grade - , . / . . . . . . . . . . . . . . . . . . . . . . . . . . ContinuOus foundation? . . . Will there be a cellar? t5. . . / f so, material of cellar Ilaor . �Ci� ` . . . . -le. /. . . . . . . . . . . . . . . . . . . . /.� . . Material of roof . . . . . .,/�t` F�` /`. S ;fig./ '. . . . . . . . . . , . _ . _ Type of roof: Sloped or ai. 5'j �' Size, wood studs . . . . . . . . . . . . . . . . . . . x . . . . . . . . . . . . spacing . . . . . . ;/A. . .c., length . . . j? . . . . . . ft. Size, floor beams, Ist floor , . - . . z . . . . " x A:? . . . . . . . . . . . , spacing . . , _ . . .147. . . . `o.c., span . . . ,r! T . . . . . . ft. Size, floor beams, 2nd floor . ,6747 .2 . . . . " x . . . . - . , - - . . . spacing . . . . . . . . . . . . . . "o.c., span . . . . . . . . ft- Size, ceiling beams . . . . . . . . . . . . . . . . . . x . . . . . . . . . . . . . . . ... spacing . . "o.c., span . _ . . . . . . . . . . . ft. Size, roof rafters or beams . . I . . . . . . , x _ . . . . , ", spacing . . . . . . . .f1. . . . "o.c., span /�5 . . - , . . . , . ft, Exterior finish . . . . (r'/�1'.Ii " With what material ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Finish of interior wall . . . . . . . . . . , �,/ -G�lw .dL!4f. . . . . . . If garage is to be attached, of w at material is all between garage and main buUding to be constructed? t . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Is there to be an opening betweery- garage and building? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Kind of heating system . . - - . e' .ff• . . . . . . . . . . . . . . . . . Oil burner or coal? . . . . . . . . . . . . . . . _ . . . . . _ . . _ . . . . Will a flue-lined chimney be provided? . . . e� e2m • • - - Depth of chimney foundation below grade Height of chimney above roof . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - Shill there be a fireplace? . , . . . . .. . . . . . , Depth of fireplace hearth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Will a toilet be installed? . . . . cG' . . . . . . . . . . - '. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Will a kitchen sink be installed and connected to wateF guPPIY? . . r S . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Water supply (public water supply or pump) . . '!r- ram. . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . _ . . . . . Distance of cesspool from any private well . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . , , . . , , . , - - feet Will drainage system be provided with required traps, cleanouts, and vents? . . . .h4��7S . . Town of Queenshury } AFFIDAVIT County of Warren State of New York I swear that to eb pe,j�if my ktta+r4Iedge and belief the afatelrieTis contained in this application, to`etlMer with the plamr said apecificatiwsa swb- mitted, a a true and cva. lete statet of all proposed work to be done on the described peettuaes and that all prow of are m en the BUILD- ING CODE% THE ZONING ORDINANCE, and all other laws pertaining to the proposed work shall he corntdied ,with whether specified or swat, and that such work is authorised by the owner. Sworn to before the this Signature .. . . . . . . . - . . _ _ UWNE'R. OWNER'S AG ETiT. ARCHITECT. Ci}NTRACTt]R . . . . . . . . . . . .. . . . day of. -. . . .- . .--. . .-. . . . . . . ... . _. . . . . .. . . 19, -. . . . . .. . . .... . . . NOTARY PUBLIC. WARREN COUNTY, N. Y, SPECIAL CONDITIONS OF THE PERMIT: By .__ . . . .. .. . ... .. . . . .. .. .. . .. . . . ... . . . .. . . .... . .. . .. . . . ..... .. . ... ...... .. . . .... .. . . .. ---- ---- _ . . ....... TOWN OF C)UFFNSBURY BUILDING & ZONING DEPARTMENT S E*TVTAQF RISPDSAL ERMIT APPLICATION 1 . Owner ' s Name.. Address Telephone No . 2 . Property location f� 3 . Name of person or fi responsible for installing system Telephone No . Address C 4 . Number of bedrooms ( residential buildings only ) 5 . Daily flow gallons/day 6 . Septic tank capacity gallons 7 . Topography : flat , rolling , steep % of slope so Nature of soil and depth 9 . If ground water , bedrock or impervious material is apparent at what depth does it begin? ft . 10 . Percolation test : A is required B is not required C If required what is the rate minutes/inch 11 . Water supply : municipal , well , other rCr f 12 . Type of system proposed : c drywwe_l_ 1.,.• the field , other 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 Sanitary Sewage ordinance . Date signature of applicant 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 TOWN CIF QUEEMSSURY f ti Date___ , v �6] AA 7674-L Pe No. 5s 9 c? 21 Weather (A/5 174<- r-m Remarks SxcaQation Footin Farms Footin & Piers Foundation Cement Coat Water roofin Baclrfill Fin6a serve Framin sheathin Roof it Roo fin Sidin Masonr Veneer no h P2 Re -Jeff valves Wall Board Ext , Porches Finished Floor Interior Trim Steirs & Raali s Cellar nr . Tile Concrete Floors PI . Fixtures Gar . Fire roofin LD)oor Closers Chimne Water Meter Tnst . Se tic A royal Floors _ �----- Foundation insulation Walls C ilin Building ngpector REMARKS ,�,V C7 1 •v t a .J '" I 7e+—IAJ 21 to w TOWN OF QHEENSBURY Building Depa►rtmont iaapactoes Report Dante Name lh �A a c ` E' L4CiboO=(A r� Pee nit. No. �i 9 0 el- we d"W Remarks 8xcaiYa ti on Footing Forms Footing & Piers Foundation Cement Coat water roofin Backfill Final Survey Framing Sheathing Roof Felt Roofing Si ding Masonry veneer Rough Pjbg Relief valves !Wall ,board Lvxt . Porches Finished Floor Interior Trim stairs & Railin s Cellar Dr . Tile Concrete Floo-rs- PIP20 Fixtures Gar . Fire roofin Door Closers Chimney Water Meter Xnsto Septic Approval Floors Foundation Insulation Falls _ Ce31in Building Inspectoz* REMARKS f " 'SC -te' e TOVIil'N OF QUEENSBU RY Building Department Name Rein 2c+GC. L ate �- I mention Permit No. X 7 0 2 , Weather ,Remarks Excai>a ti.on Footing Forms Footinq & Piers Foundation cement coat waterproofing Dackfi.l l P-in.al Survey Framing Sheathin Roof Felt Roofin Sidin Masonry Veneer noucTh Pl Relief Valves Wall Board Ext . Porches Z Floor Trim Rai 1-1 s r . Tile ` Floors xtures Gar . Fire roofin Door Closers chimney Water Meter Inst . Se ptie AdIDLI132roval Floors Foundation Insulation Walls : Ceiling Burin Xnspector REMARKS TOWN OF QUEENSBU RY Bnildaux Departmout ImWe two Report Date 2. Pe;mk Na. 9a !-g '' �-�Wl�t ar Remarks Excaoa t on Foot-in Forms Footing & Piers Foundation Cement Coat water roofin Bach€i 12 Final Surve Framing sheathing Roof Felt Roofin Siding Mamortry Veneer Rough P1 Relief Valves Wall Board Ext . Porches Finished Floor Interior Trim Stairs & Railings Cellar Dr . Tile Concrete Floors Plbgm Fixtures OL- Gar . Fireproofing Door Closers Chimney Water Meter 2nst . Septic Approval Floors .Insulation Foundation walls �f ceiling eilin Buz ding Snspeotor REMARKS BUILDING DEPT. COPY OF APPLICATION FORM 46.EL, NEW YORK BOARD OF FIRE UNDERWRITERS. FILE THIS COPY WITH BUILDING DEFT. WHEN REQUIRED. T£mr• DATE CITY OR VILLAGEv TOWNSHIP COUN�1f f /,Jr ; ."'" STREET AND no, OR ROAD AND POLE NO. BETWEEN RIMAT TWO PDAM NO. CROSS STREETS f3 �,:/ � 1.` �, PREMISE LOCATED?. BLOCK LOT OCCUPANT'$ B7JILofNG NAME OCCUPANCY OWNERS NAME ,/ f ,�a AND ADDRESS ` .,• /rr{ 1' F w„ ,•F"I Y.^ ,yf '-- d TEL. SUPPLIED _ FROM THEIR OFFICE BSUILDING NEW, OLD IYYORK NEW ADOITIONAt RDEFECTS EMOVED ❑ LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED NUMBER OF OUTLETS No, of FiRtutcl A Lpca Lew Raerpeackw MOTORS HEATERS dRCU1T'8 OFFICE USE can14ian ONLY 'Ir'o R t S'"Rs°n' Psnd.nt Brokrs Na TYw E:mi No. Each No. w , INSPECTION sidle Suit- Mont 'Not FI_ 2nd FI_ 3M FI. REMARKS: LIST OTHER ELECTRICAL DEVICE$ NOT SET FORTH ABOVE: DO NOT USE THIS SPACE, r _ This application is intandad to cover the abort ' poipmanc to M Impacted but If at tirnr of inspaetion'-thmm is found s"itional agumum t not above ihtad, you are euthoriaed to make ih* inspection and adjrras the fee to cover the additional equipment, m provided by ihs applicant. SIZE OF ELECTRIC SIGN MAINS FEEDERS LA MM WATTS CHARACTER EXPOSED OAS TUBE SIGN OF WORN CONCEALED TRANSFORMERS OF VA WORK TO BE iNUMBERI (CAPACITY) STARTED COMPLETED SIZE OF SIGN SERVICE OVERHEAD UNDERGROUND ENTERS MAKER BUILDING OF SIGN INSPECTION REQUESTED ON OR AS NEAR AS - POSSIBLE NEW El OLD AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION, ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. PRINT NAME AND ADDRESS NAME OF X APPLICANT f' ': . +�"` .{, DATE OF APPLICATION STREET AODR ESE /-"'-i`/ JJ / ,/ / TELEPHONECITY 00 POST OFFICE +' .`` f' .y(` !�` Jr Fr J,,. ZIP LICENSE NO_ i / �. ! s'r`/ r. / CODE WHEN APPLICABLE 46 EL {REV- 1/04� x A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING GEORGE KUROSAKA JR-. P.E. BUILDING SttSTEMS CONSULTANT PD11.+T OFFICE BOX NO. 4560 GiL.EN r FALLS. NEW YOR.K 1260 t 4518y 792-1522 / 13 ARBUTUS DRIVE OUEENSBURY, M. Y. 12601 PH ONG i ! � T512 "TS2 �.' BUXLDING INSPECTOR Town of Queensbury re : Factory Manufactured Home Town Hall rnstallaticrn Certification- Queensbury , New York 12801 Attention: Mack )Jean Dear sir , This is to certify that I have observed and inspected the installation of a "Factory Manufactured Home" ; as defined by the New York State Uniform Fire Prevention and Building Code , Chapter D - MANUFACTURED HOUSING , Article 2 FACTORY MANUFACTURED HCMES , as applicable to your local building regulations ; there appeared to be no apparent stx-uctural damage to the units , due to or attributable to the transportation or loading/unloading of the units , here5-n- after described as follows : Date of Installation : Site L >cation: Cormnunity : 'Town of Queensbury County : warren Manufacturer/'Supplier : /s 4::;,.0°'--rye ef;;�,,e- Address : insignia Serial No . Plan Approval No,. / �►/� Manufacturer! s Model/Component No.�.' Date of Manuf acture : Installer/Supplier : I have also examined the approved Plans & Specifications for the abovementioned "Factory Manufactured Home" , and to the best of my knowledge and belief , this vi"ome" has been installed in accordance with these approved Plans & Speci-ficatiOrs , and all other applicable laws cosies , ordinances , standards &/or recrulations - �{� Ku a�tY y Res tfull S mit edy SJ v ` l w G"ORG E KLIROSAKA ..SR - , P . E. NYS PE Lis . Now 35E369 die ��'- 3586V ip'� •- �CFn.- ... f ! i I f X� n