6019 T
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date ; Pia_ ; 1970
This is to certify that work requested to be done as shown by Permit No. 6)
has been completed.
This structure may be occupied as a CD! ►`--' i F(?'+�(-, - ( ( h1
Location J` t 1`'� ' 1,
OWnef :17 ) ra/i7e-C_
By Order Town Board
TOWN OF QUEENSBURY
/
Building & Zoning Inspector
. 1
- l .
CREATIVE ••INSTA• PRINTING. GLENS FALLS, N Y 1266I {518)793-5658
4 - BUILDING PERMIT
TOWN OF QUEENSBURY No. 6019
WARREN COUNTY, NEW YORK
PERMISSION is herebyDon F. Maynard
granted to
OWNER of property located at Lot 471 Kiley Lane (St. No. 21) Street, Road or Ave.
O
in the Town of Queensbury,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 1-11
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.,
1. OWNER'S Address is .<
20 Dorset Place `�
Glens Falls, N. Y.
1-i
0-1
2. CONTRACTOR or BUILDER'S Name
Same
3. CONTRACTOR or BUILDER'S Address
Same
4. ARCHITECT'S Name O
rt
F-'
5. ARCHITECT'S Address
N.�
• N
6. TYPE of Construction—(Please indicate by X) C"
( XWood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
60 'x46 ' per plot plan, specifications and application
No.' submitted including sewage system and two-car attached
garage._
8. Proposed Use 0
One-Family Dwelling c�
$5. 00 C/O Paid 1-'•
H
i00. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES March 1 19 80
(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.) N
H
Dated at the Town of Queensbury this 8th Day of August 1979
SIGNED BY � Jj... �. for the Town of Queensbury
Building and Zoning Inspect e
TOWN N OF QUEENSBURY ) (Space inside block to Ix filled in by
WARREN COUNTY, NEW YORK Building Inspector)
A lication for Application
No. "
PpPermit Issued lg. .
BUILDING AND ZONING PERMIT • Permit Expires. Icl. .
7.c„'nii,i District
\ uIne ,,l Work
1
THREE (3) Copies of a PLOT PLAN, Drawn to scale Ai'P" `•c1 b
showing the actual dimensions of the lot to be built 16.111:trlCf '
upon, The exact size, and location on the lot of the
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION.
F G -- /— , d:,,y,p:h z., rowN'OF QUEENSE3pM
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK 4 i 430 re—p
0(
ANSWER ALL OF THE FOLLOWING. - AUG 7 194
The undersigned hereby applies,for a permit. to. do the following work !AA. /P.m.
which will be. done in accordance with the description, plans and specifi- 7181911apY��.1213I4I6I6
cations, and such special conditions as may be indicated on the permit. tee s e e e. e a e '' e
The caner of this p operty is:, �� i ���
0,n F. 1i is rL D 0r- ���.
(NA'.E) • IP.O.ADDRESS)
•
The person responsible for .supervision of the work insofar as the Building Code and the Zoning Ordinance apply is:
(NAME) - (P.O AODRESSI',
Name of Builder. 5..4,72.4 . . . . . . ... . . ... • . . . • . . . • . . , • .Address ..
Name of Plumber Sikh�• • Address
Name of Mason • $I9 hie Address
.,-Lot Number Unit Estimated value of proposed work S .S Oi.0D 0 •
Name of Village v i!'s �''�`
'
V , Name of Street z /e G'� Y
C Side of street: north 1t1, east 0, south O. west 0
t} Nearest Cross Street . . t v ti/•,h(P/4 t- L 44,4 Distance from this cross street .75--- Ft.
51 a( Property is north 0,south eeast i i, west El from Cross Street
If on Corner, which corner, northeast ❑, northwest ❑, southeast D. southwest
(Designate by marking with an "X" in the correct space.)
�/ NATURE OF PROPOSED WORK OCCUPANCY
I Construction of a new building. Main Building
❑ Addition to a building. One-family dwelling
•
❑ Alteration to a building. Two-family dwelling
EJ
❑ Demolition of a building. • • • • -family apartment house ❑
• Store building .I
. . . 02. .-car attached garage El
Other:
• Accessory Building
One-car detached garage ❑
❑ Other work. Describe •
Two-car detached garage
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-
• posed buildings,and the location of all existing buildings.
NORTH Show proposed building(s) in.dotted line and existing
•
lwilding(s).in solid line.
Size of property J O Z.) y ft. x /SI ft.
••
Size and use of existing buildings, if any
1-
4 r �/
s w Size of proposed building . . - 6 . • . ft.x ./. . . .w• . • • ft.
Height (from grade to ridge) r,. : ..... . . /.7.. . . . . • • • • ft.
•
Front yard • -t 3 ft.
7 !
Side yards . . •
C�. .:. . . . ft. and / D ft.
Rear yard 76 ft.
SOUTH If on corner,setback from side street ft.. ..
Note: All distances are net, as measured from street side
• . line to nearest part of building.,
(OVER) •
7-73-M -
(cont'd.)
BUILDING SPECIFICATIONS.,Kind of construction: Wood frame, fire safe, etc.?. . . . <C?P.�?.S. . . ..l-r....... • • , , , , , , , , , , , , , , , , , , , , , , .
Will any second-hand lumber be used? �� fie If so, for what7
Material of foundation walls /0 R/U.c,-,6 Thickness
Depth of foundation walls below grade s7.42 4 Continuous foundation? (1
Will there be a cellar? elC-� If s,9, material of cellar floor CUl!C•.i- .ice;
e.d..'. . . . . Material of roof . . ./:. 1#(z l i. . S 4/ 7./e-.4
Type of roof: Sloped or flat? : . .� k f J p
Size, wood studs . . . " x (e., ", spacing /b'' "o.c., length i/ f ft.
Size, floor beams, 1st floor " x /0 ", spacing �� "o.c., span /i/ ft.
Size, floor beams, 2nd floor " x ", spacing t "o.c., span `. . . . ft.
Size, ceiling beams ✓t " x V 7/- a ", spacing Y "o.c., span ft.
Size,roof rafters or beams . . / "x ,/ , ., ", spacing "o.c., span, ft.
.Exterior finish c'o Jo 1 A/k-• 5<di/7• • • With what material?
Finish-of interior-walls -//'�� / i c L 4
If garage:is to be attache , of what material is wall between garage and, ain building to be constructed?
g A'e• S t6 2s. . . . . . .5*. .c. f f u. lC ,o.o ./. j. . . .S.i c1.e_S
Is.there to be an opening bet een, arage and building? no
Kind of heating-system . . .t i f:f— Oil burner or coal? .
Will a flue-lined chimney be provided? Depth of chimney foundation below grade
Height of chimney above roof "
Will there be a fireplace? e--S Depth of fireplace hearth
Will a toilet be installed? r-s
Will a kitchen sink be installed and connected to water sup ly? e'-
Water supply (public water supply or pump) pc: to Ii _ .
Distance of cesspool from any private well feet
Will drainage system be provided with required traps, cleanouts, and vents? (/ '-.
Town of Queensbury AFFIDAVIT
County of Warren
State of New York
I swear that to th v,-.).r of my know,ledge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, are a true and co.e.plete statement of all proposed work to be done on the described premises and that all provisions of the BUILD-
ING CODE,THE ZONING ORDINANCE,and all other laws pertaining the proposed work shall be complied with,whether specified or not,
and that such work is authorized by the owner. 11
Sworn to before me this Signature
" • ! G'/It;�
`_ OWNER,OW ER6A ANT,A HITECT.CONTRACTOR
S day of....0 .. / 19..J.� //
NOTARY PUBLIC, WARREN COUNTY, N. Y. ,
SPECIAL CONDITIONS OF THE PERMIT:
•
•
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 followingo
1 . Gross floor area ..!:� -3° .� . .J. :... . .
2. Type of heat C� j r'•=7 i- -- .. .. . .
3. Is the building mechanically cooled? .P.2.0 .. .. .. .. .. ... .... .
AL. Percentage of area of windows and doors .. .
A. Over 16% Only
1 . U0 value of gross area of walls, roof/ceiling and floors exposed to ambient
conditions ... .. .
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 o
1 . U value of roof and floors exposed to ambient conditions
2. U value of exterior walls
3. U value of glazed area ; (o 7
4. U value of doors 6)1 • . .. .. .
5. U value of floors over heated spaces
6. R value of slab edge insulation - unheated slab
7. R value of slab.insulation -heated slab
8. U value of heated basement/cellar walls (above grade) ..
9. Rvalue of heated basement/cellar walls (below grade) .. .:.
10. Type of insulation . .. ... :C 9 Y'. 1 5._�, ... .... ..
C. Controls
Trmostat maximum heat setting 4-
D. Duct Systems
1 . Is duct system installed in unheated spaces? YES NO
a. If YES, R value of duct insulation
b. R value of duct in other areas .. ..
E4 Piping Insulation
1 . Size of hot water or cooling carrying agent pipe
2. R value of pipe insulation
F. Service Water HeatIm
I . Performance efficiency ... ..... . . . .........y .. .
2. Temperature control setting maximum .l Ltg _ .. . .. ..
G. For Swimming Pool Only
1 ,. Maximum Heating
Telephone No. 7q3 ,3 S&2
Applicant's i attire
•
TOWN OF QUEENSBURY
BUILDING..AIM) ZONING DEPARTMENT
BAY AND HAVILAND ROADS, R. D. #1
GLENS FALLS, NEW YORK 12801
APPLICATION FOR A PERMIT TO CONSTRUCT, ALTER OR ENLARGE
A SEWAGE DISPOSAL SYSTEM WITHIN THE TOWN OF QUEENSBURY
OCCUPANT°S NAME an 122A7,6 i 4EL I ADDRESS 20 /1�i a`a �` ®`/
TELEPHONE 73, s: OWNER'S NAME
ADDRESS NUMBER OF BEDROOMS
GARBAGE GRINDER? 17() (YES OR NO) TOPOGRAPHIY: FLAT, ROLLING, STEEP, SLOPE ,
GENTLE SLOPE, OTHER F147'--
NATURE OF SOIL: CLAY, SANDY, LOAM, GRAVEL, ROCKS, ETC. 5 iiikikjc�
PERCOLATION TEST WATER SUPPLY: MUNICIPAL, WELL, OTHER M64 is icy%
DIAGRAM or PROPOSED SEPTIC SYSTEM
11
OTHER PERTINENT INFORMATION l o7-7) ���e , �✓ `
IT IS HEREBY AGREED THAT IF THIS APPLICATION AND PLANS ARE APPROVED,
INSTALLATION. OF SEWAGE DISPOSAL FACILITIES WILL BE MADF IN ACCORDANCE,
WITH DETAILS SHOWN.
DI TE A/. /97 SIGNATURE OF APPLICANT it
LARE GE ECf
PARKCOMMISSION APPROVAL: (signature
(date..
'i:aT,:a•4.. a•, •.).74,).."..x•,!a•,tati-,.•x •,.,Y.,•-1.•As•,ta•.a•.tx tia•..-a•.at a•,1 "AaP.tATI,a n,,,t>.•..,.9•KxP�a•.c.A x•.a•,t�"x 14.�•21•�4t�)."ti�N-4.94.,',Pti-11:,P.laPti�7-!,aAtia•4ta•,tr-9,t.-x•� •,Sa9.-a i_�.
er WI
j THE NEW PORK BOARD. OF FIRE UNDERWRITERS , �
�I BUREAU OF ELECTRICITY '•
ti 41 STATE STREET,ALBANY,NEW YORK 12207 . '�
Jo I 1
►; Date •' Application No.on file /� _ " f�.P . ` '
A n cn .�r ..., L' Y
1 THIS CERTIFIES THAT 'i
' only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of ;r
coca .° .s7.^L:.',.. --r ._ Y
: in the following location; s❑ Basement ❑ 1st Fl. ❑ 2nd Fl. Section Block Lot a
was examined on °J 1 f,.1.2 1 00 _and found to be in compliance with the requirements of this Board. ;T
_CI T
!p FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS ;i
RECEPTACLES SWITCHES - MERCURv r
i OUTLETS INCANDESCENT FLUORESCENT • nf-8 AMT. K.W. AMT. K.W. AMT. K.W.. AMT. K.W. AMT. H.P: IC
'Y
.:1 �a
ii
W r
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS 'Y
SYSTEMS
'AMT. K.W. OIL H.P. GAS H.P. ;IAMT. -, 7. NO:,..'. "AvW.G. AMT. AMP. AMT... 'AMPS. TRANS. -AMT. H.P. NO.OF FEET 'AMT.- WATTS ,Y
g; SERVICE DISCONNECT NO.OF S E R V I ' C E ;T
•i AMT. AMP. i1.pE METER 1,B,2W 1:9'3WT 3,0'3W 3,0"4W NO.OF C.COND. A.W.G. NO.OF HI-LEG A.W.G. NO.OF NEUTRALS' A.W.G. ;la
EQUIP. PER B OF CC.COND. OF HI-LEG OF NEUTRAL
,p 2 ,Y
tti
-' e s) L:_, '.?. Ica ;. r" /i ,Y
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i,i OTHER APPARATUS: rT
•I r-'4._"-';'p..H( P.C�J i r :::.i.1 ci <"., I:, 2 .,%a. p tix.`: .'I. e,-i_ ':.7'1, 2i: 'Y
<',j yr- o `' 7 h' �' �`r'ias r
it 2- ` .43 k-, —`,;c�Q! G P:` `:r=�Z'.i:_.,',a 'i.
,
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i. P.
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� T�4� INSPECTION
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=(. ._,. - L' ^lam :;,�._ �r�
cC1 �`'..._.... ,_'.i'- -,%'.1.:,,: ) .l'vl `J . I y�': : ,v`;,k4jL BRANCH MAN
AGER NAGER ,:-
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Per
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'CY`fYYYYY YY&YY YY YY'YY YY YY YY YI'YYiYYYY'YY YY YY Y'/YY`YAYYYY'CY Y'(YYYY`CYYY YY'YY rY FYYY YY`'l YY YY Yl'YY YY YY'Y7 YY-Y'YY YY`Cl.YY YYYY YY YY YY r9 3.1'
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE.ALTERED IN ANY MANNER. 1
•
TOWN OF QUEENSBURY
Building Department
Inspectors Report }, Date 2— S= 8d
Name A7 n7., , •
-
Location 7e / /a
Permit No. Cod I I Weather
Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill •
Final Survey ��
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves
• Wall Board
Ext. Porches
Finished Floor
Interior Trim l
Stairs & Railings e/
Cellar Dr. Tile
Concrete Floors
• Plbg. Fixtures
• Gar. Fireproofing
Door Closers ! •
Chimney
Water Meter Inst.
Septic-Approval
Floors '
Insulation Foundation ' •
Walls
Coiling
✓i
,Y
Building nspector
REMARKS
Ale e
•
•
TOWN OF QUEENSBURY
• Building Department
Inspectors Report Date / 24 J
Name `-7/ 4/,AJ /
Location .
Permit No. Gri ( Weather
r Remarks
•
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing _ V
Sheathing i
Roof Felt
Roofing
Siding
Masonry Veneer _
Rough Plbg.
Relief Valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railings
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures j
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors '
Insulation rcundatic.n j
Walls
Cei .zng i
11
Building .Ins._ actor
•
REMARKS
/4006--c �_S f `cam
TOWN OF QUEENSBURY.
Building Department •
Inspectors Report • Date
Name
Location
Permit No. (a a /7 Weather
Remarks
Excavation i
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing I
Backfill
Final Survey
Framing _
Sheathing
Roof Felt
Roofing �_ T
Siding
Masonry Veneer _
Rough Plbg.
Relief Valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railings 1
Cellar Dr. Tile
Concrete Floors
Plbg.. Fixtures
Gar. Fireproofing
Door Closers j
Chimney
Water Meter Inst. ; .
Septic Approval ! _
F%oors '
Insulation F`T7nd t-�`.2
[%a l l s •
•
Ceiling
Building Inn2ctor
REMARKS
TOWN OF QUEEM5BURY.
�uiIdi �. Department
Inspectors Depart Data J-4 -.73
Name `-i kyek mw{.,
Location
Permit No. 46 /9 / asn.:,,kt,
• Remarks
Excat>ation
Footing Forms
Footing & Piers
Foundation
Cement Coat _.
Waterproofing
Backfill 1_-
Final Survey
FramingL-
Roof 57--
Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves 1 _
Wall Board
Ext. Porches
Finished Floor
Interior Trim j -
Stairs & Railings i j
Cellar Dr. Tile j
Concrete Floors I /A\
Plbg. Fixtures
Gar. Fireproofing /l
Door Closers \\1._ —^
Chimney
Water Meter Inst,
Septic Approval _ -
F''i::'2dC' .':L c.-i j
Insulation 'Wall
•
r r d +�" ..///J
Building 1.Inspoctor
REMARKS
•
TOWN OF QUEENSBURY
Building. Department
•
Inspectors Report Date 2s 7j
Name_- �lr
Location // ./s /y�
Permit No. fv b I q / Weathesr
Remarks
Excatation }ter
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing
Sheathing
Roof Felt
Roofing iV
Siding /F`
Masonry Veneer
Rough Plbg.
Relief Valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs &Railings
Cellar Dr. Tile
Concrete Floors'
Plbg. Fixtures •
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation
Walls
Ceiling '
Buildin In e for
•
•
REMARKS •
TOWN OF QUEENSBURY.
Building. Department
Inspectors Report yDate P/f 2/7,
Name DOA/ ®2/ , ,O
Location l'i / � -�L/
Permit No. (Q 0 I / Weather;
• • Remarks
Excatiation (% .)(
Footing Forms
Footing & Piers f
Foundation I •
Cement Coat
Waterproofing •
Ba ck.fi l l •
Final Survey _
Framing
Sheathing •
Roof Felt •
Roofing •
•
Siding T
Masonry Veneer L \,
Rough Plbg. -
Relief Valves
Wall Board
Ext. Porches \ /
Finished Floor Z _
Interior Trim
Stairs &Railings
Cellar Dr. Tile / __•
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
- Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation Founda.tic5n j
Walls
Ceilin
IBuildi1g inspector
REMARKS
TOWN OF QUEENSBURY
Building Department
Inspectors Report 1 Date p-.,R-
f�7
; Namect
Location :.j
Permit No. /(ci (C4 Weather
Per Cent
Complete Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing
Sheathing ;`,
Roof Felt \ �J
Roofing \.
Siding •
Masonry Veneer
Rough Plbg. 7
Rough Htg.
Relief Valves
Wall Board
Ext.Porches
Finished Floor
Interior Trim
Stairs&Railings
Cellar Dr.Tile
Concrete Floors
Plbg.Fixtures
Gar.Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
/./
Building Inspector
REMARKS