1991-851 r f
f
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date April 7 19 92
This is to certify that work requested to be done as shown by Permit No. 91-851
has been completed.
This structure may be occupied as a s i nal a family dwelling
Location Lot 40. Herald Drive, Herald Sauare Viliane Suhdiuieinn
Owner Guido Passarel l i
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
BUILDING PERMIT
a
TOWN OF QUEENSBURY No. 91-851
WARREN COUNTY, NEW YORK
0
PERMISSION is hereby granted to Herald Square Village
cri
OWNER of property located at Lot #40 Herald Square Street, Road or Ave.
0
in the Town of Queensbury,To Construct or place a Single Family 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. m
1
1. OWNER'S Address is —�
45 Herald Drive CI.
Queensbury, NY 12804 v'
2. CONTRACTOR or BUILDER'S Name CD
Passarelli/Cerrone
3. CONTRACTOR or BUILDER'S Address
I-
0
4. ARCHITECT'S Name
V
5. ARCHITECT'S Address
fD
Cu
P
6. TYPE of Construction—(Please indicate by X)
( X Wood Frame ( ) Masonry ( ) Steel ( )
7. PLANS and Specifications
No. 1,176 sq ft Single Family Dwelling as per plot plan specifications
and application
8. Proposed Use
Single .Family Dwelling
$ 179.00 PERMIT FEE PAID —THIS PERMIT EXPIRES December 11, 19 92
(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.)
Dated at the Town of Queensbury • D f December 19 91
SIGNED BY / for the Town of Queensbury
Building and ning Inspector
TOWN OF QIEENSBURY
/f
Alitti
REVIEWED BY: :! 4e47 i r
eis FEE PAID: 0,
117
PERMIT NO. : ,,� ; OF QUEENS :-.
�l—��� _ ,Q gy
BUILDING PERMIT APPLICATION
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. NO INSPECTIONS TWI'LL•B1 MADE (JNT L
APPLICANT HAS RECEIVED A VALID BUILDING PERMIT.
All applicants spaces on this application MUST be completed and the signature of the
applicant. MUST appear on the reverse side of this application.
Owner of Property: a '
P.O. Address: Or _ Pre . ‘,:ee14.4.6e,iPHONE Yr- s_r?0/2/
Property Location: !� 4J Tax Map No./, S g / /D
Has there been any split of this property since October 1, 1988? Yes No
If yes, Planning Board Review is necessary.
Subdivision Name, if applicable: Avy / 4--- Lot No. 4/0
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
PHONE
NATURE/OF PROPOSED WORK: * ESTIMATED MARKET VALUE OF THE
Construction of new building * CONSTRUCTION: $ 9,C .moo �—
Addition to building
Alteration to building * COMPLETE INFORMATION REQUIRED BE OW:
(no change to exterior dimensions) * Size of Property: /( ft. x 72j ft.
(der work (describe) * Existing Building Size:
• • . * ft. x ft.
* Proposed building - distance from
GROSS AREA OF PROPOSED STRUCTURE: * property line:
s�� Ap:
*1st Floor f Sq. Ft. * Front Yard _Oft. Rear yard 5-�ft.
r Side Yards ft. and ft.
2nd Floor Sq. Ft. cq * If on corner, setback from side street-
*
Other Floors Sq. Ft. * �� ft.
(not cellar or basement) * OCCUPANCY INFORMATION:.
TOTAL FLOOR AREA:7 la Sq. Ft. * Primary Building -
* I1 One Family Dwelling
Size of New Structure: 7r ft. x * Two Family Dwelling
Foundation: * Multiple Dwelling/No. of Units
Pier/Slab/Crawl/Partial/Full (Circle One) * Business
* Industrial
No. of stories (Habitable space) // * Other
Height (grade to ridge) 7,2-- ft.
If residential , no. of families: / * If addition, what will use be?
No. of rooms (excluding baths): ,6.
No. of bedrooms: * —
•
No. of bathrooms: I * Accessory Building:
TypePrimary healing system: �, , /- A�,.2 * Detached Garage - One/ .
Attached Garage - One'.Two Car.
No. of fireplaces to be installed: * Private Storage Buildini -
Will a woodstove be installed?: * Other
Central Air Conditioning: Yes ✓� No *
(OVER)
•
BUILDING PERMIT APPLICATION CONTINUED:
BUILDING SPECIFICATIONS:
Type of construction: wood frame, fire safe, etc. �jfia ;e
Will any second-hand or ungraded lumber be used? If so, for what? /42'
Foundation Wall Material : '� /�
� r �� z��.��; Thickness: F
Depth of Foundation below grade (to bottom of f• ' - V1‘
Will there be a cellar? Heated o '1�-. Floor Sq. Footage:
Will there be a basement? Will any portion be used as living space?
If so, what portion? Sq. Ft. Type of Use?
Type of Roof:<1 pel/Fiat/Sh d/Other Material of Roof , 1
Size, wood studs 2 x " ; spacing 46" o.c. ; length ft.
Joists (floor beams) : 1st Floor " x /O spacing 6 o.c. ; span y ft.
Joists (floor beams): 2nd Floor " x "; spacing " o.c. ; span ft.
Overlays (ceiling beams) : " x "; spacing " o.c. ; span ft.
Roof rafters: " x " ; spacing o.c. ; span ft.
Roof trusses (pre-engineered): spacing zy " o.c. ; span �k' ft.
Exterior Wall Finish: / ,6/ / of what material ?
Interior Wall Finish: (5;4' zi
If a garage is to be ttached, describe materials to be used for FIRE SEPARATION:
Is there to be an opening between garage and dwelling? fifer
If so, will a Fire-Rated door,
enclosure, self closing device be provided? (fel
Will a flue-lined chimney be installed? Height above roof ft.
Depth of chimney foundation below grade: ft.
Depth of firep rth: ft. in.
Water supply 'Municipa or private well :
SEPTIC SYSTEM: Distance from aia private well (including adjoining properties: ft.
(A separate application is necessary for any repair or new installation of septic system. )
NAME OF BUILDER & ADDRESS: AillaAj, Cam', o7(.c_ PHONE WI-S-11L/
NAME OF PLUMBER & ADDRESS: a - PHONE 47 _37 J
7
NAME OF MASON & ADDRESS: PHONE Z-Wte
NAME OF ELECTRICIAN & ADDRESS: �a��
PHONE ;372,--.7g J()
DECLARATION
To the best of my knowledge and belief the statements contained in this application,
together with the plans and specifications submitted, are a 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 Lx- 'ter'`
• Owner, owner's agent, architect
contractor
SPECIAL CONDITIONS OF THE PERMIT:
By:
Code Enforcement Officer
ENERGY CODE COMPLIANCE APPLICATION •
TOWN OF QUEENSBURY,. WARREN COUNTY - 9000 HEATING DEGREE DAYS
Compliance Methods:
PART 5 - Acceptable Practice Method - 1 & 2 Family Dwellings (ONLY)
PART 6 - Thermal Rating - Component Trade Offs - 1 & 2 Family Dwellings;
Multi-Family Dwel 1 i'ngs OF QUEENS -
(3 Stories or Less) R ��'+1=D
PART 4 - Design By Component Performance - Commercial Buildings - Hi-RiLsee ResiIreKtiaT
PART 4 & 6 - Compliance Methods Require Submission of Worksheets
APPLICANT S NAME PROPERTY LOCA
TION
ON
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1. Gross Floor Area - /f7t4 Sq. Ft.
2. Type of Heat - Elec. Base Board Other '4/!1 -RI
3. Is Building Mechanically Cooled? J/ YES NO
4. Percentage of Area of Windows and Doors Over 17% Z Under 17%
THE R-VALUES GIVEN ON THIS SHEET MUST CORRESPOND TO REQUIRED
THE R-VALUES SHOWN ON PLANS SUBMITTED!
Baseboard
5. Insulation Values: Actual Shown Elec. Heat Other
A. Roof & Floors exposed to ambient temperatures R
B. Exterior Walls R /9
C. Glazed Area R
D. Exterior Doors - R 1/
E. Floors over unheated spaces R
F. Edge of Slab on Grade (Heated Building) R
G. Basement/Cellar Walls (Above Grade) R_47_
H. Basement/Cellar Walls (Below Grade) R '9
I. Heating/Cooling - Ducts - Piping in Unheated Space R
6. Service (Domestic) Hot Water Heating Device
A. Conforms to minimum efficiency per code. YES NO
TEMPERATURE CONTROL MAXIMUM SETTING 140° - WILL NOT BE EXCEEDED
. ea.APPLICANT' SIGNATURE / . AA A • TELEPHONE NU BER
{
INSPECTOR'S REMARKS: -
REVIEWED BY
TOWN OF QUEENSBURY
APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit #
Fee Paid
Date: ,11i q ReviewedvBy ' ;"Jrr=D
EENS ,
Z//-
t1.z
tiLOCATION OF PROPERTY FOR INSTALLATION: VCR
Owner' s Name: r' DEC,e- Ll�l;f'.� ' .
1991
Owner's Mailing Address: 2;/C- - p" �4pCODE DEPT
Installer' s Name: ( 1 earl" `—� Phone #:
Number of bedrooms (if residential ):
Total daily flow (residential-compute @ 150 gal . per bedroom) : 'V ob
Topography-Circle One: Fla Rolling Steep Slope % of Slope
Soil Nature-Circle One: Sand Loam Clay Other /Depth:
Ground Water-At What Depth? Feet
Bedrock or Impervious Material-At What Depth? Feet
Percolation Test-Circle One: Not Required Required/Rate Min. Per Inch
Domestic Water Supply-Circle One: Municipal Well Other
If domestic water supply is a well -
Separation: Water supply from any septic absorption feet
PROPOSED SYSTEM: Septic Tank /47-7 gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench 6?) feet//Total System Length ?-D'f) feet
Seepage Pit(s) : Number of / Size each: -ft. x ft.
Size of Stone to be used: # Depth or Thickness feet
**************
HOLDING TANK SYSTEM IF REQUIRED
No. of Tanks Size\of Each Gal .
Alarm system and associated electrical work to be inspected by a certified
agency.
****************
_ 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: C %� DATE:
Septic System Inspections:
A. All applications for septic system installation, alteration or repair,
as required by the Town of Queensbury Sanitary Sewage Ordinance, shall
be 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
2) location and distance to lot lines
3) location and distance to structures
4) location and distance to any water supply
5) size and dimensions of all tanks, distribution boxes, tile fields
and/or drywells
B. No system shall be covered before inspection and approval by the Building
Inspector. Failure to comply with this requirement may result in the
uncovering of the system by the installer and a fine of up to $250.00.
C. An approved copy of the plot plan shall be available on the construction
site. Failure to produce said plot plan at time of inspection may result
in an immediate work stoppage. -
D. Should unforeseen problems during construction prevent proper installation,
alteration or repair of an approved system, a new proposal must be submitted
to the Queensbury Building Department before further construction.
Town of Queensbury
Building & Code Enforcement
Department
531 Bay Road
Queensbury NY 12804
Remarks:
EMIDDf°
LE DEPARTMENT INSPECTION AGENCY; INC.� ' National Headquarters
-••/ 1337 West Chester Pike,'West Chester, PA 19380
APPLICANT COMPLETES THIS SECTION - Date: /2/9A/
City, Town or Township r' %1Z Zee„ 74i..-7 County /tip/e.L State ./ ,
rs
Location/Address /zi VC„) l{&/V
(If Located in Rural Area-Please'ttach Directions) Pole #
Owner -/;Z et; ,/ - tel{ Permit # / - 9/
Occupied As -,/ �Y �' Building: Newn Old
Occupant
Work Area in Building (Floor#,etc.):
App. for: Wiring Ti Service n or: Ready for Inspection:
Fee Remitted-$ Cash n Check n . M.O. n Make Payable To: M.D.I.A.
500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000
Number of Rough Wiring Outlets Elect. Heat
Switches
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. 1/201/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 1'/2 2 3 5 71/2 10 15 20 25 30 40 50 75 100
Mark Number
of Each Size
/
I
Applicant's / --`#
Signature te` d z-4. ,- License # Permit# _-_ _
T/A / Utility:
Applicant's Address: t1!F( �et? p (NAME) (OFFICE LOCATION)
6)r(City) .izoy2 ..-1� ., t.,r (State) ret,/.'7". (Zip) , .7fr-,V Service Request #
Phone # /., - r.. e/2, / Electrician: )' ,A.'?•et ,L;69lrj
MDtk USE ONLY DATE RECEIVED: DATE INSPECTED: -
Correct Location: Same as Above n or:
Red Notice Label n
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. 1/20 1/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 11/2 2 3 5 71/2 10 15 20 25 30 40 50 75 100
Mark Number
of Each Size
500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000
Elect. Heat
CERTIFICATIONS USE FOR INITIAL VISIT ONLY NOTIFIED DATE COFEECT FEE PAID
❑ RW Progress: Inc.❑ LKD❑ Contractor
❑ CFT Violation: Work Comp.❑ Inc. ❑ .
n L/A Owner CASH
n L/A Fee CHK #
Due MO #
n IPA Municipal
INV #
Applicant ❑
Date: Other Side❑ Utility • CI
Owner
Cut in Card n Temp # Date •
Final # Date •
INSPECTORS SIGNATURE
v� [ 'W\
TOWN OF QUEENSBURY
531 BAY ROAD
`/. • QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
_ _BUILDING ECTOR'S REPORT
FINAL INSPECTION
- J -
REQUEST FOR C-- D
NAME �,P/ o\
LOCATION jt,...71- O
DATE 1.-/
/71 C,2 PERMITS 9/
TYPE OF STRUCTURE -
RECHECK
FIRE MARSHAL APPROVAL (COMMERCIAL ST5,U CTURE)
L OOTING FOUNDATION BACKFILL Y FR ING
• OUGH PLUMBING FINAL ELECTRICAL SEPTIC
cNSULATION WOODSTOVE/FIREPLACE
REMARKS
APPROVAL
N/A YES NO
CHIMNEY HEIGHT/LOCATION •
B VENT/LOCATION 2(
PLUMBING VENT e�
ROOFING X
SIDING
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES )C
FURNACE/HOT WATER OPERATING % n
BASEMENT INSULATION/DUCTWORK / K
INTERIOR TRIM/PRIVACY DOORS /
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT; k
OTHER FLOORS SWEEPABLE ! ,✓ 7�
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS' ',
HAND-IOAPP€D ACESS /
SMOKE DETECTORS / n
BATHROOM FANStWHO6EHOU&E-EANS\ jC
ALL PLUMBING FIXTURES OPERATING X
GARAGE FIRE P OOFING ), X
DOOR CLOSERS, j'
O1HfR-FIR€'S-EPAf ION
'F ErD-EttIS E WAtL-S-
--BUMPS-TER--
SITE PLAN/VARIANCE REQUIREMENTS .
FINAL ELECTRICAL t,Po'J 5;7-¢- IC
OK TO ISSUE C/O OR C/C
COMMENTS I 9/�.`3% -g my- y- '91:�
E-",' friL,vi 1Zo Ats LA/ iff.fsi1L i
e nd�E-r YL T /1-6-4`r u.L--:S A.r0 r/v'-
ARRIVE /D;i•J
DEPART Jd:24' > L-•
IN P ��
ELECTRICAL INSPECTIONS
DUPLICATE MUNICIPAL RECORD
Permit No. /�9i ''C
CA
Owner • Px-sS/2 ezz-
Occupant /,, /°,�
Location JO I VO e�'/xe) c&
No. Street
au �.tJs3 Z /,
Town or City State
Installation as itemized on reverse side has been visually inspected pursuant to applicable codes.
Installed by R. Pe ,19
6
Date 47`--6 z /�'icas{�ector
MIDDLE DEPARTMENT INSPECTION AGENCY INC.
FORM NO.18 EL. 900 Haddon Ave.,Collingswood, NJ 08108
ROUGH WIRING OUTLETS� � H.P.AIR CONDITIONER
•��; SUS"TS / ,`g WIRING &CONTROLS FOR / w BURNER
Lf( RECEPTACLES H.P.PUMP
FIXTURES - K.W.OVEN
�07 MP.SERVICE EQUIPMENT H.P.GARBAGE DISPOSAL UNIT
CONMP.SERVICE CONDUCTORS / K.W.DISHWASHER
/(/ K.W.SURFACE UNIT K.W.DRYER
I/ K.W. RANGE . AMP. RECEPTACLE
/ K.W.WATER HEATER ly FRAC.H.P.VENT FANS
12t 6/Cc� I
40TORS N.P. I/20 1/12 1/10 '/e IA '/ % V2 '% 1 11/2 2 3 5 71 10 15 20 25 30 40 50 75 11
AARK NUMBER
IF EACH SIZE
4PPARATUS
.:, , (7<.--Ga'`-Cam/
. 47)). • . .
Jain of tueenJbur 4
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
•
• Queerisbury, New York 12801 •
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME' /-/�v-a./0) S U 0,r`-2-- .
LOCATION L -y r) /i 'Q/ cr&'(
DATE ` 3 / 7 PERMIT NO. 9/.--.0
SOIL TYPE Sand,. Loam - Clay -.
Percolation Required? YES 4 NO
Percolation rate - Min/Inch • / '
f •
TYPE of SYSTEM: .
Absorption field, total lengt h
Length of each trench' 5ei
li
t.
Depth of trenches 3-V ,{` . .
Size of gravel 2 / '
SEEPAGE PITS4Number of) 1 •
Size- - ft. X -ft/ .
Gravel size
PIPING: §ize Type
Bldg. to tank \ 'l . .
Tank to dist. bcx ye, 40 /dy'
Dist. box to field/Pit e/." 19 C
Openings sealed? ' YES NO Partial
LOCATION/SEPARA ONS: •
Foundation to an /Oft.
Foundation to abs rption _ 2ft.
Absorption tc lottine ?d ft.
Separation pf pits . 4 ft.
LOCATION OF SYSTEM ON PROPERTY(circle one)
Front - - Left' side - Right side -
COMMENTS
SYSTEM USE-.APPROVED YE NO .
, ' C- "
' Bui ing Ins ctor
01/86,md vi
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804 •
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION,RECEIVED 3p/9,_
NAME 1-leis(c
LOCATION 0� 9'J 'Z OP ,.
DATE PERMIT # 9 l U 5/
TYPE OF S RUCTURE
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS •
MONOLITHIC POUR FORM .
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS FOLLOWING
THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITEI
FOUNDATION/WALL POUR ;; • 1'
REINFORCEMENT IN PLACE {? /
FOUNDATION/DAMPROOFING 'r f
BACKFILL APPROVAL /
ROUGH PLUMBING ��;1
PLUMBING VENT/VENTS IN PLACE 1'
PLUMBING UNDER SLAB ,!
'FRAMING: r,
JACK STUDS/HEADERS a;
BRACING/BRIDGING_ Ph
JOIST HANGERS I ';
JACK POSTS/MAIN BEAM I _
HEATING ROUGH-IN v,"f ,
INSULATION: '
FOUNDATION WALLS INTERdIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R- • _
WALLS 1 R-
CEILING ;r R-' 9c,
DUCT WORK OR PIPING,IN UNHEATED
SPACES
REMARKS:
t i (1M (,L/6
4--
•
L • .1 IS ,Lib 61--" L
S L.Af
G.
ARRIVE :v -C!') • I �7t/
p
s f F ,q
ro
DEPART (C.. 9 t /��'�• t'
"INSPECTORL�
r
1)0
TOWN OF QUEENSBURY PM
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
. QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447 '
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME f/nd ',fr:.e (/,�l/�"; e_
f c/ n
LOCATION fog/ ! � ,�
DATE 6'�.?44' PERMIT # 9/" 1 S /
A
TYPE OF STRUCTURE I i°
RECHECK APPROVED
N/A YES NO
&FOOTINGS/PIERS • A
MONOLITHIC POUR FORM
NFO CEMENTJN_PLACE
THE C RACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 .URS FOLLO ING 111111
Po iCEBENI OF HE CONC''TE
MATERIALS FOR THIS PURPO IN SITE X
FOUNDATION/WALL PO
REINFORCEMENT IN PL' E
FOUNDATION/DAMPROOFI" r,
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENT: IN 'LACE
PLUMBING UNDER SLgB
FRAMING:
JACK STUDS/H ,DERS
BRACING/BRID:ING
JOIST HANG 'S
JACK POST /MAIN BEAM ,
HEATING R0 H-IN
INSULATIO :
FOUND ION WALLS INTERISR R-
FOUN TION WALLS EXTERIOR R-
FLO S R-
W LS R-
GEILING R-
/DUCT WORK OR PIPING IN UNHEATED
'`SPACES
REMARKS: POY-F-63
Ho J604TrC
10617,06 8 'W"IK_ / c.--18-- upftirpov„
--fir r2o,� r 21A/
ARRIVE Z%S-0 ,
DEPART 5
INSP CTOR
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