8120 C/O Paid
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date _ _ January 26 19 84
This is to certify that work requested to be done as shown by Permit No. 8120
has been completed.
This structure may be occupied as a One-Family Dwelling
Location Lot 9 Pine Wood Hollow Road
Owner C. C7_ Wnna hiiry ( Pe)n171
By Order Town Board
TOWN OF QUEENSBURY
Jfit
•
' ) Bu iig & Zoning Inspector •y.
•
'-I
•
CREATIVE ••INSTA• PRINTING. GLENS FALLS. N Y 12801 15181793=5658
• •
• . •
, •
•
C/O Paid
TEMPORARY
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Dec. 29
Date 19 3
•
.•
This is to certify that work requested to be done as shown by Permit No. 8120
•
has been completed.
This structure may be occupied as a One—Family Dwelling
Location Lot 9 Pine Wood Hollow Road
Owner C. G. Woodbury (LaPoint) •
TEMPORARY CERTIFICATE OF OCCUPANCY By Order Town Board
FOR 30 DAYS
TOWN OF QUEENSBURY
•
•
)
( Building & Zoning Inspector
•
CREATIVE ••INSTA- PRINTING. GLENS FALLS. N V 12801 15181793-5658
BUILDING PERMIT
TOWN OF QUEENSBURY ' 8120
No.
WARREN COUNTY, NEW YORK •
PERMISSION is hereby granted to C. G. Woodbury (LaPoint)
5T. //.. 6
OWNER of property located at Lot 9 Pine Wood Hollow Road Street, Road or Ave. Op
in the Town of Queensbury,To Construct or place a One—Family Dwelling
n
at the above location in accordance to application together with plot plans and other information hereto filed and h<
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
t:+
1. OWNER'S Address is
679 Upper Glen St. 'b
Glens Falls, New York H•
• rt
2. CONTRACTOR or BUILDER'S Name
same
3. CONTRACTOR or BUILDER'S Address
0
same rt
4. ARCHITECT'S Name IT/
(D
5. ARCHITECT'S Address O
G
. O-
6. TYPE of Construction—(Please indicate by X)
O
(x) Wood Frame ( ) Masonry ( ) Steel ( )
rd
0
7. PLANS and Specifications
28 'x54 ' per plot plan, specifications and
No. application submitted including two car
attached garage and sewage system.
8. Proposed Use
One—Family Dwelling
0
$5. 00 C/O Paid
108 . 00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 1 19 84
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 23rd Day of September 19 83
N
SIGNED BY 'f�'I o �L. -�, �� for the Town of Queensbury
Building and Zoning Inspector
TOWN OF QUEENSBURY (Space inside block to be filled in by
WARREN COUNTY, NEW YORK Building Inspector)
Application for Application No. .
Permit Issued 19. .
BUILDING AND ZONING PERMIT 1',•1-,,,it Expires. • 19.
/.( inng. District .
•
\ :iluc of Work ____).
THREE (31 Copies of a PLOT PLAN, Drawn to scale •\1'1".""•c1 by
showing the actual dimensions of the lot to be built. 1zi•iii.ii)($ .
upon, The exact size, and location on the lot of the
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION. .
? TOWN OF QUEENSBURY
J DATE
[R,
0 E [1 V E I))
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK •
SEP 2 01983
ANSWER ALL OF THE FOLLOWING. Fe Psi I CI
A.M. 113. 00 - P.M.
The undersigned hereby applies for a permit to do .the following work 7lglgi10�11)12�1�2,3� �5I6
which will be done in accordance with the description, plans and specifi- ,a ' ° '
cations, and such special conditions as may be indicated on the permit.
c.46 i Ii c.:
The owner of this_property is:
(NA`4E) (P.O.ADDRESS)
The person res nsibie for •supervision of the work insofar as the Building Codieand the Zoning Ordinance apply is:
67
(NN/AME)�E) „,,P 0.AT:TESS)
Name of Builder. . C....1! ' Ir3B`7� � �9 Address . . . !.1r-r
Name of Plumber. . .I.',/(--)C-1 4 )`.ram r\ Address - . .&F,..... �'
Name of Mason'P I/ )' ""—d—\, 4 Address .
Lot Number Una i Estimated value of proposed work t '�' ' -?
Name of Village. . . . 1•-1 / (fit��/ /Name of Streee '�'-C " �r'k' 1 I Side of street: north 0, east 0, south O. west/�,
Nearest Cross Street . ) T '' �r .Distance from this cross street Ft.
Property is north ❑,south ❑,east west CIfrom Cross Street
..rLf,,
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
Construction of a new building. • Main Building
CI Addition to a building. , . • One family dwelling
D Alteration to a building. Two-family dwelling ❑
❑ Demolition of a building. -family apartment house D.
Store building ❑
.72�car attached garage
Other:
• • Accessory Building
One-car detached garage ❑
Other work. Describe Two-car •detached garage Cl
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 buildings) in dotted line and existing
building(s) in solid line.
Size of property ft. x ft.
Size and use of existing buildings, if any
H
s w Size of proposed building ... • • . . ft.x' ft.
Height (from grade to ridge) ft.
Front yard • ft.
Side yards • ft. and ft.
Rear yard 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.? f"/•
Will any second-hand lumber be used? . a,�. . .• • . . . If so, for what' ,(.�.i)
Material of foundation walls `� �" 1 Thickness . . . . ,�
Depth of foundation walls below grade / c.
Continuous foundation?
Will there be a cellar? H Ts If so, material of cellar floor _� y �, R
Type of roof: Sloped or flat? -L Material of roof A -y
,. . " x ", spacing . . . ) ."o.c., length. . .R' ft.
Size,wood studs • • '
Size, floor beams, 1st floor "x f . • ", spacing ( p— "o.c., span . . . . . . : —. . . ft.
Size, floor beams, 2nd floor . . . ' _ " x . . . ", spacing 1. "o.c., span ft.
Size, ceiling beams -L.
19x • • • ", spacing "o.c., span I ft.
Siie, roof rafters or beams L.—. ' x ", spacing . . . .� "o.c., span . . ./a. ft.
Exterior finish . . l. ^ �' % . With what material?
Finish of interior walls. . . . . . . . . . . . . }o�j"`'�-�. �`.� 7"
If garage is to be attached, of what material is wall between garage and main buiging to be constructed?
Is there to be an opening between garage and building? . . .H
Kind of heating system . . . . .� . : 1al' Oil burner or coal?
Will a flue-lined chimney be provided? 'NI�. Depth of chimney foundation below grade
Height of chimney above roof
Will there be a fireplace? - ., ,. Depth of fireplace hearth
Will a toilet be installed •i-.
Will a kitchen sink be installed and connected to water supppi ? 1' 'Q
Water supply (public water supply or pump) cc u i I L
Distance of cesspool from any private well .� `^ feet
Will drainage system be provided with required traps, cleanouts, and vents? .)1' '� 2
Town of Queensbury AFFIDAVIT
County of Warren
State of New York
I swear that to tr be j of my knowledge and belief the statements contained in this a lication,together with the plans and specifications sub-
mitted, are a true and co.n.plete statement of all proposed work to be done on the esc bed premt d that all provisions of the BUILD-
ING CODE,THE ZONING ORDINANCE,and all other laws mm
\ ng to a pro sha Y work co plied with,whether specified or not,
and that such work is authorized by the owner. p� V v\
Sworn to before me this Signature 1��,
OWNER.OWNER'S AGFTT. CHITECT,CONTRACTOR
day of 19
NOTARY PUBLIC, WARREN COUNTY, N. Y.
SPECIAL CONDITIONS OF THE PERMIT: .
•
•
By
TOWN .OF QUEENSBURY
BUILDING & ZONING DEPARTMENT
SEWAGF DISPOSAL PERMIT APPLICATION
1. Owner' s Name C, , � ��1 �?1 ,•
Address
�j
Telephone No. -7 1 -' �1
2. Property location
3 . Name of person or firm responsible for installing system
Telephone No.
Address
4. Number of. bedrooms (residential buildings only)
5. Daily flow gallons/day
6. Septic tank capacity gallons
410 7 . Topography: rolling, steep
% of slope
8 . 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,hell, other
12 . Type of system proposed: drywell, tile 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 i tion 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 OF. QUEENSBU,RY ..-. '.
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: d
1. Gross floor area • • I �''' .
. 2 . Type of heat (�
the building mechanically cooled? y `✓
3 , Is ,
4 .
Percentage of area_ of windows and doors ( 3
- A. • Over 16% Only .and floors
-1 . Uo value of. gross area of walls , roof/ceiling
" exposed to ambient conditions
2 , Floor over heated sp
aces YES . NO
. a. Are. foundation walls insulated? YES
Na'
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
•
g. Under 16% Only
- 1. R value of ro f and�;;fl0000rs exposed to ambient conditions_
V� U
2 . R value of exterior walls
3 .• R value of •.glazed area: /
, '
4 R value of doors . . ."._ .
5 . R value of floors over unheated spaces
6_. R value of slab ' edge insulation - unheated slab .
7 . R value of slab insulation'.- heated slab
B . ' R value of heated basement/cellar walls (aboye .grade)
9 . R value of .heated basement/cellar walls (below grade) • .
•
10 . Type of insulation
C... . Controls : . .
1 . Thermostat maximum heat setting
D. Duct Systems NO
1. Is duct system installed in unheated spaces? YES
a. . If YES , R value of --duct installation .
. b. Rvalue of duct inother .areas
E . Piping Insulation agent. pipe
1. Size of hot water or cooling carrying
•
. - 2 . R value of pipe insulation
F . Service Water Heating •
1 . Performance efficiency maximum
2. - Temperature control setting
•
•
G. For Swimming Pool Only
1 . Maximum heating
Telephone No. (applicant ' s- signature
•
BUILDING DEPT.COPY OF APPLICATION FORM 46-EL.NEW YORK BOARD OF FIRE UNDERWRITERS.
FILE THIS COPY WITH BUILDING DEPT.WHEN REQUIRED.
CITY OR ,y � \\\
VILLAGE V \ < 1>U V--'/ TOWNSHIP J -- • COUNTY " �r�
ROAD AND POLE NO.STREET AND NO.OR ��I. p K .a04 J`. �%'y,_f S- Y 1/�Z.r.-�/.2 �"L - .
1�� POLE NO.
BETWEEN WHAT TWO i_ . - - '
CROSS STREETS ISM •
PREMISES LOCATED? SECTION . BLOCK LOT
OCCUPANT'S // 9 •/' BUILDING. - / /
NAME �C( / O / ,✓( J
OCCUPANCY ( c1( ) L G4/ „4..Jl'7
f.
OWNER'S
ANDADDRESSE C/ "'' �q„yt'' 2 tit) ('-. ' . C')-' .
CURRENT
SUPPLIED / ✓J ram-"
BY i \ a FROM THEIR / J� (r OFFICE
SBUILDING NEWS. OLD❑ REMODELED ❑ SORK NEW ADDITIONAL❑ REMOVED ❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETS No.of Fixtures MOTORS HEATERS BRANCH LAMP S
Lamp ReceptaclesCIRCUITS
Loca-
tion
Ceiling Side Attach't Switch Pendent Bracket No. Type H.P. No. Watts No. A W.G. NO WATTS
Wall Recept'ls Each EachGauge EACH
Out- I
side
Sub-
base
.Base-
ment
1st Fl. .-2nd Fl.
3rd Fl.
•
•
REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: - DO NOT USE THIS SPACE.
•
•
This application is intended to cover the above-listed equipment to be inspected but if at time of inspection there is found additional equipment not above listed,
you are authorized to make the inspection and adjust the fee to cover the additional equipment,as provided by the applicant.
SIZE OF ELECTRIC SIGN TOTAL
MAINS FEEDERS LAMPS WATTS •
CHARACTER EXPOSED GAS TUBE SIGN
OF WORK CONCEALED TRANSFORMERS OF VA
WORK TO BE (NUMBER) (CAPACITY)
STARTED COMPLETED SIZE OF SIGN _
SERVICE MAKER
ENTERS
_ BUILDING OF SIGN
INSPECTION REQUESTED - -
ON OR AS NEAR AS n
POSSIBLE NEW OLD I I
• AVOID DELAY BY GIVING FULL AND ACCURATE'INFORMATION.-ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
NAM OFAPPLE CAN ��i t'Y' ° APPLICATION DATE OFN ,
� u fi ` )
STREET ADDRESS �� �( I
J� _.
CITY OR -t .., - ZIP --�, LICENSE NO.
POST OFFICE t '-) t CODE WHEN APPLICABLE
A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING
'J,4-1".C�_J.Al e.1.)_ !l_miIJJ.V.%)_n.17iV_•4.9.1.._C ..p"4IA�.1!�A.... CJ..CJ sU..V %_, Jed%J19,V_9,!-I _��n J.!..INCJ_RAJ A-kir/.0.1.).C.1_C." .)."tl.A._9/. .J_ ,"/.)J/. p,, •AJ_I? 0!
.•. /. .a9%".a a"/..movi-oi. ,,l.,)!' --
u.. t,
_= ,. THE NEW YORK BOARD. OF FIRE UNDERWRITERS
4 k, BUREAU OF ELECTRICITY y -
�' -, 41,STATE STREET,ALBANY,NEW YORK 12207 'P
-- Date Application No.on file +
r !, THIS'CERTIFIES THAT -
only the electrical equipment'as described below and introduced by the applicant named on the above application number in the premises of y
�' 'f -� �� ti - ,�f.! -' '-t -,;- faq=•`�� T.',i`' T, T-;q I_.- ^�r+� �: •t"r`+�,'d 4^ =1_ ,r
10 �'fJ U1.;y .L42.`irtjb:a' h:_l0 s i .urea �..4i._- OW :.) :i uLd. `,,V, ..;J:_.>_ ;-
_- . in the following location; ❑ Basement III 1st Fl. ❑ 2nd Fl. Section Block Lot o-
, was examined on • -2 9 ;e',, and found to be in compliance with the requirements of this Board. ;y `
--
— . i r
= ; FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS ;1•
-� 1, OUTLETS INCANDESCENT FLUORESCENT MERCURY -
•, VAPOR AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P: - '
— -' DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS ,r -.
' STEMS ;i -
:' -AMT. K.K.W.W. OIL H.H.P.P. GAS H.P. AMT. NO. A.W.A.W.G.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.H.P.P. NO.OF FEET AMT. WATTS : _-
'4 '�• 1Y'c� 'r?:11 .41 r
' 2 SERVICE DISCONNECT NO.OF .i. ';±t a't- S ",' trb I E R V I C E
AMT. AMP. TYPE EQUIP 1,B'2W 1 If 3W 3,B'3W 3 2 4W NO,OFFER CCOND. OF CC.COND. NO.OF HI-LEG OF.HI LEG NO.OF NEUTRALS OF NEUTRAL 'T
.T
it ,7.r J, r5 77 >r r ,r .-
OTHER APPARATUS:
(i _
!( ,r'
is .r .:
� u ,
-j 1f
, =
L: t`�a _ ....
— e .'L:li $✓t D. ..e',e. '.-e -'y...Y
— .•it d CY;1 .. '_!11 .'i ,D .,ti a' .T.:7 r c ti'�l: 12,: 9 BRANCH MANAGER 'i ;:
ilk, r
- K' Per ,;, _
— ''CYYYYYYY YY YY Y`/YY YY YY`GY YY YiiiYYYYafrYYYY14e?'Cie IiYYiY YiYYii-ie?i'V-%ii'YYiY'4Ylii-iV ie'rei YlkYYiiY'%YY YYeYY YY YY YY YY YY-i'Y-i i'i YY YY i'YY'7'Y'i i'1 YY YY 17
COPY FOR BUILDING DEPARTMENT.THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
TOWN OF•QU'EENSBURY
Building Department
Inspectors Report • Date /2/i 7/1.3
Name_C ,.. c4/11-06 4(
Location c.a.,- -#'9 (M U /, 1e rebil7 -
. Permit No. P rg p Weather
Remarks
Excavation
Footing Forms
Footing & Piers
• Foundation
Cement Coat
•
Waterproofing
Backfill I
Final Survey
Framing
Sheathing /,
Roof Felt /
Roofing
Siding /
Masonry Veneer / \
Rough Plbg. /
Relief Valves ,/
Wall Board /A :\
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
Ceil
• Build n nspecto
REMARKS
Si d <6 p5c.70--c ---- Olc
1/iV/ L- EL c lC iJ ' r
I- 01 i/a.6/Xy •
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date/// �
Name ZeA 17(
Location Pi A3 E dr , 1 h t ,2
Permit No. l' 5 Weather
‘97- -f 9 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 1
Wall Board J
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railings
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst. T
Septic Approval ///
Floors
Foundation
Insulation
Walls
'Ceiling
'47B111i1 ing Inspe or
REMARKS
7/4/
C iI�
o -b9c
.,4
71/ j-,e4 {e&C
TOWN OF QUEENs•BURY
Building Department
Inspectors Report Date
Name -17-Q
Locates y HA-it/Ili/—
Permit No. X/.,2 0 Weather
Remarks
Excat)a t on
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 /J
Interior Trim
Stairs & Railings
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Foundation
Insulation Walls
Ceiling
77fl,L (Buiming In4pector
REMARKS
r
,e
Vol
Y r _
r
. .
o, r
-
` -
yy 4 r * '
AW
lot
t x:
t
{
p�
.Y.y
Tv
—YW
x ,
i
�r z
1�
r
• . d
„
tt
y
'