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8381 CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date 1 �hne 7 19 PI This is to certify that work requested to be done as shown by Permit No. rl n has been completed. This structure may be occupied as aO i a �r i�_'� u�:e`l.1_i �r Location Lot_ 1/' P r c,l_�_t1�,:, �?:�,a �tree-t_ i`Ic_ 23 Mar in C 'i08)]e Owner By Order Town Board TOWN OF QUEENSBURY Building & Zoning Inspector - - - CREATIVE "INSTA"PRINTING. GLENS-FALLS. N V_ 12801 1518.)793-5658 - - -- -. . - _ - -_ _. • • s 1 T F r:r P n R A P. Y CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK June227 84 Date _ _ _19 This is to certify that work requested to be done as shown by Permit No. 8381 has been completed. This structure may be occupied as a One- Family Dwelling rci Location Lot 14 Pin Wood Hollow Road - St. 17o. 23 Martin C e Mosk!er Owner Temporary Certificate of By Order Town Board • Occupancy pending final electrical.. TOWN OF QUEENSBURY Building & Zoning Inspector CREATIVE "INSTA" PRINTING, GLENS FALLS. N Y 12801 IS18)793-5858 A BUILDING PERMIT TOWN OF QUEENSBURY No. 8381 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Martin C. Mosher - pi OWNER of property located at Lot 14 Pine Wood Hollow Road Street, Road or Ave. fi Street No. 23 H. 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 n approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. O 1. OWNER'S Address is 15 Greenway North Glens Falls, New York m 2. CONTRACTOR or BUILDER'S Name same 3 3. CONTRACTOR or BUILDER'S Address same O H 4. ARCHITECT'S Name ro m 5. ARCHITECT'S Address oi- 0 6. TYPE of Construction—(Please indicate by X) 1✓ _o ( )Wood Frame ( ) Masonry ( )Steel ( ) O 7. PLANS and Specifications P 26 'x50' per plot plan, specifications and a, No application submitted including sewage system and two-car attached garage. 8. Proposed Use One-Family Dwelling $5. 00 C/O Paid $136. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES November 1 19 84 ' N (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the town of Queensbury before the expiration date.) Dated at the Town of Queensbury this 5th Day of April 19 84 �n l SIGNED BY /f�Ll� (,/� (. ki for the Town of Queensbury Building and Zoning Inspecto' , r t * ' ' `TOWN OF QUEENSBUR®Y (Space inside block to he filled in by WARREN COUNTY. NEW YORK Building Inspector) Application for \I,I�licatio!t No. PP Permit Issued I'l BUILDING AND ZONING PERMIT Permit F.\pires 1'1. %i,niii I)ktrirt THREE 131 Copies of a PLOT PLAN, Drawn to scale \I'I"" '`I 1"• 0 showing the actual dimensions of the lot to be built R'••t';.'"i upon, The exact size, and location on the lot of the building to be erected or altered MUST BE SUB- MITTED WITH THIS APPLICATION. I DATA A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK 1 'TOWN OF QUEENSBURY rECIEIYED -°-:. ANSWER ALL OF THE FOLLOWING. APR 5 1984 The undersigned hereby applies for a permit to do the following work �9 40 ne with the description, plans and eeifi- /. t P•N which will be done in accordance p p A.1fA,`�'L cations, and such special conditions as may be indicated on the permit. 7%8I9%1 112i 41 I6 e r e m e m m m C-PT e owner of this property is: l �� °� ZN- e, �7'I�l�-mil,c� / / -L.l� cc�.(-4. �'?ll' �/1 L�%L c,`h.`/ (NA - •.•E) IPVO ADDRESS) • Therson responsible for supervision of the work insofar as the Building Code and the Zoning Ordinance apply is: (NAME) (P.O.ADDRESS) Name of Builder �J� ' "• >71"`—c�u,+' Address �4-77,�. Name of Plumber ��i) � Address . . . -/4-9:�� Name of Mason ���"`-' Address . " ` �4!r"u-- Lot Number l 1/ Unit Estimated value of proposed work$ 1P 0� /- -z r `ei Name of Village ,1-ti-wvi.0— . Jt t Name of Street .f. j Side of street: north 0, east q, south ❑. west 0 a:5 Nearest Cross Street . L(""' 't:/• • Distance from this cross street ,.�/2" Ft. •0 Property is north 0,south 0,east ,,west ❑from Cross Street If on Corner, which corner, northeast ❑, northwest ❑, southeast ❑, southwest (Designate by marking with an "X" in the correct space.) NATURE OF PROPOSED WORK OCCUPANCY Construction of a new building. Main Buiitlang ❑ Addition to a building. One-family dwelling tRf • ❑ Alteration to a building. Two-family dwelling ❑ O. Demolition of a building. -family apartment house ❑ Store building . ❑ . . . A -car attached garage gf Other: • Accessory Building . One-car detached garage ❑ ci 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. Side and setbacks of pro- NORTH posed buildings,and the location of all existing buildings. Show proposed building(s) in dotted line and existing r:=L_I building(s) in solid line. A. Size of property ft. x �� `f €t. • Size and use of existing buildings, if any 31:1: ~ w Sizeofproposedbuilding ft.x .v`` O. . . ................... . ft.Height(fromgradetoridge) aO . ft.Frontyards .ft.( Side yards ' 0 ft, and `�� ft. p(4-�u�,,ti (�•v(�icA.44.) Rear yard �D ft. f'' ' SOUTH If on corner,setback from side street ft.. •. Note: All distances are nat, as measured from street side line to nearest part of building. (OVER) mow _ (cont'd.) BUILDING SPECIFICATIONS4 z.. Kind of construction: Wood frame, fire safe, etc. •---.2/ 61---A.---/-- - -L-4----1--,- ' , Will any second-hand lumber be used? LA--19-' If so, for what -. Material of foundation walls /a " ,., ,--c.Z., Thickness /, Depth of foundation walls below grade 6, . ' " Continuous foundation? . . ."---.V-.-4 . Will there be a cellar? - If so, material of cellar floor `---/ a et-,.4.,.....4., Type of roof: Sloped or flat? . ./ :4-- --x, , Material of roof /4.,.e.e.-e- ,X-7-e,_.,) 5 , Size,wood studs .'' "x ep ",spacing /(p "o.c., length ok . ft. Size, floor beams, 1st floor .-.2 " x / a ", spacing /6 "o.c., span /5.3 Size,floor beams,2nd floor -?-• "x / D ", spacing / "o c., span /--- ft. Size,ceiling beams . . . . . . . .----(!- . " x ", spacing . • "o.c., span /3 ft. Size, roof rafters or beams t2-'-4-°---'-'1 " x ", spacing a 171 "o.c., span /c_.? ft. Exterior finish '---i/t/-i ---1--f /-74:1 With what material? ---/kii_41-0 Finish of interior walls //-2 If garage is to be attached, of what material is wall between garage and main building to be constructed? ' ,--5-/1.4.c_%n,o.-.--E,1- Is there to be an opening between garage and building? . . . .C-714"--• Kind of heating system . . . .E.--1--,-,-c..-r;-,c,-i-i Oil burner or coal? Will a flue-lined chimney be provided? . . .Z/1-1.-- Depth of chimney foundation below grade Height of chimney above roof Will there be a fireplace? 7_,-/-e-a Depth of fireplace hearth /c Will a toilet be installed? LE--/-t-z---/ • Will a kitchen sink be installed and connected to water supply? Water supply(public water supply or pump) '22-1--14-n -c-,---/2:a-/ Distance of cesspool from any private well feet Will drainage system be provided with required traps, cleanouts, and vents? AFFIDAVIT Town of Queensbury County of Warren 1ss. State of New York I swear that to me beet of my know,ledge and belief the statements contained in this application,together with the plans and specifications sub- mitted_, area true and complete 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 to the proposed work shall be complied with,whether specified or not, and that such work is authorized by the owner. Sworn to before me this Signature -- /-h--6,A;(---C-/ e-'- - L7 OWNER.OWNER'S AGENT.ARCHITECT.CONTRACTOR day of 19 ' • NOTARY PUBLIC, WARREN COUNTY. N.Y. .. sM9MINIUMS7•11.121.02.a" SPECIAL CONDITIONS OF THE PERMIT: • . • • . . . • , . • • . ' • By . • •- .1.,- -`'S.,. ' , ' ,, •, TOWN OF QUEENSBURY - . BUILDING & ZONING DEPARTMENT SEWAGF DISPOSAL PERMIT APPLICATION 1. Owner' s Name —/-r,-A4L7 .,, ; e. • Lj-)- ter• .',,, , Address // , i5,r.l w,.„L.-4, (720 . • L`c-4.,.,-47,7/4 ,,A_4, Telephone No. % 9.z- / :s--n 2. Property location V,c.-t-- i y , -/„„ , ,�✓,i� �/-�L,,,•_,.:L 3 . Name of person or firm responsible for installing system 1y„,yz„„i L': }r,.,„,J ��) Telephone No. '7 9_.,2 - //"-p Address �_,-,,,� • 4. Number of bedrooms (residential buildings only) ,. . • ..5. Daily flow / G�-a--o gallons/day 6. Septic tank capacity / P--2,�0 . gallons 7. Topography: flat, rolling, steep • • % of slope .1,_T • 8 . Nature of soil and depth S ,6(_,y 9. If ground water, bedrock or impervious material is apparent at what depth does it begin? iviev5 ft. 10. Percolation test: A is required B is not required C If required what cte is ,the rate 04r minutes/inch 11. Water supply: municipal, well, other 11 ., ,,,x J. 12 . Type of system proposed: drywell, tile field, other Le., /,,,:,_(.,„e2 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 $250aas provided for in Section 6 . 010 of the Queensbury Sanitary Sewage Ordinance. Date 11` ` �J`7/ /)---)�/i},T Ci --7)„,..„-z., PP signature nature of applicant g • 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 . 9 .J If • :. .. Form 3-82 r- - _ � . 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. following: 1. Gross floor area I -2 2 0 2 . Type of heat 3 . Is the building mechanically cooled? fl 0 4. Percentage of area of windows and doors A. Over 16% Only . • 1 . Uo value of gross area of walls , roof/ceiling . and floors . exposed to ambient conditions 2 . 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 . 1. R value of roof and floors exposed to ambient conditions (Z-10 2 . R value of exterior walls 3 . R value of glazed area 4 . R value of doors 1 S ))s 5. R value of floors over unheated spaces 6. R value of slab edge insulation - unheated slab Y1 }A 7. R value of slab insulation - heated slab ir) J ,4) 8 . R value of heated basement/cellar walls (above grade) 1.3 9 . R value of heated basement/cellar walls (below grade) 8 10 . Type of insulation CLSL1-07g i"► MO RDQ'Ci-F� C. Controls °, 1 . Thermostat maximum heat setting D. Duct Systems 1 . Is duct system installed in unheated spaces? YES NO a. If YES , R value of duct installation v) 0 ' b. R value of duct in other areas E . Piping Insulation 1. Size of hot water or cooling carrying agent pipe 2 . R value of pipe insulation F. Service Water Heating 1 . Performance efficiency P35 `n 2. Temperature control setting maximum /9:0c' G. For Swimming Pool Only 1 . Maximum heating Telephone No. 7 Y I2--,3-v (' -4wt (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 VILLAGE TOWNSHIP r- A 4,, COUNTY r STREET AND NO.OR 6 ROAD AND POLE NO. ,15/7'Y ,/- /'/ ��/,\/ 11`/'—' ..fi /--/!% POLE NO. BETWEEN WHAT TWO CROSS STREETS IS � PREMISES LOCATED? 7�Y',5 Y A)/:i r!! T:c J / SECTION BLOCK LOT OCCUPANT'S BUILDING • NAME `? se:. (/ OCCUPANCY ._S , T. v!/'r•,/,,,,// OWNER'S NAME / A AND ADDRESS // CURRENT I SUPPLIED `' / FROM THEIR / BY /`Y //-J l_-->/-).i%!.1 !) / / Al .,-�(r. /.� �....JF- t:_ / OFFICE BSUILDING NEW I4 OLD❑ REMODELED El is NEW I ADDITIONAL El REMOVED DEFECTS ❑ LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED NUMBER OF OUTLETS No.of Fixtures MOTORS HEATERS BRANCH LAMPS Lamp Receptacles CIRCUITS Loca- tion • Side Attach't H.P. Watu A W.G. WATTS Ceiling Wall Recept'Is Switch Pendent Bracket No. Type Each No. Each No. Gauge NO. EACH Out- 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 POSSIBLE /-// ( L 7'_ , L L NEW ri OLD El • AVOID DELAY/ /BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. NAME OF //)' / ! L //-r%r'1 6 /4 T'•P /t/ i lam- APPLICATION DATE OF APPLICANT / , 1 • STREET ADDRESS / /Y,/ /A/ /�l Lr /t i h1 D r CITY OR /`/) ZIP LICENSE NO. POST OFFICE 1,-- L- ' `� !t/� J 1,1 l� (J- �` �/ CODE (-•Z•S'12 I WHEN APPLICABLE A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING • - -€,4-1•&a•d.a•..x•Ax•�.a•��•.��.•,��•tia•.��.•..A'AA'A •.4.- .I a•,�a ti.n.I•..a•�"..?-�". .a-!.A. ��.•.�a•.�a• a•,�.t.N. ."1. .4.,_�In"..1 i.a•�.a•�a•.�a tia tix i.a• a•..a•��.•..".,_na•.�a•�.1a,_4• -. s • THE . NEW YORK BOARD. OF FIRE UNDERWRITERS • BUREAU OF ELECTRICITY ,y Far! 41 STATE STREET,ALBANY,NEW YORK 12207 ' �- Date U�ailua7- y 15, 1935 Application No.on file 0 5C�'0-149_8 + A 633136 ,3 3 @��ys -` ' THIS CERTIFIES THAT ;r jj only the electrical equipment as described below and introduced by the applicant named on the aboveg application number in the premises of «- '1'... f sa l3 Wood Hollow r.� OP"�a(`;1 gli�e ��Y� S.��-3E �i +� 1��T r in the following location; ❑ Basement ❑ 1st FL El 2nd FL Section Block Lot :� • was examined on , P and found to be in compliance with the requirements of this Board. ,r . •' FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS ;C. s ( OUTLETS ECEPTACLES SWITCHES MERCURY •, INCANDESCENT FLUORESCENT VAPOR AMT. K.W. - AMT. K.W. AMT. K.W.. AMT. K.W. . AMT. H.P: 0-• �- • y)r 50 ,a a I°''R. - 1 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT� TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS 2.7 ' 'AMT. K.W. OIL ' H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H. YSTEMS AMT.- WATTS ,,_ • NO.OF FEET .r1 0 • • SERVICE DISCONNECT NO.OF 1 T.,,oyp S :1 1 fl E R V I C E METER • AMT. AMP. TYPE EQUIP 1,2'2W 1,B'3W 30 3W 30 IW NO,OPER gCOND. OF CC.COI.1D. NO.OF HI-LEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL r, ^� • 1 O C1 ::1', 11 4si0 1 2d g n OTHER APPARATUS: t: •, a s ec..:. • i a-Prs:i 31.5 c•:'; 2-1.0w 7; 2 .7531cw '4-e 517 -:? ����; C ram'!)/�/ -( W•�`�.' am b �br p :4A�.e.1. L'i tr.'7'o.`J `.✓® 1: c O i / 7 15, ��yy�S� ti ?„n. Do`" 201 g w BRANCH MANAGER ':i Per_ ,Yi CY•YY•YY•YileYgYYiYYs-eivi•YvYvY,,,,-Yii-v-iiYY•YYiY Yiii-IA'? `CYiYY•YY(i-?Wri YYlirY•YY•YYleY eY iYY•fYiYi-le Y•y Y eY e7Y iiYY iYY•Y i AYY iiYY•Y YibY'r II"yeY'i'aY.7e.liYY►YY•YY•Y r$(£P1Wriai-? ::. COPY FOR BUILDING DEPARTMENT.THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. TOWN OF QUEENSBURY Building Department l Inspectors Report Date 'r 7 Name r. • Location AjAP5e-o 2*i`rt 7ZZe>e<-?e-= . Permit No. P..3$ Weather t-f.1-(7 PJc,J 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 f Ext. Porches c- ^- Finished Floor v ?r — • Interior Trim Stairs & Railings 1,./1,4,-' Cellar Dr. Tile Concrete Floors Plbg. Fixtures N/'61, Gar. Fireproofing — Door Closers t/ /A Chimney Water Meter Inst. Septic Approval Floors Insulation Foundation Walls 'Ceiling ' Building Inspector REMARKS TOWN OF•QUEENSBURY Building Department Inspectors Repot Date r// 7 . %1� Name -7j/�/I`/L /E?s ` c Location %- rim' Permit No. /V"3 8 I Weather Remarks Excati a ti 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 NN\K\I 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 'Ceiliri �G"Gr Cam( // / • Building—Inspector REMARKS TOWN OF•C EENSBURY Building Department Inspectors Report Date C/p`l Name F sn 5 Location //fir inAti'rsvOO v ate! . Permit No. r S 2 j Weather Remarks Exca fra ti 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 Board27N 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 +- Flobts Insulation Foundation Walls ' Ceiling ' JL Building Inspector REMARKS TOWN OF QUEENSBURY Building Department Inspects Report Date Name--- ,7n�Y��i?'tis /� .ad1.� L.oeation Z / /:1/ P:J yE'.'6.)c., Permit No. ' k 3 j Weather ,/�f/��1•�c�l lc� �%rOR-17,0t Remarks Excatiation Footing Forms Footing & Piers Foundation Cement Coat Waterproofing Backfill Final Survey Framing • Sheathing Roof Felt Roofing Siding Masonry Veneer ,> Rough Plbg. Iry (:)/ 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 " Building Inspector 7c757')21 i REMARKS • g3 E'1 TOWN OF'QUEENSBURY Building Department Impactors Report Date *I /97i Name /���'?>c / ��r�. . Location / , ' P/41`5u-ic),A / o ,aA.r . Permit No. / 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 Stairs & Railings Cellar Dr. Tile Concrete Floors Plbg. Fixtures Gar. Fireproofing Door Closers Chimney Water Meter Inst. Septic Approval Floors Insulation Foundation Walls 'Ceiling Buig Inspector REMARKS MARTIN C. MOSHER 15 GREENKAY, NORTH GLENS FALLS, IVY 12801 TOWN OP QUEENSBURY RECIEllYED An 6 1984 �.AN. P.M. 11 k ))//:AY V-1) ��J 9 V I <1` �---- e 7