8623 BUILDING PERMIT
TOWN OF QUEENSBURY No. 8623
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Keith W. and Cherie A. Coe •
OWNER of property located at 20 Centennial Drive Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Inground Swimming Pool
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. x
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1. OWNER'S Address is 20 Centennial Drive
Glens Falls, N. Y.
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2. CONTRACTOR or BUILDER'S Name
Adirondack Pool Service n
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3. CONTRACTOR or BUILDER'S Address
ID
27 2 First St.
South Glens Falls, New York
4. ARCHITECT'S Name •
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5. ARCHITECT'S Address
1.
6. TYPE of Construction— (Please indicate by X) (D
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( )Wood Frame ( ) Masonry ( )Steel ( ) - (D
7. PLANS and Specifications -
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20 'x40 ' inground swimming pool per plot plan and
No. application submitted. •
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8. Proposed Use
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Swimming Pool •
15. 00
$ PERMIT FEE PAID —THIS PERMIT EXPIRES Feb. 1 19 85
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the 0
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this nth Day of July 19 8 4 to
SIGNED BY etr- • 0— for the Town of Queensbury
Building and Zoning Inspector (C - H'
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TOWN OF QUEENSBURY (Space inside block to be filled in by
WARREN COUNTY, NEW YORK - Building Inspector)
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ApplicationApplication NO. ;
Permit Issued Ig.
BUILDING AND ZONING PERMIT Permit Expires. 19
%(whip. District
THREE (3) Copies of a PLOT PLAN, Drawn to scale \I'I' "cd by '
.showing the actual dimensions of the lot to be built. 1 cniarKc
upon, The exact size, and location on the lot of the
building to be erected or altered MUST BE SUB •
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,MITTED WITH THIS APPLICATION.
`: TOWN OF QUEENSBURY
... :: 6 — a.— i b, Lf . -Ti.)--1•( .2 i l 'UN REGV1VE D
DATE
A PERMIT MUST BE OBTAINED BEFORE. BEGINNING WORK jUL 6 1984
``'- ANSWER ALL OF THE FOLLOWING. -
The undersigned hereby applies for.-a permit to do the following work ,�I8�9t1(11J .2l1l2)314I5'6
which•will be done in accordance"with the description, plans and specifi- ,, r.f..r ` a ' ` '
cations, and such special conditions as may be indicated on the permit. �6-
' The owner of this property is: ,
. .K� 1T(1 (,J C1rt :21rz . A _ eat . 0 C(zrs•!z'.ru(, -.. . . .P.O., ... : .c_ .iv..s .r/.3 5Aiv
INA`,E) (P.O.ADDRESS)
The person responsible for -supervision`of the work insofar as the Building Code and the Zoning Ordinance apply is:
S'A 60 ?*.[. S A a J ?(/ t-t 2 Sr,i S . G -
(NAME) IP.0.ADDRESS)
Name of Builder. AOl12•c?NO/tC PJoL Jz2,.VfS� . . . . .Address .4 Yz- . .f-t25..... . S . . .s�.•.Cil��!v .F �,N`f
Name of Plumber - - Address
Name of Mason • Address
Lot Number. . . ca J Unit Estimated value of proposed work 3 -Sv' 0 .b J
Name of Village . . . 1.4..--ii-4-1.4s /3"(z-y
Name of Street e-E-"-)`�e c"(-s r.4-c- OR!V ,z Side of street: north 0, east is, south O. west 0
Nearest Cross Street . ,'--1Au.I=•M• .LAAJZ ' Distance from this cross street 300 Ft.
Property is north ' ❑,south ID,east i i, west. 0 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
❑ Constru ion of a ne uilding, - Main Building
❑ Addition t a b •• ing. . . One-fa 'ily dwelling ❑
•❑ , Alteratio building. Two-fami , dwellin ❑
❑ Dem •lion of a ilding. -fa it , partment house ❑
Store buildi ❑
•
ar atta ed garage ❑
• Other:
Acc ry Building
- One-car etached age ❑
Other work• . Describe. 1' A -e4 1 i t..I . •'9•r• . • • • Two car de ch garage ❑
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r Private chic house ❑
.o��?. .x.�(.J. . .•S W i MM.I:IJG. ate.��.<-.
Private s rage b ilding • ❑
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
• NA a L-A(-)c building(s) in solid line.
i3 Size of property (J . . • ft. x I �� ft.
e
E. Size and use�of existingtbuildings, if any
I; p `�O`.! (uvOr ,n
u - i W Size of proposed r,.0• ft.x .`-(.O. . . . . . ft.
P P° �g
( - 5 Height(from grade to ridge) ft.
4
L ' Front yard . . . .4(. .k PtZ
k. . O t o,� :z-, f, s ft.
4 - n Side yards - l - `�/�44t. nal SLcQ -- ft.
'Po-rn 2 U2 0. Rear yard . . . . .2S?49-. DJ'�?;•. 1PS-r. :�:4-e. . . . . . ft.
SOUTH If on corner,setback from side street ft.. -
rill e.' p or- N,z
Note: All distances are net, as measured from treet side
line to nearest part of building.
(OVER) •
7-73-N
(corit'd.)
BUILDING SPECIFICATIONS.,
Kind of construction: Wood frame, fire safe, etc.?. . . . . .V•t..r v , •L.f*J e eZ
Will any second-hand lumber be used? . . JJ.J If so, for what2 —
Material of foundation walls . . .C+Ma"'` Thickness
Depth of foundation walls below grade Li--" Continuous foundation?
Will there be a cellar? — If so, material of cellar floor
Type of roof: Sloped or flat? Material of roof
Size, wood studs "x ", spacing "o.c., length • ft.
Size, floor beams, 1st floor "x ", spacing "o.c., span ft.
Size, floor beams, 2nd floor . . . . . . . . " x ", spacing "o.c., span . . . ft.
Size, ceiling beams . . . . . . . . . . . . . . " x ', spacing "o.c., span ft.
Size, roof rafters or beams " x ", spacing "o.c., span ft.
Exterior finish With what material?Finish of interior walls. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If garage is to be attached, of what material is wall between garage and main building to be constructed?
Is there to be an opening between garage and h Trg?t9 OL YES
Kind of heating system . . .S.�[_•,e4-re 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? Depth of fireplace hearth
Will a toilet be installed' '—
Will a kitchen sink be installed and connected to wirer supply? —
Water supply (public water supply or pump) rt..•M Pc o I4.JQ • • a_G!v*We�42_
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 tr, ova 1 of my knowledge and belief the statements contained in this application,together with the plane and specifications sub-
mitted, are a true and co,a.p•lete 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. y�
Sworn to before me this Signature -..!.a-.••..LJ • C.
_ ^'1 c.,� OWNER.OWNER'S AGENT,ARCHITECT.CONTRACTOR
day of S3 LJ f� 19 1..
NOTARY PUBLIC, WARREN COUNTY, N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
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By
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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( 1.l ,-, ,„ i/),_. - - . COUNTY / ;i;J
STREET AND NO.OR n /
ROAD-AND POLE NO. ,... .] f ,,�iitl-:--/,�j.,J,r/ri: /%'C POLE NO.
BETWEEN WHAT TWO ,
CROSS STREETS IS /� /-, / _ •
PREMISES LOCATED? f,..)"f7..r.c' P�e4 :�-it I:i 1=1„i r r-r I':I fJ.-• SECTION BLOCK LOT
OCCUPANT'S ) /'�' _ BUILDING _
NAME T' i / i-1 ft r `, G� OCCUPANCY n i/ I t'., ;i— ,- '/f f/l '/ /2/J,.r G/:VG
OWNER'S N ME
ANDADDRESS --- •r Z..✓yam %,<rt_C_)
,� t 7;-r t,�J. �'.,,.r - __) ._� C�:r,J��i-�,'�J.rv:.C. • ,.7�- - C
CURRENT i /
SUPPLIED . • •
BY !' ir' / 7'i7ti /I-!�.)/IL't,:�jr FROM THEIR OFFICE
BUILDING WORK DEFECTS
IS NEW CI OLD p REMODELED III IS NEW ❑ ADDITIONAL REMOVED
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETS No.of Fixtures& MOTORS HEATERS BRANCH LAMPS
Lamp Receptacles CIRCUITS
Loca- '
lion Side Attach't H.P. Watts 'rug,' WATTS
Ceiling Wall Recept'Is Switch Pendent Bracket No. Type Each No. Each No.:, 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.
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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 OF SIGN
BUILDING
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.
NAME OF c,{/:'"�" t / DATE OF - •,j /1 tt ;
APPLICANT / l r ' / r ! - t ^"r APPLICATION .J Lt ,_
STREET ADDRESS`J-c ( ,':,, -- / 1 :" ,,
CITY OR 7 / f ZIP ;, 'LICENSE NO.
POST OFFICE ��, �% / 1% I r CODFI/--. t2 F - WHEN APPLICABLE
A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING
ii (FIR`44447147W m/114.m 71444 44714/1111W7 714 Mk 7il714 mm 7Pg m m 74X RIX 7t1 111 l ls\MRMt.W71WS4W1la IRm7✓Elm m lin m 74%./11c/14 714711R Mk mJp an.7iT 3.
k 4166415 THE NEW YORK BOARD. OF FIRE UNDERWRITERS :T
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E �L� BUREAU OF ELECTRICITY .-
41 STATE STREET,ALBANY,NEW YORK 12207 '1.,
n nr_ i er.- �7 'Y
Date June �� 2 `��� Application No.on file ®,JE"Jo`''' -7s !1 `r`r' C
iTHIS CERTIFIES THAT " b Y
k only the electrical equipment'as described below and introduced by the applicant named on the above application number in the premises of ,r
g Ke:Lth W Co.=, 20 Centennial Drive, Q1-' '-'atsT:tury, CIW York ¢r
,r •
kin the following location; ❑ Basement ❑ 1st Fl. ❑ 2nd Fl. Section Block Lot Y
was examined on {{ and found to be in compliance with the requirements of this Board. Y
• FIXTURE ECEPTACLES SWITCHES FIXTURES Meacuar RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS Y
• OUTLETS -7 INCANDESCENT FLUORESCENT ERCUR AMT. K.W. AMT. K.W. AMT. K.W.. AMT. K.W. AMT. H.P:
i E r
,Y
,r
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS r `
'AMT. K.W. OIL ' H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P SYSTEMS .AMT.- WATTS ''
NO.OF FEET Y
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- ,r ,
Y
— .r
iY
-- SERVICE DISCONNECT NO. S E R V 1 C E ;r
6 AMT. AMP. TYPE EQUIP 1 if2W 1.3 B•3W 3, 3W 3 if 4W NO,OPER SCOND. OF CC.COND. • NO.OF HI-LEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL 7
,Y •
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,Y '
IY
OTHER APPARATUS: ,i
1 This
certificate e covers c_.U1.I)1`1 ace at ^- f"�:=9 e r e. } -,rr
rz tile ... C?_ Z.._ 17=;LL...t._� only. • ,Y
Because r?us of TJ6S$"Ls L 7 t t 'rL11� tL i itis advisable I14 to »9_ r7^ 'r
i CYtil tisJ" tx�l. �(,� CjL�,`_ai. tests. ,Y
.._-: . and/or repairs u-dicta b✓� a qualified per:cn_a , �
,Y
,Y
,Y
— ,T
Y
Mil
' b' 'mt P PiarC Jr ie �
!95l :Ansel; Drive. _..—
South Glens Fm ls, Nr:7 ork 17_00 c, f
BRANCH MANAGER Y
'T
,Y
Y
Per ;
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- tIES71119 51EMENElinliniffilEllnaininliO ® ® ® n n ® ® ri n 'CY Y YY YY YY YY YY YY YY Y'r YY YY 4:
COPY FOR BUILDING DEPARTMENT.THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
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TOWN OF QUEEWSBURY
Building. Department
Ingmmtam Report Date n, / �
Name e i C'O e /
Location o C ., T e n n i Gt( P-
P ' No. Weather
00 f•-r I h L-4 Remarks
Excafta t on
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing , •
Sheathing a�
Roof Felt /9
Roofing •
Siding
Masonry Veneer •
Rough Plbg.
•
Relief Valves •:(
Wall, Board ."
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railings /
Cellar Dr. Tile 1
Concrete Floors
Plbg. Fixtures •
Gar. Fireproofing
Door Closers
Chimney _..
Water Meter Inst.
Septic Approval
Floors '
Insulation Foundation
Walls
Ceiling
Building Inspector
REMARKS
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