7989 C/O Paid
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date October 27 19
This is to certify that work requested to be done as shown by Permit No. 7 9 8 9
has been completed.
This structure may be occupied as a One—Family i..w° 17'nt?
Location Lot 15 Pine Wood Follow Road
Owner (7. l.�s 'Woodbury
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoning Inspector
•
CREATIVE '•INSTA" PRINTING. GLENS FALLS. N ♦ 12801 1518)793-5658
BUILDING PERMIT
TOWN OF QUEENSBURY No 7989
WARREN COUNTY, NEW YORK
, 0
PERMISSION is hereby granted to C. -G. Woodbury
3r. Ha. 1 S'
0
OWNER of property located at Lot 15 Pine Wood Hollow Road Street, Road or Ave. 0
in the Town of Queensbury,To Construct or place a One-Family Dwelling K
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.
1. OWNER'S Address is 679 Upper Glen Street
Glens Falls, New York
2. CONTRACTOR or BUILDER'S Name
Same
3. CONTRACTOR or BUILDER'S Address 0
rt
Same
.Ul
ro
4. ARCHITECT'S Name
• (D
O
p
5. ARCHITECT'S Address 111
. O
N
H
6. TYPE of Construction— (Please indicate by X) 0
(x)Wood Frame ( ) Masonry ( ) Steel ( ) `U
0
p)
al
7. PLANS and Specifications
62'x28 ' per plot plan, specifications and
No. application submitted including two-car attached garage
and sewage system.
8. Proposed Use
One-Family Dwelling
$5. 00 C/O Paid 0
94. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES February 1 19 84 C
(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.
Dated at the Town of Queensbury this 26th Day of July :. 19 83
CJ
�^ N
SIGNED BY 5 ,1 for the Town of Queensbury
rifuilding and Zoning Inspect F-'
s �
TOWN OF QUEENSBURY (Space inside block to be filled in be
WARREN COUNTY, NEW. YORK ' . Building Inspector)
Application for Application No. •
Pp Permit Issued 19 .
BUILDING AND ZONING PERMIT Permit Expires. Ig.
%,mini District
. \ Ale uc iii Work
THREE (31 Copies of a PLOT PLAN, Drawn to scale '\I'1"o\ed by
showing the actual dimensions of the lot to be built Itcm,(('K5
upon, The exact size, end location on the lot of the
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION. I
i TOWN OF QUEENSBURY
l9 6 �-- 5 . • -7 / - V- i }{�) :CEIVEL:I ! DATE `�A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK UL 1 81983
ANSWER ALL OF THE FOLLOWING. AM. pThe undersigned hereby applies for a permit to do the following work 7I81O)11)12)1J2I3)4I5I6
which will be done in accordance with the description, plans and specifi-
cations, end such special conditions as may be indicated on the permit. cl g,(741
The owner of thiproperty is: r \ • q }
(NA, E) (P.O.ADDRESS)
The person responsible fo supervision of the work insofar as the Building Code and the Zoning Ordinance apply is:
1 t . , " .
(NAME) ,,/,--
(P.O.ADDRESS)
'\ 1��
Name of Builder Address_
Name Of Plumber `,4-\ . �2 �� ', Y\--' Address
Name of Mason 19 ^"1 a ) " G- . . • • • • • • • • . • • . . •Address
Lot Number —� Unit �^, Lr Estimated value of proposed work S -- ) ) �` �
Name of Village 02 `---. (5 g`� 1 a��l e,
Name of Street •(V. 5� � •''may 'ram , I ^v✓ 1 Side of street: north ❑, east , south ❑. west ❑
Nearest Cross Street Distance from this cross street Ft.
Property is north ❑,south ❑,east iii, west ❑from Cross Street •
If on Corner, which corner, northeast ❑, northwest ❑, southeast D. southwest
(Designate by marking with an "X" in the correct space.) --__ f
NATURE OF PROPOSED WORK OCCUPANCY
�\ Construction of a new building. Main Building
❑ Addition to a building. One family dwelling �
El Alteration to a building. Two-family dwelling El
❑ Demolition of a building. -family apartment house ❑
Store building ❑
•
. . . -car attached garage • -.1>I;
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
• I uilding(s) in solid line.
i. f` ) a
Size of property •-I "1- I ft. x . ( / ft.
•
Size and use of existing buildings, if any . iy. d •�•OI•��'.
F r
n40
s w Size of proposed building . . :,. . ft.x ft.
Height(from grade to ridge) I L ft.
Front.yard . .0 ft.
6
Side yards 7 . /r F ��;t' ft. and 1 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. '---)' J�
Will anysecond-hand lumber be used? . . .J.,. •_Lso, for what ti
Material of foundation walls \�' -; •�--C ,)�` Thickness Co ` y('
Depth of foundation walls below_grade G Continuous fpundation?
Will there be a cellar? .�i ). . . . . . . If so_material of cellar floor . �.: �-' - . ��.' .
Type of roof: Sloped or flat? r '. Material of roof . . \.'�t�.- Y. -:e.t—:j . . ._� I1. N . ;. �� ;. . .
`af " x ", spacing r
Size,wood studs o "o.c., length. . . . ,. . .•. . . . . ft.
Size, floor beams, 1st floor . "x • • • •c• • • • • - •", spacing 1 '1 "o.c., span f -- ft.
�r " x ", spacing i
Size, floor beams, 2nd floor "o.c., span ft.
Size, ceiling beams �gg ' ) "l`x , spacing . . . . . ."o.c., span ft.
Size, roof rafters or learns i , `' 'fit ", spacing "o.c., span ft.
Exterior finish �'J With what material? n - -,7;�.'--'.�
Finish of interior walls. . . . . . . . . .,7:'!\-). '•• -• . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If garage is to be attached, of what material is wall between arage and main bui.Jding to be constructed?
Is there to be an opening between garage and building? --
Kind of heating system Oil burner or coal?
Will a flue-lined chimney be provided? • Depth of chimney foundation below grade
Height of chimney above roof ; I 7\
Will there be a fireplace? . . . . .. . , • • • • • Depth of fireplace hearth 1Will a toilet be installed' - t^
Will a kitchen sink be installed and connected to water sup ly?
Water supply (public water supply or pump) G 1 3-f5 j•(--
Distance of cesspool from any private well feet
Will drainage system be provided with required traps, cleanouts, and vents? e
AFFIDAVIT
Town of Queensbury
County of Warren
State of New York
I swear that to tr. j, j of my know,ledge and belief the statements contained in this application;t)Arether with theeplans and specifications sub-
mitted, are a true and coa.plete statement of all proposed work to be done on the described"pre'mses and-thiL all�pr visions of the BUILD-
ING CODE,THE ZONING ORDINANCE,and all other laws pertain' to the proposed wprk shall be.4-mplied withi hether specified or not,
and that such work is authorized by the owner. j I jL ( -
Sworn to befor ,me this Signature j"
- /� C1. `� OWNER.OWNER'S AGENT,ARCHITECT,CONTRACTOR
1 -� day of I 19..
NOTARY PUBLIC, WARREN COUNTY. N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
•
•
•
By .
TOWN OF QUEFNSBURY
BUILDING & ZONING DEPARTMENT
SEWAGE' DISPOSAL PERMIT APPLICATION
1. Owner ' s Name
Address
ric
Telephone No.
2. . Property location . � ` `b.��
3 . Name of person or firm responsible for installing system
r.
Telephone No. 7 �� -&. j
Address
4 . Number of bedrooms (residential buildings only)
5. Daily flow A.5 6 gallons/day
6. Septic tank ca•acity ` gallons
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; ell, other
1
12. Type of system proposed: drywell Ile field other
Any contractor,, corporation, indivival, etc. engaged in the construction
of a sanitary sewage disposal system who covers the same before inspection,
does not have an approved permit, or aries from the a proved application
will be subject to a penalty of $250 a provided for in e:ettion 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 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 [ 1
2 . Type of heat ' I�- ( 7 V ) c
3 . Is the building mechanically cooled? ' ► C)
4 . Percentage of area of windows and doors I' '--4- t7
A. Over 16% Only
1 . U 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
2 . R value of exterior walls
3 . R value of glazed area
4 . R value of doors -�
5. R value of floors over heated spaces
6 . R value of slab edge insulation - unheated slab
7 . R value of slab insulation - heated slab
8 . R value of heated basement/cellar walls (above grade)
9 . R value of heated basement/cellar� walls (below grade)
10 . Type of insulation (7 L--V �{
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
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 .►
2 . Temperature control setting . maximum --4,,
G., For Swimming Pool Only
1 . Maximum heating
Telephone No . ` 7 - 1 �f
(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 t
VILLAGE� ;b���--,�.�&�, (< 7� `J�,•`t,..'" TOWNSHIP COUNTY t �N it\---r L.F i '
STREET AND NO.OR �^�,,�-q 1 - 55 _ .�-_I (_� ; �yl (f_ ;---I
ROAD AND POLE NO. CFI I N ''�/yf -1‘''- ' ,,,7 !LA,. . N.,1 `o �! POLE NO. i
BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? SECTION BLOCK LOT t--.�
OCCUPANT'S BUILDING
NAME OCCUPANCY _
OWNER'S NAME (/ yy —^�_ e l
AND ADDRESS t. \,,r'i!`:: \_i ,i-� 1, `.3�.`•�-- ',� 'j
CURRENT
SUPPLIED BY FROM THEIR OFFICE
BUILDING '�. WORK DEFECTS
IS NEW OLD❑ REMODELED ❑ IS NEW Ali ADDITIONAL❑ REMOVED ❑
^-
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
No. Fixtures& BRANCH
NUMBER OF OUTLETS LampfReceptacles CIRCU TS MOTORS HEATERS NUMBER OF LAMPS
Loca-
tion Side Attach't H.P. Watts A.W.G.
Ceiling Wall Recep'Is Switch Pendant Bracket No. Type Each No. Each No- Gauge I F M.V.
Out-
side
Sub-
base
Base-
ment
1st Fl.
2nd Fl.
3rd Fl.
F 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 OF SIGN
BUILDING
INSPECTION REQUESTED
ON OR AS NEAR AS n
POSSIBLE NEW I I OLD 1-1
r
AVOID DELAY BY GIVING FULL AND ACCURATE fNFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
PRINT NAME AND ADDRESS -- %
NAME OF ,--" (1 ` I t.--: DATE OF
APPLICANT �'�'° >• �'`" I'-�'�` "� +�� APPLICATION
I STREET ADDRESS • 1.-r - S�j iP-''`� -� ,'-'' jrr.r_'')
CITY OR t-' is -( �y^^^'---,,,' _ t: ZIP LICENSE NO.
POST OFFICE - `��'�' "-�"` -) -'1 S 5�'� � -' CODE WHEN APPLICABLE
46 EL(REV. 1/82) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING
•
s _
.1.:!..,_,__..la A.S 4-1-/.J, J_..1)_./_.....Cl.la._CJ.A._...V.1.-1.!,4,I-_I.a_CJ.I.J. J..1-1,,,0_,.CJ.,!..,.1)_,.1>`.CS_1>,11,.11,J,a_C,AJ.,!.J_.4.491"-J!/,J.•!-J_'4.J.N-1,1 J_./_.J_.•!J_%J_AG_At1•J•_CJ_.CJ.(.J_,L.a l,J...-,'- ,!• -
' 00136 j THE NEW YORK BOARD, OF FIRE UNDERWRITERS y
BUREAU OF ELECTRICITY '•�
k lj� 41 STATE STREET,ALBANY,NEW YORK 12207 Y _
Date October 28 , 1983 Application No.on file 0t=Z,T?08--8J A 6 i 0 47• .. .-
. THIS CERTIFIES THAT 4
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of Y
•
C.G. Woodbury, Pinewood Hollow Road, Queensbury, New York }
't: in the following location; ❑ Basement ❑ 1st FL 2nd Fl. Section Block Lot
4 was examined on r,�` and found to be in compliance with the requirements of this Board. ;r .
__ -t, 10/25/ j ,r
�. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS -
�' ECEPTACLES SWITCHES� OUTLETS INCANDESCENT FLUORESCENT MVWAMT. K.W. AMT. K.W. AMT. K.W.. AMT. K.W. r AMT. H.P: :
1, r �.
tt .P
-- 6 1 5 4 1 1 U 2 F r ° ;
_(' DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS r —
_ r —
:(' 'AMT. K.W. OIL ' H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEETT.• WATTS %y
.1, 1
1 anp e i`0 'r r
q .•
0
...<<-: SERVICE DISCONNECT NO.OF 1_ riWT S A'•L U E R V I . C E
�I AMT. AMP. TYPE EQUIP; 1,B'2W 1 a 3W 3,B'3W 3,0'4W NO,OFPERCiCOND. OF CC.COND. NO.OF HI•LEG OF fi�l IEG NO.OF NEUTRALS OF NEUTRAL 'r
1 200 GB 1 a.. 1 1 1!/0- 1 2/0 4
'1, OTHER APPARATUS:
,� ; Electric Room Heaters . 3- 2 . 5 kw, 1-- 2 . 0 kw, 1 .1 5 kw, 1— 1 . 25 �:i��
�i 1— 1. 0 kw, .r 5 1 `r`7 :r
=_. f<4 1-- GFCI T
1 - Smoke detector
- , __
4r
1, r
1.
:r
1 -
Dave Ibbor • -7
: 121. Hudson 239 _
- South Glens Falls , New York 12801 BRANCH MANAGER
c.
Per • • _
'PYYYYY YY YY YY YY YYeYY•YYdiYYeY�iellYYiYY YYai-ie'rYYYY YY YYYYYY'CY YYYY YY YY YY YY CY F1'irY Y•i YY i"?Y'i YY YY YY YY Y'i rY Y Y Y YY N.Y rY Y'i YY Y•i Y'i Y'i Y•i Y3'
- COPY FOR BUILDING DEPARTMENT.THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
TOWN OF QUEENSBURY
• • Building Department
Lospe tors Report • Date le '7-7-
Name C I ,rm '24.4.i ff
Location /_r3T Pi0-14l('1d,0 I*i_L_eyf/
. Permit No. -74 q Weather
Remarks
Excat7a ti on
Footing Forms
Footing & Piers
Foundation
Cement Coat j
Waterproofing /
Backfill
Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves.
•
Wall Board
Ext. Porches / Gar
Finished Floor
Interior Trim /'� i �l
Stairs & Railings '
Cellar Dr. Tile
Concrete Floors /'
Plbg. Fixtures 1/ , (�(�
Gar. Fireproofinq/' , ()b
Door Closers k,, ' 01<
Chimney
Water Meter Inst.
Septic Approval
Floors '
Insulation Foundation '
Walls
Ceiling
B ilding Inspector
•
REMARKS
.S Al 1 KE Dom•=TE-C-76 5 (f) K
TOWN OF QUEENSBURY
Building Department
Inspectors Report •
Date (.5 `., 3
Name /6 � ,s4 u
Location P/ rig e> r o)
Permit No. 2476.)7 Weather
Remarks
Excat>ation
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 & Rai ngs
Cellar Dr, Tile
Concrete Floors
Plbg. Fixtures .—
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst. __4_ —
Septic Approval
FloOrs
Insulation Foundation
Walls
Ceiling
r V Bui`f- ing Inspector
REMARKS
//
P/64:)17
/g,o
•
TOWN OF QUEENSBURY
Building. Department
Inspects Report Date , -2
Name bBo,y
Location 4 7./_5 i-2N L.t)C D/1.f,/ 0
Permit No. 779 Weather
Remarks
Excatia t on
Footing Forms
Footing & Piers
Foundation ,
Cement Coat
Waterproofing
Backfill
Final Survey f' �,
Framing C� C11
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer / (c
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 " '
Building Inspector
REMARKS
TOWN OF QUEE SBU Y
Building Department
Inspectors Report Date e-3- �
Name �� s17(3�J, v .4e.)A4f�l
Location Z ? /s r ';4 c��rlgD N icl&)
Permit No. -7 7 F 9 Weather
Remarks
Excatia 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 / _
. Ext. Porches
Finished Floor \ /
Interior Trim V
Stairs & Railings
Cellar Dr. Tile
Concrete Floors \ _
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
•Insulation Foundation
Walls
Ceiling
;;;; /
(Bnildrng Inspector
REMARKS
•
•
TOWN OF QUEENSBURY
Building Department
Inspectors Repo • Date 7-26 ?
Name %,./ b.Tt,i�., '
Location .%/ t c> J r i-49//&J RV) .4f-7-
. Permit No. y Weather
Remarks
Excavation
Footing Forms � • ,P
Footing & Piers
Foundation SP'e COIVG� - l
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
' Bui ing Inspector
REMARKS
•
•
TOWN OF QUEENSBURY
Building Department
hispectora Report Date Z --/4--R3
Name 004;ju �/
Location L.0-►-, 1.5—( PG wly 479
�� Weatherf l r�Uc/
' Permit No.
- •
7 1 0 Remarks
Excajta ti on /
Footing Forms ✓ •
Footing & Piers
Foundation
Cement Coat
Waterproofing
Ba ckfi ll
Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.Relief Valves
Wall Board
Ext. Porches
Finished Floor2f)(1/////
Interior Trim
Stairs & Railings
Cellar Dr. Tile/ •
Concrete Floor's
Plbg. Fixtures
Gar. Fireproofing
Door Closers ~�
Chimney
•
Water Met/r Inst.
•
Septic Approval
Floors
Insulation Foundation
Walls
• Ceiling
•
Bui d ' g Inspector
REMARKS
;; .� �,- ,£ �.. .:�✓ a +,�a,�, .s - ,e.+ f � �' _' '.