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5210 CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date ( I 19 7'-2 • This is to certify that work requested to be done as shown by Permit No. • .V has been completed. This structure may be occupied as a QI.V-e" . +WlI 7)1/✓-e )1(09 ' J Location 2 . IT '' Owner Mai;-4.7 f 4/10 SI2Q'! - • By Order Town Board TOWN OF QUEENSBURY Building & Zoning Inspector CREATIVE '•INSTA•• PRINTING. GLENS FALLS. N V 12001 171111793.685E BUILDING PERMIT TOWN OF QUEENSBURY No. 5210 WARREN COUNTY, NEW YORK Iv PERMISSION is hereby granted to Martin C. Mosher P. OWNER of property located at Lot 99 Helen Street (St. #91 Street, Road or Ave. • • 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 0 approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. 0' (D 1. OWNER'S Addressis R.D. #3Sherman Ave. Glens Fans, N. Y. 2. CONTRACTOR or BUILDER'S Name Same • 0 ci- 3. CONTRACTOR or BUILDER'S Address Same . x (D 4. ARCHITECT'S Name (D U) 5. ARCHITECT'S Address (.1) a+ 6. TYPE of Construction— (Please indicate by X) • ( *Wood Frame ( ) Masonry ( )Steel ( ) 7. PLANS and Specifications 26' x 54' per plot plan, specifications and applicationCD �o N°' submitted including sewage system and two car attached garage. 1T1 Cu 8. Proposed Use One-Family Dwelling d $5.00 C/O Paid $ 70.00 PERMIT FEE PAID —THIS PERMIT EXPIRES December 1 19 78 P. (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.) to Dated at the Town of Queensbury this 19th Day of May 1978 • SIGNED BY FR for the Town of Queensbury Band Zoning Inspector TOWN OF QUEENSBURY • ` (Space inside block to Ix filled in by WARREN COUNTY, NEW YORK Building Inspector) Application No.ApPlication for P(.rmit Issued 19. BUILDING AND ZONING PERMIT Permit Expires. 1d. i:„ilini District . \ aliie of Work THREE (3) Copies of a PLOT PLAN, Drawn to scale \l'I,r„„•(1 by showing the actual dimensions of the lot to be built l:(•m:u•KS• upon, The exact size, and location on the lot of the • building to be erected or altered MUST BE SUB- MITTED WITH THIS APPLICATION. • -1_ ch.Y-' Im TOJ,1 OF t t.3 i-n:,Sr.%':Y fYo _ y _ z si/ 6/ /-7rSE L' U -E 3 �,� � ., . . uu A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK • 19 i . ANSWER ALL OF THE FOLLOWING. A.M. P.M: The undersigned hereby applies for a permit. to. do the following work 7�8' =1�111.�E F �� I�� I�.M which will be. done in accordance with the description, plans and specifi- 7 ` ` ' ' ') ' ' ' ` cations, and such special conditions as may be indicated on the permit. A he owner.of/�this property i :. 4�er A/__is • V. y •"!� Z� `,U.(. .O.ADDRESS)�s-C(.ir✓. .�G�L-. ./�.�". . v'� (NA`•c) The person responsible.for .supervision of the work-insofar as the Building Code and the•Zoning Ordinance apply is: (NAME) • (P.0 ADDRESS) Name of Builder ��'��'�'� Address • Name of Plumber' /fin"'` Address Nam Me of on C� . Address Lot Number 9, Unit . .0--1 • • Estimated value of proposed work i --t_— Name of Village 7-0-t; f. • . • --4. Name of Street . . .,aJ 1-1✓ "-1"—" 64., -A i o str north ❑, east 0, south 0. west JK Nearest Cross Street .�.1�+%t4-v • \...S; Distance from this; cross street .0 0 Ft. Property is north 0,south'X east [ i, west- 0 from•Cross Street If on Corner, which corner, northeast 0, northwest ❑, southeast ❑. southwest - • (Designate by marking with an "X" in the correct space.) , NATURE OF PROPOSED WORK OCCUPANCY Jnl( Construction of a new building. Main Building dwelling ❑ building. Addition to a. One-family, [� Two-family dwelling ❑ Alteration to a building. -family apartment house ❑ ❑ Demolition of a building. Store building ❑ . . . - .-car attached garage ❑ .. 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, site and setbacks of pro- • posed buildings,and the location of all existing buildings. NORTH Show proposed building(s) in dotted line and existing lwilding(s) in solid line. Size of property /0 Q ft. x / .7 ft • • Size and use of existing buildings, if any F N s w Size of proposed building t ft.x . . 4'- - . . ft. Height (from grade to ridge) /d ft. . Front yard ' • 7 & • ft. • Side yards / . . . . ft. and . . : 4. . . . . . . ft. 4uni Si^• ' Rear yard 0 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.7 ,i!"r—. --,4- • �1� . n,- e Will any second-hand lumber be used? /v0 If so, for what7 Material of foundation walls /0 " ik-C /� Thickness Depth of foundation walls below grade 6 0 `', ( �� Continuous foundation? Will there be a cellar? . . � material of cellar floor . ' p� Type of roof: Sloped or fla ? . . . >2 Material of roof adiea- e� Size, wood studs " x Y ", spacing / 6 "o.c., length P ft. Size, floor beams, 1st floor c2. " x /O ", spacing / . . . ."o.c., span ,/..,3. . . . ft. Size, floor beams, 2nd floor a " x / 0 spacing / to "o.c., span / ft. Size, ceiling beams ✓ 7 .4 " x ", spacing "o.c., span ft. Siie, roof rafters or beams . _.....-- --(..,e-de-%"x ", spacing "o.c., span ft. Exterior finish ,Ad • �'. Cc. ) With what material? Finish of interior walls If garage is to be attached, of hat material is wall between garage and main building to be constructed? Is there to be an opening between garage and building? 71-0 Kind of heating system . . . c -cif Oil burner or coal? Will a flue-lined chimney be provided / Depth of chimney foundation below grade . . . ry o Height of chimney above r f / /, Will there be a fireplace? Depth of fireplace hearth /C� Will a toilet be installed? Will a kitchen sink be installed and connected to�y:at�r su ply? Water supply (public water supply or pump) !! 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, tee,c of my know,Iedge and belief the statements contained in this application,together with the plans and specifications sub- mitted, are a true and con.o 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 shallb�ed with whether specified or not, and that such work is authorized by the owner. Sworn to before me this. Signature "�� OWNER.OWNERS AGENT.ARCHITECT.CONTRACTOR day of 19 NOTARY PUBLIC. WARREN COUNTY..N. Y. SPECIAL CONDITIONS OF THE PERMIT: • By TOWN OF QUEENSBURY BUILDING & ZONING DEPT. OUEENSBURY TOWN OFFICE BUILDING BAY & HAVILAND ROADS, HD41 GLENS FALLS. NEW YO 12801 APPLICATION FOR A PERMIT TO COMSTRUCT9 ALTER OR ENLARGE A SEWAGE DISPOSAL SYSTEM WITHIN. THE TOWN OF QUEENSBURtY© OCCUPANT IS NAME ,MDRESS "e/C.,-.60 TEL ETHON ovitlinv s `NAME ADDRE:m #2" Noma. OF BEDROWS GARBAGE GRINaER? "120 (Y'SS OR NO) TOP=APHY% FLAT. ROU,TNG,; STEEP 81AVE. GENTLE SLOPE OTHER. UrsirOZ. , --nkrz.Z.7.704reArAr..a.z.ara,,,Srasutsz._ NATURE OF SOIL% CLAYS. SANDY, LOAM, GnAvaL, RICK0 PERCOLATION TEST WATER SUPPLYi, MUNICIPAT,, WELL, OTHER . DIAGRAM OF PROPOSED SIC MtWEM • • • • ),,E1 MIER PERTINENT INFORMATION • Mal4SASS ....1 .1paarspse.trwatear.e.-Yra.s21.41.33..aswead,-.INSas..folosAla,-X,..1.,, ca--r-I.MAIrszezwERmasaaseitstratroc. .,Dvers litMuzxgcsuwanesavg.-erm.cipf cOft.2 IT IS HEREBY AGREED THAT IF THIS APPLICATION AND PLANS ARE APSROIM,D9 INCTALLATION OF SEWAGE DISPOSAL FACILITIES WILL. BE mAne IN ACCOPDAVLE WITH DETAILS SHOWN. PERMIT FEE IS $5,00. DATR 9- 7, SIGNATURE OF APPLICANT • • TOWN OF QUEENSBURY. Building- Department Inspectors R�/ep,rt Date 1 `r?J'- /� Name (-J////�;: 1�i(--( Location Zit/, Permit No. .°S ,/U Weather Per Cent • • Complete Remarks Excavation Footing Forms Footing & Piers Foundation Cement Coat Waterproofing Backfill • - Final Survey Framing Sheathing Roof Felt Roofing /1/ Siding Masonry Veneer A / Rough Plbg. t Rough Htg. V Relief Valves Wall Board ( ) (f Ext.Porches Finished Floor Interior Trim • Stairs&Railings [- Cellar Dr.Tile Concrete Floors Plbg.Fixtures / • Gar.Fireproofing Jj Door Closers Chimney Water Meter Inst. • Septic Approval Building Inspector REMARKS TOWN OF QUEENSBURY Building Department Inspectors Report Date Nara, `�,�t4�.t Location 5 Permit No. 51 V Weather Per Cent • Complete Remarks Excavation Footing Forms Footing & Piers Foundation Cement Coat Waterproofing Backfill Final Survey Framing Sheathing Roof Felt Roofing Siding Masonry Veneer Rough Plbg. j O/ Rough Htg. Relief Valves Wall Board r r Ext.Porches Finished Floor Interior Trim Stairs&Railings ', Cellar Dr.Tile rrA Concrete Floors Plhg.Fixtures Gar.Fireproofing Door Closers Chimney Water Meter Inst. Septic Approval • • 1 a Building Inspector REMARKS I . TOWN OF QUEENS-BURY Building Department Inspectors Report Date 7`i0j1/ Nam: / //ee. Location Permit No. Sa /0.. Weather Per Cent • Remarks Complete Excavation Footing Forms Footing & Piers Foundation Cement Coat ; Waterproofing Backfill Final Survey Framing Sheathing Roof Felt Roofing Siding .Masonry Veneer Rough Plbg. Rough Htg. Relief Valves Wall Board s\l< Ext.Porches Finished Floor Interior Trim Stairs&Railings . Cellar Dr.Tile Concrete Floors Plhg.Fixtures Gar.Fireproofing Door Closers Chimney Water Meter Inst. Septic Approval t/ „g2/q Building Inspector REMARKS i1 d1 TOWN OF QUEENSBURY. - Building Department Inspectors Report Date �/�,17 Name �4, e< L Location 0 Sys, 2 01- Permit No. a I0 Weather Per Cent Complete Remarks Excavation Footing Forms Footing & Piers Foundation Cement Coat Waterproofing Backfill • _Final Survey „ Framing () Sheathing. ✓✓✓✓ Roof Felt Roofing Siding Masonry Veneer Rough Plbg. Rough Htg. Relief Valves Wall Board -- Ext.Porches Finished Floor Interior Trim Stairs&Railings Cellar Dr.Tile Concrete Floors Plhg.Fixtures Gar.Fireproofing Door Closers Chimney Water Meter Inst. Septic Approval Building Inspector REMARKS TOWN OF QUEENSBURY Building Department iz ln5pectorm Report ate � (U11 Nara' & � LLocationLli fi �' �(� Permit No. 5-7 / ‘Y Weather Per Cent • Complete Remarks Excavation r/ Footing Forms / Footing & Piers L."' (/ ( , Foundation — Cement Coat Waterproofing Backfill Final Survey Framing Sheathing Roof Felt Roofing Siding Masonry Veneer Rough Plbg. Rough Htg. Relief Valves Wall Board fif5 \7 Ext.Porches J Finished Floor Interior Trim Stairs&Railings Cellar Dr.Tile Concrete Floors Plbg.Fixtures • Gar.Fireproofing Door Closers Chimney Water Meter Inst. Septic Approval wilding Inspector REMARKS