1985-301 ✓ /O 'Dd i d
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Dare 19
This is to certify that work requested to be done as shown by Permit No. c
has been completed.
This structure may be occupied as a
Location
Owner
By Order Town Board
- T;TOWN OF QUEENSBURY
_ SJ
Building & Zoning Inspector
r
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 8 5-3 01
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Annegret LaVoy
Lake
OWNER of property located at Fitzgerald Road and on Glen Street, Road or Ave.
N
one-Family Dwelling `n
in the Town of Queensbury,To Construct or place a y g _ n
at the above location in accordance to application together with plot plans and other information hereto filed and oy.
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
C
9. OWNER'S Address is RD #1 BOX 167 0
Glens Falls, New York
2. CONTRACTOR or BUI LDER'S Name
Same
3. CONTRACTOR or BUILDER'S Address F-t
same 't
(a
n
4. ARCHITECT'S Name `
O
5. ARCHITECT'S Address
P)
6. TYPE of Construction—(Please indicate by X) O
-Tw
(XI Wood Frame ( ) Masonry 1 1 Steel ( 1 l
. N
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7. PLANS and Specifications
22'x40' per plot plan, specifications and N
No. application submitted including sewage system. ?.
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8. Proposed Use
One Family Duelling
0
�5. 00 C/O Paid 7-. P
m
$63. 00 January 1 - 19 86
PERMIT FEE PAID—THIS PERMIT EXPIRES �
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the .
town of Queensbury before the expiration date.)
85tZI
Dated at the Town of Queensbury this lath Day of June �g :4
(D
SIGNED BY 1'J6 % for the Town of Queensbury N
Building and Zoning Inspe r F5
LQ
TOWN OF QUEFNSBURY
r BUILDING & ZONING DEPARTMENT
SEWAGE DISPOSAL PERMIT APPLICATION
1. Owner's Name lr-e�
Address �� � "Za Y. tl-
C� L&#JS I4LAA 9.2•$`fl Telephone No. ' 11 - S &3 1
2. Property location Fli?.temA
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3 . Name of person or firm responsible for installing system
Telephone No. r
Address ?
4. Number of bedrooms (residential buildings only)
5. Daily flow gallons/day
6. Septic tank capacity r® ® f gallons
7. Topography: fla , rolli , .steep
% of slope
8 . Nature of soil and depth ("
9. If ground water, bedrock or ixTa
vious 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
Pat I.#.4t) W(�L,L- �
11. Water supply:
12 . Type of system proposed: tdrywel7ltile 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 in Section 6 .010 of the
Queensbury Sanitary Sewage Ordinance.
Date 1 �' "-`'�
'" /signat re 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
JIi;
-75
061- b}8R
C3
well _
R�ptate ccoo
tst< y
P t rya
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t�t,�W' ��� r►tNErnar.Ma.
' 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 ggo L
2 . Type of heat G �e4+t-L�,
3 . Is the building mechanically cooled? N O
4. Percentage of area of windows and doors
A. Over 16% Only
1 . Uo value of gross area of walls , roof/ceiling and floors
exyosgd to ambient conditions
K"2
2. Floor over heated spaces YES NO
a. Are foundation walls insulated? NO
1. If YES , what is the R value?
3. Slab on grade YES NO
valu
a. If YES , what is the e of insulation around
perimeter of floor?
4 . Is basement heated? ES 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 unheated ' 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
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
TOWN OF QUEENSBURY
(Space inside block to lie filled in be
WARREN COUNTY, NEW YORK Building- Inspector►
Application for .application No.
Permit Is,ued 14.
BUILDING AND ZONING PERMIT I'c'rmit Expires. 1�7.
- 7.nirin� I)�strirt ¢��J
� i n-r r cd hN
THREE (3) Copies of a PLOT PLAN, Drawn to scale I ► "
showing the actual dimensions of the lot to be built llc'niaryx
upon, The exact sire, and location on the lot of the
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION.
'SOWN OF
DareIEENb" U �l
A PERMIT MUST BE OBTAINED. BEFORE BEGINNING WORK
ANSWER ALL OF THE FOLLOWING. I€l, : F
t �The undersigned.hereby applies fora permit to do the following work
} 8 , >
which will be done in accordance with the description, plans and specifi- A.M.' �P.M.
cations, and such special conditions as may be indicated on the permit. 71�1?Rql�Ml ',y
The owner of this p perty is: - c° UZ
. . . . . . . . . . . . . . . . . � e. et. . . �:aU. . . . . . . . . �?•"D. . . . .`B. . . .��7. . . - . ��.�s . . �4.4,e7 . . t,) ri%o(
(NA'•,_) � (P.O.ADDRESS)
The person responsible for supervision of the work insofar as.the Building Code and the Zoning Ordinance apply is:
l l
(NAME) (P O.ADDRESS)
Name of Builder. . . . . . . . .. . . . . . . . . .Address . . . . . . . . . . . . I . . . . . !.l. . . . . . . . . . . . . . . . . . . . . .
Name of Plumber. . . . . . . . . . . . . �. . . . . . . ..- . - . . . . - . . . . :. . . .Address . . ... . . . . . . . . . . . .! t. . . . . . . . . . I . . . . . . . . . . . . .
Name of MasoLLnt.. . . . . .e. . - :. . . . . �. . . . . . . . . : . . . . :. . . . . . . . .Address . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Lot Number. .?/`�". . . . . Unit . . . . . . . .. . . . Estimated value of proposed work S . 440. . . . . . . . . . . . . . . . . . . . . . . . .
Name of Village . . . . .t �tttusbN.e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . .
Name of Street . . .FI�".?� {'�! . . . ($i�. . . . . . . . . . . . . . . . . . . . Side of street: north , east ❑, south ❑. west ❑
Nearest Cross Street . . . .1444,yto1 . . . . . . . . . . . . . . . . . . . . . . . Distance from this cross street . . . . .;��.'�. . . . . . . . . Ft.
Property is north R,south ❑,east i i, west ❑from Cross Street
If on Corner,which comer, northeast Ll, northwest ❑, southeast ❑, southwest ..
(Designate by marking with an 'A" in the-correct space.)
NATURE OF PROPOSED WORK OCCUPANCY
Construction of a new building. Main Bugging
0 Addition to a building. One-family dwelling
❑ Alteration to a building. Two-family dwelling ❑
❑ Demolition of a building. . . • • - .-family apartment house ❑
Store building ❑
. . . . . . . .-car attached garage ❑
Other: . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . .
• . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . ... . . . . . . . . . Accessory Building .
One-car detached garage ❑
C] 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, sire and setbacks of pro-
NORTH posed buildings,and the location of all existing buildings.
Show proposed building(s) in dotted line and existing
l;uilding(s) in solid line. .