1986-464 • CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date amuary 30
This is to certify that work requested to be done as shown by Permit No. 66-464
• has been completed.
This structure may be occupied as a One—Yznily Dwc.1ling
Location Piciae Pill Road, •~and Upper Ridge Road
Kathleen Mar tillez
Owner
By Order Town Board
•
TOWN OF QUEENSBURY
4,1
47,4
7 -
Building & Zoning Inspector
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 86-464
WARREN COUNTY, NEW YORK
.Kathleen Martinez
PERMISSION is hereby granted to r
OWNER of property located at Pickle Hill and Upper Ridge Roads 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 n`
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is Star Route
Glens Falls, New York
d
2. CONTRACTOR or BUILDER'S Name
Northern Homes Inc.
•
3. CONTRACTOR or BUILDER'S Address
51 Glenwood Avenue
Glens Falls, New York b
N•
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4. ARCHITECT'S Name
(D
F'•
N
5. ARCHITECT'S Address P
P,
_ U
6. TYPE of Construction—(Please indicate by X) co
( )Wood Frame ( )Masonry ( )Steel ( ) p;
QQ
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7. PLANS and Specifications ,b
0
No. 24'x28' per plot plan, specifications and application submitted p,
including sewage system, one—car garage under. '
8. Proposed Use
One—Family Dwelling
$5.00 C./0
82.00 PERMIT FEE PAID—THIS PERMIT EXPIRES Feb. 1 19 87
(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 31st Day of July 19 86
SIGNED BY 2a for the Town of Queensbury
Building and Zoning Inspector ��
Application No. _.•✓own. ol Queenaburi Permit Issued 19 TOWN OF QUEENSI URY
•BUILDING and ZONING DEPARTMENT Permit Expires 19 (�1 (�
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation • I�
Queensbury, New York 12801 Variance No.
Site Plan Review No. � i G,O,
/ A.M.l! ��Pe6 g g r
1 -- �, l Approved by:
. „`' APPLICATION FOR • �i(f/Y`"1 e e e r e e. e o a
•
. EUILDING .AND ZONING PERMIT
* * *:.4 * *. * ..* * * * -* * * * * * * 1 * * * * * * * * * * * * * * * * * * * ::
` 'A.PERMIT MUST. BE OBTAINED BEFORE BEGINNING CONSTRUCTION.' ANSWER ALL.OF THE FOLLOWING.
. The undersigned hereby applies for a Building Permit to do the following work which will
be done in accordance with the description, plans and specifications submitted, and such •
special conditions as may be indicated on the Permit. - . ' . .
i
The owner of this property is: \v r '&L 2i� is M AR 7I N
P.O. Address j Tel.
Property Location: eVi2f1i t2. to vi Glee 111 I I I j, ,/�te;, 0d) S,- 6`15/S' • Tax Map-
ap No. /
Street number or building lot dumber ' 0,-k 14/ -u - =—
Subdivision name (if applicable) Aii A
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS: •
.4!eir,,.Name , _�,� l �"-' P.O.- Address Tel. No.
Name of builder I,C•=�`t-L •ILe-tdz' ViA Address Tel.
Name of. plumber , Address . ' Tel. '
Name, of Mason Address Tel.
NATURE OF PROPOSED WORK: * ZONING INFORMATION: •
•
Construction of a new building * A'PLOT PLAN MUST BE PREPARED AND SUBMITTED,
Addition to a building ' . * drawn reasonably to scale and attached hereto,
Alteration to a building * showing clearly and distinctly all buildings,
•
(no change to exterior dimensions) * whether existing or proposed-andlindicate all
Other work (describe) * set-back dimensions from property lines. Give
* street and number or lot number and indicate
FOR DEMOLITION PERMIT, STATE SIZE AND * whether interior or corner lot. Show location
•
LOCATION OF STRUCTURES AFFECTED. • * of water supply and location and configuration
of septic disposal area.
*
' * COMPLETE INFORMATION REQUIRED BELOW. .
* ,Size of property '[s ue ft X i ft.
. * Existing building(s) Size ft X ft. _ I
* . .
PROPOSED BUILDING AND USE: *• Existing building(s) Use
Size of new structure V f t X t€,�f t � *' '
Foundation-pier/slab/crawl/partiai/�u * Proposed building, distance from property line
(circle one)
•No, of stories (habitable space) .. * Front yard cx ft Rear yard ��. ft
Height" (grade to ridge) %12 ft. * Side yards L2 ft and 1/2-5- ft
If residential, no. of families * If on corner, setback from side street ft
No. of rooms(excluding baths) 57"• * • • OCCUPANCY INFORMATION •
No. of bedrooms * PRI RY BUILDING -
No. of bathrooms a, * One familjr dwelling
Primary heating system FJ, eits * Tw family dwelling
Type of fuel
No. of fireplaces to be installed ,/OI'0. * - ltiple dwelling / Number of units
* Permanent occupancy
Will a wood stove be installed? 1 * Transient occupancy
Central Air conditioning? 00 .
* Business •
BUILDING STYLE, PRIMARY STRUCTURE *' Industrial
Ranch Contemporary Log cabin * . other ' .
Raised ranch Mansion Duplex * If addition, what will use be?
Split level Old style Bun alo
Cape Cod Cottage • Other SAS& * ACCESSORY BUILDING-
Colonial Row Town House * ' Detached garage/one car/ two car/ .car
( CIRCLE ONE PLEASE ) * Attached garage/one car/ two car/ car
* * * * * * * * * * * * * * * * * * ' Private storage building
ESTIMATED MARKET' VALUE OF * •Other f (,1k, 666 btewIliPek, •
CONSTRUCTION ; * .
INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
Form BPA 4/86 and-vl • -
BUILDING .PERMIT APPLICATION CONTINUED - '
'BUILDING SPECIFICATIONS:
`Type of construction; clod ffr fire safe,etc. '
Will any second-hand or ungraded lumber be used? If so, for.what? Oczs.
' Foundation wall material (D\fie - Thickness f( Tbcd, .
r
Depth of foundation below grade (to bottom of footing) Ca ._
Will there be a cellar? (446 Heated or �nheateV • Floor sq. footage j‘l sq ft
Will..there ,be a basement Will any portion be used as living space? k)O,
(If so, what portio.? sq.ft. - - Type of .use? _
Type of roofc- slope lat/shed/other Material of roe W o 1
Size, wood stud "X 4 " spacing rt, "o.c. length-7--e ft.
Joists(floor beams) 1st. floor / "X (. 0 " spacing ft,' "o.c. span `oft. •
Joists (floor beams) 2nd. floor /) "X /b " spacing 1,,Ip "o.c. .span IC. ft. .
Overlays(ceiling beams) /7 "X (, " spacing l,, "o.c. span (L ft.'
Roof rafters Q "X " spacing o.c. span t j,ft. ,(tom /6 aC-- f/ . efe'l
Roof trusses(pre-engineered) spacing IV4 "o.c. span ft.
• Exterior wall finish ►X U 2. ►X 3 !Z,S£ ?iib e Of what material? Vt/tTty, •
Interior wall finish °1f2,. a -u tLL:
'II a -garage_is to be attached, describe materials to be used £ar FIRE SEPARATION:
• 1/54e Eke ; ye ,
Is :there- to be an openingy between garage and dwelling? ge,S If so will a Fire-rated •
door, enclosure, and self-closing device be provided?- C, p S
Will a flue-lined chimney be installed? k/tl- Height above roof ft.
Depth of chimney foundation below grade imhs.. ft. - - .
Depth of fireplace hearth 0/A- ft. in.
Water supply - Municipal or private well
SEPTIC SYSTEM _ Distance from ANY private.well(including adjoining properties 100 ft.
(A separate application is necessary for any repair or new installation of septic' system)
Town of Queensbury • A F F 1 'D A V 1 T STATE OF NEW YORK
County of Warr„pn
•
I swear that to the best of my knowledge and belief the statements contained
in this application, together with the plans and specifications submitted, are a true and
complete statement of all proposed work to be done on .the described premises and that all
provisions of the BUILDING CODE, THE ZONING ORDINANCE, and all other laws ilertaining to
-the proposed work shall'be complied with, whether specified or not, and that such work is
authorized by the owner. // /
1` ,-
SWORN TO BEFORE ME THIS Signature /Ur _
Afeieeta>
Owner, owner's agent,axcnitect,c tractor
• day of 19
Notary Public, Warren County, N.Y. -.'i 1,.
* * * * * * * * *" * * * * * * * * * * * * * * * * * * * '* * * * *+ -* * * * * * * * * * * * *
' SPECIAL CONDITIONS CF THE PERMIT: ' ` : • '..
. - C
By 4% 3
own of Queenitury APPLICATION FOR SEPTIC DISPOSAL PERMIT
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.O. 1 Box 98 '"�
Oueensbury, New York 12801 DATE / / 8 46,
•
LOCATION OF PROPERTY FOR INSTALLATION
OWNER'S NAME
N
a( : -) --tt �--� � - i2°�t 1/U~e.2- i
ADDRESS C--'ta.0 K-�X a - !IP.
/ it / TEL 6 - ! 7
INSTALLER' S NAME _iiiiiLIE a � (�j� TEL TEL / -J7
' Number of bedrooms(residential only) . `G..- i
•
• Total daily flow(compute @ 150 gal per bedroom) E
Topography: Flat - Rolling - . Steep slope - (circle one) % of slope
Soil nature \sLa�m1- Clay - Other Depth ft.
Ground water -At what depth? Nii - ft. .
Bed-rock or impervious material - At what -depth? / . ft.
Percolation test- - .Not required - Required - -Rate A-V A. min-inch.
Domestic water supply Municipal jii7 Other -
Separation - Watersupply(if well)- from Septic absorption to to ft.
Proposed System: Septic tank (to'o gal. ( -Minimun size, 1000 gal. )
Tile Field - Each trench ,, # ft. Total system legnth • ), ) ft. ,
Seepage pit(s) Number of - . Size each ' ft X ' ft .
Size of stone to be used # Depth or thickness - - ft.
IMPORTANT! !
On. a separate piece of paper, submit a diagram of the proposed system
with all dimensions shown; including, distance from any structure, •
distance from property lines and from ANY DOMESTIC WATER SUPPLY or
shore-line of lake, stream,pond or. wet-lands. Include all dimensions of
•
the system, itself.
* * * * * * * * * * * * * * * * * * * * * * .* * * .* * * * * * * * * * -* *
I .have read the. regulations on the reverse side of this sheet and .agree
to abide by these and all requirement of The Town of Queensbury
Sanitary Seage Disposal Ordinance.
Signature "f r sponsible per: on ' : ,...„ 40-7 44-H)
Date • cr.-- %....___..- k
05/86 and/vl
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 iDy
4
2 . Type of heat 1gL 1
3 . Is the building mechanically cooled? �®
4. Percentage of area of windows and doors e2CD
A. Over 16% Only
1. Uo value of gross area of walls , roof/ceiling and floors
exposed to ambient conditions
2 . Floor over heat spaces YES NO
a. Are foundatio\n walls insulated? YES NO
1. If YES, what is th-e' R value?
3 . Slab on grade YES - NO
a. If YES , what t e R value of insulation around
perimeter of floor?\
4. Is basemen eated? YES NO
a. R val a of insulation
5. Type of insulation
•
B. Under 16% Only
1. R value of r G:f and floors exposed to ambient /Conditions_
2 . R value of exterior walls `��g.� e fig + -
3 . R value of glazed area
4. R value of doors ( .. j 4.i e4
5. R value of floors over unheated spaces 12.14
6. R value of slab edge insulation - unheated slab � +c
7. R value of slab insulation - heated slab /PK.
8. R value of heated basement/cellar walls (above grade) .` _/JL-
9. R value of heated basement/cellar walls (below grade) WA-
10. Type of insulation aLO ` el-WAWA-1 '��a B Q 4L0'�<
C. Controls 02-111titAlC ri--%
1. Thermostat maximum heat setting C: Oe
D. Duct Systems A
1 . Is duct system installed in unheated spaces? YES 0
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 - if _ i 3/ty
2. R value of pipe insulation
F. Service Water Heating
1. Performance efficiency /,,
2. Temperature control setting maximum IClt)
G. For Swimming Pool Only
1. Maximum heating (`-)l (4.)-
Telephone No. 79 - (0007 �! 14.
C( �pli nt I s'gnat�ure)
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R 006 E 2
Ric, \ PS\P -c-i1c O--3-ses T-L-Ait 1110 VtL1 r
_Down o/ QueeniUur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME /I/ 'r"/,.i G—`�..
LOCATION f-I i.� ,j-J2-f?
DATE ///Z/C PERMIT NO. t4 ._ii 6
--/-
SOIL TYPE - and - Loa - Clay -
Percolation Te quired? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM: _
Absorption field, total length
Length of each trench 2
Depth of trenches a (,42. 1
Size of gravel O____. _
SEEPAGE PITS4Nuinber of)
Size- ft. X _ ft.
Gravel size
PIPING: Size Type
Bldg. to tank I ( w',�7-
Tank to dist. box 7% I
Dist. box to field/•
Openings sealed? NO Partial
LOCATION/SEPARATIONS: -
Foundation to tank ft.
Foundation to absorption ft&
Absorption to lot line jb ft'
Separation of pits ,f, ft.
LOCATION OF SYST u el '•OPER>TY(circle one)
Front - Rear - L-ft side - Right side -
COMMENTS:
SYSTEM USE APPROVED YE NO
�/�
Bu��ding Inspector
01/86 and vl
_/oivn •o/ Queenitury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC ISPOSAL SYSTEM IiN�P/ECCTION
NAME N`/1C't �G....-
66-7---
LOCAT I ON kie-4. 7 ./ ��f.1//4- A
DATE l u /3/ PERMIT NO. 6^f "�
SOIL TYPE - Sand - Loam - .Clay
Percolation Test Required? YES - NO
Percolation rate - Min/Inch .
TYPE of SYSTEM:
Absorption field, total length 1J
Length of each trench ,,51::›
Depth of trenches • a`
Size of gravel 21.',�-
SEEPAGE PITS{Number of) --
Size- ft. X ---ft.
Gravel size -
PIPING: Size Type
Bldg. to tank 'a* W2
Tank to dist. box
Dist. box to fiel. .
Openings sealed? NO Partial
•
LOCATION/SEPARATIONS:
Foundation to tank Q2(ft fi
Foundation to absorption by ft. p'
Absorption to lot line ft--:-i
Separation of pits . ^ ft.
LOCATION I STEM ON PROPERTY(circle one)
Front - Left side - Right.side -
COMMENTS:
\ k
5 ••l
P ,
•
•
SYSTEM USE APPROVED NO •
Building Inspector
•
01/86 and vl
_Down o� Queen3bury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR' S REPORT
NAME
LOCATION Q\6o 60-
Date id z-/ Permit No.
* * * * * * * * * * * * * * * * * * * * * * *
f� = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing • I
Backfill
Framing D.
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors A
Plbg. Fixtures
Gar. Fireproofing
Door Closers \
Smoke Detectors
C)ximney /'� \
INSULATION:
Foundation �\
Floors
L- alls c .�
moiling ifr
FINAL ELECTRICAL INSPECTION
Final Building Survey
Next scheduled Inspection(call when ready)
Remarks- -
Building Inspector
6/86 and-vl
Carrcq -71 (D(Jt.*
Jown o/ Queenihury
BUILDING and ZONING DEPARTMENT
Bay and Havilarid Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR' S REPORT
NAME 4 f' /eey P44"A M C'Z
LOCATION P,Ck/r ,'iiii OLD 4 g" Nj'C
•
Date 7/.L1 /16 Permit No. JG " TG
* * * * * * * * * * * * * * * * * * * * * * *
io' = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing R -4—r. '
Roofing
Siding •
Masonry Veneer
cRough Plumbing5,o B01��. 9a. . 2_ •
Relief Valves
Ext. Porches
Finished Floors
Interior Trim •
Stairs & Railings
Cellar Drain Tile
Concrete Floors \ ✓ •
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION:
Foundation
Floors • •
Walls •
Ceiling
FINAL ELECTRICAL INSPECTION •
Final Building Survey
Next scheduled Inspection(call when ready)
Remarks- - / v
Hee,"
f 7
ierm/6„
Building Inspector
6/86 and-vl
N-b111-0-7077) Pr"
actin o f Queenibury •
BUILDING and ZONING DEPARTMENT
Bay and Havilarid Road, R.D. 1 Box 98
Queensbury, New York 12801
/ 2 - / �wd
BUILDING INSPECTOR' S REPORT
NAME / (elei `hafr-r)62 �Z
LOCATION J{,c;, L`/ 12. c.
,(
Date ,f /5t, Permit No. W i-
* * * * * * * * * * * * * * * * * * * * * * *
PRWED - YES / NO
®Footing/Pier Forms g. .,,i,L-)
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding •
Masonry Veneer
Rough Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings )'
Cellar Drain Tile \
Concrete Floors \
Plbg. Fixtures '
•
Gar. Fireproofing 1
Door Closers
Smoke Detectors
Chimney
INSULATION:
Foundation •
Floors • '
Walls
Ceiling •
FINAL ELECTRICAL INSPECTION •
Final Building Survey '
•
Next scheduled Inspection(call when ready)
Remarks-
•
Building Inspector
6/86 and-vl
•
awn of Queeni‘ury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queenbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME 4i7/9""gr-/ it_
LOCATION 1411lL
Date g t/er / Permit No. '(p_ L(a�
* * * *` * * * * * * * * * * * * * * * * * * *
✓= 7ROVED - YES / NO
"Footing/Pier Forms .r. ,� kaoze
Foundation (,
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings q
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures
Gar.. Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION:
• Foundation
Floors I
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
Final Building Survey
Next scheduled Inspection(call when ready)
Remarks- -
1-44481-4-1
Building nspector
6/86 and-vl
_ 1 i
awn of Queenurcy
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME �, �
G i
LOCATION
440
rr
Date D ? / 0 Permit No. t� - ��
* * * * * * * * * * * * * * * * * * . . * * *
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing `\
Backfill .
Framing ,
Roofing 1
Siding I .
Masonry Veneer
Rough Plumbing
Relief Valves 1
Ext. Porches j
Finished Floors
Interior Trim
Stairs & Railings 1
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures
fir. Fireproofing ,��
Lor Closers Z,i
Smoke Detectors
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
P Next scheduled inspection (call when ready)
Remarks-
Building Inspector •
6/86 and-vl
owGn •lof Queen it ury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
• Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME /
LOCATION
Date !/2 g / Permit No. /0 L'--
00/ APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext. Porches N it
Finished Floors �, fi
Interior Trim
Stairs & Railings
Cellar Drain Tile (�
Concrete Floors Ii
4bg. Fixtures
a�G .r. Fireproofing Q ,��� v boor Closers j GG
Smoke Detectors •
Chimney
INSULATION:
Foundation
Floors
Walls
' Ceiling
✓rLINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)__'
Remarks- f \ �"
c/01'6
Building Inspector
6/86 and-vl
• awn 'Of Queens1ur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME K� I- [eeii /176Iu- Il'I e2-
LOCATION plc Ak red
Pr,c1 '`c'
•
Date //,l / Permit No. .® y
k' = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
/Roofing
�iding 4
Masonry Veneer
RoughR Plumbing
'lief Valves \ 7 Q t
Al. Porches
/�f�'ished Floors 42
Lnterior Trim / \ SPC
airs & Railings . I
Cellar Drain Tile /
Concrete Floors
AS.bg. Fixtures i I"
ar. Fireproofing (? `,j ,'r' l/
or Closers Z?JS?/jtL PirIJ
,smoke Detectors
Chimney
1SULATION:
Foundation
.PToors &9 lc
ling
FINAL .ELECTRICAL INSPECTION ?e�,,,,,q/
DRIVEWAY APPROVAL "((,//��
Final• Building Survey
Next scheduled inspection (call when ready)
Remarks-
411'a-"
4
•
•
•
t4416
Building Inspector
6/86 and-vl
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