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7638 d CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date -1.e4 f 198_,5 301( This is to certify that work requested to be done as shown by Permit No. has been completed. This structure may be occupied as a � e-o l,21// 1 I AO. -1//�j Location �'_ %/ Die-if C. L 5) Owner ® n `ia. rr -4 ' By Order Town Board TOWN OF QUEENSBURY Building & Zoning Inspector CREATIVE "INSTA" PRINTING. GLENS FALLS. N Y 12801 I5I8 793.5656 BUILDING PERMIT TOWN OF QUEENSBURY 0 No. 7638 WARREN COUNTY, NEW YORK - PERMISSION is hereby granted to Don F. Maynard OWNER of property located at Lot 96 Helen Drive (St. No. 15) 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 approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. 1. OWNER'S Address is 20 Dorset Place Glens Falls, N. Y. t-+ 0 cr. 2. CONTRACTOR or BUILDER'S Name Same rn lri m 3. CONTRACTOR or BUILDER'S Address Same t7 4. ARCHITECT'S Name (D rn rt 5. ARCHITECT'S Address 0 H 6. TYPE of Construction— (Please indicate by X) • cv (X)Wood Frame ( ) Masonry ( ) Steel ( ) 7. PLANS and Specifications 32 'x60 ' per plot plan, specifications and No. application submitted including sewage system and 3 car garage (under) . 8. Proposed Use 0 One-Family Dwelling c� • $5. 00 C/O Paid H- $155. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES June 1 19 83 (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the C7 town of Queensbury before the expiration date.) (D Dated at the Town of Queensbury this 5th Day of November 19 82 SIGNED BY 67., :cam for the Town of Queensbury Building and Zoning I spector TOWN OF QUEENSBURY: (Space inside block to lx filled in by WARREN COUNTY, NEW. YORK Building Inspector) Application for Application No. . pp Permit Issued • 19. BUILDING AND ZONING PERMIT Permit Expires. 19 . /,"Wing District , • \ a l"c "I Work i • THREE (3) Copies of a PLOT PLAN, Drawn to scale ,\1)►,r"`c11 by showing the actual dimensions of the lot to be built ltcniui)( • upon, The exact size, and location on the lot of the . building to be erected or altered MUST BE SUB- MITTED WITH THIS APPLICATION. I TOWN OF QUEENSBURY /J q 6 — Li ---- 9 (a ' /742). it . 1 v7.2 12 V E Di - DATE A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK NOV 1 1982 ANSWER ALL OF THE FOLLOWING. • A.M. ‘60 12'e M781ryry11�12112i3 � � 6 The undersigned hereby applies for a permit:-to do .the following work 7181 1`1 tvl s 1 1 E r 1 e 1. )5 I. which will be done in accordance with the description,. plans and specifI- !_,.. cations, and such special conditions as may be ,indicated on the permit. G/ d The caner of this roperty is: l �G- (NA•lE) [P.O.ADDRESS) The rson responsible for supervision of the work insofar as the Building Code and the Zoning Ordinance apply is: fciel F /77*7<n i7 r-d 27) D.v/.-3-: . .a.:. (.1... . . . . . . . . . . . . . . . . . . . . . . (NAME) (P.0.ADDRESS Name of Builder. . . .c.(,77'e- Address Name of Plumber:. .S........... Address - Name of Mason J frri G- Address ] Lot Number GJ ./• . Unit Estimated value of proposed work S J-/-1 00.Z 4 `'D Name of Village cti tie-e s b 0f`t '( Name of Street )4 eii i O• 'v' Side of street: north 0, east 0, south O. west — Nearest Cross Street P e rn t-ic A e i p-,./Z_ Distance from this cross street ..i7'b Ft. er Property is north .1 ,south ❑,east' [-I, west 0 from Cross Street If on Corner, which corner, northeast ❑, northwest 0, southeast 0, southwest • (Designate by marking with an "X in the correct space.) • NATURE OF PROPOSED WORK " OCCUPANCY R IC Construction of a new building. . Main Building - - ❑ Addition to a building. . One-family dwelling' ❑ Alteration to a building. Two-family dwelling • ❑ ❑ Demolition of a building. -family apartment house ❑ Stor building J �� . . g -car attached garage Ca n c+'el`� . 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 buildings) in'dotted line and existing ,z, i ''/(Jl Id..(... huilding(s) in solid line. !, Size of property %O cl ft. x /S "(.) ft Size and use of existing buildings, if any • . ., r -\--t s ) J m Size of proposed building . . . .�0. . . ft.x ft. kHeight(from grade to ridge) _ '3 ft. Front yard , :3 3 ft. Side yards . . . . 1.D . ft. and 3. 7 ft. 1-ft,tifftJ Rear yard l 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: ood frame, fire safe, etc.?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Will any second-hand lumber be used? If so, for what? Material of foundation walls Thickness Depth of foundation walls below grade Continuous foundation? Will there be a cellar? If so, material of cellar floor Type of roof: Slo ed or flat? Material of roof . ' 3E.53 .A. { S n . " x ", spacing ((= Size, wood studs "o.c., length I E ft. Size, floor beams, 1st floor 1�• • "x �- ", spacing i C% "o.c., span .l:C*t .4-. . . . . .. ft. Size, floor beams, 2nd floor �Z " x . . .KC) ", spacing )to "o.c., span . . .j . 7..l.'L. . ft. Size, ceiling beams 12_ " x • • . fie ", spacing 1(. . . . ."o.c., span . .�l1 irl Ifil ft. Size, roof rafters or beams " x 0 ", spacing t "o.c., span k - ft. Exterior finish 1.-Ii F*)1 1 • •�U(4. St 01 e1 With what material? Finish of interior walls. . .�J If garage is to be attached, of what material is wall between garage and main building to be constructed? ` . . l iF` �l vet;-. . . .� Is there to be an opening be{ . . wem garap and building? F � . r z ,y. c i 1 �.-. Kind of heating system . ��� I Oil burner or coal? Will a flue-lined chimney be provided?LIDepth of chimney foundation below grade . ? >>3 0 4f: Height of chimney above roof. . - 1 v1',1gy Will there be a fireplace? . .1k)2? •(..\"t Depth of fireplace hearth r biji Will a toilet be installed? Will a kitchen sink be installed and connected to water supply?'�- Water supply (public water supply or pump) . i Distance of cesspool from any private well 1 t 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. ba r of my know,ledge and belief the statements contained in this application,together with the plans and specifications sub- mitted, are.a true and co.,.pplete 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 p posed work shall be complied with,whether specified or not, and that such work is authorized by the owner. a Sworn to before me this Signature ! )7� ayt'� •-!ez'�'�+_ y�� } OWNER.OWN, R'S AGENT.ARCHITECT,CONTRACTOR day of ! '�cL't'" 19. �' NOTARY PUBLIC. WARREN COUNTY. N. Y. SPECIAL CONDITIONS OF THE PERMIT: OCO • • • • • • By 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. Gros floor area 'LIG 2 . Type of heat \Q‘C ' 3 . Is the building mechanically cooled? IQD 4 . Percentage of area of windows and doors 1120.0k 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 1121i ���'U . - B 2 . R value of exterior walls ' 1y) J . 0)(4 /4- .` -� PsA u 3 . R value of glazed area /26 N3 4 . R value of doors t4-4,5 5. R value of floors over heated spaces 6 . R value of slab edge insulation - unheated slab C�a 7 . R value of slab insulation - heated slab ,3 8. R value of heated basement/cellar walls (above grade) 'a) 9 . R value of heated basement/cellar walls (below grade) WC) 10 . Type o.f insulation V.k -''[44 '" L)R -t J_F> C. Controls 1 . Thermostat maximum heat setting D. Duct Systems 1. Is duct system installed in unheated spaces? YES N a. If YES , R value of duct installation b. ' R value of duct in other areas E. Piping Insulation\ lr 1. Size of hot water or cooling carrying agent pipe 3 2 . R value of pipe insulation '-F. Service Water Heating 1 . Performance efficiency . 2 . Temperature control setting maximum G. For Swimming Pool Only 1 . Maximum heating Telephone No. 292- .3s3 2 (applicant ' s si�nature) TOWN OF QUEENSBURY BUILDING & ZONING DEPARTMENT SEWAGE DISPOSAL PERMIT APPLICATION 1. Owner ' s Name Address .Q (7 0 ars e P4_ . • Telephone No. 7q3-3S?'' Z. Property location /✓�/�h d)i-, 3 . Name of person or firm responsible for installing system • C,U.. .) 117/). 1 /c Telephone No. • Address 4 . Number of bedrooms (residential buildings only) -1-t.A, -'a 5. Daily flow gallons/day 6. Septic tank capacity / dpp gallons 7 . Topography: flat, rolling, steep % of slope 5'ce,pd 8 . Nature of soil and depth 54z4(71) r 9. If ground water, bedrock or impervious material is apparent at what depth does it begin? /V/44 ft. 10. Percolation test: A is required B 'T is not required C If required what is the rate minutes/inch 11. Water supply: municipal, well, other /n o „ ic/0 12. Type of system proposed:On ` , tile 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 floe. / i / 'A) 7( /i signature of V plicant 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 - BUILDING DFPARTN.ENT P. D. *1 BAY A`:D EAVILAND ROADS GLFNS FALLS, NF%' YORK Phone 792-5832 DATE: fs`vAI TO: ‘2,4 lS ,,, - -ems 47 Our records indicate that you were issued a building permit number 7 c, .3 2 on e a- for the construction of Our files show that the required inspections are incomplete. If still under construction please contact this office for an extension of your building permit, or if completed please contact -.as so we can take your card out of the active file. Next required inspection {,,�;u1 - For all new construction Town Law requires a Certificate of Occupancy to be issued by this Department before occupancy. Noncompliance may result in legal action. To avoid further delay and possible legal action, contact this office to make arrangements to update your file. OUFFNSRURY BUILDING DFPART? ENT BUILDING DEPT.COPY OF APPLICATION FORM 46-EL.NEW YORK BOARD OF FIRE UNDERWRITERS. FILE THIS COPY WITH BUILDING DEPT.WHEN REQUIRED. CITYOR- VILLAGE TOWNSHIP COUNTY } STREET AND NO.OR ROAD AND POLE NO. _ ,_ POLE NO. BETWEEN WHAT TWO CROSS STREETS IS • • PREMISES LOCATED? %-' - , , = - /.'. SECTION BLOCK LOT ir. OCCUPANT'S _ r BUILDING .1 NAME r - c ii r. % OCCUPANCY /,., 1 7 fC. ) OWNER'S NAME AND ADDRESS )"-`,, /. . , •, CURRENT SUPPLIED i ; • BY :. _ !: FROM THEIR f J,,r-I! _ OFFICE BSUILDING NEW /ii OLD❑ REMODELED ❑ ISORK NEW 0 ADDITIONAL❑ REMOVED.- DEFECTS ❑ LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED No.of Fixtures& BRANCH NUMBER OF OUTLETS Lamp Receptacles MOTORS HEATERS CIRCUITS 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 •r ._ - - Sub- base Base- / ment ): i r t7i 1st Fl. " 2nd Fl. F' ,.__ / ,' 3rd Fl. 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 '.} "j FEEDERS Li/. ,.,,,y LAMPS WATTS CHARACTER EXPOSED, GAS TUBE SIGN OF WORK ..CONCEKLED TRANSFORMERS OF VA WORK TO BE _.__ (NUMBER) (CAPACITY) STARTED COMPLETED SIZE OF SIGN - SERVICE r/ • MAKER ENTERS } BUILDING 1_ ..,,,, / : ,- J-1•„i , ':. -. . _ . . t / OF SIGN INSPECTION REQUESTED• l ON OR AS NEAR AS 'r' "`' v' �-' - r n POSSIBLE - % NEW I I OLD I I _ AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. PRINT NAME AND ADDRESS NAME OF 7 - r DATE OF - j% APPLICANT / _'•f -"!=i `71/ i APPLICATION - . ' — STREET ADDRESS P."/, _,- r 1-=''- 4' r: CITY OR / I ZIP LICENSE NO. POST OFFICE r : • /"/ r/R. - /r7 -(-J I CODE WHEN APPLICABLE / • • 46 EL(REV. 1/82) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING , r _ J....1: �J.P a..CA,,c)2k-��a...-$.... C��44..J.iCa,.lJ_,.CJ...),,k -.f.".CJne...e.1..),,,. �.!.A.),i.)�ti1-J..JJtia.".C�,.-l.....4.....).PtiaP.l)...ne-ilJ_�L•a.�J.�,!Jy4-J....-la��a�.adt.A.)_••,..a..l).�.A.A....VI.A. �/-4! — i- -i . % THE NEW YORK BOARD OF FIRE UNDERWRITERS �' BUREAU OF ELECTRICITY f 41 STATE STREET,ALBANY,NEW YORK 12207 • April �' 3 A location No.on file 6 �} �,2 C '� 4' Date PP f A fisA i ,� THIS CERTIFIES THAT ' - only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of • Don F. Maynard, Helen Drive, Quoensbuty, NPw York in the following location; ❑°-Basement LI 1st Fl. 2nd Fl. outside dC Section Block Lot 96 was examined on 3/3 0/ 3 3 and found to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS -.. OUTLETS ECEPTACLES SWITCHES INCANDESCENT FLUORESCENT MERCURY AMT. _K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. _ 26 83 37 25 1 2 FR - - DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS _ 'AMT. K.W. OIL ' H.P. GAS H.P. AMT NO. YSTEMS l -) .x, tr A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.H.P.P. NO.OF FEET 'AMT.• WATTS 1 Dryer #10 'Y ITT.? it 1 n, 4 SERVICE DISCONNECT NO.OF S "-v E R V I . C E - AMT. AMP. TYPE METER 1�,2W 1,S'3W 3 0 3W 3,9'4W NO,OF CC.COND. A.W.G. NO.OF HI-LEG A•W G• NO.OF NEUTRALS A.W.G. ` EQUIP. PER.B' OF CC.COND. OF HI-LEG OF NEUTRAL OTHER APPARATUS: j 7 0 INSPECTION , 0 _ 1 Don F. Maynard Glens Falls, New York 12 801 / 1 7 BRANCH MANAGER l f _ = Per 4 L*(11RAWNOnEntRARRnW vet vet 1tt vanilnat vo uZltt lit lit vet 1tt vet utu[ltt'mums lit ltt ut 1tt lttlttltt vat\k 1it lit lief]tie 1iV13i 1!Y - COPY FOR BUILDING DEPARTMENT.THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. TOWN OF QU•EE S U Y Building Department Inspectors Report Date 1.- tp.= Name . % fr'uol e; Location i>ie (e P 22) Permit No. VVeathtW Remarks Excat}a t1 on Footing Forms Footing & Piers Foundation Cement Coat — Waterproofing Backfill Final Survey r . Framing Sheathing Roof Felt Roofing Siding Masonry Veneer Rough Plbg. S9 (r) — Relief Valves Wall Board _. Ext. Porches — Finished Floor `• Interior Trim \ /L Stairs & Railings • Cellar Dr. Tile Concrete Floors _. Plbg. Fixtures iI Gar. Fireproofing _ Door Closers Chimney ---._— Water Meter Inst. Septic Approval Floors I Foundation Insulation Walls Ceiling . ,7",/ /, • • Building Inspector REMARKS TOWN •F U PS r L '.Y Building. i5ep:.anneal Inspectoin Repot Date 12—Z Name �, ,,, Locations Peanut No. Q _ Weather Remarks Excatiation 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 &Railings Cellar Dr. Tile Concrete Floors. Plbg. Fixtures Gar. Fireproofing Door Closers Chimney Water Meter Inst. Septic Approval Floors Insulation Foundation Walls Ceiling 4l . Build ng Inspector REMARKS TOWN OF QU•EENSBURY Building Department Inspectors Report ate f Name AilatA,-, Location `i R 11,t cy, . Permit No. 1 10 g Weather Remarks ExcaOat 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 Stairs & Railings Cellar Dr. Tile Concrete Floors Plbg. Fixtures -- Gar. Fireproofing - _. Door Closers �_ w Chimney --�_—_ Water Meter Inst. ° Septic Approval Floors L Insulation Foundation Walls ' Ceiling a Building Inspector REMARKS /r /i ) r:f, 7f7 OF ollIEENSBURY Built i$g ,n,:pargment huvectms Report Date /f:.-/r Name (444(4 LOCCEOB Prnit No. -7 6-3$ Weather Remarks Excavation Footing Forms Footing & Piers Foundation • Cement Coat Waterproofing Backfill Final Survey Framing • Sheathing Roof Felt , Roofing Siding Masonry Veneer Rough Plbg. ��fg�/ r�► ��In oA)4 Relief Valves Wall Board Ext. Porches Finished Floor Interior Trim Stairs & Railings Cellar Dr. Tile Concrete Floors P1bg. Fixtures /r Gar. Fire.roofin• Door Closers Chimne Water Meter Inst. - Septic Approval Floors Insulation FOundat_ion� �� Y Walls Ceiling Building nspector REMARKS TOWN f I UEE SBU Y Builidiallg Department Inspectors Reg Date //'Y2 9 - Name r -� /e4) Location __— Permit No. Weather _,_ Remarks Excatia t on Footing Forms Footing PiersI 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 & Railings Cellar Dr. Tile Concrete Floors Plbg. Fixtures Gar. Fireproofing Door Closers Chimney_ Water Meter Inst. Septic Approval Floors FoUndation Insulation Walls Ceil.in Building Inspector REMARKS N tt°F QL E NSBURY Building Department linspecters Repeat Date It— Na "k :v4 L.ocatioa /hV e 1).'. Permit No. 76 3 a 'ether Remarks Excavationaer 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 & Railings Cellar Dr. Tile Concrete Floors Plbg. Fixtures Gar. Fireproofing Door Closers ��_.. Chimney --- Water Meter Inst. Septic Approval Floors Foundation Insulation Walls Ceilin Building Inspector REMARKS STATE OF NEW YORK t:ik'�AR:.;. DEPARTMENT OF HEALTH '�� 1 OFFICE OF PUBLIC HEALTH DISTRICT OFFICE • 21 BAY STREET • GLENS FALLS, N.Y. 12801 • TEL. (518) 793-3893 DAVID AXELROD, M.D. Ian T: Loudon, M.D. : D.P.H. GLENN E. HAUGHIE, M.D. Commissioner Regional Health Director Director c-c'—;,n nc ^ ^n Brian S. Fear, P.E. • ' District Director Dl ( I ( (I(g1(tI(oTIG(slL •w°a w•� Z861 P f10N raR11310EU l 166 Azinesivaano mo NM®.L November 18, 1982 Mr. Stephen Lynn Queensbury Town Hall RD #1 Re: Evergreen Subdivision, Sect. III Glens Falls, N. Y. 12801 Lot #96 Queensbury (T) , Warren County • Dear Mr. Lynn: This letter is to confirm our recent telephone conversation regarding the use of seepage pits instead of a tile field on Lot #96. The subdivision map approved December 18, 1973, showed tile fields as the only means of sewage disposal. It is acceptable to this office that seepage pits be employed, provided that it is done under your direction and in accordance with the.New York State Department of Health Standards. Very truly yours, DSM/mh Dan S. Machell, P.E. Assistant Sanitary Engineer cc: Don Maynard