8204 C/O Paid
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW. YORK
Date January 18 19 8 4 •
I n ‘)
This is to certify that work requested to be done as shown by Permit No. 8 204
has been completed.
This structure may be occupied as a One—Family- Dwelling
Location Lot 27 Algonquin Drive (St. Noe 7)
Owner Dennis and Susan 17at.7J,51
• By Order Town Board
TOWN OF QUEENSBURY
th`l-014---4/(;—:, t--C1--e"
•
U"
Building 6 Zoning Inspector
{
CREATIVE "INSTA- PRINTING. GLENS FALLS. N V 12801 IS I C793-5658 •
BUILDING PERMIT
TOWN OF QUEENSBURY: . No. 8204 •
WARREN COUNTY, NEW YORK ro'
N,:
PERMISSION is hereby granted to Dennis and Susan Davis
OWNER of property located at Lot 27 Algonquin Drive (St. No. 7) 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
166 Bay St. N.
Glens Falls, New York Ci}
2. CONTRACTOR or BUILDER'S Name
R. B. Rickard Const. Co. Inc.
3. CONTRACTOR or BUILDER'S Address
122 Circular St.
fi
Saratoga Springs, New York
N
4. ARCHITECT'S Name
4
0
5. ARCHITECT'S Address •
/
6. TYPE of Construction— (Please indicate by X) H=
�)Wood Frame ( ) Masonry ( )Steel ( )
U)
7. PLANS and Specifications
24 'x62 ' 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
$ 70. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES May 1 19 84
(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.)
i..,.
Dated at the Town of Queensbury this 31st Day of October 19 83 1-,
SIGNED BY r l Y 64 (il../ ta. for the Town of Queensbury
Building and Zoning sbector
F-'
•
W
TOWN OF QUEENSBURY (Space inside block to be filled in by
WARREN COUNTY, NEW YORK Building Inspector)
Application for Application No.
Permit Issued 19.
BUILDING AND ZONING PERMIT - Permit }•:.pires. If1.
. ninc District
• \ ;doe ,i1 Work$ n„�
THREE (3) Copies of a PLOT PLAN, Drawn to scale \I,I ui c(1 by (�/
showing the actual dimensions of the lot to be built Rcinzit 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.
• TOWN OF QUEENSBURY
' 1. ' b:eki ' ' ' ' RECEJTE: '
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK ET 3 :t 1983
ANSWER ALL OF THE FOLLOWING. �. ��-UG ��
The undersigned hereby applies for a permit to do the following work A7�8J9�10�11g12y:1 p.m.
which will be done in accordance with the description, plans and specifi- A o ./a , e , a
cations, and such special conditions as may be indicated on the permit. e - L.f.
They,caner of this property is:
. . _t9ere-'/LV/& 'Y c-5'4154?-z/r) . .04--.CW5. M6 A2.e/. ‘5Z. d 6/67.ii:5 -7)/ )9/. ./d.?.)o/. . . . .
INA"E1 IPO.ADDRESS
Thexerson responsible for supervision of the work insofar as the Building Code and the Zoning Ordinance apply is:
3..R�G,.ebe�. . . .6/.,. .Crt�?r` it/&,1. . ./.43. :.6i�L'-.c:11 . 5e. .54C2-//l9 c7 .e/rr✓ .tV ,
_ '�' (NAME) IP.O.ADDRESS)
9 5/'i,�2
Name of Builder t7 F�.d9'�,r� Address
Name of Plumber.gyp-. .l�i�e•-, •,+ �• •&,)/-2 Address /`Ag.2-,C/ o.. 5 , .li!z/.•.�AA .�•
Q i/dCo / . Address . . . . . .J� mc=
Name of Mason _
A Lot Number. . . a.',� Unit Estimated value of proposed works . .3.8.5. ea .
( Name of Village /�
Name of Street �!/9U •yai/0 • /�/4r 4??_ Side of street: north 0, east 2'south ❑, west 0
J. Nearest Cross Street ..X cktft . . .S 1 - Distance from this cross street - • ".1--•
•
Property is north Pi south ❑,east i ],west. 0 from Cross Street
If on Corner, which corner, northeast 0, northwest ❑, southeast D. southwest
(Designate by marking with an "X" in the correct space.)
NATURE OF PROPOSED WORK OCCUPANCY
Construction of a new building. Main Building
❑ Addition to a building. •. One-family dwelling • .
Two-family dwelling ❑
CI Alteration to a building. -family apartment house ❑
CI of a building. Store building ❑
. .f.W P.-car attached garage 11
Other:
• Accessory Building
. One-car detached garage 0 ----,`
❑ 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
' IA .� size of the property, the location, sire and setbacks of pro-
f L posed buildings, and the location of all existing buildings.
NORT/H� Show proposed buildings) in`dotted line and existing
V./I11 S` `�f j _ / Y/ /. �/ huilding(s) in solid line.
I ( ' S ` / Size of property /-� ft. x /G ft.
:.� Size and use of existing buildings, if any
F , .
It m Size of proposed building . . .0.7 4• • • ft.x • Q• • • • ft.
Height(from grade to ridge) _ /' ` ft.
s`. f j j� Front yard . / pS ft.
c'. / Side yards ✓w .a ft. and . . . . I.').I.•.`-�'. . . ft.
.
4 Rear yard 'HI. ft.
SOUTH If on corner,setback from side street ft..
i
//,/' . 1 9 S . 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, etc2 (ARMS feneri�
Will any second-hand lumber be used? . . . .140 Aso, for what ��
Material of foundation walls . . . .10G).4 Y— . .e:7 Thickness .
Depth of foundation walls below grade 'I-2. Continuous found Lion?
Will there be a cellar? . . .076 If so, material of cellar floor . . . ./1ou4C=3-0 CUY1G' /0
Type of roof: Sloped or flat? . .S 40.8Z3 Material of roof . .L. . -
Size,wood studs Q. " x ", spacing f lD "o.c., length. . . -.g�/e. . . ft.
Size, floor beams, 1st floor a. "x /0 ", spacing /6."o.c., span 1..!2 ' . . ft.
Size, floor beams, 2nd floor' " x ", spacing - "o.c., span • `ft.
Size, ceiling beams " x '`•-1 ", spacing ca`f"o.c., span (2+.F.`.C'c11.'-i . ft.
,r
Siie, roof rafters or beams 4.12. . " x .7). u,s5• 5 ", spacing a4 "o.c., span c1-F.`.00Y) '`e. ft.
Exterior finish With what material?
Finishof interior walls
If garage is to be attached, of what material is wall between garage and main building 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
Will there be a fireplace? Depth of fireplace hearth
Will a toilet be installed?
Will a kitchen sink be installed and connected to water supply?
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?
AFFIDAVIT
Town of Queensbury
County of Warren
State of New York
I swear that to tt b rof my knowledge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, are a true and co.i.p•lete statement of all proposed work to be done on the described premises and that all provis. ne of the BUILD-
ING CODE,THE ZONING ORDINANCE,and all other laws pe ' roposed ork shall pc) pli with w er specified or not,
and that such work is authorized by the owner. n
Sworn to before me this Signature
OWNER. NEWS A ENT.ARCHITECT, ONTRACTOR
day of &— /7'ei" 19..E'.3
NOTARY PUBLIC. WARRrN COUNTY. N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
•
•
•
By
•
TOWN OF .QUEENSBURY
•
WARREN COUNTY , NEW PORK
�Y Q1%v IOyq F •
�� �4�APANT yc�
•
Application for : BUILDING PERMIT IN COMPLIANCE WITH T` ,0;`' ,,_ s Y' A
STATE ENERGY CONSERVATION CODE `
• A permit 'must be obtained before beg t f'3a-:•n•— *) ' �
ANSWER ALL of the following: `o�3213
THE SAN
1, Gross floor area 960 sq. ft.
•
2 . Type of _heat Electric baseboard • •
•
3 . Is the building mechanically cooled? no
. 4 . Percentage of area of windows and doors •
. A. Over 16% Only
1. Uo value of gross area of walls , roof/ceiling and floors
exposed to ambient conditions
•
•
2 . Floor over heated spaces YES•
a. ' 'Are foundation walls insulated? , YES
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 D .
• a. R value of insulation '
5. Type of insulation •
•
B. Under 16% Only
1. R value of roof and floors exposed to ambient conditions• ,
R=lq MA) • X;r3B iZe '
2 . R value of exterior walls
• 3 . R value of glazed area g^ /,Vc
•
4. R value of doors �r a•SP
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) 12.S.
9 . R value of heated basement/cellar walls (below grade) '5.5
10 . Type of insulation 'F,i3026, AS €ATTS
C. Controls
1. Thermostat maximum heat setting c
D.. Duct Systems -
1 . Is duct system installed in unheated spaces? YES 4
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 f5Co
G. For Swimming Pool Only
1 . Maximum heating
•
Telephone 'No. .5.8.50, 4/2u1 [';
44-e•-,49.
(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
VILLAGE - - TOWNSHIP • COUNTY ,
STREET AND NO.OR -
ROAD AND POLE NO. , POLE NO.
BETWEEN WHAT TWO
CROSS STREETS IS
PREMISES LOCATED? SECTION BLOCK LOT
OCCUPANTS BUILDING
NAME • _ OCCUPANCY•
,
OWNER'S NAME
AND ADDRESS • - -
CURRENT
SUPPLIED FROM THEIR •
OFFICE
BUILDING WORK DEFECTS I--I
IS NEW❑- OLD❑ REMODELED ❑ IS NEW ❑-- -ADDITIONAL❑ REMOVED Li
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
No.of Fixtures& BRANCH
NUMBER OF OUTLETS Lamp Receptacles MOTORS HEATERS CIRCUITS LAMPS
Loca-
tion
CeilingSide Attach't Switch Pendent Bracket No. Type H. No. Watts No A W-G- NO WATTS
Wall Switch yp Each Each Gauge EACH
Out-
side
Sub-
base
Base-
ment
1st Fl.
2nd Fl.
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 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
AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
NAME OF --- / - DATE OF
APPLICANT ! - - - APPLICATION - __ - -- '
STREET ADDRESSCITY OR ZIP LICENSE NO.
- - - -
POST OFFICE f CODE WHEN APPLICABLE
A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING
TOWN OFQUEENSBURY
BUILDING & ZONING DEPARTMENT
SEWAGF DISPOSAL PERMIT APPLICATION
1. Owners Name ✓/6,1/ .//,5 5c1S3. i A9/91Wc
Address /ll , ./I - 54.
/rirJS /5?-/�5' 4 j / 140/ Telephone No. 7 / elUz
2. Property location ? Q f,/7t')/,,t) r',,Piof 6/67,./5
3. Name of person or firm responsible for installing system
/40Z /9. G6/,9- Telephone No;
of //D
Address i 7�
, (7 ,, 47 6-6,ie'I4; /,,(/°!
/d.1j cD '
4. Number of bedrooms (residential buildings only) 7, e c
5. Daily flow A/5 6 gallons/day
6. Septic tank capacity /,, Odd (;!/ic c, . ' gallons
7. Topography: 400110 rolling, steep
% of slope,
8. Nature of soil and depth 3,9 /0/
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: municipl) well, other
12. Type of system proposed: drywell, i1e 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 /3 /9 c241 G ( ,l
signature of applic nt
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 Department
Inspectors rt epo ate / /6
Name eK /<.
Locaon
Permit No. Z. Weather
Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey �\
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves
Wa11 Board
Ext. Porches
Finished Floor ®�L
Interior Trim
Stairs & Railings IJ�1 Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures Q
Gar. Fireproofin f/
Door Closers V. O'
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation
Walls
Ce '1in
B i ing Inspe for
REMARKS
L< - DETrot CD S
•
TOWN OF QUEENSBURY
•
Building Department
Inspectors Report _ Date Z- 2-
Name f0/7-Vrs. . i,
Location L v T 7
. Permit No. '2-6 (/ �er
Remarks
Excavation
Footing Forms
Footing & Piers
• Foundation
Cement Coat
•
Waterproofing
Backfill
Final Survey
Framing •
Sheathing
Roof Felt
Roofing
Siding •
Masonry Veneer r
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. C�
4c.
Septic Approval V
Floors '
Foundation '
Insulation Wa1Zs
Ceiling
/ -� cJL
• Bif lding Ins ector
REMARKS
kLeY
•
TOWN OF•QUEENSBURY
Building Department
Inspectors depart Date 1 Z'S`'3
Name Rock et7 ! DAVIS
Location L-d'r 7 A- e r't
Permit,No. 0 If 'Weather
Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
•
Waterproofing
Backfill
Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding ////
Masonry Veneer d
Rough Plbg. ( 0/2
Relief Valves l \
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railings
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures -
Gar. Fireproofing 1
Door Closers • /
• Chimney `/
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation
Walls
Ceiling
(1!
. '} uilding In pector
REMARKS
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date //^ .5 -e-
Narne 7)Au/,5
Location 1,6+41 27 ,
Permit No. F o i�u Wea er
Remarks
Excatta tion
Footing Forms •
Footing & Piers ,�
Foundation I f
Cement Coat
,
Waterproofing If V,__
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
/r:2 r
Bui 1ding-?nsbectoCr
REMARKS P�
\e
v ` TOWN OF QUEENSBURY
Building Department
� il Q
Inspectors R Date (6/ 2-U G—
Name !g {� A v(sQ
0 3
1
Locationa 7
Permit No. c_ Weather
✓I
{{;7 c2 0 Remarks
ExcatjatonFooting Forms 14,
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 N
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation
Walls
Ceiling '
al 7A 1
'ng Insector
19- ii4-
REMARKS
• I
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