8698 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 8698
WARREN COUNTY, NEW YORK
t7
K
PERMISSION is hereby granted to Dr. .and Mrs. Frank Rollo
to
�*
OWNER of property located at Lot 25 Wildwood Race R+.
ran Acres Su ivisi.on) Street,Road or Ave. M
in the Town of Queensbury,To Construct or place a One—Family Dwelling HS
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.
n
EOMNIER'SAddressis
7 Wincrest Drive P'
Glens Falls, New York W
0
N
2. CONTRACTOR or BUI LDERS Name O
Howland Construction Inc.
3. CONTRACTOR w BUILDERS Address
Box 140 Star Route r
Glens Falls, New York K 0
4. ARCHITECT'S Name 0 it
Ct N
to
O :z
Fi H_
5. ARCHITECTS Address
(aa
E
00 .�
6. TYPE of Construction—{ply indicate by XI
C =
1✓•
OQ Wood Freme ( )Masonry 1 )Steel
'W to
O
7. PLANS and Specifications
28 'x74 ' per plot plan, specifications and
No. application submitted including two-car attached
garage and sewage system.
8. Proposed Use
One-Family Dwelling M
i
$5. 00 C/O Paid
$ 213 . 00 PERMIT FEE PAID—THIS PERMIT EXPIRES March 1 19 85
(If a longer period is required an application for an extension must be made to the Buildingand Zoning
town of Queensbury before the expiration date.) ng inspector of the
C7
Dated at the Town of Queensbury this 17 th Day of August 19 84
N
SIGNED BY '*—ma 0. „(,qMn
for the Town of Queensbury `Q
Building and Zoning Ingxeator
TOWN OF QUEENSBUR i •
(Space inside block to lx filled in by
WARREN COUNTY, NEW_ YORK Building Inspector)
Alocation for Application NO.
pP Permit Issued 19.
BUILDING AND ZONING PERMIT . Permit Expires. 'g.
7.c,i,i,.,, District
•
THREE (3) Copies of a PLOT PLAN, Drawn to scale .\l►1nc"c•ct by --"'
showing the actual dimensions of the lot to be built 1ti'mat'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 QUEENSBLIR';
)[) 4 - '-6 8 /G4 REGHVE3
DATE
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK AVG.; I. 6 ");iLi
ANSWER ALL OF THE FOLLOWING. P.M.A.M.
The undersigned hereby applies for a permit to do .the following work ?lgIgl1Ql1.1}12)1l2)31415�6
x
which will be done in accordance with'the description, plans and specifi- ., , a
` ' " a ao ` ��
cations, and such special conditions as may be indicated on the permit. ' do 8 F
The ow r of thi properertly is: • o t /L�-•,
a/',`%�`/ r I4 ,6 44., 7�i r�L�iE' 1 S-7 64s1)5/C:AiLc •
(NA.1E) /(P.O.ADDRESS)
The pe;son responsible/ for/ .supervision of the work insofar as the Building Code and the Zoning Ordinance apply is:
/��/ff.J[9n C:ox,B, Z . ,(�c, /'S'O 57, ,Q, T.1f�.GGEs�S. .i f-GG4,.o•�D,
(NAME) (P.O.ADDRESS)
Name of Builder GGS 4 Address /�
Name of Plumber. . ..it", C 4 Address /� % k4s /6/ ,10 5# r
Name of Mason _� Address
Lot Number Z 6-. . Unit Estimated value of proposed work S /J`O, ODe)
Name of Village n
Name of Street . . . . i:Lu� l/i''•/ Side of street: north ,, east. 0, soutp 0. west 0
Nearest Cross Street . . . W04, Distance from this cross street . . . 2 Ft.
Property is north 0,south ❑,east ' , west ❑from Cross Street
If on Corner, which corner, northeast [.:3, northwest ❑, southeast 0. southwest
(Designate by marking with an"X" in the correct space.)
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NATURE OF PROPOSED WORK OCCUPANCY •
N Construction of a new building. Main Building
❑ Addition to a building. One-family dwelling 0
❑ ,Alteration to a building. Two-family dwelling
❑ Demolition of a building. -family apartment house ❑
Store building ❑
•
. . . .a -car attached garage El
Other:
• v 'Accessory Building
. One-car detached garage Li
❑ Other work. Describe Two-car •detached garage 0
Private chicken house 0
Private storage building ❑
Other:
ZONING SPECIFICATIONS. Fill in for new building, or addition to existing building, or a change of occupancy.
_ . i • Indicate on the plot plan street names, the location and
size of the property, the location, size and setbacks of pro-
posed buildings,and the location of all existing buildings.
NORTH J Show proposed building(s) in;dotted line and existing
.Q l;uilding(s) in solid line.
332./ „0 Size of property 3 2 ft. x 3 90 ft
Size and use of existing buildings, if any
' b r
'' F- t
s tvj '1V5 m Size of proposed building 28 .:.� ft.x 7'y' ft.
5) (�j� Height(from grade toyridge) G/ ft.
Front yard . . ..tQ ft.
•
282.06 '` /9G.28� Side yards . . ./. U.4.. . .I. . . . . ft. and /60 ft.
(,v/lpu' O genii, Rear'yard '2 70 f 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.?. . . . f? '.. ...
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Will any second-hand lumber be used? NO If so, for what?
Material of foundation walls GeNe,R-941 Thickness .e
Depth of foundation walls below grade " Continuous foundation? .&
Will there be a cellar? 9444
IIf so, material of cellar floor . . Cv0e!Pikr?' .
Type of roof: Sloped or flat? . ...doiei" Material of roof // 1"'I ' 5 s/t/.)GG•ts
Size,wood studs 2, " x G ", spacing . . . . /.G. N . . . ."o.c., length.0 �" "a/ ft.
Size, floor beams, 1st floor . Zx/9.'' /Z"x ", spacing /G "o.c., span . .«�!. !S. . . . ft.
v-2e/2„ x '7 r
Size, floor beams, 2nd floor Z ", spacing . . . ./.(�. . . . . ."o.c., span rZ 13 ft.
g . . . . ./ y. . . . ."o.c., span /Z/� ft.
Size, ceilin beams . . . - . . 2. • • " x �i spacing
Size, roof rafters or beams 2 " x 12 ", spacing . . ./G "o.c., span /Z P. /4`../. ft.
Exterior finish y With what material? lv s��"�(
Finish of interior walls. . . . . . . ..1W.AZ4,-. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If garage is to be attached, of what material is wall between garage and main building to be constructed?
6/8 -� pneitzas e ,e/,,u/ ui - 2n6 .5TI/.O5— 'l. pr94,,,:tie
Is there to be an opening b ween arage and building? . 361,4
Kind of heating system 4'frr',/J' Oil burner or coal?
Will a flue-lined chimney be provided? . . .i1 ? Depth of chimney foundation below grade ,1-14
Height of chimney above roof ? ) Go.:4_ 2440 e(-4-00,44,0cs eke,,,044
Will there be a fireplace? V " Depth of fireplace hearth /G '
Will a toilet be installed? • 114"
Will a kitchen sink be installed and connected to water supply? . G/E-T
Water supply (public water supply or pump) /0 v/jo / �/
Distance of cesspool from any private well /d0 feet
Will drainage system be provided with required traps, cleanouts, and vents? . . 1,05
Town of Queensbury AFFIDAVIT �V/
County of Warren
State of New York
I swear that to it bra i of my knowledge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, are.a true and co.n,p 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 posed wo k shall be complied with,whether specified or not,
and that such work is authorized by the owner.
Sworn to before me this Signature ?.
OWNER.OWNER'S AGENT RCHITECT•CONTRACTOR
!Co day of AV 11-5/ 19
NOTARY PUBLIC. WARREN COUNTY, N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
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By
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TOWN OF QUEENSBURY
BUILDING & ZONING DEPARTMENT
SEWAGF DISPOSAL PERMIT APPLICATION
1. Owner' s Name f�, y./719S. 15;dl_,JE 0
Address 7 GlJiw c. ,44vi / eze.„„ ,„ ,.,'' ,
Telephone No.
2. Property location 6a f 2 5 -f,-' f4:4 - ‘a ,/ -
3. Name f� person or firm responsible for installing' system
/ ie/Zoixx! fr/eXo.. "ogle,, • Telephone No. 793 6507
Address v>(- /40 ,572M Auir4. 664 us / 9 ,v• g'
i /-
+ 4.' Number of bedrooms (residential buildings only)
5. Daily flow gallons/day
6. Septic tank capacity 1 ZSD :Noqr gallons
7. Topography: flat, rolling steep
% of slope
8. Nature of soil and depth ,S ,p9 0, vy`¢UJ L
9. If ground water, bedrock or impervious material is apparent at what
depth does it begin? ft.
10. Percolation test: A is required
B X is not required
C If required what is the rate minutes/inch ,
11. Water supply: municipal, - other G G
12. Type of system proposed drywell, tile field, other 3--' B x8044zp •
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 anitarys Sewage Ordinance.
Date ;� /G'l/ .7#7
sig ature o 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
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
2 . Type of heat 4,a4�A/t. '4 2 6T/1,,,,,,,a
3 . Is the building. mechanically cooled? Y4 s .
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 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
k 3 8 ,Qcaf —
2 . R value of exterior walls /Q/Q
3 . R value of glazed area 24
4. R value of doors
5. R value of floors over unheated spaces 3 0
y1 6. R value of slab edge insulation - unheated slab /J4f-
7. R value of slab insulation - heated slab A4 -
8. R value of heated basement/cellar walls (above grade),'
9. R value of heated basement/cellar walls (below grade)
10. Type of insulation ica 44sr
C. Controls Y
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
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
G. For Swimming Pool Only '
1. Maximum heating
Telephone No'. 793- Cfa7
applicant ' s si nature)
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BUILDING DEPT.COPY OF APPLICATION FORM 46-EL,NEW YORK BOARD OF FIRE UNDERWRITERS.
FILE THIS COPY WITH BUILDING DEPT.WHEN REQUIRED.
TEMP.# DATE
CITY OR
VILLAGE TOWNSHIP `'JFJ " ' JC /flu COUNTY
STREET AND NO.OR p1 f
. ROAD AND POLE NO. PJ/Z 1,VOJ"��i^•;1t POLE NO.
BETWEEN WHAT TWO
CROSS STREETS IS �j p �•
PREMISES LOCATED? Oil ledG�'tl �// SECTION BLOCK LOT 2
OCCUPANT'S BUILDING
NAME J �• ref. 4.J(.:�. POLL—, " OCCUPANCY C-'i"t E- — ! ', # 1 17'✓f=7 •
OWNER'S NAME � / n /
AND ADDRESS `/v, F,ll -,(.:p,,,tCG � �l.',C,P<.•^` ��/riele� (/�1..44.ri:�9� TEL.#
CURRENT
SUPPLIED
BY 4U4 (.: FROM THEIR OFFICE
BSUILDING NEW L OLD❑ DEFECTS
IS NEW 5.ti ADDITIONAL❑ REMOVED ❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
No. Fixtures&NUMBER OF OUTLETS LampfRec Receptacles MOTORS HEATERS BRANCH CIRCUITS OFFICE USE
Loca- ONLY
tion Side Attach't H.P. Watts A.W.G.
Ceiling Wall Recep'Is Switch Pendant Bracket No. Type Each No. Each No. Gauge INSPECTION
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 OVERHEAD UNDERGROUND MAKER
ENTERS
BUILDING OF SIGN
INSPECTION REQUESTED
ON OR AS NEAR AS
POSSIBLE NEW OLD ri
AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
PRINT NAME AND ADDRES
NAME OF / DA OF
APPLICANT�.+� F' /! /7.✓;%74',I ' • APP TLIECATION • g/Y/'`f
STREET ADDRESS ROY /-/O 7A2 e'i7Uiff Gl' r/1L.:✓ TELEPHONE# f -65
CITY OR f ZIP LICENSE NO.
POST OFFICE G .fir. 7-4//r _ CODE/����/ WHEN APPLICABLE
46 EL(REV.1/84) A SEPARATE APPLICATION MUST BE F.I LED FOR EACH SEPARATE BUILDING •
•
TOWWOF-QU'•EENSBURY •
Building Department
Inspectors Report • Date //51/i 5-
• Name J7h Fr-a_A,/<- R,e} 1 l 6
Location L-nT q s hi,. lcd 14)oa �( j,/er
Permit No. ��G, 7 r Weather
e h a( e/� / h? Remarks
Excat'ation
Footing Forms
Footing & Piers •
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing •
Sheathing
Roof Felt
Roofing
Siding e
Masonry Veneer •�
Rough Plbg.
Relief Valves /.
Wall Board �
Ext. Porches /
Finished-Floor �/ _ b/-\
Interior Trim f.,,/;,,,,p1:4( z:
Stairs & Railingsl
Cellar Dr. Tile
Concrete'Floors
Plbg. Fixtures �
Gar. Fireproofing •
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation
Walls
Ceiling
•
�rC
Building Inspector
REMARKS
i
z,
•
TOWN OF QU•EENSBU RY
Building. Department
inspectara Report Date `Q /,' X
Name Cis-%'-cr� — pc74
i
Location tvC..4 L
Permit No. -F(-,cJ 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
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railings / • \
Cellar Dr. Tile r
Concrete Floors
Plbg. Fixtures /
Gar. Fireproofing y�
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation '
Walls
Ceiling
Building Inspector
REMARKS
TOWN OF QUEENSBURY •
• Building Department
•
Inspectors 'Date /OA/ 4
Name (Or ( to Z. I!J-lit) c.c.)Le/v-0
L,ocatioc L► a k't d,l;u r r
. Permit No. "76 ?'? Weather
Remarks
Excavation •
Footing Forms
• Footing & Piers
Foundation
Cement Coat
Waterproofing
Ba`ckfill
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
•
• Building Inspector
•
KS
•
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