8760 } C/O Paid
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 19
t )-1 '
8760
• 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 One—Family Dwelling
l nranon
9Pilot Knob Road
Owner David Shaw
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoning Inspector
CREATIVE ••INSTA" PRINTING• GLENS FALLS. N Y 12601 1518)793-5658
e BUILDING PERMIT
TOWN OF QUEENSBURY
No. 8760
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to David Shaw p•
OWNER of property located at Pilot Knob Road 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 Box 31
Kattskill Bay, New York
2. CONTRACTOR or BUILDER'S Name
Jim Schoonover
ro
3. CONTRACTOR or BUILDER'S Address
Star Route 0
Glens Falls, New York
4. ARCHITECT'S Name 0
tr
0
ly
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel (X) Log
7. PLANS and Specifications 0
No. 38 'x40 ' per plot plan, specifications and application
submitted including sewage system.
8. Proposed Use Per Variance No. 935 granted 8-15-84. H"
One-Family Log Dwelling 'C
$5. 0 0 C/O Paid
$ 147. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 1 19 85 N
(If a longerperiod is required an application for an extension must be made to the Buildingand Zoning
4 PP inspector of the LC1
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 13th Day of September 19 84
SIGNED BY Q. /�J�?.�� for the Town of Queensbury
Building and Zoning Inspector 6
TOWN OF QUEENSBURY (Space inside block to lx filled in bv
WARREN COUNTY, NEW. YORK Building Inspector)
Alication for Application No.• :
pp Permit Issued 19"
BUILDING AND ZONING PERMIT . Permit Expires.
• - 'Lolling. District
\ : h R• n1 Work$`
THREE (3) Copies of a PLOT PLAN, Drawn to scale .\,',".",c•cl by iC ,l�',Q-
showing the actual dimensions of the lot to be built Itcmai'Kf
upon, The exact size, and location on the lot of the
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION.
`�^ Lf c �J y[/ TOWN OF QUEENSBURY
(itii� 61 J r 9- ' /J / // 0/C/ / DATE ' 8 !! :11ip A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK `� 1g�ANSWER ALL OF THE FOLLOWING. Cr a.The undersigned hereby applies-for a permit• to do the following work 7.1 ��which will be done in accordance with the description, plans and specifi- 7�$r9�ato1v e ll �Ications, end such special conditions as may be indicated on the permit. .
The owner of this proBety is: _De(//)(3F, '.tis//ifs ( ed R 3/. . . . A stf- i9/
The person responsible for supervision of the work insofar as the Building Code and the Zoning Ordinance apply is:
-0e4. Vi , . . . ...,).4 1-&..) 7-1- 3X ( ((A- / loll . ./st y
(NAME) (P.0.ADDRESS)
Name of Builder •t may` /1 ��U Ai`����''/` Address ;. ` X-"
Name of Plumber " ' a4 f/!T • • • 3 /0 t • Address
Name of Mason - • - , 't1 bt!Address
Lot Number Unit 1. Estimated value of proposed work S 7/ 7_2) d' 6 ..
Name of Village .+;.4_ •1 -I 4(..,«'y
Name of Street . . .,i/d . . •r�Na•6 ge.1,4 Side of street: north ❑, east 0, soul 0. west ,
Nearest Cross Street . ... tit e� dRi ve Distance from this cross street 3 Ft.
Property is north 0,south rx,east Li, west 0 from Cross Street •
If on Corner, which corner, northeast L:1, northwest ❑, southeast Q, southwest
(Designate by marking with an "X" in the correct space.) •
NATURE OF PROPOSED WORK OCCUPANCY "
N 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 ❑
Store building ❑
. • -car attached garage ❑
Other:
• Accessory Building
One=car detached garage 0
c=i Other work. Describe. Two car detached garage
per. ()ail,. 9 3 5 c1 Y a h T e ai Private chicken house ❑
✓ Private storage bu ldinJ ❑
• /0 (� 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, size and setbacks of pro-
posed buildings, and the location of all existing buildings.
NORTH
Show proposed buildings) in dotted line and existing
f,-/?, e'.J "(4,2/ve huilding(s) in solid line.
1 j /1L.
11%yAQ Size of property /q:i/- -J ft. x . . ?.. . . . . ft.
,'�C� Al�� Size and use of existing buildings, i.eany �d o1,K 34,
r i J -e O aid` d,4 rri,% a.d k =2 y
W c— 4/S'—� ;,fit�Fsl--7 �/
s - � L W Size of proposed building . . . . . . . • • ft.x . . .I.. • • ft.
EL, Height (from grade to ridge)
c, Front yard ! �� ft.
� // Side yards y5 . ft. and . . . ..I. • • • • . ft.
i—/, /(,/d, /7o,aI Rear yard I 1 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.' p240-)wf, cfwi2ei . o 6-
Will any second-hand lumber be used? AfO f so, for what' C
Material of foundation walls . Joua<d.O.IUr.��u' I hickness . . ;!'',4
Depth of foundation walls below grade 4 / Continuous foundation?
Will there be a cellar? VeS If so, material of cellar floor . .cU�JC2re.f e
Type of roof: Sloped or flat. . ... ..5f ere 1Material of roof . . .iq??/i./ .r` 2 1<-�3,/�'-
Size,wood studs . ." x Z1 ', spacing "o.c., length . • ft.
Size, floor beams, 1st floor _ "x I e) ", spacing J "o.c., span /5'
j r ft.
:.,. f-4).G'" x ", spacing f/ "o.c., span /1-2 I.Size, floor beams, 2nd floor . ft.
Size, ceiling beams 6 " x ', spacing "o.c., span . . . �6 ft.
i t 1.i f I
Size, roof rafters or beams " x ", spacing "o.c., span ft.
Exterior finish yQC'-.i• With what material?
Finish of interior walls ^"_ `• " lA/Oj d
If garage is to be attached, of what material is wall between garage and main building to be constructed?
A7./..-
Is there to be an opening between.garage and building?
Kind of heating system .rik..C7.7G/.G. Oil burner or coal?
Will a flue-lined chimney be provided . Depth of chimney foundation below grade
Height of chimney above roof L/
Will there be a fireplace? " y -? Depth of fireplace hearth /-2 if
Will a toilet be installed? ye=-1
Will a kitchen sink be installed and connected to water supply? . . . . .d)/ t;
Water supply (public water supply or pump) /2 _ _ to/Distance of cesspool from any private well . . . . . . . . . /3- f�. . . ./7)/c:I feet
Will drainage system be provided with required traps, cleanouts, and vents? . . . .y 5
Town of Queensbury ) AFFIDAVIT
County of Warren
State of New York
I swear that to tt ihr.of my knowledge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, are a true and co.c.p lete statement of all proposed work to be done on the described premises and that all 'visions of the BUILD-
ING CODE,THE ZONIN ORDINANCE,and ell other laws pertaining to the proposed wo shall be.co lied wi lvhether specified or not,
and that such work is authorized by the owner.
Sworn to before me this Signature •,.�•!` '-'f` �.' '� -
,,f'` V OWI�E i.OWNERS AGENT,ARC ITE T.CONTRACTOR
�J day of � � I 195�� /
NOTARY PUBLIC. WARREN COUNTY. N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
•
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. Gross floor area /DO S
2 . Type of heat 0 di • /e`,s/t(C.:
3 . Is the building mechanically cooled? /046
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 an Rfloor exposed to ambient conditions •
2 . R value of exterior walls R: /%
3 . R value of glazed area • �1 3c
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) /c "'
10. Type of insulation LLI e ,J C -(0/+sr-N •
C. Controls. .
1. Thermostat maximum heat setting
g
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 ` ice.
2 R value of pipe insulation
F. Service Water Heating
1. Performance .eff,iciency ,
2. Temperature control setting maximum /.2•)"'
G. , For Swimming Pool Only
•
1. Maximum heating
•
Telephone No. ‘.5-' �/2 i-
(( plicant ' s f nature)
•
n ,/_ `vs0 L TOWN OF QUEENSBURY
BUILDING & ZONING DEPARTMENT
SEWAGF. DISPOSAL PERMIT APPLICATION
1. Owner' s Name 4,j/(7)
Address eD, ?( , # &LL Z,4 v Y •
Telephone No. , t .
e
2. Property location �l/o .s . .
3 . Name of person or firm responsible for installing system
% �� 77-1/ , Telephone No. ]9 ?-37g1
Address j iL 7 efi',Je 7A4.
4.- Number of bedrooms (residential buildings only)
5. Daily flow to Q-3 gallons/day
6. Septic tank capacity gallons
7. Topography: fClat, rolling, steep
% of slope
8 . Nature of soil and depth j e)r`7-/7>
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: municipal, well, other
12. Type of system proposed: drywell, tile field, other l't L.C,
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 7//3 P�� �.
signature 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
BUILDING DEPT.COPY OF APPLICATION FORM 46-EL,NEW YORK BOARD OF FIRE UNDERWRITERS.
FILE THIS COPY WITH BUILDING DEPT.WHEN REQUIRED.
TEMP.# DATE (� -
/�/s/ 4 t i
CITY OR // / '/ /
VILLAGE !` �/5/(, c,,- /�,�7 TOWNSHIP 6c.e_e'„JS Lj c.,j7./ COUNTY 4�� f��?(Q,./�
STREET AND NO.OR l� I /
ROAD AND POLE NO. {�//Q I A�J,J b 4POLE NO.
BETWEEN WHAT TWO ff
CROSS STREETS IS r C i13�.
PREMISES LOCATED? SECTION I BLOCK / LOT !
OCCUPANT'S BUILDING f
NAME -D /� SA�!( OCCUPANCY /r�(1-0 Sid/o j l fq
OWNER'S NAME /
AND ADDRESS S A ir, e TEL.# /_��� /
�., Gj / Z
CURRENT 0 LLL
SUPPLIED
8Y VJ/!� ///2 f CJ FROM THEIR f %4/e?"",=-j S K/7(,- OFFICE
BUILDING WORKS DEFECTS
IS NEW OLD El is NEW,�LVJ ADDITIONAL El REMOVED ❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
No. Fixtures&
NUMBER OF OUTLETS LampfReceptacles MOTORS HEATERS BRANCH CIRCUITS OFFICE USE
Lora- ONLY
lion 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 Ei
POSSIBLE NEW OLD TI
AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
PRINT NAME AND ADDRESS(16
NAME OF APPLICANT A//C 4- /2/�
7 2 2 e 0 DATE OF �/j
✓/APPLICATION /
�STREET ADDRESS • - • • - ' TELEPHONE# ' (/i
CITY OR ZIP LICENSE NO.
POST OFFICE • - - v CODE WHEN APPLICABLE
:v
f' 46 EL(REV.1/84) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date au/�-
Name O 4►i 11 <l . -t �%
Location P/I UT A'--Nv7
Permit No. S'7 lv o Weather
E.P'TC 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
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval V ()A
Floors
Insulation Foundation
Walls
Ceiling
Building—Inspector
RE KS
TOWN OF QUEENSBURY
Building Department
Inspectors Repast Date bf ��J e,
Name(ith),/) 5 fFu )
Location of LOT KK/1113_` /i 4)
Permit No. I b Weather
Remarks
Excatia ti on
Footing Forms f;)
Footing & Piers l.®"
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
Buildi-ng Inspector
REMARKS
TOWN OF QUEENSBURY
Building Department
•
Inspectors Report Date 9 / 7/3 '
C� i,.n
Name ll .�• ftf � J
Location f l a l
Permit No. -7 V C7 Weather
Remarks
Excafja tion
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
Floats
Insulation
Foundation '
Walls
Ceiling
J
Building Inspector
REMARKS
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