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1986-493 BUILDING PERMIT TOWN OF QUEENSBURY No. 86-493 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Michael S. Hayes OWNER of property located at Ridge Road ( G Street,Road or Ave. in the Town of Quesnsbury,To Construct or place a Two-Family Modular 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. H 1. OWNER'S Adr)res:is Helen Drive Glens Falls, New York m w 2. CONTRACTOR or BUILDERS Name John Hughes 3. CONTRACTOR or BUILDERS Address 7d F4 Bay Road a. oa Glens Falls, New York fD 4. ARCHITECT'S Name o N W 5. ARCHITECTS Address 6. TYPE of Conatructbn—(Please indicate by X) 1 1 Wood Frame 1 1 Masonry 11 Steel ( 1 H E 0 1 7. PLANS and Specifications 93'x48' per plot plan, application submitted including sewage system FU No. and two car attached garage. B. ProposedUn Septic disposal soil information to be submitted before C/O p issued. r sn Two-Family Modular Dwelling $5.00 C/O Paid m $ 164.00 PERMIT FEE PAID-THIS PERMIT EXPIRES March 1 ,19 87 w (if a longer period is required an application for an extension must be made to the Building and Zoning inspector of the o town of Ouasnsbury before the expiration date.) OQ Dated at the Town of Queensbury this 14th Day of August 19 86 SIGNED BY iCJX� for the Town of Queensbury Building and Zoning inspector l f \� TO BE COMPLETED BY BLDG. DEPT. awn of Queeniur, Application No. N.a� �19UFiY Permit Issuedp 19 ni (L •.(� E8VE BUILDING and ZONING OEPAHTMENT Permit -Expirea 19 �'.• (� Bay.and Haviland Road, R.D. 1 Box 98 Zoning Designation Ai Queensbury, New York 12801 Variance No.. �9�6 { o�Ly�a� Site Plan Review No. M. / 1' Fri J 6- 01 APPLICATION FOR Approved b : 71$19f Z914; I��� � � [0:!.. afritmon t ® BUILDING AND ZONING PERMIT . e_`v ilt, 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 arid specifications submitted, and such special conditions as may be indicated on the Permit. The owner of this property is: I4 ,Q,Fi.t !.a e 1 P.O. Address 4 L- ,4 PR OS- ` CDIXZ-14.14TN ZI 1 j...f t y Tel. 193--Zoo 1 Property Location: P&D4 '4C>1 Tax Map No.5-1" / / Street number or building lot number Subdivision name (if applicable) THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS: Name P.O. Address Tel. No. Name of .Installer 1e, ) 94, 5 Address F4-414 tam, , Tel. Name of plumber Address / � Tel. Name of mason Address Tel. /'rO HOME INFORMATION: * ZONING INFORMATION: New Home Placement * A PLOT PLAN MUST BE PREPARED AND SUBMITTED, -"` drawn reasonably to scale and attached hereto, Replacing existing Home * showing clearly and distinctly all buildings, Size of new Home ft X ft , * whether existing .or proposed and indicate all * set-back dimensions from property lines. Give Single wide • Double wide * street and number or lot number and indicate No. of rooms (excluding baths)' 5 * whether interior or corner lot. Show location * of water supply and location and configuration No. of bedrooms • * of septic disposal area. * No. of bathrooms 4 * COMPLETE INFORMATION REQUIRED BELOW. Fireplace? . 4 Wood stove? gO * Size of property .F85 ft X //fO ft. Foundation style and size: Existing building(s) Size ft X ft. Piers- No.of Size- ft x ft- * Existing building(s) Use * Depth below p grade ft. * Proposed building, distance from property line FOUNDATION - Footing size S " X f(, " * -' * Front yard 32 ft Rear yard O. ft Wall material [_j/i)4. �4 . * Side yards lP) ft and Q ft i0 * If on corner, setback from side street ft Wall thickness p " Height it-gjft. Total depth below grade Q-" ft. * OCCUPANCY INFORMATION * !� * PRIMARY BUILDING - Grade to Home floor level 1� ft. famil dwellin* * * * * * * * * * * * * * * * * * * * * - Y 4 *c- • family dwelling Proposed date of placement eg, / / * Multiple dwelling / Number of units * J1ermanent occupancy Aprox.• Value_ of Home $ 49,000 * Transient occupancy Water supply - Well . Municipal L- * Business * Industrial Septic Permit required? 6.5 ** Other ,L(6.5 / * If addition, what will use be? * . FURTHER INFORMATION REQUESTED • * ACCESSORY BUILDING- ON/THE REVERSE SIDE OF THIS SHEET.* Detached garage/one car/ two car/ ' car * t Attached .garage/one car/ two car/ 7, car • * Private storage building * Other • Form MHP 5/86 and-vl __ APPLICATION FOR MOBILE HOME PERMIT, (CONTINUED) State of New York Division of Housing and Community .Renewal INSIGNIA OF APPROVAL OF THE STATE BUILDING CODE 1 . INSIGNIA SERIAL NUMBER 2 . NAME OF MANUFACTURER Da �� t-,+(ems It� 3 . PLAN APPROVAL NUMBER 4 . MODEL OR COMPONENT DESIGNATION • 5 . MANUFACTURER' S SERIAL NUMBER kit/F j4 '4 6 . DATE OF MANUFACTURE [9 (a • All the above information is.- to be found on a plate or sticker which should be affixed to the Mobile Home. Complete above with, that information. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * Town of Qbury AFFIDAVIT STATE OF NEW YORK County off Warren 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 premisesand that all provisions of the BUILDING CODE, THE ZONING ORDINANCE, and all other laws pertaining to the proposed work shall be complied with, whether specified or not, and that such work is authorized by the owner. Signature_ _ _ owner's ent rcnirect,contractor • * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * SPECIAL CONDITIONS OF THE PERMIT: By • - TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Application for: BUILDING PERMIT IN 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 '7 1 (12- 2 . Type of heat c.. , 3. Is the building mechanically cooled? 4. Percentage of area of windows and doors 17 A. Over 16% Only 1 . Uo value of gross area of walls , roof/ceiling and floors exposed to ambient conditions 2 . Floor over 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 �14e of roof and floors exposed to ambient conditions_ 2 . R value of exterior walls 3 . R value of glazed area II 7, 5 4. R value of doors /4 • 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) P- 1,g10. Type of insulation 1/ NIC7 C. Controls 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 j. ' 2. Temperature control setting maximum G. For Swimming Pool Only 1: Maximum heating - Telephone No. 44- tikr4en r applicant s signat e) j'u'n of Qucen.ilury APPLICATION FOR SEPTIC DISPOSAL PERMIT BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Oueensbury, Nev. York 12801 DATE / ..��- LOCAT ] ON OF PROPERTY FOR INSTALLATION4 �,. .2. OWNER' S NAME • r PI - !-kp P_ ADDRESS 17 _L , r7 �, i_1-�: TEL INSTALLER' S NAME TEL Number of bedrooms (residential only) 4 Total daily flow (compute @ 150 gal per bedroom) (.. Topography: Flat - Rolling - Steep slope - (circle one) % of slopeFeL/447, (: 1ri /•r-Y Soil nature: Sand - Loam - Clay - Other { '___yDepth ft. • Ground water -At what depth? ft. Bed-rock or impervious material - •At what depth? ' , ft. Percolation test - Not required eq--"ire _u -Rate min-itch. Domestic water supply - Municipal - Well Ocher .,Lat ���,^,; ,�,� . . Separation - Watersupply(if well) from Septic absorptionr ft. )Ze, Proposed System: Septic tank gal. ( Minimun size, 1000 gal. ) Tile Field - Each trench. 17. ft. Total system legnth '� fit. Seepage pit (s) Number of . Size each • ft -X ft . Size of stone to be used # � Depth or thickness: •j - ft. * *MPOR*TANT* ! !* * * * * * * * * t * * * * * * * * * * * * *! * * * * * * * * * I 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. * * * * * * *- * * * . * * * * * * * * * * * * * * * * * * * , * * * .*. * * * * 1 have read the regulations on the reverse side of this sheet and agree to abide by these and aZZ requirements of The Town of Queensbury Sanitary Sewage Disposal Ordinance . Signature of responsible person Al„ 1� � s , ,A, 05/86 and/v1 • • Section II Septic System Inspections: • A. All applications for septid system installation, alteration or repair, as required by the Town of Queensbury Sanitary Sewage Ordinance, shall be submitted to the Buildina Department at least 24 hours before start of construction and shall include a plot plan showing: 1) the proposed location iof the system. 2) location and distance to lot lines 3) location and distance to structures 4) location and distance to any water supply . 5) size and dimensions of all tanks, distribution boxes, tile fields and/or drywells B. No ;system shall be covered before inspection and ' approval-.by the Building Inspector. Failure to • comply with this requirement may result in the • . uncovering of 'the system by the ,installer and- a fine of up- to $250.00. C. An approved copy. of the plot plan shall be available _on the construction site.- Failure to produce said _plOt plan at time. of_ inspection may result in- an immediate work stoppage. D. Should unforeseen problems during construction . prevent proper installation, alteration or • repair- of an approved system, a new proposal must be submitted to the Oueensbury Building Department before further construction . • • • • • • _gown 01 Qtt APPLICATION FOR SEPTIC DISPOSAL PERMIT BUILDING and ZONING DEPARTMENT • Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 DATE " / �� LOCATION OF PROPERTY FOR INSTALLATION OWNER' S NAME �oti�, -5, ff-A ,9-5 ADDRESS P/ TEL INSTALLER' S NAME „SAW , ,,,� p TEL Number of bedrooms (residential only) 4 Total daily flow(compute @ 150 gal per bedroom) Topography: Flat - Rolling - Steep slope - (circle one) % of slope PeLL4496,1. Soil nature: Sand - Loam - Clay - Other Depth ft. Ground water -At what depth? ft. Bed-rock or impervious material - At what depth? ft. Percolation test - Not required - Required - -Rate min-inch. Domestic water supply - Municipal - Well - Other p_AcputeAIp,, Separation - Watersupply(if well) from Septic absorption ft. Proposed System: Septic tank /2 a 0 .gal. ( Minimun size, 1000 gal. ) Tile Field - Each trench 4,6 ft. Total system legnth ,c ft. Seepage pit(s) Number of . Size each • ft X ft Size of stone to be used # 3 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 requirements of The Town of Queensbury Sanitary Sewage Disposal Ordinance. Sig:atu;105P0n8 f person • ( $56 05/86 and/vl • • • Section II Septic System Inspections: A. All applications for septic system installation_, alteration or repair, as required by the Town of • Queensbury Sanitary Sewage Ordinance, shall be submitted to the Building Department at least 24 hours before start of construction and shall - include a plot plan showing: • 1) the proposed location of the system 2) location and distance to lot lines - 3) location and distance. to structures 4) location and distance to any water supply . 5) size and dimensions of all tanks, distribution boxes, tile fields and/or drywells • B. No system shall be covered before inspection and ' approval by the Building Inspector. Failure to comply with this requirement may result in the uncovering of the system by the ,installer and a fine of up to $250.00. C. An approved copy of the plot plan shall be • • available on the construction site. Failure to produce said plot plan at time of inspection • may result in an immediate work stoppage. . D. Should unforeseen problems during construction • prevent proper installation, alteration or repair of an approved system, a new proposal must be submitted to the Queensbury Building ' Department before further construction. aUfft0/Qtteen,J11/tity BUILDING & CODES DEPT. MODULAR / MOBILE HOME ACCEPTANCE DATA NAME (Property owner) /*/(6-7. ADDRESS east side Ridge Road - Tax Map No. 55-2-22,23 Location of property upon which home is placed BUILDING PERMIT NO. 86-493 . State of New York Division of Housing and Community Renewal INSIGNIA OF APPROVAL OF THE STATE BUILDING CODE COUNCIL/ DHCR 1 . INSIGNIA SERIAL NUMBER S� 2 . NAME OF MANUFACTURER � /( (? -r S1/✓ 3. PLAN APPROVAL NUMBER ®p 2/ 4 . MODEL OR COMPONENT DESIGNATION • 5. MANUFACTURER'S SERIAL NUMBER g /. • 6 . DATE OF MANUFACTURE 9g� • All of the above information is to be found on a plate or sticker which should be affixed to the Mobile/ Modular Home. .;/A-cg7 Date ' uilding Inspector COMMENTS: • • • Form MHA 3/87 and/vl au)n, o �Leen4 ar BUILD I N _G & CODES DEPT.. (MODULAR / MOBILE HOME .ACCEPTANCE DATA NAME (Property owner) G G'// ADDRESS • east side Ridge Road = Tax Map No. 55-2-22.23 Location of property upon which home is placed BUILDING PERMIT NO. 86-493 • State of New York Division of Housing and Community Renewal • INSIGNIA OF APPROVAL OF THE STATE BUILDING CODE COUNCIL/ DHCR 1 . INSIGNIA SERIAL NUMBER 2-3 O 2 . NAME OF MANUFACTURER 4 43-- Cl/"' 40 e1,5�,�/ 3. PLAN APPROVAL NUMBER 4/y g z-( 4 . MODEL OR COMPONENT DESIGNATION 5. MANUFACTURER' S SERIAL NUMBER 27 • 6 . DATE OF MANUFACTURE / '�� . All of the above. information is to be found on a plate or sticker which should be affixed to the Mobile/ Modular Home. �8� Date building Inspector • COMMENTS: • • Form MHA 3/87 and/vl flown of Queenibur j BUILDING and ZONING DEPARTMENT Bay and Havilarid Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR' S REPORT ch_� � ( NAMEOto LOCATION al f 0 "lirS Date 3//�/ y Permit No. — 93 * * * * * * * * * * * * * * * * * * * * * * * V = APPROVED -. YEAS / NO Footing/Pier Forms I SERE .71 JiPic. Foundation Waterproofing Backfill vFraming i-Roofing U.K 0 t L8' ding t,K (,), s Masonry Veneer O Rough Plumbing relief Valves 1 �} � ;9, N, , L-Ext. Porches nj 9 N A- ✓Finished Floors 9!r k 'fnterior Trim Q.t- o. stairs & Railings 5 20 Cellar Drain Tile Concrete Floors ' ibg. Fixtures pr e7, Lear. Fireproofing ,,4 0 moor Closers aK. D, r noke Detectors NO a, (. Chimney s--INSULATION: Foundation p,k D,/C. Floors Walls Ceiling FINAL ELECTRICAL INSPECTION PaZ,"f'"��,� XFinal Building Survey Next scheduled Inspection(call when ready) Remarks- - 54 4 0 c 4- ° a — Building for 6/86 and-vl ' J _town o� Queen ury BUILDING and ZONING DEPARTMENT i ct Bay and Haviland Road, R.D. 1 Box 98 / Queensbury, New York 12801 c '�J1 \/\\\ BUILDING INSPECTOR ' S REPORT r— NAME �Ay /kL �Sc�c�7t� LOCATION ll��Co14,6 Date ./3 / 7 Permit No. e96" Q3 * * * * * * * * * * * * * * * * * * * * * * * ✓ = APPROVED - YES / NO Footing/Pier Forms Foundation Waterproofing Backfill Framing piloting Siding (/ Masonry Veneer „0.0)co, Rough Plumbing Relief Valves )-Ext. Porches Y/A Finished Floors )-Interior Trim //' W-Stairs & RailingsCellar Drain Tile Concrete Floors dif/A1, Ajar e©Mpe ' � }CPlbg. Fixtures �/y" ) Gar. Fireproofing 1:4Door Closers !� }(Smoke Detectors {` Chimney INSULATION: Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION J C5T i,e '6.Y'7 DRIVEWAY APPROVAL )anal Building Survey VI, Next scheduled inspection (call when ready) Remarks- /� lJ /�/( /A S E1a!A-G p/z®Nr(Z�) ft/'CJ/Lt z Z-5-O 7 / f`4cari4 - �i�iZi QD/ 1 ' /a- t3) /Ns/6 Al s 2zsc>8 41i-A'FA- AJt j77 Building Inspectorjj��� . 6/86 and-vl flown o/ Queen iur, • BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 Sa u SEPTIC DISPOSAL SYSTEM INSPECTION NAME � L ,4 J KL LOCATION /C/))6-6---/C6. DATE/ Cv/ P/''PERMIT NO. 86 V // SOIL TYPE(-�J Loam - Clay - Percolation Test Required? YES NO Percolation rate - Min/Inch 40 TYPE of SYSTEM: Absorption field, total length ,34FD f- Length of each trench ,j Q' Depth of trenches ' „f 4" '' Size of gravel /( -. SEEPAGE PITS4Number of) Size- ft. X ft. Gravel size - PIPING: Size ' „" Type Bldg. to tank �'`7 �f ` • Tank to dist. :boxes% /Jj,/ . Dist. box to field/pit Openings sealed? 4100 NO Partial LOCATION/SEPARATIONS: Foundation tb tank Z3ft. r'c}"- Foundation "tb absorption 11AiH� Absorption to lot line f� ft. 7L . Separation of pits ft'. LOCATION F SYSTEM.;ON RO (dircle one) Front - ear - PLeft' side R ht side= COMMENTS: • • ± • \� / • SYSTEM USE APPROVED YES NO ' Building Inspector. • 01/86 and vl . �] /T2 ass-Z-xZ>Z Joeun of Queens ur, BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 Ce>4/Td_, BUILDING INSPECTOR ' S REPORT NAME LOCATION • Date/2Aefea Permit No. % to -14 3 * * * * * * * * * * * * * * * * * * * * * * * ✓ = APPROVED - Y S 14,Zooting/Pier Forms 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 Door Closers Smoke Detectors Chimney INSULATION: Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection (call when ready) Remarks- 'C I 7. .#7,#) `) Building Inspector i/86 and-vl I REVISIONS 16Y I LP JPS OF PAUL J. 4AYE.S STOMDRA"UM ►UM NO. 101-U � b 2 loot' '),O.pv' LAI,-As dC r--rj6zvka CIF. L4t:>s OF MtGNAEL S. 4611-YES `-110 0t iJ L s, � ins 0y Ai c"Wo DATE SCALE u o IDRAYM s JOB SHEET Pf'-1 OF �, SHEETS