1986-509 BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-509
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Robert and Ann Pendas
OWNER of property located at Lots 19, 20 Bronk Drive 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 o
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
M
1. OWNERS Address H rt
3 Water St.
Warrensburg, NY 12885 Q,
2. CONTRACTOR or BUILDERS Name b
Rickard Const.
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3. CONTRACTOR or BUILDERS Address
P. 0. Box 1149
Saratoga Springs, NY
4. ARCHITECT'S Name
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a, an
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6. ARCHITECTS Address C
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6. TYPE of Construction—(Planes indicate by X) b 0
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(id Wood France ( ►Masonry ( )Steel ( 1 C
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7. PLANS and Specifications m
No 84'x3.0' per plot plan, specifications and application submitted
including sewage system and two car attached garage.
S. Proposed Use
One-Family Dwelling M
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$5.00 C/O
$ 129.00 PERMIT FEE PAID—THIS PERMIT EXPIRES March 1 19 87 `4
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the V
town of Ousensbury before the expiration date.) m
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Dated at the Town of Queensbury this 20th Day of August 19 86
SIGNED BY 2?za-,ed a, for the Town of Queensbury
Building and Zoning Inspector
TO LIE iJOMPLLTED UY•.IILlAJ. ULP'1'.
Ap
plication No.
Sown of Queenib
ur f Permit Issued : 19 pExires 19 -
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BUILDING and ZONING DEPARTMENT Permit
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation VIIN OF UIlII "s"
Queensbury, New York 12801 Variance No: r _.a ( ,I
Site Plan Review No.e., __ a _ Ia.. , . 1. I 4d me. `1 1.
Approved b < L.`
APPLICATION FOR. 0
BUILDING. AND ZONING PERMIT 718J9. 1, 11) )i12131./5/6
4 * *;;: * * *.. *-.*..* * * * * * * * * * * * *. * * * * * * it' * * * . * 4 * * * *' * :*
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' 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 and specifications submitted, and such
special conditions as may be indicated on the Permit.
The owner of this property is: .koloo_rr VW "4 ., 1"eoLLS
P.O. Address 2 f a t r- Ste se.f et2t4-f2,05 kwr Al V 1 z PSr Tel. (,Z3 ZOS
Property Location: f/94,Zo e& 1)r:
yr; V2 Tax Map No. / ` /
Streetnumber or building lot number
Subdivision name (if applicable) West Ifrj,pi.A.inta,,,n I'o,.t
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS: •
Name P.O. Address Tel. No.
Name of builder�,/ k!l 60$/6 Z Address 54 1 ',--e. Tel 3� `f 7' /
Name of plumber ir,1t.4.2;., ritti,t44 ;.: Address �.,_jp-..,5 J.,//s- Tel /✓(i.
Name of mason Rh,E41/) /i, .S''". Address '40, f Tel .s i 4- Y&/
NATURE OF PROPOSED WORK:
* ZONING INFORMATION:
Construction of a new building * A PLOTPLAN MUST BE PREPARED AND SUBMITTED, . "
Addition to a building * drawn reasonably to scale and attached hereto,
Alteration to a building * showing clearly and distinctly all buildings,
(no change to exterior dimensions) * whether existing or proposed andlindicate all
Other work (describe) * set-back dimensions from property lines. Give
* street and number or lot" number and indicate
FOR DEMOLITION PERMIT, STATE SIZE AND" * whether interior or corner lot."..Show location
of water supply and location and configuration
LOCATION OF STRUCTURE AFFECTED. *-of
. septic disposal area.
* COMPLETE INFORMATION REQUIRED BELOW.
*
Size- of: property ZOO ft X /SC, ft.
Existing building(s) Size ft X ft.
PROPOSED BUILDING AND USE: * E xisting buildings) Use
Size of new structure `85 ft X30. ft -
Foundation-pier/slab/crawl/partial/eM * Proposed building, distance from property. line
(circle .one) ,�.
* Front yard y� ft Rear yard ft
No. of stories (habitable space) /. Side yards i,1,0 ft and , ft
Height (grade to ridge) /$ ft. *
* If on corner, setback from side street ft
If residential, no. of families-S„► ie
No. of rooms(excluding baths) r, ( * OCCUPANCY INFORMATION
No. of bedrooms 3 ** PRIMARY BUILDING -
No. of bathrooms Z * k One family dwelling
Primary" heating system Di/ //a*- /tir. Two familydwelling* 9. '
Type of fuel oi1 * Multiple dwelling / Number of,units
No. of fireplaces to be installed. 1 permanent occupancy
Will a` wood stove be installed? No * P X "
•
Central Air, conditioning?. ' Y.Qs * Transient occupancy
* Business :
BUILDING STYLE, PRIMARY STRUCTURE *' Industrial
'Ranch(. Contemporary Log cabin *.'___Other '
Raised ranch. Mansion ' Duplex-
* If addition, what will use. be?
Split level Old style Bungalow
Cape Cod- Cottage • Other * ACCESSORY BUILDING-
Colonial Row Town House * " Detached garage/one car/ two car/ . . car
( CIRCLE ONE PLEASE ) * )( Attached garage/ '/ /two car/ Z. car
* * * * * * * * * * * * * * * * * * Private storage building
ESTIMATED MARKET VALUE OF * "Other
CONSTRUCTION ,:
INFORMATION ON. BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
Form BPA 4/86 and-vl
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BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS: •
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Type of construction; wood frame, fire safe,etc. " W®oet rra.rave
Will any second-hand or ungraded lumber be used'? .If so, for what A/b •
•
Foundation wall material CoviGre.re Thickness 9
Depth of foundation below grade (to bottom of footing) 4,'
Will there be a_ cellar? Y s Heated or unheated? yheallitk Floor sq. footage /6;cy sq ft
Will there be a basement? y%s Will any portion be used as 'living space? A/o
(If so, what portion? sq.ft. - - Type of use?
Type of roof - sloped/flat/shed/other S_o acs( Material of roof F; rp�Q,0g . h '9.`e 4
Size, wood studs Z "X '/ " spacing / "o.c. length lj ' ft.
Joists(floor beams) 1st. floor z "X /b " spacing a, "o.c. span JSrft. 1)ovtr,sr Lr.w..loet•
Joists (floor beams) 2nd. floor "X " spacing "o.c. span ft.
•
Overlays(ceiling beams)Y,2.sseg"X " spacing • "o.c. span . ft. •
Roof rafters J'osgei'X " spacing • o.c. span, ft.
Roof trusses(pre-engineered) spacing -Z4 "o.c. span z/, ft. •
Exterior wall finish Oiell ,•„/ASP/'e S,4tA,Of .what material? t ccb
Interior wall finish A " r, ...N�/1 •
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
e 6re Code ate-reek •
Is there to be an opening between garage and dwelling? .1/e g If so will a Fire-rated
door, enclosure, and self-closing device be provided? Ye g
Will a flue-lined chimney be installed? Ye S . Height above roof pq;n, 3' ft.
Depth of chimney foundation below grade 6, ft.
. Depth of fireplace hearth Z. ft. 'D in.
Water supply - Municipal or private well /141. i'po.1 v i -
SEPTIC SYSTEM' Distance from ANY private well(in'cluding adjoining properties zpo' ft.
(A separate application is necessary for any repair or new installation of septic' system)
Town of Queensbury A F F I D a V . I T• County of Warr„�n STATE OF NEW YORK
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 premises and that all
provisions of the -BUILDING' CODE, THE ZONING ORDINANCE, and all other laws Flertaining to'
the proposed work shall be complied with, whether specified or. not, and that such work is
authorized by the owner.
�
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SWORN TO BEFORE ME THIS Signatu -�re �.
Owner, owner's agent,arcnitect,contractor
day of 19
Notary Public, Warren County, N.Y.
* * * * * * * * * * * * * * * * *.. * * * * * * * * * * * * * * * * * *. .* * * * * * * * * * *
SPECIAL CONDITIONS OF. THE PERMIT:
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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 i(p-C1
2 . Type of heat oil het' a, r
3. Is the building mechanically cooled? �g
4 . Percentage of area of windows and doors 7/627e,
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
- 3$
2 . R value of exterior walls IC/
3 . R value of glazed area /C - 3.3
4 . R value of doors t / 1. 9
5. R value of floors over unheated spaces A/Pli.
6. R value of slab edge insulation - unheated slab A//i?.
7. R value of slab insulation - heated slab / g
8. R value of heated basement/cellar walls (abovelgrade)d '-9.
9. R value of heated basement/cellar walls (below grade)/e-9
10. Type of insulation rsbela,65 Pl��nn`s�crpGt.rr}
C. Controls
1 . Thermostat maximum heat setting 9I"
D. Duct Systems
1. Is duct system installed in unheated spaces? YES GNP
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 !L "
2 . R value of pipe insulation ///jf
F. Service Water Heating
1. Performance efficiency gs", 4,
2. Temperature control setting maximum /5/pb
G. For Swimming Pool Only
1. Maximum heating NP1 •
r
Telephone No. /Y- 4lz-1"' 24A1/2 7 -
(applicant ' s signature)
Sown of Quefnibury APPLICATION FOR SEPTIC DISPOSAL PERMIT
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road. R.O. 1 Box 98
Oueensbury, New York 12801 DATE ?
LOCATION OF PROPERTY FOR INSTALLATION ot./9,Zd Brook Dr..ve
OWNER'S NAME ,/� _
ICob2� �' mvi ' eV� a '
ADDRESS a w - St. GOaer6.44bor 11/4).Y. fz8>SS TEL(0Z7 -ZOcy
INSTALLER'S NAME �, �. a,vci. '4'.n Gk.
TEL 79 Z - 6681
a,.
Number of bedrooms(residential only) 3
Total daily flow(compute @ 150 gal per bedroom) L/cO.
c
Topography: Rolling Steep slope -(circle one) % of •slope
Soil nature: I-and - Loam -. Clay - Other Depth B ft.
Ground water -At what depth? 1710 ' ft.
Bed-rock or impervious material - At what .depth? ft.
Percolation test - /ot required - Required - -Rate min-inch.
Domestic water supply -Municipal - Well - Other
Separation' - Watersupply(if well) from Septic absorption ft.
Proposed System: Septic tank /Ooo gala( Minimun size, 1000 gal. )
Tile Field -- Each trench 619 ft. Total system legnth ' Zao ft.
Seepage pit(s) Number of . Size each ft X ft
Size of stone to be used # ...2, Depth or thickness 2 ft.
IMP* * *ORTA*NT* ! !' * * * * * *. * * * * * * * * * * * * * * * * * * * * * * * * * *.
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 aZZ requirements of The Town of Queensbury
Sanitary Sewage Disposal Ordinance.
Signature of person
ponsible p
Date r/iYl/res°
05/86 and/vl .
- j
Section II Septic System Inspections:
• A. Al]. applications for septic system installation,
alteration or repair, as required by the Town of
Oueensbury' 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 he
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.
•
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Jown of Queenilury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
Goo ; n 3 IT �7
BUILDING INSPECTOR ' S REPORT
NAME j ?eh J
LOCATION Lot � #`6/1/ /
Date /A/y / V(D Permit No. /f6 -.d9
* * * * * * * * * * * * * * * * * * * * * * *
t� = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding ti
Masonry Veneer
Rough Plumbing �� r�
Relief Valves
Ext. Porches
Finished Floors i
Interior Trim ,.
Stairs & Railings .!„
Cellar Drain-Tile - -
Concrete Floors I
Plbg. Fixtures
Gar. Fireproofing
Door Closers r�
Smoke Detectors
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
DI AY APPROVAL
inal 'Building Survey
Next scheduled inspection (call when ready)
Remarks-
R/m'J}-6 D ri 6P'S TO (4 v5 it
Ar--GG 2.0 d2Sk
Building Insp to
\/86 and-vl
all e f �1 I a,-5fi'
J �'
own of Queeniur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME 0 . p G. yl j c s
LOCATION I C)J 1 1 / a6 /J)- F /Dv`
Date 7/ //(( Permit No. 36_,c- 6
* '* * * * * * * * * * * * * * * * * * * * * *
= APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
K Framing 564, ) LOU)
Roofing
Siding
Masonry Veneer
0 Rough Plumbing C 6
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floor
Plbg. Fixtures .�
Gar.. Fireproofing
Door Closers a
Smoke Detectors 4'
Chimney
INSULATION: \
Foundation X<L-yzjic rL
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
Final Building Survey .
Next scheduled Inspection(call when ready)
Remarks- -
Q1-7 i7 d� Lo✓� d
Y i^vn
7D iST" (4AU6 (IT- `-
L2M1 S
1
Building Inspec or
6/86 and-vl
Ce(// �� /(22„? / � /o ` � r77
Jou!n o/ Queensbur, •
BUILDING and ZONING DEPARTMENT
Bay and Havilarid Road; R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME R o L7 t-. . PP,,d QS
LOCATION LOT /�, 02 a )3)-Uh /( Ph
DATE .l 2/P,' PERMIT NO. (Y6 - �0 ,,
SOIL TYPE Sanj- Loam - Clay -
Percolation Test Required? YES - T�O�
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length 2 C9C
Length of each trench c-�
Depth of trenches Z 3..� `'
Size of gravel i�
SEEPAGE P ITS4Number of)
Size- ft—X ft. j'
Gravel size
PIPING: Size Type
Bldg. to tank
Tank to dist. box _
Dist. box to field/pit - -
Openings sealed? YES NO Partial
LOCATION/SEPARATIONS:
Foundation to tank f 5 ft.
Foundation to absorption Z5ft.4-
Absorption to lot line / 3' ft.
Separation of pits - fin
LOCATION OF SYSTEM ON PROPERTY(circle one)
Fi ront- Rear. - Left side - Right side -
COMMENTS:
(A t l i . 11141 I I e. C O nT/' n 1^
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11
SYSTEM USE APPROVED YE NO
‘--171:)
Building Insp tor
01/86 and vl
gla.i lece
awn of Qur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR' S REPORT
NAME Rohr.C r. ? P.h c(q-)
LOCATION ! c r / y� �o g�-ah/ a—
Date Permit No. (f(, - 2 O
* * * * * * * * * * * * * * * * * * * * * * *
i/ = APPROVED - YES / NO
Footing/Pier Forms
I.Foundation 0 k�
Waterproofing Fj
ckfill Qd'
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 \ I
Door Closers
Smoke Detectors !�
Chimney
INSULATION: — ,(l
--Foundation ,.�yv. l2 i V (,tau/1
Floors 1
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
Final Building Survey
Next scheduled Inspection(call when ready)
Remarks- -
�iV
uilding Inspector
6/86 and-vl
...awn of Queen3Lry
BUILDING and ZONING DEPARTMENT
cite) Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION
Date 5/ 'Permit No. ��1 �
* * * * * * * * * * * * * * * * * * * * * * *
= APPROVED - YES / NO
ootira�g/Pier Forms e Gz-
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
Final Building Survey
Next scheduled Inspection(call when ready)
Remarks- -
6('(418
/tAj6'
Building Inspector
6/86 and-vl
awn of Queens6urcy
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME P&AJv+ _
LOCATION—
Date ilvir/_n' Permit No. R( - S D y
* * * * * * * * * * * * * * * * * * * * * * *
= APPROVED - YES / NO
Footing/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-
,FOLI-cit()
Build n4 Inspect'r
6/86 and-vl
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