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86-651 i CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date Seatember 28" 19. 88 3 0, 3 This is to certify that work requested to be done as shown by Permit No. 86-651 has been completed. This structure may be occupied as a One-Family Dwelling Location Lot 47 Willow Road (See No, 7) The Pines of queensoury Owner Joe Roulier By Order Town Board TOWN OF QUEENSBURY (--2) Building b.Zoning Inspector • CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date ' 19 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 LOCatiOn OlVna - By Order Town Board TOWN OF QUEENSBURY - _ - , Building & Zoning Inspector CREATIVE "INSTA PRINTING GLENS FALLS. N V 12801 IS I81793-5658 BUILDING PERMIT TOWN OF QUEENSBURY No. 86-651 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Joe Roulier OWNER of property located at Lot 47 Willow Road (St. No. 7) Street, Road or Ave. One—Family Dwelling c°o in the Town of Queensbury,To Construct or place a 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. m 1. OWNER'S Address is Box 301 Cleverdale, New York 12820 2. CONTRACTOR or BUI LDER'S Name rip same rr o • rt o z � 3. CONTRACTOR or BUILDER'S Address H. same I r 0 H4 4. ARCHITECT'S Name CD PJ 0 ro H. P• CD cn 5. ARCHITECT'S Address r0-n (D CD 0 6. TYPE of Construction—(Please indicate by X) • o, ( k Wood Frame ( ) Masonry ( 1 Steel ( ) 7. PLANS and Specifications 0 No. 64'x26' per plot plan, specifications and application submitted 0lo including sewage system and two-car attached garage. 8. Proposed Use H. One-Family Dwelling ,e ty CD $5.00 C/O N• $ 164.00 PERMIT FEE PAID —THIS PERMIT EXPIRES May 1 19 87 (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.) Dated at the Town of Queensbury this 2nd Day of October 19 86 (� for the Town of Queensbury BY �� �• c�—�_IZ Building and Zoning Inspector 1 ge. TO BE COMPLETED BY BLDG. DEPT. i cc�� .Application No. _ I Joeun of QueeniLr y Permit Issued 19 1.rowN OF C?UEEWBURY BUILDING and ZONING DEPARTMENT Permit Expires 19 MEGEllYED Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation Queensbury, New York 12801 Variance No. . I SEP t. �f P.M 9 .� 6 Site Plan Review No.' • ! / ' 5/ 7 V Approved b IAA. /6 1 '7)$)g1�.0)l l2)Xj21,�,i41516 APPLICATION FOR -/ l d /0 / ri-C..--) BUILDING AND ZONING PERMIT ______._______.___..____L_._ ........._ . # #, # # # # * # # # # # # # * # # # # # # # # # # # * # # # # # # # * * # #::* 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: �� ,,yc /c - P.O. Address eY �® /r, ��c-crd�e�_, f2/..y Tel.e__j'l-3s'y% Property Location: . 2------- 5/7 Gr/ec'a c✓/-C� Tax Map No.' / / Street number or building lot number / Subdivision name (if applicable) �-;e_ .. �c-cc.,s Z. '� THE PERSON RESPONSIBLE FOR SUPERVISION OF ' ORK AS REGARDS BUILDING CODES IS: Name P.O. Addresses� • / Tel. No. Name of builde a„ec;. Address , : 30 /r`G1.,g.4s , ").'Tel. �j�-G,Z. 3 i y5/ Name of lumber - Address Tel. Name of. mason ,�,, L� Address ,_� ,qvc/ Tel. NATURE OF PROPOSED� WORK: • * ZONING INFORMATION: Construction of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED, Addition to a building * drawn reasonably to scale and attached hereto, _Alte ration to a building * showing clearly and distinctly all buildings, (no change to exterior dimensions) * whether existing or proposed and indicate all Other work (describe) * set-back dimensions from property lines. Give * street and number or lot number and indicate * whether interior or corner lot. Show location FOR DEMOLITION PERMIT, STATE SIZE AND * of water supply and location and configuration LOCATION OF STRUCTURES AFFECTED. * of septic disposal area. * * COMPLETE INFORMATION REQUIRED BELOW. * Size of property /38 ft X /7a ft. * Existing building(s) Size ft X ft. .* . . . . . PROPOSED BUILDING AND USE: Existing building(s) Use Size of new structure < 47, ft X.? ft * Foundation-pier/slab/crawl/partia]�ull * Proposed building, distance 'from property line (circle one) * Front yard Gs ft Rear yard 7f ft No. , of 'stories (habitable space) "Z ft * Side yards z.33 ft and �- 33 Height (grade to ridge) 3 ft.' * If on corner, setback from side street — ft If residential, no. of families 1 No. of rooms(excluding baths) J * OCCUPANCY INFORMATION No. of bedrooms y * No. of bathrooms ' * PRI ARY BUILDING - -� z * //One family dwelling Primary heating' system AnLc,;--- Two family dwelling Type of fuel ��«� No. of fireplaces to be installed / * Multiple dwelling / Number of units Will a wood stove be installed?/ * Permanent occupancy Central Air conditioning? * Transient occupancy * Business BUILDING STYLE, PRIMARY STRUCTURE k.• 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/one car/ two car/ t/ car * * * * * * * * * * * * * * * * * *_Private storage building ESTIMATED MARKET VALUE OF * Other CONSTRUCTION $`-- pZO eery * INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED! Form BPA 4/86 and-vl , BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATIONS: Type Of construction, wood frame, fire safe,etc. �/ X:le.- Will any second-hand or ungraded lumber be used? If so, for what? it/ Foundation wall material Z,,,,,.:ee %�,. /C Thickness /e Depth of foundation below grade (to bottom of footing) 4- G -1- ' z Will there be a cellar?lt/', Heated or unheated? Floor sq. footage sq ft Will there be a basement? /2 s Will any portion be used as living space? h' (If so, what portion? sq.ft. - T pe of use? '- Type of roof sloped at/shed/other ,iz- Material of roof Size, wood studs . "X e' " spacing "o.c. length d7 ft. Joists(floor beams) 1st. floor ,..J "X io " spacing iC "o.c. span/i' ft. Joists (floor beams) 2nd. floor "X io " spacing/ "o.c. span /3 ft. Overlays(ceiling beams) .� "X y " spacing ..j e/ "o.c. span/Aft. Roof rafters aZ "X f/ " spacing..cy o.c. span _ft. 7721 Roof trusses (pre-engineers ) spacing 1 "o.c. span 7 ft. / Exterior wall finish%jc /4 +C ,,�pf what material? Ced� Interior wall finish 7 s(,�,t / If a garage is to be att ched, describe materials to be used for FIRE SEPARATION: `s�� s( i o /( Is there to be an opening between garage and dwelling? If so will a Fire-rated door, enclosure, and self-closing device be provided? ).s Will a' flue-lined chimney be installed? !c.) Height above roof 3 ft. Depth of chimney foundation below grade‘,C ft. Depth of fireplace hearth ft.e,jyin. . Water• supply - Municipal or private well ",,< ,,/o.-, SEPTIC SYSTEM _ Distance from ANY private well(including adjoining properties p ft. (A: separate application is necessary for any repair or new installation of septic system) Town of Queensbury AFFIDAVIT STATE OF NEW YORK County of Warren `.,rl 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 pertaining to the proposed work shall be complied with, whether specified or not, and that such work is authorized ,by the owner. SWORN TO BEFORE ME THIS Signatur — �� Owner, owner's agen arcnitect,contrac /o day of 5�.�/ 19 if Notary' Public, Warren County, 'N.Y. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * SPECIAL CONDITIONS OF THE PERMIT: ' By 004/80,447203-- , --- • 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 oj/ yo 2 . Type of heat �� .� �� ice. c • • 3 . Is the building mechanically cooled? 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 cgnd,itions • • 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 oof and floors exposed to ambient conditions 2 . R value of exterior walls /Q- /7 33 . R value of glazed area _3 4. R value of doors • /.Z 5. R value of floors over unheated spaces• 6-. •Rvalue 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) 10. Type of insulation - "4Zs.s-, C. Controls 1. Thermostat maximum heat setting Oro ° D. Duct Systems : 1. Is duct system. installed in unheated spaces? YES NO • a. : If yg, R value 9f cluet installation b. R. value of duct n bth r a as Wes 1. Size of hot water or cooling carrying agent pipe '0 2 . R value of pipe insulation F. Service Water Heating . 1. Performance efficiency .tG % 2. Temperature control setting maximum t `yt,sb . G. For Swimming Pool Only 1 . Maximum heating ' Telephonef No. 3 yy V .(applicant ' signature) • • J04'n• Of Io/ucen'bury, APPLICATION FOR SEPTIC DISPOSAL PERMIT BUILDING and ZONING DEPARTMENT Bay and Haviland Road. R.D. 1 Box 98 Oueensbury, Nev► York 12801 DATE /.PC LOCAL ION OF PROPERTY FOR I NST,' LLAT]ON � � l� y7 Li/,Cw 644CC4/SGL, � J OWNER'S NAME • < 6yC'r� - ADDRESS C/ G� C^ 3 j yy 3a/ / Gr�'r� � v,� TEL i INSTALLER' S NAME // /e7 Al a.us/�� /io . TEL Number of bedrooms(residential only) ` y Total daily flow(compute .@ 150 gal per bedroom)- Topography- Flat Rolling - Steep slope -(circle one) % of slope Soil nature Sand Loam - Clay - Other Depth ft. Ground water -At what depth? a ft. Bed-rock or impervious material - At what depth? — ft. • Percolation test - Not required - Required - -Rate min-inch. Domestic water supply - Municipal - Well - Other Separation - Watersupply(if well) from Septic absorption -- ft. Proposed System: Septic tank Minimun size, 1000 -gal. ) Ti?e Field - Each trench ,S� ft. Total system legnth 0 ft. Seepage pit (s) Number of . Size each ft' X ft Size of stone to be used r 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 DO) ESTIC WATER SUPPLY or shore-line of lake, stream,pond or wet-lands.' Include all dimensions of the system, itself. * * * * * w * * * * * * * * * * * * * * ' * * * * .* * * * * * I I * I * * * r-Za. of tkis shccf: and cercE to cb i de t th<<c. and a 1 Z recui rerrent. c1 The Town of Quecnsbury Sanitary SE:...acc 1.;i'sposc7 Ordinance. Si pncti.rc of r Fronr::?,Ze ppr:nn �- 05/86 and/v1 Section II Septic System Inspections: A. All application for septid system installation, alteration or repair, as required by the Town of Oueensbury Sanitary Sewage Ordinance, shall be submitted to the Buildinc 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 dryvells 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. BUILDING DEPT.COPY OF APPLICATION FORM 46-EL,NEW YORK BOARD OF FIRE UNDERWRITERS. FILE THIS COPY WITH BUILDING DEPT.WHEN REQUIRED. !TEMP.# IDATE ! CITY OR / ,,+ VILLAGE TOWNSHIP ., .Y COUNTY ,' ,�';..; STREET AND NO.OR - ' - / ROAD AND POLE NO. POLE NO. BETWEEN WHAT TWO CROSS STREETS IS .. i_ . - '' PREMISES LOCATED? . . ? - ' ''• / SECTION BLOCK LOT OCCUPANT'S BUILDING NAME OCCUPANCY ' OWNER'S NAME --- AND ADDRESS _ .. •j . CURRENT SUBBYPPLIED './ ',-' ; _f' FROM THEIR - OFFICE BUILDING / WORK DEFECTS IS NEW� OLD❑ IS NEW ❑-' 'ADDITIONAL❑ REMOVED ❑ LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED No. Fixtures& NUMBER OF OUTLETS LampfReceptacles 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 FI. 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 ,s 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 ,...............—.......------ OF SIGN BUILDING INSPECTION REQUESTED ON OR AS NEAR AS Et POSSIBLE NEW n OLD ` r AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES � DATE OF • ''- - - MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. APPLICATION "-" - PRINT NAME AND ADDRESS NAME OF �' V SIGNATURE .. APPLICANT Arlk OF APPLICANT —` — . • `— STREET ADDRESS - -•., TELEPHONE# CITY OR ZIP LICENSE NO. _POST OFFICE .---__ , .., - . .. / . CODE /�: " - WHEN APPLICABLE 46 EL (REV. 1/86) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING i • _town of Quecnitur, BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 j;(;W. . . BUILDING INSPECTOR ' S REPORT i NAME / 2/e, z,�.ce/rJ LOCATION /L ///i /j�/lei �C// L � C Date 9-/27 /��_ Permit No. 4 , -.�/ /•'' * * * * * * * * * * * * * * * * * * * * * */* ✓ = APPROVED - YES / Nf0 Footing/Pier Forms ,' Foundation / Waterproofing / Backfill\ r Framing \ / Roofing \ ,/ Siding \ ,,J . Masonry Veneer / Rough Plumbing �I Relief Valves Ext. Porches Finished Floors . Interior Trim / Stairs & Railings ., ,� Cellar. Drain Tile A, Concrete Floors / Plbg. Fixtures / '.v. Gar. Fireproofing Door Closers :f \ Smoke Detectors .27/ �IChimney ( . 6.0 ii, / INSULATION: / \ Foundation / \ Floors .f Walls Ceiling / • FINAL ELECTRICAL INSPECTION DRIVEWAY 4PPROVAL Final Building Survey t Next scheduled inspection (call when ready) Remarks- Buildi Inspector 6/86 and-vl /G`d /6/4 w� P J ry ocun f Queen.ilury , BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR' S REPORT NAME LOCATION y- G(J,7/U iJ , d 1)07 c Date // jai Permit No. BSI /e/ = APPROVED - YES / NO Footing/Pier Forms Foundation Waterproofing Backfill x Framing ✓ Roofing Siding Masonry Veneer. )(Rough Plumbing t� 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 P`--'FN---Cl,i0P617-Ukb $V' FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey I-- -A4IA 0- Next scheduled inspection (call when ready) Remark - vA e t_ L � � (alkPah4' 62,--4_,13) 747'n Building Inspector 6/86 and-vl _ im •of Queen.I‘ury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME fr2;t7...4.___t_j_a_A„ • ff Ze..) *Ze/trt) LOCATION d1.4t 7 DATE ! D / 2-g/ I T NO. 7. cpv 6 .S SOIL TYPE - Sand - Loam - Clay - Percolation Test Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM: Absorption field, total leng h Li Length of each trench 6-1 Depth of trenches • ;? Size of gravel_ T_ SEEPAGE PITS{Number of) Size- ft. X ft. Gravel size PIPING: Size Type Bldg. to tank 1� i ' 544 ,i/e) Tank to dist. box 4 ?° ? 2Z- 7/ eo Dist. box to field/pith� r4? '2;1 Openings sealed? YES) NO Partial • LOCATION/SEPARATIONS: Foundation to tank 1 U ft. Foundation to absorption 2ts''ft. Absorption to lot line ft. Separation of pits ft. LOCATION OF SYSTEM ON PROPERTY(circle one) Front - Rear - Left side - Right side - COMMENTS: ///\// (1 / SYSTEM USE APPROVED Y NO r Building Inspector a ' 01/86 and vl .oeun of Queeniury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME �":"-` L0CAT I ON '4/ .�L ,_ Date/V / 9, Permit No. R (e - (Q 5 * * * * * * * * * * * * * * * * * * * * * = APPROVED - YES / NO Footing/Pier Forms Foundation Waterproofing (ackfill o_ Framing Roofing Z Siding N:N. )N. Masonry Veneer % / Rough Plumbing / Relief Valves A Ext. Porches / j 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- - lAfil/8/11(.11 Building Inspector 6/86 and-vl Awl-l--3 Jown of Queeni‘urt� BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR' S REPORT NAME JZJLf &r ... LOCATION �T7 C It.�OW Date i 3o/ �'va Permit No. OU -d5/ * * * * * * * * * * * * * * * * * * * * * * * / kr = APPROVED - �NO 'Footing/Pier Forms ?N46- 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 - 1 Plbg. Fixtures f Gar. Fireproofing if- Door Closers Smoke Detectors Chimney INSULATION: / / Foundation \ 1\ Floors Walls Ceiling FINAL ELECTRICAL INSPECTION Final Building Survey Next scheduled Inspection(call when ready) Remarks- - 1 i-tI ..... Mktg 4 0Ins 9 / Bui ding p 'ctor 6/86 and-vl flown o/ Queeni4ur1 BUILDING and ZONING DEPARTMENT Bay and Havilarid Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR' S REPORT NAME LOCATION ' c . Date 5fr/ / Permit No. 84 � ✓ = APPROVED - YES / NO "Footing/Pier Forms 1 d)-t Foundation Waterproofing Backfill Framing Roofing 7/ Siding Masonry Veneer Rough Plumbing Relief Valves / Ext. Porches / Finished Floor Interior Tri Stairs & Rai ings 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- - 64013/1-41 Building Inspector 6/86 and-vl r - ,1 , • „33 ► stG re.% o S < ti33 1 1° 1 DIV' yo, /20 d2e.^S J v