1987-434 1
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MCA 1 E V t` OCC +1.1 1 A TC" 1
TOWN OF QUEENSSURY
WARREN couNTY, NEW YiJRK
Date
January 18 19
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This is to certify that work requested to be done as shown by permit No. $7-434 1
has been completed.
'i TV10 FAMILY �}D,W�ELL NG
This structure may ouPiod ' 0 J
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Loaation
RICHAPD RUZLLL t�,[ \ � CA I
C'lwntr
By Order Town Board
. TCr'Wfif OF QLTLENSBLiCtY
Building d' 2onitoyg ;nypector
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BUILDING PERMIT
TOWN OF +QUEENSBURY No 87-434
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to RICHARD ROZELL
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OWNER of property located at CORINTH RD Street. Road or Ave. to
in the Town of Oueensbury, To Construct or place a TWO FAMTT.Y DWRT-ETNG a
at the above location in accordance to application together with plot plans and other information hereto filed and ry
approved and in compliance with the Town of Oueensbury Building and Zoning Ordinance. y
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1 . OWNER'S Address is [ 5
22 Fox Hollow Lane
Glens Falls , N . Y .
2. CONTRACTOR or 8UI LDERS Name
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Same r'
.3. CONTRACTOR or BUILDERS Address
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4. ARCHITECT'S Name t"
5. ARCHITECT'S Address
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B. TYPE of Construction — (Please indicate by X) z
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f XVNfood Frame I ) Masonry I } Steel I )
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7. PLAINS and Specifications
Na, 25r x 40r Two family dwelling , including septic system, per plot
plan and specifications and application . Site Plan Review No . 16-87
8. Proposed Use
Plans in drawer , o
Two Family dwelling
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$5oOO C/O
$ _140 * 00 PERMIT FEE PAID - THIS PERMIT EXPIRES ZE:
{If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the tom"
town of Ousensbury before the expiration date-
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Dated at the Town of Oueensbury this 10th �❑ay of July 19 $7
SIGNED BY ��i�G � ��c2r � for the Town of Oueensbury
Building and Zoning I nspector �.� /
TO BE COMPLETED BY BLDG . DEFT .
Application No . I . ;yVC� C7's L+i4civc
OLL I7 0/ QLfLtif'il3xL[I'I� Permit Issued 19
BUILDING and ZONING DEPARTMENT Permit Expires 19^�
Bay and Haviland Road, R. D. 1 Box 98 Zoning Designation �raa
Queensbury, New York 12801 Variance No . JUN 2 2 egg]
Site Plan Review No .(a
Appr ed b B�,l��{-DING ,�c CODE DEPT.
APPLICATION FOR Vq
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FU I LD I NG AND ZONING PERMIT `
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION , ANSWER ALL OF THE FOLLOWING .
The undersigned hereby applies for a Building Permit to do the followings wont 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 ofTthis property !so j 1G a-�
P . O . Address '7 Cyr c�-� /' Tel . S-A 7 �Sie�
Property Location : Tax Map No . / /
street number or building lot number
Subdivision name ( if applicable )
THE RSpN RF PONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS :
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Name P_ O . Address Tel . No .
Name of builder 5 4- --ti. Address Tel .
Name of plumber Address Tel .
Name of mason i Address Tel *
NATUREOF PROPOSED WORK : ZONING INFORMATION :
Construction of a new building A PLOT PLAN MUST BE PREPARED ARID 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 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 � r 3ST ' ft
Existing building ( s ) Size — ft X ft .
PROPOSED BUILDING AND USE : * Existing buildings ) Use
Size of new structure Z. S ft X Selo ft "
Foundation-pier/slab/crawl/partial/ u;_):,/ Proposed building, distance from property line
( circle one ) !�/ ft Rear yard 7� ft
Noe of stories (habitable space) Front yard 410 2 * Side yards ft and S� 5 ft
Height { grade to ridge) _ ' ft If on corner , setback from side street ft
If residential , no . of families
No . of rooms ( excluding baths ) 5 * OCCUPANCY INFORMATION
No . of bedrooms Z�
PRIMARY BUILDING -
No . of bathrooms / One family dwelling
Primary heating system
Type of fuel - ._X_Two family dwelling
Na _ of fireplaces to be installed Multiple dwelling / Number of units
Will a wood stove be installed? ,zip „ . Tr occupancy
Central Air conditioning? jo ,� * Transiansient ent occupancy
� BllS1neSS
BUILDING STYLE, PRIMARY STRUCTURE Industrial
Ranch Contemporary Log c in * Other
If addition , what will use be?
Raised ranch Mansion plea
Split level Old style B alow
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/_ car
Private storage building
ESTIMATED MARKET VALUE OF —Other
CONSTRUCTION
INFORMATION ON BUILDING SPECIFICATIONS , ON REVERSE SIDE OF THIS 'SHEET , TO BE COMPLETED :
Form BPAA 4/86 md--vl
df QeZ4d6WV
APPLICATION FOR SEPTIC DISPOSAL PERMIT
DATE / s�er 17
LOCATION OF PROPERTY FOR INSTALLATION 47
Owner's Name: r=- ��Z2� _ee' Telephone:
Address: _Z c' /'�- . C'c#--- �3 �//�',r d'T�Y / ?ram/
Installer's Name: /Grr (r_ � -' � e -G t Telephone:
Number of bedrooms (residential only) _
Total daily flow (compute @ 150 gal per bedroom)
Topography: circle one: �i�a�t Rolling Steep Slope 3�0 of slope ,
Soil Nature: circle one an oam Clay Other / Depth: _ feet
Ground Water: At what depth? feet
Bedrock or Impervious Material*. At what depth? i feet
Percolation test&. circle one: not required required f rate min. inch.
Domestic water supply: circle one: icipa Well Other
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption _ feet
PROPOSER SYSTEM: Septic Tank gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench feet / Total system length '2'S: Z� feet
SEEPAGE PIT(S): Number of / Size each feet by feet
Size of stone to be used # / Depth or Thickness feet
IMPORTANT
...Please_..LIST NEW EQUIPMENT TO BE INSTALLED
(over)
1A') � Joeun a ueen36urr�
UiLL]fNG and ZONING DEPARTMENT
Bay and Ha,,iland Road, R. D. 1 Bax 98
i7 Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
FW
LOCATION ,A - �"{ 9�
Date /� $ / Permit No
✓ r APPROVED - YES NO
Footing/Pier Forms
Foundation
waterproofing
Backfill
Framing
Roofing v
Siding t
Masonry Veneer
Rough Plumbing
Relief Valves
Ext . Porches I'
Finished Floors
Interior Trim
Stairs & Railings !/
Cellar Drain Tile
Concrete Floors
Plbg . Fixtures
Gar . Fireproofing kip
Door Closers
Smoke Detectors
Chimney
INSULATION
Foundation
Floors
Walls
Ceiling
FINAL ELECTRIC L INSPECTION _
KIVEWAY APPRO AL,__ _
al iBuildin Survey
Next scheduled inspection ( call when ready )
Remarks--
Build ' ng Inspector
6/86 and-vl
vwn o/
Quive" Ji " ry
BUILDING and ZONING DEPARTMENT
Bay and Maviland Road, R. D. 1 Box 98
pueensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION x�
Date
� ermit No . 7 Y
APPROVED* -AYES* NO
Footing/Pier Forms
Foundation
WaterPrOOfing
Backfili
Framing
Roofing
Siding
Masonry Venee
Rough Plumbin
Relief Valves
Ext . Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Til
Concrete Floors
plbg . Fixtures
Gar . Fireproo ing
Door Closers
Smoke Detec ors
S Bey
✓
N SL3 LAT I O
FoUn da t io
Floors
<a' lls
filling
FINAL ELEC RICAL INSPECTION _...
DRIvEWAY APPROVAL.
Final Building Survey
- Next scheduled inspection (call when ready )
Remarks-
Building Inspector
6/86 and-vl
�/ I JOWn 0/ Q"eerl .y "ry
r
iBUILDING and ZONING DEPARTMENT
i Say and Haviland Road, R-D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME / I
'
LOCATION
Date / ' / / .._ Permit No .
► ' APPROVED - YES NO
Footing/Pier Forms
Foundation
Waterproofing '
B kfill
r.� rami ng M
Roofing
Siding
M sonry Venee
�ough plumbing
Relief Valves
Ext , Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg . Fixtures
Gar . Fi.reproafin
Door Closers
Smoke Detector
Chimney
INSULATION
Foundation
Floors
Walls
Ceiling
FINAL EL TRICAL INSPECTION
DRIVEWAY A PROVAL
Final Buil ng Survey
Next scheduled inspection (call when ready )
Remarks-
Building Inspector
6/86 and-vl
/�m'� I � �otv►t o� �utJrns6urt�
! - 4014 BUILDING and ZONING DEPARTMENT
; `T Bay and Haviland Road, R. D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME
JO C:Wc
LOCATION C. bv+
DATE / PERMIT NO .
SOIL TYPE - Sand - LoZngt�h
Percolation Test Requ NO
Percolation rate - Mi
TYPE of SYST
Absorption f i Id . totLength of eac trenchDepth of trenc es
Size of gravel_ 2
SEEPAGE PIMN er f)
Size- ft. X _ ft.
Gravel size
PIPING : Size Type
Bldg . to tank t
Tank to disc . x
Dist. box to f eld/rnll=
Openings seal ? Y S O Partial
LOCATION/SEPA I
Foundation to ank ! t.
Foundation to absorption 02�
Absorption to lot line -,±:jt.
Separation of pits --- ft.
ZACATI STEM ON ON PROPERTY (circle one)
Front Rear Left side - Right side -
Ct7MM S
SYSTEM USE APPROVED (YES NO
_ s
Buildin Inspector
01/86 and vl
__.!c►wn o/ Qceen s � ure�
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R. D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPE,✓CfTOR ' S REPORT
NAME
LOCATION
Date Z f Permit No .
✓ APPROVED - E$ NO
Doting/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
Pibg . 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-
� ✓ x
Buildin Inspector
6/86 and-vl