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1986-147 CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY • WARREN COUNTY, NEW YORK Date October 9 l9flf>_ SCR' •-• (1 I 86-147 This is to certify that work requested to be done as shown by Permit No.has been completed. Addition to mobile home dwelling This structure may be occupied as a Warren Lane Location Michael R. LeBlanc Owner By Order Town Board TOWN OF QUEENSBURY Building & Zoning Inspector • BUILDING PERMIT TOWN OF QUEENSBURY No. 86-147 WARREN COUNTY, NEW YORK _ PERMISSION is hereby granted to Michael R. LeBlanc Warren Lane Street,Road or Ave. OWNER of property located at X H. w in the Town of Queensbury,To Construct or place a Addition to mobile home nr 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 RD #3 Box 231 Glens Falls, New York F' y 2. CONTRACTOR or BUILDERS Name same 3. CONTRACTOR or BUILDERS Address same m n n 0 q 4. ARCHITECTS Name of P+ co m 5. ARCHITECTS Address 6. TYPE of Construction—(Please indicate by X) ( Wood Frame 1 )Masonry I 1 Steel I ) y rt T. PLANS and Specificationsl+ No. 14'x20' per plot plan, specifications and application submitted. 0 rt B. Proposed Use Mobile Home Dwelling (addition) la 0 $5.00 C/0 Paid 86 10.00 Nov. 1 19 $ PERMIT FEE PAID—THIS PERMIT EXPIRES (If longera of QueanAwe required redra ta expiration li io f e r an extension must be made to the Building and Zoning inspector of the town Dated at the Town of Queensbury this Mari Day of April 19 86 SIGNED BY ` . P Q for the Town of Queensbury Building and Zoning Inspector G ` TO BE COMPLETED BY BLDG. DEPT. c7 401 Application No. Ciii"'��•.' C Joan o` �ueendturt� • t�'::' ,c,.,, ,,. Permit Issued 9�,FY,' 19 � ', I BUILDING and TONING DEPARTMENT Permit Expires / 19 �r I:� j� v Bay and Haviland Road. R.D. 1 Box 98 Zoning Designation_ � � j )ui Queensbury, New York 12801 Variance No. Site Plan Review No. y 7M.. 9 �/...� d Approved GG 9 / s I, ' ��I:-f�3�a s' APPLICATION FOR � � / /'v( BUILDING AND ZONING PERMIT * * * * *h * * M ♦ M Y * * * * * * * * * * N • * * * M # * * * * * * * A *;:• 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: 1ir (4,4F/ /l. Lai1/42(%P.O. Address 1 I, I Y P A�.3) � b .' I. V,—ro, 1, L.. /b: Tel. ry/`/,1-(tf/ 2 Property Location: QC) . r.r"re r) 2--6, ,7Y Tax Map No./21 / /je_ Street number or building lot number Subdivision name (if applicable) THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS RFCARDS BUILDING CODES IS: ('u-rn & ' �lFiin eregoci i - Lucerne Rd G.0 179a- 9,2 yS Name .o. Addres Tel. No. C Name of builder '6i/1 e r'p SA/ne Address Tel. Name of plumber Address Tel. Name of mason Address Tel. NATURE OF PROPOSED WORK: * ZONING INFORMATION: Construction of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED, X 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 22 S ft X /CL ft. * Existing building(s) Size /./ ft X /(> ft. * 41rh le fizore- PROPOSED BUILDING AND USE: t * Existing building (s5 Use b' Size of new structure /*//_ft X -14ft * Foundation6ier/slab/crawl/partial/full * Proposed building, distance from property line * (circle one) / * Front yard .` y' ft Rear yard 2, . ft 'I e. of stories (habitablespace) * Side yards j*' ft and j } ;: ft i 1 H Height (grade to ridge)) J it — ft. * If on corner, setback from side street ft If residential, no. of families No. of rooms(excluding baths) / * OCCUPANCY INFORMATION No. of bedrooms * * PRIMARY BUILDING - No. of bathrooms If/ One family dwelling Primary heating system .{f/ •;yrq„( �n1A2,,:;-:*Type _Two family dwelling No. of£fireplaces✓to fuel k L be installed ^..C. * Multiple dwelling / Number of units Will a wood stove be installed? * Permanent occupancy *A-L` _Transient occupancy Cc„tral Air conditioning? a,J * Business (BUILDING STYLE, PRIMARY STRUCTURE _Industrial nr nA Other /lac(21,E)I Ranch C Cain cabin w f addition, what will use be? r{'(1-ra /it/1 Raised ranch-Mansion _. Duplex 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/ car * * * * * * * * * * * * * * * * * * Private storage building ESTIMATED MARKET VALUE OF Other CONSTRUCTION $— n r� 4_�oCC (i * — INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED! Form BPA 4/86 and-vl BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATIONS: / Type of construction, wood frame, fire safe,etc. /, 'p�rrf /f[ln)C Will any second-hand or ungraded lumber be used? If so, for what? IL'( Foundation wall materia® `�/L A$ Thickness LV L. y;I,: F ei?; ,c Depth of foundation below grade (to bottom of footing) 4 e Will there be a cellar? f ( Heated or unheated? /;;,,,/-( ) Floor sq. footage y 10 sq ft) Will there be a basement? /\,( , Will any portion be used as living space? , /, (If so, what portion? sq.ft. - Type of use? ,- ( ,, +/,,il ' Type of roof - sloped/flat/shed/other, _ / Material of roof 0 , ._ Size, wood studs ? "X (/ " spacing j "o.c. length I' ft. Joists(floor beams) 1st. floor q, "X " spacing ) L "o.c. span )A ft. Joists (floor beams) 2nd. floor "X " spacing "o.c. span ft. Overlays(ceiling beams) "X " spacing "o.c. span ft. hoof rafters "X " spacing o.c. span ft. ✓Roof trusses(pre-engineered) spacing_ -L "o.c. span )g ft. Exterior wall finish {/� _S • Of what material? / - /f _ ,'t Interior wall finish 7 "�% If a garage is to be attached, describe materials to be used for FIRE SEPARATION: Is there to be an opening between garage and dwelling? If so will a Fire-rated door, enclosure, and self-closing device be provided? Will a flue-lined chimney be installed? Height above roof ft. Depth of chimney foundation below grade ft. Depth of fireplace hearth ft. in. Water supply - Municipal or private well /t . it c SEPTIC SYSTEM Distance from ANY private well(including adjoining properties ,`.t A c ft. (A separate application is necessary for any repair or new installation of septic system) Town of Queensbury County of Warren AFFIDAVIT 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 pertaining to the proposed work shall be complied with, whether specified or not, and that such work is authorized by the owner. 12 SWORN TO BEFORE ME THIS Signature_/<<*-� 6fiec- Owner, Owner's agent,arcnitect,contractor day of 19 Notary Public, Warren County, N.Y. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * SPECIAL CONDITIONS OF THE PERMIT: By V11.0 -V/ E-'L/ 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 %�V/ 2 . Type of heat rOg/ 0 f o HD7 A //Z 3. Is the building mechanically cooled? UC' w 4 . Percentage of area of windows and doors Nil- A., Over 16% Only / 1. Uo value of gross area of walls , roof/cei ing 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. Under169 Only 1.. R R value of roof an� fl;� n rs exposed to ambient conditions_ 2 . R value of exterior walls 'C - ft �3 . R value of glazed area D Q ' ( 9 . ) R value of doors /\ — q '. 5. R value of floors over unheated spaces R - 11 6. R value of slab edge insulation - unheated slab _. -- N Ar 7 . R value of slab insulation - heated slab p ,4- 8 . R value of heated basement/cellar walls (above rade) (��,--'I /^wT 9 . R value of heated basement/,c¢Iellar walls (below grade) - 1 10. Type of insulation GI(Jit 64.*“ C. Controls 0 1. Thermostat maximum heat setting 07 D. Duct Systems 1. Is duct system installed in unheated spaces? NO If YES, R value of duct installation R value of duct in other areas - U E . Piping Insulation 1 . Size of hot water or cooling carrying agent pipe / '; i0P 2 . R value of pipe insulation % ' F. Service Water Heating +. 1 . Performance efficiency is, L ' 2. Temperature control setting maximum wl4.-, G. For Swimming Pool Only 1 1. Maximum heating N11/. �/' p // <l ( 'bi / ,/,CJ 4 % ///, ,, Telephone No. (applicant ' s signature) • THE NEW YORK BOARD OF FIRE UNDERWRITERS � /��1 BUREAU OF ELECTRICITY 0 • err 41 STATE STREET.ALBANY.NEW YORK 12207 July 11, 19A6 Application No.on file 008841-86 Date A 664270 THIS CERTIFIES THAT r�d,an ,�.a��r.1.� tune numbs In[ha premisPP of4 only the electrical equipment as described below ad 4stmdnesdoh'ttre rypline riffs '^ffew Y[1rX E Michael R LeBlanc, Warren Lane RD it 3 B L.5 s ❑ Basement ® 1st Ft ❑ End Ft. Section Block Lot in thefol retie location: was easnind on 6/6/R6 and found to be in compliance with the requirements of this Board. ___ FIXTURES RANGES COMIKO mats OVENS DISH WASHERS EXHAUST FANS r '� RICWTAQES SWITCINS rap1ry unr. x.w. NpT. • •w NAT t.w. AMr. N.r. S FIXTURE rIINAIMFNT v,rP w. •W, 9 DRYERS FURNACE MOTORS IIITURE APPLIANCE NEMO SNCMt OCR TIME CLOCKS act UNITMARES HISTS I DIMMERS S 3 a C R V I C I flRWQ pfODT1/1EE.T NO.Of S E .w.oauruu Aw a. 3 NMr. Nnr. Me scepu I A TV t/Sow >/TV ]/,w n o J. ,NC;CCM. a CC•CaaN°. NM Of m.11a a M.IEO NO.OF r at NSM/A i OTHER APPARATUS: I Michael R LeBlanc e / BRANCH MANAGER ° Box 231 RDA 3NewrYorkren La12Bo1 Elena Falls, Per This certificate must not be altered in any manner;return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. Call e4 e7//a//gG Jown of Queendlury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Gueensbury, New York 12801 Fr 0 BUILDING INSPECTOR' S REPORT NAME /�CIr Le [3IR,nC LOCATION /.UQ,rk2 h Date 3/3` / �� Permit No. kl * * * * �t = APPROVED R-*YES# NO Footing/Pier Forms _ Foundation Waterproofing Backfill _ Framing fing rra ing fl Masonry Veneer _ Rough Plumbing _ �qr¢pl�ief Valves tXt. Porches 1111111.11111111r5.711 Finished Floors SSP' `interior Trim --� `Cellar & Railings rang-- Cellar Drain Tile Concrete Floors —__ Plbg. Fixtures Gar. Fireproofing _= Door Closers _ Smoke Detectors _ Chimney INSULATION: Foundation rum �la ing INAL ELECTRICAL INSPECTION Final Building Survey Next scheduled Inspection(call when ready) Remarks- - 5/ off Building Inspector 6/86 and-vl TOWN OF QUEENSBURY Building Department Inepecten Report Date S- Co Name i, nn Location WriAu,ti 1'tMQ Permit No. kJ.. /5'7 Weather ( - Remarks I'4 Excagation �m � Footing Forms Footing & Piers Foundation Cement Coat Waterproofing Backfill Final Survey �> . Framing V 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 Foundation Insulation Walls Ceiling Building Inspector REMARKS TOWN OF QUEENSBURY Building Department lnapec an Report Date S 7 -`64' Name ie tant.c. Location (pv .wry Permit No.Na 8 L— 1 Yl Weather Remarks Excavation Footing Forms Footing & Piers Foundation Cement Coat Waterproofing Backfill Final Survey Framing SEI^ (5F,Lpu) 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 ieti,,n Building Inspector FL.. 0 .Ra a*a€Ac � x u cAj* lmwo c--.�a/ curow �J'�< repz 14 t° 000 a. 4( attro oir .e TOWN OF QUEENSBU Y Building Department hammier' ,� Date �� / '6N Name � 7 e __ n .,,r location (Alin.. Permit No. X 6 -/y7 Weather yyy Remarks Excavation Footing Forms &r 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 Floors Insulation Foundation Walls Ceiling Gd211 C Building Inspector REMARKS