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