3989 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
Owner
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoning Inspector
CREATIVE "INSTA" PRINTING GLENS FALLS N V 12801 (5,81783-5658
BUILDING PERMIT
TOWN OF QUEENSBURY No. 3989 '
WARREN COUNTY, NEW YORK
H.
PERMISSION is hereby granted to Hilton A. Tallman Const. Co . Inc .
OWNER of property located at Lot 2 Lantern Hill Road Street, Road or Ave. ?'
in the Town of Queensbury,To Construct or place a One Family dwelling su
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
R. D. #3 o
Saratoga Springs. New York 12866
c+
2. CONTRACTOR or BUILDER'S Name 0
O
Same
1-1
3. CONTRACTOR or BUILDER'S Address 0
Same
4. ARCHITECT'S Name
Curtis D. Dybas 0
tV
5. ARCHITECT'S Address
i (1)
C't
yy
•J
6. TYPE of Construction— (Please indicate by X1
( )Wood Frame ( ) Masonry ( 1 Steel ( ► ►''
F-'
7. PLANS and Specifications
38' x 69' per plot plan . specifications and application 0
No. submitted including sewage system and 2 car attached
garage.
8. Proposed Use
One—Family Dwelling
$5.00 C/0 Paid
$ 110.00 PERMIT FEE PAID —THIS PERMIT EXPIRES — November 1 1976 N.
(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 19th Day of April 19 76 cep
SIGNED BY " ea4.41 ' 0f) for the Town of Queensbury
a Building and Zoning nspector
TOWN OF QUEENSBURY ;space inside block to Ix filled in b,
WARREN COUNTY. NEW YORK Building Inspector)
Application for \''l'Iuatie"' No. •
I'crnot Issued _19
BUILDING AND ZONING PERMIT l'u nit Expires . Iq
i:,,nu)i.1 District
\ .ilia• OI \\'ork$
THREE (3) Copies of a PLOT PLAN, Drawn to scale \i'i'r'"c'cl by
showing the actual dimensions of the lot to be built l:c in,o Kf
upon, The exact size, and location on the lot of the
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION.
TOWN OF QUEENSBUr-. Y
i —/q-7‘ , A
r 1 Sse. F =PD J
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK APR 13 i i/b
ANSWER ALL OF THE FOLLOWING.
The undersigned hereby applies for a permit to do the following work A.K. P.M.
�1
which will be done in accordance with the description, plans and specifi- q_$�$ E�11�I2�1+2I3�4I5'6
cations, and such special conditions as may be indicated on the permit. A
The of thi p perty is:
f-E t /./4 1 , a L L Pr),c r.-. Cvn S'7 CeJ 4.h c ?V Jive? cSc t rCt �I 4i. . . . .r. Z�{. h.
INA E) !P O ADDRESS)
The person.r spy ibie for su rvision of the work i c)far as.the Building�Co�de and the` Zoning Ordinance apply is:
17 r / eh /. i a' 4 L i-n of c-r l 1 U !f 3 6 ct. ✓,c¢ -e,,C,,�.. .\`.H, ( 2 E`4
N ME) y ?SC)
0 . DRESS)
Name of Builder Ai'/7YI /7 1`' 1 L-`""4 &.5 es (.'Address li"IC)'1.? , r-u ',-; 'N.y 1?F.0 C- . .
Name of Plumber .d,/7/ t^ L. � 4.- . Address �/
Name of Mason / / / cc:d r'",�"`-.
/� l7 Address .
Lot Number 2--�. . . Uni ` ' c4 pima ed value of proposed work S 5„ ' . .71..13)
Name of Village (1' ''c 4-o-t.s2--
Name of Street L ct.rTe`h Ale It RU q d Side of street: no-th 0, east g south 0. west 0
Nearest Cross Street Distance fr(,1, .lei;, -rosy street 3 oe Ft.
Property is north >:t ,south 0,east i , west 0 from Cross Street
If on Corner, which corner, northeast ❑, northwest ❑, southeast [.�' southwest
(Designate by marking with an "X" in the correct space.)
NATURE OF PROPOSED WORK OCCUPANCY
Z Construction of a new building. Main Building
❑ Addition to a building. One-family dwelling !NT
❑ Alteration to a building. Iwo iamiiy dwelling ❑
❑ Demolition of a building. • . . `amily apartment house ❑
Store building
-ear attached garage ❑
Other
Accessory Building
One-car detached garage Li
❑ Other work. Describe Two-car detached garageEi
Private chicken house
Private storage building I❑
Other:
ZONING SPECIFICATIONS. Fill in for new building, or addition to existing building, or a change of occupancy.
Indicate on the plot plan street names, the location and
size of the property, the location, size and setbacks of pro-
NORTH posed buildings, and the location of all existing buildings.
Show proposed building(s) in dotted line and existing
'RfC ev- �C-C ,. building(s) in solid line. -3 yo y S.1,/+`- b r
za-or 2/
Size of property g7 J ft. x . . . .cy,Y .A A . . ft.
Size and use of existing buildings, if any
I-
y' Size of proposed building ft.x .. . . . ft.
't Height (from grade to ridge) A7r ft.
d i° Front yard 7 5 ft.
A ft. and F" ft.
Side yards
,it do Rear yard ‘C' i ft.
SOUTH If on corner,setback from side street ft.
vNote: All distances are net, as measured from street side
line to nearest part of building.
'�
(OVER)
7-73-M , .,
(coned.)
BUILDING SPECIFICATIONS.,
r v-d I,h
Kind of construction: Wood frame, fire safe, eta ?. . . . . . . ... . . . . ... . . . . . . t. ... . . . . . . . . . . . • • • • • • . . . . . . . . . .
Will any second-hand lumber be used? 1� G' If so, for what?
Material of foundation walls
pvin e 1'2 1T , Thickness g A�
Depth of foundation walls below grade 2. Continuous foundation? . . .Y ems. .
Will there be a cellar? Y O` / If so, material of cellar floor Ce el. c ice... 1-4,:...
Type of roof: Sloped or flat? . . . s51:'a.19 .< . . . . . Material of roof OS F /9 k S f 3 L'c L-b
X -xspacing /4 "o.c., length • ft.
Size,wood studs `� ", p g g
Size, floor beams, 1st floor A X' O " x ", spacing to "o.c., span ft.
Size, floor beams, 2nd floor 2/ x ', spacing / "o.c., span ft.
Size, ceiling beams . . . . . . . . .2X. . . . . " x spacing /` "o.c., span
ft.
Size, roof rafters or beams . . .a?.X.t. . . . " x ", spacing /'e�
"o.c., span ft.
Exterior finish '.'-' -k'- With what material? C. c s. c ,
Finish of interior walls te: .5'! �f /2ort' C.. . . • . . . . . . . . • . . . . •
. . . . . . . . . . . . . .
If garage is to be attached, of what material is wal�ll,`between garagA and main building to be constructed?
Is there to be an opening between
rage and building? /
r�
Kind of heating system e''r V-N Oil burner or coal? 0 t ( �,
Will a flue-lined chimney be provided? . ./. �/. :�:5. . . . . . Depth of chimney foundation below grade . . .d. . . . . . . . .
Height of chimney above roof. . . . ... .
Will there be a fireplace? Q-5 Depth of fireplace hearth 22-
Will a toilet be installed? . . . . . . . . . . . . . J
Will a kitchen sink be installed and connected to water suppl ? y :5
Water supply(public water supply or pump) J '+ � —
Distance of cesspool from any private well ( v--c feet
Will drainage system be provided with required traps, cleanouts, and vents? . . . . .3
Town of Queensbury AFFIDAVIT
County of Warren
State of New York
I swear that to t.t oaa j of my knowledge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, are a true and co.e. fete statement of all proposed work to be done on the described premises and that all provisions of the BUILD-
ING CODE,THE ZONING ORDINANCE,and all other laws pertaining to e . .posed work shall be complied with,whether specified or not,
and that such work is authorized by the owner. /ram
le- c-
Sworn to before me this Signaturee If'OWNER.OWNER'S AGENT.ARCHITE ,CONTRACTOR
day of 19
NOTARY PUBLIC,WARREN COUNTY. N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
•
By
TOWN OF QUEENSBURY
BUILDING & ZONING DEPARTMNT
ZII.SrAIITTNRgFICERBILDW
GI, NS FALLS, NEW YORK 12801
APPLICATION FOR A PERMIT TO CONSTRUCT, ALTER OR ENI.A?.GE
A SEWAGE DISPOSAL SYSTEM WITHIN THE TOWN OF QUEENSBURV
OCCUPANT'S NAME A/e/:/6 il /2 Ll-- 4.'n ,;-: C°2'"ADI;;SS f? 0
TELEPHONE 6g 4' - / 2 ( 4 OWNER'S NAME ,A4 / c'll 4 (c, 0- e. ,--
/7
_______
ADDRESS NUMBER OF BEallODMS ,L4" ,
GARBAGE GRINdER? -1\t& (YES OR NO) TOPOGRAPHY: FLAT, ROLLING, STEEP
SLOPE, GENTLE SLOPE, OTHER F-4,f---
......
NA7URE OF SOIL: CL,AY, ANDY LOAM, GRAVEL, AOCK, 'ITC,
PERCOLATION TEST `I -:, n WATER SUPPLY° MUNICZPAL. WEI.L., °THU,
. _ .
DIAditAM OF 1) ,OPOStit SEPTIC SYSTEM
C
<------1
( 1.
)
4-el---...,
/ 2.0 /
$r '
OTHER PERTINENT INFORMATION
_.......,.
IT IS HEREBY AGREED THAT IF THIS APPLICATION AND PLANS ARE APPROVED,
INSTALLATION OF SEWAGE DISPOSAL FACIU:TIES WILL BE MADE IN ACCORD :A
WITH DETAILS SH WN.
DATE ( ;7/
. ._
SIGNATURE OF APPLICANT
LAKa GDVSi PAR CGMMISSIM
''ce
'''‘VI'
M 1�
iv t
4l
Ord
14 ' (( Pc,C) ,
C�
.k
/ ,N
43."----/-;-jIM /7,
-/---/- --t 1 lira, 43/43,
TO OF QUEENSBURY
Building Department
Inspectors Report Date frk
Name
Location � � ',_, ,,
Pezmit
No. ; Weather
lPer Cent
Complete RemarksExcavation
MEMFooti_ng Forr,1s "T
Footing & Piers
Foundation
Cement Coat
1.11111.11
Waterproofing
MOM
Backfill
Final Survey
1 r
Framing IIIIMAY ,
Sheatkrng _
ill
Roof Felt ---�;-----._
Roofing '�
Sidin, }— --'
- -T—
Masonry Veneer C �
Rough Plhg. .'
Rough IIt�. .
Relief--- Valves
Wall Board
Ext.Porches_Fin_.__,hedloor_
F
IMMEMINFar
Interior Trim li
Stairs&Railings 11.7 C
Cellar Dr. Tile
Concrete Floors um
Plh_.Fixtures amm �
Gar. Fire.roofin:
Door Closers ��
irlIF-j
Chimne11111
1111111111111111
Water Meter Inst. _
Septic. App_ r�va_t
Building Inspector
REMARKS
7 --1Z,-/Chill`
-"hti ' ‘
Ca
/' ae4
;/ 'efiii(A‘
TOWN OF QUEENS BURY
Building Department
Inspectors ReportMf1 f .Y Date
Nam a>- / / x:
Location `
Permit No. • Weather
Per.Cent
Complete t Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
F Waterproofing
Backfill
Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Rough Htg.
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.
f� Septic Approval />
Building Inspector
REMARKS
jl,c 722 113l//!lk- e>
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date `.I (p
Name pir l 1` d1 _r GI /l lh a r!
Location LOT„2 L<;/q 7 efr-v-a tb`i / Cf
Permit No. 3`'i ? 7 Weather
Per Cent
Complete Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing r`
Sheathing 61/
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Rough Htg.
Relief Valves
Wall Board
Ext.Porches
i
Finished Floor
Interior Trim
Stairs&Railings
Cellar Dr.Tile
Concrete Floors
Plhg.Fixtures
{ Gar.Fireproofing
Door Closers
Chimney
Water Meter Inst.
614#61/7
Septic Approval
Building Inspector
REMARKS
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date • / :71`J/
Nary- a
Location I,��Js'� e.
Permit No. er tit;:i Weather / 11-1/
Per.Cent •
Complete Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill _..
Final Survey
•
Framing
Sheathing
Roof Felt
Roofing ofmg
Siding
Masonry Veneer
Rough Plbg.
Rough Htg.
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
Building Inspector
REMARKS
•
TOWN OF QUEENSBURY •
•
Building Department
Inspectors Report Date
Location
Permit No. Weat er %/",+ 71-
1,
Per.Cent
C� Complete Remarks
Excavation
Footing Forms p/!
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Rough Htg.
Relief Valves
Wall Board
Ext.Porches
Finished Floor
Interior Trim
Stairs&Railings
Cellar Dr.Tile
Concrete Floors
Plhg.Fixtures
Gar.Fireproofing
—T -
Door Closers
Chimney
Water Meter Inst.
Septic Approval ,,-r` ! •ri
Building Inspector
REMARKS
1 J4�."�.T�/..91."..�tf�19.t ..!" ..„..!�%,.._CJ4!„19)„Ori,"„14)�4.l J.4/,,4)?4l�4)„,41„ .,}41,,k•t„1��4 �1,),4c),44.)4•,„14), c.��,)4(.4,1,, � J4/,J4/.a�,a�„14/14)„14„f41„k41,,��),,14C14/. /C.14C 4/.\4C?P%41
,Y
4
THE NEW YORK BOARD OF FIRE UNDERWRITERS '
BUREAU OF ELECTRICITY �i
-, 1 41 STATE STREET,ALBANY,NEW YORK 12207 i
Date Application No.on file A ,\e
�: THIS CERTIFIES THAT /��►
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of ,r
1.
ii r
in the following location; ❑ Basement ❑ 1st Fl. ❑ 2nd Fl. Section Block Lot
is was examined on and found to be in compliance with the requirements of this Board. ''e
i'
• FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS 'is
�� OUTLETS RECEPTACLES SWITCHES INCANDESCENT FLUORESCENT MERCURY
' - - VAPOR AMT. K.W. AMT. K.W. AMT. K.W.. AMT. K.W. AMT. H.P. .'i.
i'
,e
�' DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS BELL SYS
AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OTEMS AMT.- WATTS '�F FEET
1
', SERVICE DISCONNECT NO.OF S E R V I C E •
�: METER
ANT. AMP. TYPE EQUIP. B'1,3 2W 1, 3W 3,3 3W 3 0 4W NO.OF CC.COND. A.W.G. NO.OF HI-LEG A.W.G. NO.OF NEUTRALS
�� PER if OF CC.COND. OF HI-LEG OF NEUTRAL
ti -
4 :.,:a
ii: OTHER APPARATUS: i'
r
.
G i
�r
i
4
!-:, i
< —
!C
77,L,:.03746))
1-0
BRANCH MANAGER
Per
'CYY7..........YYYYYY'YYYYYYYYYYYYYYY.YYYYYYYYY'Y-"--'YYY'Y"YY.7 YY fY-'Y-";,-'Y^"-i'^i- i-'Y 'Y Y7 YY YY YY YYY Y A
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNED_