88-065 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY., NEW YORK
.Date ('4i4.(.J ,. 19
Qq • S-k-5
This is to certify that work requested to be done as shown by Permit No. £8—65
has been completed. -
This structure may be occupied as a. One Family Dwelling
1531%
Location Birdsall Rd.
Owner Datd Stevens
,By Order Town Board
TOWN OF QUEENSBURY
%11/,/A11;/')V/9_//jjJ1/7
Building�rYZoning Inspector
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 88-65
WARREN COUNTY, NEW YORK •
9D\
ERMISSION is hereby granted to David Stevens
'N
OWNER of property located at C91 Birdsall Rd. Street, Road or Ave.
in the Town of Queensbury,To Construct or place a One Fami 1 y dwellling
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.
rj
1. OWNER'S Address is RR 5 Box 27
Glens Falls, N.Y. 12801
2. CONTRACTOR or BUILDER'S Name
Same
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
bj
r•
rt
c.
5. ARCHITECT'S Address cn
fv
l-
F-'
6. TYPE of Construction—(Please indicate by X)
(X)Wood Frame ( ) Masonry ( ) Steel ( )
7. PLANS and Specifications
c-,
No. 28' x 36' as per plot plan, specifications and application including o
septic system.
8. Proposed Use
One Family Dwelling
$5.00 C/O
$ 119.00 PERMIT FEE PAID —THIS PERMIT EXPIRES October 1, 19 88
crQ
(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 10th Day of March 19 88
SIGNED BY 67-6!L ,. Z� for the Town of Queensbury
Building and Zoning Inspector
a,s'. TO BE COMPLETED BY BLDG. DEPT. i 't
Application No.
_�] wn o/ Queenitury Permit Issued 19 TOWN OF QUEENSaUt 1
r--
BUILDING and ZONING DEPARTMENT Permit Expires 19 I II Ti i , iiiri1 1.
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation D
Queensbury, New York 12801 Variance No. 3 `�y P d-
� ( Site Plan Revi No. AR 9.
)\' 7y!
Appro e D V & CODE DEPT.
i .
APPLICATION FOR
BUILDING 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 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: , O Jl J.rt W• s7L`-\jEA S
P.O. Address a, YL. lti)0 .S; ii o)( ,)-) ('LE S FAL4S ) No • )a9,o) Tel. '29 -9y97
Property Location: -vrLgsALt. not.40, QU1;t±�1s`p,ov1,Y Tax Map No. e a /s /
Street number or building lot number ( ,, ar-
OF)
Subdivision name (if applicable) 1-Jo
- THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
.0Pu _ TEdeos Rat. 10a. T. 00 a" 66C)U-5 FALLS, 1%). . -79a-82/97
Name P.O. Address Tel. No.
fall
Name of builder 3,0gIo w. sTF.Jews Address r.n, No,S')slox 7 ecEws Fpu.S,n9,Y• Tel. 7qa-A 4
97
Name of plumber" " Address" " Tel." r'
Name of mason OpLL pmL,O"J '3 Address V,vtt.n. Mrtx raNA,u rh.c/a)o Tel. 79a-137)
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,
_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
FOR DEMOLITION PERMIT, STATE SIZE AND * whether interior or corner lot. Show location
*
LOCATION OF STRUCTURES AFFECTED. of water supply and location and configuration
-
* of septic disposal area.
-- .-._.
*
* COMPLETE INFORMATION REQUIRED BELOW.
Size of property -690r ft X 1(0 ft.
--_--• * Existing building(s) Size001JL ft X wovi ` ft.
* . . . . .
PROPOSED BUILDING AND USE:
* Existing building(s) Use n)o p,u1-1,1oxW6
Size of new structure 21,43 ft X 3(p ft c:U•r,,v%,ev-1els( ®� L14"a1)
Foundation-pier/slab/crawl/partial fib * Proposed building, distance from property line
(circle one) *
* Front yard -70 ft Rear yard 6.,9* ft
- No. of stories (habitable space) a.
•- Height (grade to ridge) a_� ft. * Side yards 10o ft and iyp ft
* If on corner, setback from side street leo ft
If residential, no. of families 1 rhIslwrir h.12afl/t
No. of rooms(excluding baths) * OCCUPANCY INFORMATION
No. of bedrooms 3 - *
No. of bathrooms * PRIMARY BUILDING Primary -
heatingsystem p- * V/One family dwelling
Y -LLj HoT w. TE1'L * Two family dwelling
Type of fuel OIL
-No. of fireplaces to be installed * Multiple dwelling / Number of units
Will a wood stove be installed? N6 * Permanent occupancy
Central Air conditioning? Jp * Transient occupancy
y
* Business
- BUILDING STYLE, PRIMARY STRUCTURE Industrial
Ranch Contemporary Log cabin * Other '
* If addition, what will use be? WovJL
Raised ranch Mansion Duplex
Split level Old style Bungalow *
ape Cod Cottage Other * ACCESSORY BUILDING-
Colonia Row Town House * Detached garage/one car/ two car/ car
( CIRCLE ONE PLEASE ) * Attached garage/one car/ two car/_ car
* * * * * * * * * * * * * * * * * * Private storage building
b ESTIMATED MARKET VALUE OF * Other
CONSTRUCTION $ *
INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
Form BPA 4/86 and-vl
4
G ��, rJ p7 -c y} s
BUILDING PERMIT APPLICATION CONTINUED -
•
•
BUILDING SPECIFICATIONS:
Type of: construction, wood frame, fire safe,etc. WOOD rri,ArnE' •
Will any second-hand or ungraded lumber be used? If so, for what? 6
Foundation wall material . Loc.K 1=ou;Afl1a11or1 Thickness (p��
Depth of foundation below grade (to bottom of footing) “0,40.) F-AosT ?,3•.>ti,
Will there be a cellar?YES Heated or unheated? owmfirrEO Floor sq. footage 1008 sq ft •
Will there be a basement? Yes Will any portion be used as living space? 'Np
(If so, what portion? sq.ft. - - Type of use? ---
Type of roof - sloped/flat/shed/other..Su sEo Material..of roof 4LRFTt-h.s i W h.0 'yt i- . Frwvi uiss s)41"41AS .
Size, wood studsa.o, "X tip(," spacing 16 "o.c. length 719" ft.
Joists(floor beams) 1st. floor .. "X jp " spacing )L "o.c. span /y ft.
Joists (floor beams) 2nd. floor . "X j " spacing )6 "o.c. span ft.
Overlays(ceiling beams) a "X (, " spacing 16 "o.c. span jy ft.
Roof rafters Q1, "X " spacing IL o.c. span •jy ft.
Roof trusses (pre-engineered) spacing "o.c. span--- ft.
Exterior wall finish 1Nop,Nn . '(1(4l-TG'J Of what material? h.000.1+ 1Pz+JE
Interior wall finish - " S14 rr 8 t h,00 K
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
1V0 E-TTAc N 1=O 613h-f4(.1r •
Is there to be an opening between garage and dwelling? w o If so will a Fire-rated
• door, enclosure, and self-closing device 'be. provided?
— Will a flue-lined chimney be installed? NO Height oof - ft. -�
- Depth of chimney, foundation below gradePwsr ft. G Nz►i 'V C AAs,- TO AE a,asa14‘.1e43
Depth of fireplace hearth -- ft. ---in. - vt.Jti •
Water supply - Municipal or private well ha%) 1t w>r 1.t •
SEPTIC SYSTEM _ Distance from ANY private well(including adjoining properties 1)o' 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
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 doneLon 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 Signature :) Ot�►l. Ini" •
Owner, owner's agent;arcnitect,contractor •
day of 19
Notary Public, Warren County, N.Y.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
SPECIAL CONDITIONS OF THE PERMIT:
•
•
By •
Jiuht. o Otiandfitni
APPLICATION FOR SEPTIC DISPOSAL PERMIT
DATE /9 / 99
LOCATION OF PROPERTY FOR INSTALLATION [fin pSALL flc1A:6) QoEE.1a5 Bah.).
ArTG"3:30
Owner's Name: °Auto 8vaS Telephone: _ 77d- 9 997 799 313/
K �, ►�10 s, pal, a� GLEuS r-pusiNhy mfaa,swc, I)017.1,1,L'55
Address: payoo.$t u. YL0A)3
Installer's Name: voRc-�y Gr,,,N.AA,nti Telephone: `/ Li 9' 5 9
Number of bedrooms (residential only) 3 _
Total daily flow (compute @ 150 gal per bedroom)
Topography: circle one: Flat Rollin Steep Slope % of slope Jo 10
GruaJb'L
Soil Nature: circle one: Sand Loam Clay Other / Depth: feet
Ground Water: At what depth? feet
Bedrock or Impervious Material: At what depth? _ feet
Percolation test:. _circle-one: rot require required / rate min. inch.
Domestic water supply: circle one: Municipal Oel Other
IF domestic water supply is a Well: 1
Separation: Watersupply from Septic absorption — I /0 feet
PROPOSED SYSTEM: Septic Tank /loco _ gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench 'O feet / Total system length RcX5 feet
SEEPAGE PIT(S): Number of / Size each ------feet by —feet
Size of stone to be used # c�-- / Depth or Thickness _ feet
* * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
IMPORTANT
...Please...LIST NEW EQUIPMENT TO BE INSTALLED
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
(over)
Section II Septic System Inspections:
A. All applications for septic system installation, alteration or repair, as
required by the Town of Queensbury Sanitary Sewage Ordinance, shall
be submitted to the Building 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 drywells
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.
I have read the regulations above and agree to abide by these and all requirements
of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
Signature of responsible person: . Q/ / OA) •
Date: _ -',/9/E3&
Town of Queensbury
Building and Code Department
Bay at Haviland Road R.
Queensbury, New York 12801
(518) 792-5832 Q`
SF '"TLEf,? '•?`3 . . . HOME OF NATURAL " ' ., i Y A GOOD.PL° IVE
• f
.3a�, � TOWN OF QUEENSBURY
cid
--O 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 1 ,o)
•
2 . Type of heat cs a L 1-4cv • i3 P-tl?h., .
3 . Is the building mechanically cooled? No c�7
• 4 . Percentage of area of w /indows and doors '?.O °
A. Over 16%•"Only
• 1 . Uo value of gross area of walls , r f/ceiling and floors ,
. exposed to amb\ent conditions i /y5" )3ro/ran, Fow 31.10 5Q014v,A Fe-t-
1T -2a � .
2 . Floor over heated spaces YES' NO
a. Are foundation wal in ated? YES NO
1. If YES , \what is the R value? -
,
3 . Slab on grade S NO •
. a. If YES, wha \is the R value of insulation around
perimeter - f floor? ft-
4 . Is basement/heated? YES 1
a. .--R valu of insfu-lation 'y�d)) ,
• 5. Type of in ulation E (oL 55 -Ask)-0 Pi)EmdC/C FCj ni - r•_
B. U n dam[. n '(1---.)
(/l
• 1. R value of roof and floors epos to ambient conditions_
/ �/ r r 1,—
/
• 2 . R value of exterior walls - - T-- /—/ -/� .. ('
3 . R value of glazed area "L <
4 . R value of doors Z< ; •
•
5 . R value of :floors over unheated spaces , /QT4I3J6 6. R value of slab edge insulation - unheated slab '
7 . R value of slab insulation - heated slab
8.! R value of heated basement/cellar walls (above grade)' /Z //,
/ 9' R value of heated basement/cellar walls (below grade). Af -/?
10 . Type of insulation
C. Controls •
1 . Thermostat maximum heat setting !',:1,`- 7 Co
•
-
D. Duct Systems
•
/ 1. Is duct system installed in unheated spaces? YES . NO
a. If YES , R value of duct installation
�/ b. R value of duct in other areas -_______-
, E. Piping Insulation .
1. Size of hot water orcooling car yang agent pipe •
2 . R value of pipe insulation .
F. . Service Water Heating .
1. Performance efficiency `/
2. Temperature control setting maximum '
•
. G. For Swimming Pool Only
• 1. Maximum heating 6 .S W tvti ri zwco 'Poo L
Telephone No. 9d - g,-, _D -^�
(applicant ' s signature)
1
•
T€1 OF QUEENSBURY
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792�-_5�8�3�2 -
INSPECTOR'SBUILDING f�T
FINAL INSPECTION "
REQUEST FOR INSPECTION RECEIVED ' ////(/
NAME - -c7N?`2Ar\.5 t) ) �>
LOCATION C et f
DATE / / 9 / • PERMIT# �I —((75
TYPE OF STRUCTURE S t\naQZ •) Q )
J
RECHECK
FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
7FOOTING ZFOUNDATION Z/ ACKFILL ✓FRAMING
_/ROUGH PLUMBING FINAL ELECTRICAL ASEPTIC
INSULATION WOODSTOVE/FIREPLACE I
SITE PLAN/VARIANCE REQUIREMENTS 1 YES' NO
REMARKS CI\1O 2 C��� . ��I:G/C��' (j
APPROVAL
N/A YES ,,NO
CHIMNEY HEIGHT/LOCATION r/
B VENT/LOCATION
PLUMBING VENT • J
ROOFING
SIDING ; ;; ✓
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES
FURNACE/HOT WATER OPERATING imot/
BASEMENT INSULATION/DUCTWORK( ✓
INTERIOR TRIM/PRIVACY DOORS r:; ✓
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT I!'
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS /
HANDICAPPED ACCESS f
SMOKE DETECTORS / 3 �✓
BATHROOM FANS/WHOLEHOUSE FANS
ALL PLUMBING.FIXTURES OPERATING ✓`
GARAGE FIRE PROOFING I` ✓
DOOR CLOSERS i I;' ✓
OTHER FIRE SEPARATION/
FIRE/DEMISE WALLS I
DUMPSTER
FINAL ELECTRICAL /
OK TO ISSUE C/O OR`C/C t , ✓''
COMMENTS:
•
ARRIVE /" So
DEPART ,' .
TOWN OF QUEENSBURY /1/
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 1280c-
TELEPHONE (518) 792-5832
BUILDING,,;INSPECTOR'S REPORT
REQUEST FOR INSPECTIOX,RECEIVED % �b0 re:2F',
NAME ! 4/ /I!""�I�-�
�1.(4;% �y �"� &f,LOCATION
DATE 70 i', PERMIT #
APPROVED
YES NO
FOOTING/PIERS if
MONOLITHIC POURiFORMS
FOUNDATION/DAMZIPROOFING •`
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN /
1JINSULATION: •
FOUNDATION tj
FLOORS
WALLS j
CEILING -
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/STEPS
STAIRS-CLEARANCE & RAILS
PLUMBING FIXTURES/RELIEF VALVE
INTERIOR TRIM/PRIVACY DOORS
FINISHED FLOORS ,
GARAGE FIREPROOFING
DOOR CLOSER(S)
SMOKE DETECTORS
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS:
•
1
9
Jr 7"
r,
G
INSPECTOR
Cc7 // / �
Jown o/ QUeen.burcy
• BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAMECCe-)-a - �Q
LOCATION �d CL' 0 ,ee
DATE �, /L9/ 6'y PERMIT NO. (3 - (,,:
SOIL TYPE - Sand - Loam - Clay - •
Percolation Test Required? YES - N0
Percolation ate - Min/Inch
TYPE of SYSTEM:
Absorption field, total lengl
Length of each trench ' s'{
Depth of trenches '
Size of graver
SEEPAGE PITS{Number of) /
Size- ft. X \ ft./�
Gravel size \ '
PIPING: ° .!Size Type
Bldg. to tank \igef
F,
Tank to dist. box
Dist. box to field/pi d: i G
Openings sealed? ,,` iES ' .•` NO 'Partial
LOCATION/SEPARATIONS:
Foundation to -b4nk `i l,... ft.
Foundation. to absorption `V_ ,fft.
Absorption to/lot line ft.
Separation of pits - .\ ft.
LOCATION OF //SYSTEM ON PROPERTY;(c r.cle.one)
Front - Rea - Left. side =, Right sidsJ
COMMENTS: I E !~
•
✓, e ? �J/ .
l • f
SYSTEM USE APPROVED 'YES J NO
Building Inspector
01/86 and vl
TOWN OF QUEENSBURY U�
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS /f,✓J7
QUEENSBURY, NEW YORK 12804- /f' �<
TELEPHONE (518) 792-5832
/1_
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME �
LOCATION �.Zs / Z-
DATE PERMIT
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP—PROOFING
BACKFILL APPROVAL
i../ISUGH PLUMBING
V RAMING V
ELECTRICAL ROUGH—IN
INSULATION:
FOUNDATION
FLOORS c
WALLS
CEILING
FINAL INSPECTION: g"
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/STEPS
STAIRS—CLEARANCEi& RAILS
PLUMBING FIXTURES/RELIEF VALVE
INTERIOR TRIM/PRIVACY DOORS,
r
FINISHED FLOORS
GARAGE FIREPR OFING
DOOR CLOSERS)
SMOKE DETECTORS
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!'
REMARKS:
1 /
411
t IV
INSPECTOR
Jown o19 Queeniur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
/11
Queensbury, New York 12801
i",
BUILDING INSPECTOR' S _ REPORT
NAME ,ti a eto-,�
LOCATION ii�Ce.441/ A
...e
Date ��- (n / Fr Permit No. ff- �-Js
* * * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES / NO
Footing/Pier Forms
/undation /
Waterproofing j
Backfill
Framing
Roofino
Siding
Masonry -neer
Rough Plum'.ing
Relief Valv:s
Ext. Porches
Finished Floo
Interior Trim
Stairs & Railing .
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproof.ng
Door Closers
Smoke Detect.rs
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-
•
Bui ding Inspector
6/86 and-vl
_lown o/ Queenitury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME /60C 1,_„f
LOCATION "65
Date 4 4//i Permit No. ge--/8
��' ✓ Y
= APPROVED - / NO
noting/Pier Forms qq//
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Venee
Rough Plumbin•
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
FINAL ELECTR CAL INSPECTION /
DRIVEWAY APP'OVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-
7\d/111t
Building Inspector
6/86 and-vl
b
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723:? Q --do'
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