1986-144 -;r
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date August 1 19 8 •
9
This is to certify that work requested to be done as shown by Permit No. 86-144
has been completed.
This structure may be occupied as a
One-Family Dwelling (alterations and
deck added)
Location Glen Lake Road and on Glen Lake
Jef? Godnick
Owner
By Order Town Board
TOWN OF QUEENSBURY
(3,
•
/ ad •
Building & Zoning Inspector
it 4 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 86-144
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Jeff Godnick
Glen Lake Road and on Glen Lake
OWNER of property located at Street,Road or Ave.
in the Town of Queensbury,To Construct or place a Alterations to dwelling/add deck
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 221 Glen St. r�r
Glens Falls, New York
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2. CONTRACTOR or BUILDER'S Name n
Mike Stevens
3. CONTRACTOR or BUILDER'S Address
P. 0.Box 2202
Glens Falls, New York
4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X) G�
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( )Wood Frame ( 1 Masonry ( )Steel ( ) 0
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7. PLANS and Specifications x
alterations to dwelling and add deck per plot plan, specifications 0
No. and application submitted.
8. Proposed Use
One—Family Dwelling (alterations and added deck)
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an
$5.00 C/0 Paid a rt
50.00 November 1 86 o
$ PERMIT FEE PAID —THIS PERMIT EXPIRES 19 w
(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.) o
22nd April 86 a,Dated at the Town of Queensbury this Day of 19
(10
SIGNED BY /// t.(. N for the Town of Queensbury
Building and Zoning Inspect°
TOWN OF QUEENSBURY APPLICATION FOR BUILDING AND ZONING PERMIT
Pate-
Reei.eved
Reviewed
ti, y
Fee Paid c,2_ f1Z f ic,e' (
BUILDING AND CODES DEPARTMENT Date Lseued /b 3
SAY and HAVILAND ROADS RD 1 Box 98 /
OUEENSBURY,NEW YORK 12804 Pehm.c t No. -"6,-#4`
Tel. (518) 792-5832 Ext 204
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. NO INSPECTIONS
WILL BE MADE UNTIL APPLICANT HAS RECEIVED A VALID BUILDING PERMIT.
All applicable spaces on this application must be completed and the
sicTuature of the applicant must appear on the reverse side of this sheet .
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
The owner of this property is : `TT( c,„3 kw.X_
P . O. Address D;) tvl A i_,T sr blt.:;73`, ,.,4 FrALiS . TEL. -741 7 - ,-5u
Property location GLcii‘i LAk_E. TAX MAP NO. 3' / 1 / S
Has there been any split of this property since October 1, 1988? /,
yes no
If yes , Planning Board Review is necessary.
SUBDIVISION NAME, IF APPLICABLE LOT NO .
The person responsible for supervision of work as regards Building Codes is :
..TECV- C7o 3 i‘i i cie.... 5-.;i=o-Ae_ (43 A P3,3__,Zi.)
NAME P .O. DDRESS TEL. NO.
Name of builder `;aaNrE
Address Tel
Name of Plumber Address Tel
Name of Mason Address Tel
4ATURE OF PROPOSED WORK: * ZONING INFORMATION (Office use only)
Construction of a new building * ZONING DESIGNATION OF PROPERTY
Addition to a building * PERMITTED PRINCIPAL PERMITTED ACCESSORY
_Alteration to a building *
(no change to exterior dimensions) * REVIEW REQUIRED - PLANNING BOARD ZONING BOARD_
/Other work (describe) * SITE PLAN REVIEW # APPROVED DATE
__ _ *
AiN 3cric°;JA{* tlEi.04. , i) PcfN * VARIANCE # APPROVED DATE
DROSS AREA OF PROPOSED STRUCTURE
1st Floor 34 sq ft . * Remarks:*
*
2nd Floor _d4`\ sq ft . ,,. COMPLETE INFORMATION REQUIRED BELOW.
Dther Floors sq ft . * Size of property Si.) ft X i3 6 ft.
(not cellar or basement) * Existing buildiiig•(s) Size 941 ft X Se, ft.
ar
TOTAL FLOOR AREA ? } '- sq ft . * Existing building(s) Use I FA1",)L"j 4)-.c ,OO'Ji
Size of new structure ft X ft *
Foui,dation-pier/slab/crawl/par.tial/full * Proposed building, distance from property line
(circle one) -
* Front yard .514 ft Rear yard 'in ft
No. of stories (habitable space)
Height (grade to ridge) ,9tj + - ft. * Side yards 3'LA'' ft and _ 'G;' ' ft
if residential, no. of families ( * If on corner, setback from side street ft
No. of rooms(excluding baths) tp * OCCUPANCY INFORMATION .
No. of bedrooms * PRIMARY BUILDING -
No. of bathrooms VcOne family dwelling
Primary heating system O,t le.e:0 ;44 k..� Y Two family dwelling
Type of fuel d:(,.,.
No. of fireplaces to be installed * Multiple dwelling / Number of units
* Permanent occupancy
Will a wood stove be installed? NOTransient occupancy
Central Air conditioning? —
* Business
*
BUILDING STYLE, PRIMARY STRUCTURE * __Industrial
Ranch Contemporary Lon cabin * Other
*
!3 If addition, what will use be?
Raised ranch Mansion �,
Split level Old style unga1ow *
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 * 1(ti+� .i rtOZe 1�`:...J
CONSTRUCTION $ 250���* *
INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
Form BPA 10/88 v1
BUILDING PEIMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS:
rype of construction, wood frame, fire safe,etc. PtZAr rift
dill any second-hand or ungraded lumber be used? If so, for what? I-1
Foundation wall material C;.e.rhn+r 13e 1. Thickness B •
Depth of foundation below grade (to bottom of footing) is -r '
Will there be a cellar? VE5 Heated or unheated? rt Floor sq. footage /6, 6' c, sq ft
Will there be a basement? yc 5 Will any portion be used as living space? ye-5
(If so, what portion? 3.o sq.ft. - - Type of use?
Type of roof - sloped/flat/shed/other EA 15nNL Material. of roof .� -A i) d '5
Size, wood studs "X " spacing /i. "o.c. length ; ft.
Joists(floor beams) 1st. floor "X . " spacing "o.c. span /) ft.
Joists (floor beams) 2nd. floor 9 "X " spacing , . "o.c. span /� ft.
Overlays(ceiling beams) "X Li " spacing /(. "o.c. span t3 ft.
hoof rafters ,- "X (,. " spacing /b o.c. span /41 ft.
Roof trusses(pre-engineered) spacing "o.c. span ft.
Exterior wall finish ) X Of what material? C.-ED
Interior wall finish l)J'• 5rrerri2o"X-
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? N O If so will a Fire-rated
door, enclosure, and self-closing device be provided? N C ft.
Will a flue-lined chimney be installed? \E 3 Height above roof
Depth of chimney foundation below grade -1 ft.
Depth of fireplace hearth , ft. V'in. •
Water supply - Municipal or private well 1,12.1v Alt er=t-t- ft.
SEPTIC SYSTEM _ Distance from ANY private well(including adjoining properties 5
(A separate application is necessary for any repair or new installation of septic system)
DECLARATION
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 ion the described premises and that all
provisions of the BUILDING CODE, 'PILE 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.
Signature 4,
Owne 410 • ner's agent,arcnitect,contractor
* * * * * * * * * * * * x * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * k * *
SPECIAL CONDITIONS OF TILE PERMIT:
By
TO BE COMPLETED BY BLDG. DEPT.
9 Application No.
�Ulvst Of Queenslur, Permit Issued 19 ' TOWI'•' . '''-t'"'"'"-=
BUILDING and ZONING DEPARTMENT Permit Expires 19 ,rt! ~' , \ ' ;
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation -5•j:it.3� .`
Queensbury, New York 12801 Variance No. L
E-
Site Plan Review No. R 18198p
.
3`i 3mi i Appr y: 7181911°111 1 213
APPLICATION FOR r
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: Err `q ON/c
P.O. Address dal GL.E>,M ST GLENS PALC.S Tel. 798-5-cQ /
Property Location: Gruen Lic},r Tax Map No.31 / I / 6-
Street number or building lot number
Subdivision name (if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
P' i tE STEV E/4 5 P.a . Xaa a C . r 6s G 3c-$O
Name P.O. Address Tel. No.
Name of builder /I/KZ STEUEi,S Address Sfl 0,16 RS A. o 'E Tel.
Name of plumber-&,Lais r4m5 co;asre. ress Tel.
Name of mason . A dress Tel.
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
I D P irk d,Jai. D E.-cic h5 Q Qi_AA,ts * 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 So ft X 13 d ft.
* Existing building(s) Size 9/4 ft X 34, ft.
*
PROPOSED BUILDING AND USE: * Existing building(s) Use I FIr►' i I*t )2e;3tJor e
Size of new structure @4- ft X ft *
Foundatio pier/slab/crawl/partial/full * Proposed building, distance from property line
*
(circle one)
No. of stories (habitable space) * Front yard ,�� ft Rear yard #� ft
* Side yards 31," ft and p3.6 " ft
Height (grade to ridge) ;z + - ft. * If on corner, setback from side street ft
If residential, no. of families j
No. of rooms(excluding baths) ,S * OCCUPANCY INFORMATION
No. of bedrooms 3 *
* PRIMARY BUILDING -
No. of bathrooms * One family dwelling
L
Primary heating system p, F.e.ED 4'T wI* Two family dwelling
Type of fuel OIL * Multiple dwelling / Number of units
No. of fireplaces to be installed 1
Will a wood stove be installed? iJa * Perman::rit occupancy
Central Air conditioning? 146 * Transient occupancy
* Business
BUILDING STYLE, PRIMARY STRUCTURE * Industrial
Ranch Contemporary Log cabin * Other
Raised ranch Mansion Du le * If addition, what will use be?
Split level Old style ungalow *
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 * 7-Other Pont Q 140056: ( -'610.s.ritli
CONSTRUCTION $ 0754600 *
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._ 4060.D FeArn E
Will any second-hand or ungraded lumber be used? If so, for what? N
Foundation wall material C FillErT eLadL Thickness - ,tM
Depth of foundation below grade (to bottom of footing) 0'4v I/'
Will there be a cellar?''l5 Heated or unheated? IHEATeD Floor sq. footage /49C sq ft
Will there be a basement?`e.5 Will any portion be used as living space? No
(If so, what portion? sq.ft. - - Type of use? STD-2-ACE - frvaNiCE - Vic,•y► S
Type of roof - sloped/flat/shed/other 6w5 AAJIpaterial of roof t' ft0A(:t- SA.A0(p i4--S
Size, wood studs rg "X 4 " spacing ) . "o.c. length 1 ft.
Joists(floor beams) 1st. floor 1 "X 8 " spacing /4 "o.c. span IA ft.
Joists (floor beams) 2nd. floor oZ "X a " spacing /C "o.c. span /.Z ft.
Overlays(ceiling beams) 0 "X e-/ " spacing / "o.c. span la ft.
Roof rafters "X ` " spacing /` o.c. span /`/ ft.
Roof trusses(pre-engineered) spacing _"o.c. span ft.
Exterior wall finish f 4o Of what material? C4F0At. C(.A p ao.A P DS
Interior wall finish '/ Sifee7 JLac.e
If a garage is to be attached, describe materials to be used for FIRE SEPARATION: /y'p
Is there to be an opening between garage and dwelling? No If so will a Fire-rated
door, enclosure, and self-closing device be provided? NO
Will a flue-lined chimney be installed? ye-5 Height above roof a ft.
Depth of chimney foundation below grade ¢ ft.
Depth of fireplace hearth ,2 ft.8 in.
Water supply - Municipal or private well Pp_)uATE C.efE-ZL
SEPTIC SYSTEM _ Distance from ANY private well(including adjoining properties ft.
(A separate application is necessary for any repair or new installation of septic system)
N ON E 1J6E-QeD
Town of Queensbury
County of Warren AFF ID AV I T 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 f the BUILDING CODE, THE ZONING ORDINANCE, and all other laws pertaining to
the propose work shall be complied with, whether specified or not, and that such work is
authorized b the owner.
SWORN TO BEFO ME T Signature_-_41,/
Ow el owner's agent,arcnitect,contractor
day o 19
Notary Public, Warren unty, N.Y.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
SPECIAL CONDITIONS OF THE PERMIT:
By
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 6 o
2 . Type of heat 011. Pi EJJ /4oY 414762_
3 . Is the building mechanically cooled? 44Q
4 . Percentage of area of windows and doors
A. Over 16% Only
1 . Uo value of gross area of walls , roof/ceiling and floors
exp sed to ambient conditions
2 . Floor o er heated' spaces YES NO
a. Are oundat,ion walls insulated? YES NO
1 . I \AYES, what is the R value?
`ter
3. Slab on grade YES ' NO
a. If YES, wha is the R value of insulation around
perimeter of loor?
4 . Is basement heated? S NO
a. R value of insulation
5. Type of insulation
. Under 16% Only
1. R value of roof and floors exposed to ambient conditions
2 . R value of 'exterior walls 2.- 1 3
3 . R value of glazed area a- 10
4 . R value of doors (2, -
5. R value of floors over unheated spaces /l" 4 2-
6. R value of slab edge insulation - unheated slab 2 -4
7. R value of slab insulation - heated slab R - 4-
8. R value of heated basement/cellar walls (above grade) a-
9. R value of heated basement/cellar walls (below grade) 2-
10. Type of insulation ,311a. PJRea G.4.-A-b /liA Fiee7-I a + f ArA
C. Controls a
1 . Thermostat maximum heat setting a,0
D. Duct Systems
1. Is duct system, installed in unheated spaces? YE 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 or cooling carrying agent
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
Telephone No. 7 8- .,Sp °/1 `./ / ( ���
,. • ' is nt ' s signature)
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12801-
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR I SPECTION REEEIVE
NAME �, �
LOCATION 44
DATE )- 3/- / PERMIT #
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:,.GP L ��
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 ti
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION x
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS:
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT /
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12804.
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED $2?
NAME i 3D,PJrCam- GG
LOCATION 61 L. '-
DATE,�f/`*�_1` PERMIT #
C
` "a es, G jr- Off' APPROVED
5L51 4E-44 YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL /
ROUGH PLUMBING V{
`FRAMING 1,/
ELECTRICAL ROUGH-IN
M(SULATION:
FOUNDATION
FLOORS
WALLS
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: j/ / - „/j 9 7
4/e.e_c0 eci
fro7fr,44'
INSPECTOR
TOWN OF QUEENSBURY 1;%/
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12804-
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INS PECTION RECEIVED � s
NAME U 'qn
LOCATION 6'644 4764
DATE 7/a(/ PERMIT #
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
-'INAL 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 t f
FINAL APPROVAL OF CONSTRUCTION
q SIGNED CERTIFICATE OF OCCUPANCY MUST BE
)BTAINED FROM THE BUILDING DEPARTMENT BEFORE
PHESE PREMISES ARE OCCUPIED!
?EMARKS:
INSPECTOR
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