1986-465 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date April 16 19 87
j.
This is to certify that work requested to be done as shown, by Permit No. 86-465
has been completed.
This structure may be occupied as a One—Family Dwelling
Location Lot: 585 Fox Hollow Lane (St® No. 20) Section 15 Westland.
Owner Ranold Raynor
By Order Town Board
TOWN OF QUEENSBURY
v Building&'Zoning Inspector
-�' BUILDING PERMIT
TOWN OF QUEENSBURY
No. 86-465
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Ronald Raynor
OWNER of property located at Lot 585 Fox Hollow Lane (St. No. 20) Street, Road or Ave. Pd
o
U
in the Town of Queensbury,To Construct or place a One-Family Dwelling a
.s
at the above location in accordance to application together with plot plans and other information hereto filed and ,h
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
0
1. OWNER'S Address is 583 Dixon Road
Glens Falls, New York
2. CONTRACTOR or BUI LDER'S Name
same
3. CONTRACTOR or BUILDER'S Address
same
co
rt 0
4. ARCHITECT'S Name rt
t2� Li
0 Co
Ln
N �J
O O
Aj
5. ARCHITECT'S Address to
m x
n o
rt N
r• 11
O 0
6. TYPE of Construction-(Please indicate by X) r
L, w
(B)Wood Frame ( ) Masonry ( )SteelrD
( )
ED
rt
7. PLANS and Specifications ~
w
No. 67'x42' per plot plan, specifications and application submitted a.
including sewage system and three car garage (attached) O
8. Proposed Use
I
w
One-Family Dwelling
$5.00 C/O Paid d
225.00 PERMIT FEE PAID -THIS PERMIT EXPIRES Feb. 1 �g87
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the ~
9 P 4 PP 9 9� sP N•
town of Queensbury before the expiration date.)
GQ
Dated at the Town of Queensbury this 31st Day of July 19 87
SIGNED BY ,' for the Town of Queensbury
Building and Zoning Inspector
":;L3 TO BE COMPLETED BY BLDG. DEPT.
c] A I' Application No.
Oran O� Queenjiur' y Permit Issued 19
BUILDING and ZONING DEPARTMENT Permit Expires 19 OWN OF QUEENSBURY
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation n
Queensbury, New York.12801 Variance No. u
[y c� �/ Site P1 n Review No. r� 1986
2q �i'��� ! 7 " ? APpro d by• L.Oa �,eP,J
APPLICATION FOR 1��21314I.51g
a e a
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: el 4Zrpr4` Y
P.O. Address :ST', .2 Tel. 7%3 7 0
Property Location: [�a+ {} ZJ Tax Map No. s/ /
Street number or building�7�ot numbe
Subdivision name (if applicable) �,f / 21'J/
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
Name P.O. Address 9 Tel. No.
Name of builder_ wr- Address � O �i ��}� Tel. 22 LF CC
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,
_Addition to a building * drawn reasonably to scale and attached hereto,
_Alteration to a building showing clearly and distinctly all b-dildings,
(no change to exterior dimensions) * whether existing or proposed andlindicate 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 219K 23D x!"2,-ft x2J_7k100 ft.
* Existing building(s) Size ft X ft.
PROPOSED BUILDING AND- USE:
* Existing building(s) Use
Size of new structure ft XZ//Zft * . . . . . . . . . ' . . . ' "
Foundation-pier/slab/crawl/partial/ ul *. Proposed building, distance from property line -
(circle one)
* Front yard JOQ _ft Rear yards. 'O. ft
No. of stories (habitable space) Side yards ft and ft
Height (grade to ridge) . ' ft. * y — 3 5— ��'�
If residential, no. of families . 1. . * If on corner, ,,e hack from side street ft
No. of rooms(excludin baths) ' ' * OCCUPANCY INFORMATION
No. of bedrooms
No. of bathrooms * PRIMARY BUILDING -
Primary heating system * L One family dwelling
Two family dwelling
Type of fuel Multiple dwelling / Number of units
No. of fireplaces to be installed /pb
T * Permanent occupancy
Will a wood stove be installed? �r
Central Air conditioning? �d * Transient occupancy
* Business
BUILDING STYLE, PRIMARY STRUCTURE * Industrial
Ranch ntemporar Log cabin * Other " "
Raised ranch Mansion Duplex * if addition, what will use be.
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 $--- ?�+v Occ
6 � -----------
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. ®6
Will any second-hand or ungraded lumber be used? If so, for what? a
Foundation wall material - /•71e C k Thickness
Depth of foundation bel ow r o,bottom of footing) /C3
Will there be a cellar? (Z• ' eated r unheated? Floor sq. footage sq ft
Will there be a basement? of Will any portion be used as living space? p
(If so, what x ? sq.ft. - - Type of use?
Type of roof - sloped lat/shed/other Material,-of roof
Size, wood studs "X spacing_"o.c. length ft.
Joists(floor beams) lst. floor 2. "X�" spacing "o.c. span1 ft.
Joists (floor beams) 2nd. floor 2 "X�" spacing:_"o.c. span��ft.
Overlays(ceiling beams) "X spacing "o.c. span ft.
Roof rafters 2 "X spacing f6 o.c. span�2 ft.
Roof trusses(pre-engin ed) spa jing ( "o.c. span ft.
Exterior wall finish O what material? � �Y
Interior wall finish
If a arage is to,be attached, d scrib 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? y2f Height a ove roof ft.
Depth of chimney foundation below grade ft.
Depth of firepl e h ft. in.
Water supply - unicipal r private well
SEPTIC SYSTEM _ ce from ANY private well(including adjoining properties 0,0 ft.
(A separate application is necessary for any repair or new installation of septic system)
Town of Queensbury County of Warren A F F .`ID A V 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 donefon the described premises and that all
provisions of the BUILDING CODE, THE 'ZONING ORDINANCE, and all other laws ]Sertaining to
the proposed work shall be complied with, whether cified or not, d tha such work is
authorized by the owner.
SWORN TO BEFORE ME THIS Signature__ ____ _____ ________ _________________
Owner, owner's agent,a izect,contractor
day of 19
Notary Public, Warren County, N.Y.
SPECIAL CONDITIONS OF THE PERMIT:
By---------------------------------------
Jouln of Queendury APPLICATION FOR SEPTIC DISPOSAL PERMIT
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801 DATE /
LOCATION OF PROPERTY FOR INSTALLATION.
OWNER' S NAMEO
ADDRESS �p /
T E L 7�
INSTALLER' S NAME PC-It/e— �d._cA) q rC1 TEL
Number of bedrooms (residential only)
Total daily flow(comp @ 150 gal per bedroom)
Topography: Flat - Rolling . Steep slope - (circle one) o of slope
Soil nature: Sand - Loam - Clay - Other Depth ft.
Ground water -At what depth? ft.
Bed-rock or impervious material - At what depth? ft.
Percolation test - Not required - Required - -Rate min-inch.
Domestic water supply - Municipal - Well - Other
Separation - Watersupply(i ell) from Septic absorption ft.
Proposed System: Septic tank gal. ( Minimun size, 1000 gal: )
ile Field - Each trench eft. Total system legntli ft.
�-
p•
Size of stone to be used # _ Depth or *thickness ft.
* * * * * * * * * * * * * *
IMPORTANT! ?
On a separate piece of paper, submit ,a diagram of the proposed system
with all dimensions shown; including distance from any structure,
distance from property lines and from ANY DOMESTIC WATER SUPPLY or
shore-line of lake, strea-m,pond or wet-lands. Include all dimensions of
the system, itself .
I have read the regulations on the reverse side of this sheet and agree
to abide by these and aZZ requirements of The Town of Que-ensbury
Sanitary Sewage DisposaZ Ordinance.
1
Signature of responsible person
Date
05/86 and/vl
Section II Septic System Inspections:
A. All' applicationd for .septid system installation,
alteration or repair, as required by the Town of
Queensbury Sanitary Sewage Ordinance., shall be
submitted .to the Buildina Department at least
24 hours before start of construction . an_d 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) , Iocation 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 Buildinq ' 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 Buildinq
Department before- further construction.
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
P V
2 . Type of heat G �
3 . Is the building mechanically cooled?
4 . Percentage of area of windows and doors
A. Over 16% Only
1 . Uo value of gross area of walls , roof/ceiling and floors
exposed to ambient conditions
2 . Floor over heated spaces ES NO
a. Are foundation walls insulated? ES NO
11 If YES, wha is the R valu .
3. Slab on grade YES NO
a. If YES , what is the v,� ue of insulation around
perimeter of floor?
4 . Is basement heated? O
a. R value of 7-tation_
1 I
5. Type of insulait�ion
B. Under 16% Only a
1. R value o4 of and floors exposed to ambient conditions
2 . R value of exterior walls �--1 9
3 .. R value of glazed area
4. R value of doors e
._._ .... ,__.._.- .__.. ... __�G_"may.."............. ....... ....�__.
5. R value of floors over unheated spaces_
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) ,4-®qM
9. R value of heated basement/cellar walls (below grade) 'ta=../I
" 10. Type of ' insulation ��,�j•Q.�- ���
C. Controls G
1 . Thermostat maximum heat setting -"
D. Duct Systems
1. Is duct system installed in unheated spaces? YES
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 pipe _
2 . R value of pipe insulation
F. Service Water Heating
1. Performance efficiency
2. Temperature control settiing maximum
G. For Swimming Pool Only
1 . Maximum heating
Telephone No. ��0 3� O
(applicant ' s si ature)
INFORMATION FOR BUILDING DEPARTMENT
WE ARE IN THE PROCESS OF ISSUING A CERTIFICATE
OF COMPLIANCE FOR THE ELECTRICAL INSTALLATION
AS COVERED IN AN APPLICATION FILED WITH OUR
DISTRICT OFFICE.
TH �IZ4
W YORK BOARD OF FIRE UNDERWRITERS
APPLICATION 0. ) -� -
LOCATION
DATE INSPECTOR
I
ELECTRICAL INSPECTOR
ATTACH TO SERVICE EQUIPMENT ONLY
Down oy QueenjLry-
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
J
LOCATION
Date Ll//Y/ �'7 Permit No.
* * * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors X
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Smoke Detectors
Chimney f \
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-
c
Building Afnspector
6/86 and-vl
• r
.Jowta o f Queenitury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION
Date / Permit No. O&?
* * * * * * * * * * * * * * * * * * * * * * *
APPROVED - YES NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext. Porches
FinisheA
s
XnterioTrim ,
Stairs gs
Cellar ile
Concrets ��Plbg. FGar. Fiing�,
'xQor ClSmoke Ds I
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
NexC scheduled inspection (call when ready)
Remarks-•
WoUsC /s
Building Inspector
6/86 and-vl
TOWN OF QUEENSBURY
Building- Department
hopectors Report Date /
Name— P��.� r�_ .
Location_ 11 <�c,f
Permit No. 1,14' Weather
Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Water roofin
Backfill
Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plh .
Relief Valves
Wall Board
Ext. Porches
Finished Floor l
Interior Trim
Stairs & Railings
Cellar Dr. Tile f
Concrete Floors
Plb,q. Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation
Walls
Ceilin
B ilding Inspector
REMARKS
Jowr: o� Queendbury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUY, ?
ING INNS�PECTOR ' S REPORT
NAME `.��!JG>f2
LOCATION
Date/ Permit No.
* * * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
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 ELECTRICAL INSPECTION
r
RIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-
�X
ell �
Building Inspector
6/86 and-vl
Jowfz oI Queenibur y
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME Ci �d gay 1161-
LOCATION Lo7- �5 Fax Hdll ow 4 qat. 'e-
Date / Y(o Permit No.
* * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES NO
Footing/Pier Forms
Foundation
Waterproofing
jackfill !'
raming _ ,�
Roofing
Siding
Masonry Veneer
X Rough Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings _
Cellar Drain Tile-- --— y
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION:
Foundation
Floors
Walls 2 — --
Ceiling O
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey y�
Ang- 1 ?T CA-K_ e1 liver:;
Remark Re
Remas-
ark sueI S-rCO®L)J6 4-7�) 12lratbV
/ja'J0 Sjvpon-;7-uAllol/a- PAX i VOV
A-A)- '5vPPosy"
Building Inspector
6/86 and-vl
_Down of QueenJlury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPT,,IppC DISPOSAL SYSTEM INSPECTION
NAME /L o h 61V/I/
LOCATIONvJ7oz
DATE /d 131 /S( PERMIT NO. 11465
SOIL TYPE - an) - A am Clay
Percolation st Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length 2 0
Length of each trench
Depth of trenches 'Z 4, " N�_
Size of gravel'_ A-—_
SEEPAGE PITS{Number of)
Size- ft. X _ ft.
Gravel size
PIPING: Size Type
Bldg. to tank i-t S7(4"U I�UC-
Tank to dist. box u J7 d C_
Dist. box to field/pit _ 0 V L
Openings sealed? ES NO Partial
LOCATION/SEPARATIONS:
Foundation to tank -A ft.
Foundation to absorption .--oftf—
Absorption to lot line ft.
Separation of pits ft.
LOCATION OF SYSTEM ON PROPERTY(circle one)
Front - Rear - Left side - Right side -
COMMENTS:
Z><
SYSTEM USE APPROVED YES -, NO
//1
_Building In ' e for
01/86 and vl
Down of Queenilury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME�O1^
V VIbIr
LOCATION Lot SSS E6Y� NOP6w
Date )D 9� Permit No. $—
* * * * * * * * * * * * * * * * * * * * * * *
APPROVED - YES NO
Footing/Pier Forms
Foundation
Waterproofing,
Backfill
Framing i
Roofing
Siding
Masonry Veneer
Rough Plumbing
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 ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-
Building Inspector
6/86 and-vl
Jown o . QueenjLry
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION
Date Permit No.
* * * * * * * * * * * * * * * * * * * * * * *
01' - APPROVED - YE NO
L.,F'6o t ing/-P4-,r-zooms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
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 ELECTRICAL INSPECTI N
Final Building Survey
Next scheduled Inspection(call when ready)
Remarks- -
Bui ding Inspector
6/86 and-vl
Jown o/ QueenjLry
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR' S REPORT
NAME l\. 011
0�-
LOCATION L' T 5 ZEa Y- Z7 c2 oG,j
Date 1�Y / 8C� Permit No. „ 5
* * * * * * * * * * * * * * * * * * * * * * *
01 = APPROVED - YES NO
Footing/Pier Forms
✓Foundation
(/Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
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 ELECTRICAL INSPECTION
Final Building Survey
Next scheduled Inspection(call when ready)
Remarks- -
Building Inspector
6/86 and-vl
Jown o/ QueenjLry
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME 12 ply- l'(fAyvag
LOCATION
Date 9 7 / Permit No. (�jr
* * * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YE / NO
ootin Pie Forms
oundat'
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
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 ELECTRICAL INSPECTION
Final Building Survey
Next scheduled Inspection(call when ready)
Remarks- -
r
Building Inspector
6/86 and-vl