1986-035 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY . 1
WARREN COUNTY, NEW YORK
Date 19
&3t1
This is to certify that work ilequested to be done as shown by Permit No. `' J '�
has been completed.
This structure may be occupied as a ULic--Yami1y
Location Lot 17 wady Sl-Lpno - Drive (Peggy Ann Park Sub-div1_a:_oi:
David !{c iir tou/Ju7.1e I{ar=r'ingLon
Owner
By Order Town Board
TOWN OF QUEENSBURY
` v-'s i��'i'.i��,,,•- ' /'�� cG�-L''�/%tom_ •r
Building & Zoning Inspector -- -----
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CREATIVE "INSTA" PRINTING. GLENS FALLS. N V 12801 15181793-3658
ti BUILDING PERMIT
TOWN OF QUEENSBURY 86-35
No.
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to David Rolleston/Julie Harrington
OWNER of property located at Lot 17 Lady Slipper Drive Street, Road or Ave.
Peggy Ann Park Subdivision
in the Town of Queensbury,To Construct or place a One—Family Dwelling
at the above location in accordance to application together with plot plans and other information hereto filed and �o
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
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1. OWNER'S Address is Sagamore Apts.
Glens Falls, New York
2. CONTRACTOR or BUILDER'S Name CD
x
Pliney Tucker
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3. CONTRACTOR or BUILDER'S Address
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RD #4 Box 425 0
Glens Falls, New York
4. ARCHITECT'S Name
0
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5. ARCHITECT'S Address
ca
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6. TYPE of Construction—(Please indicate by X)
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P) '0
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(g)Wood Frame ( I Masonry ( ) Steel ( ) x m
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cn
7. PLANS and Specifications cY ri
28')(72' per plot plan, specifications and application submitted c
No. including sewage system and two—car attached garage.
8. Proposed Use
One—Family Dwelling o
$5.00 C/O Paid
$ 94.00 PERMIT FEE PAID —THIS PERMIT EXPIRES September 1 1986
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the ry
town of Queensbury before the expiration date.)
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Dated at the Town of Queensbury this llth Day of February 19 86
SIGNED BYW6 . .� for the Town of Queensbury
Building and Zoning Inspect'
TOWN OF QUEENSBURY (Space inside block to Ix filled in by
WARREN COUNTY. NEW YORK Building Inspector)
Application for Application No.
�p Permit Issued 19.
BUILDING AND ZONING PERMIT Permit Expires. Ift.
/.Ifni District
• \ Am:uc I li work If . / yAn ' .1
.\Illl1Yl\c•(1 by /i! .!YA/v1�13'/7///.% ,4�
THREE l 3) Copies of a PLOT PLAN, Drawn to scale
showing the actual dimensions of the lot to be built Itc'I»a1•)GS'
upon, The exact size, and location on the lot of the •
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION.
I .
✓/ V — 1 r 1 1 c / /O /U � [tom!1�c
/ DATE �� ����atlA PERMIT MUST BE OBTAINED BEFORE BEGINNING WOR0TOWIN
ANSWER ALL OF THE FOLLOWING. 1.::s 3 7 `�98,?;t yAmtag'`e
The undersigned hereby applies for a permit-to do .the following work 40°1) rime- �1 P.M. 7•`'�
cations,which will
ande done in accordance such special conditions l as the
may bedescription,
ind indicatedplans
the permit. AA;
�S1911.31�-1l121, 1)2�3'4I/ul;° r'-D;
The owner of this property is: .
•'.4..&'s.�. ./.i v i,/G !..i—'. .`/ . ie.� 4-... . . .!` !a.,.", , .�i. .......!`J. . . .S!•9 ,9..rrv-:'?. .✓.g %...67e...'---- //,
(NA`.E( (P.O.ADDRESS) •
The person responsible for ' supervision of the work insofar as the Building Code and the Zoning Ordinance apply is:
. (. !..1!.r?.'. .4 .4iN st' (P0 ADDRESS) /e,�c7,
Name of Builder. . . . . .5-.c,2..,,c. . . . . 7.s.. ?..6.4,: E: .c'.Address
,p• Name of Plumber ' % r '' ' Address
. :Name of Mason I f ..e. ,i Address
It,`� Lot Number. . .1.7. . . . . Unit Estimated value of proposed work S . . . .�i v c-,
aS Name of Village
Name of Street . i-� '� -`y . •'"l'• •/7/�•`'•:,:—.- ri-...'•'`'• r'• • • • • Side of street: north 54, east 0, south ❑. west 0
Nearest Cross Street . . . .5-r'.jAww • .' Distance from this cross street . . . .3."?'.,— Ft.-
Property is north g,south ❑,east [1, west 0 from Cross Street
If on Corner,which corner, northeast ❑, northwest 0, southeast ❑, southwest
(Designate by marking with an "X" in the correct space.)
NATURE OF PROPOSED WORK • OCCUPANCY
1 Construction of a new building. Main Buittiing
❑ Addition to a building. . One-family dwelling ki•
❑ Alteration to a building. Two-family dwelling ❑
❑ Demolition of a building. -family apartment house ❑
Store building Q.
. . . .,,Z, -car attached garage ❑
Other:
Accessory Building
• . One-car detached garage ❑
❑ Other work. Describe• Two-car detached garage ❑
. Private chicken house Cl
Private storage building • ❑
. 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-
posed buildings,and the location of all existing buildings.
NORTH
Show proposed building(s) in dotted line and existing
,-----,L 4 n y 6 G/PP1 R ltuilding(s) in solid line.
j `or f _ Size of property - '` t' n ft. x -,1!, c�r% ft.
Size and use of existing buildings, if any
1-.
Ilt { W Size of proposed building . . .2. f ft.x . .7.47. . ft.
Height (from grade to ridge) / ft.
Front yard ' ft.
Side yards 2-- ft. and . /6 ft.
? G-L, rf till-i r L ; Rear yard / Z- . __.: ft.
SOUTH If on corner,setback from side street ft.. .
Note: All distances are net, as measured from street side
line to nearest part of building. •
(OVER)
7-73—M • .
(cont'd.)
BUILDING SPECIFICATIONS.,
Kind of construction: Wood frame, fire safe, etc.?. . ., . . . . . .(4? e4. . .!'. .Ape-.
Will any second-hand lumber be used? V G If so, for what?
Material of foundation walls /6 7' eC% G . /3/ Thickness
Depth of foundation walls below grade r Continuous foundation?
Will there be a cellar? . . . . . .. :? .5. . . If so, material of cellar floor CI v c
Type of roof: Sloped or flat? . ... / Material of roof . . 0. .0-
Size, wood studs "x ", spacing / 6 "o.c., length ' • ft.
Size, floor beams, 1st floor ,2 " x /G-' ", spacing / C "o.c., span ft.
Size, floor beams, 2nd floor " x ", spacing "o.c., span ft.
Size, ceiling beams " x ', spacing "o.c., span ft.
Size, roof rafters or beams . .f2 v.(:.F-. . " .", spacing "o.c., span ft.
Exterior finish . . . ..5 P r. G1 G:e . . . .C'411?.•. .23.c? d s . With what material?
Finish of interior walls. . . . . Z. . . ).Y.y. .Gr%� /l
If garage is to be attached, of what material is wall between garage and main building to be constructed?
. . . /.. . e. . . .
Is there toe an opening between garage and building? /LP c •
Kind of heating system . . .k� .�.i.r. i.4 — Oil burner or coal?
Will a flue-lined chimney be provided? 1 s . Depth of chimney foundation below grade . . . !G;4--
Height of chimney above roof -2 /--1—
Will there be a fireplace? Ai 4) Depth of fireplace hearth
Will a toilet be installed? ,/
Will a kitchen sink be installed and connected to water supply? . .s
Water supply (public water supply or pump) . . . . 1.a..�./c�. .Distance of cesspool from any private well feet
Will drainage system be provided with required traps, cleanouts, and vents?
Town of Queensbury AFFIDAVIT
County of Warren
State of New York
I swear that to tt-A r of my know,Iedge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, are a true and co.l•lete 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 he 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 - r. � — --e
OW R.OW AGENT,ARCHITE T.66NTRACTOR—"
day of 19... '
F.
NOTARY PUBLIC, WARREN COUNTY. N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
•
By
WARREN COUNTY , NEW YORK
Application fora BUILDING PERMIT IN COMPLIANCE WITH THE. NEW .YORK
STATE ENERGY , CONSERVATION CODE
A permit Must be obtained before beginning work.
ANSWER ALL of the followings
1 . Gross floor area
2 . 'Type of heat
3. Ia the building mechanically cooled_? V1 C 2s
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 YES NO
a. Are foundation walls insulated? YES NO
1 . if YES , what ix 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. Under 16% Only
1 . R value of roof and floors exp sed - to ambient conditions
' 2 . R value of exterior walls
3 . R value of glazed area Mai , 9
4 . R value of doors ,23
5. R value of floors over heated spac,ee
6. R value of slab edge insulation . - unheated slab INlfl
7. R value of slab insulation -heated slab
6. /R value of heated basement/cellar walls (above g,rade),
9. R value of heated basement/cellar walls (below grade)._
10. Type of insulation CQ_
C. Controls -`
1 . . Thermostat maximum heat setting g56
D. Duct Systems
1 . Is duct sy.sttm installed in unheat3d spaces? YES , t:0
a. If YES , R value of duct installation ,
b. R value of duct in other areas (li
E. Piping Insulation (�
1 . Size of hot water or cooling carrying agent pipe
2 . R value of pipe insulation '
F. Service Water Heating a(
1 . Performance efficiency o
2. Temperature control setting maximum 1 *)
G. For Swimming Pool Only,"
1 . Maximum heating
to .
Telephony No. _
4. (applicant ' s signature)
TOWN OF QUEENSBURY
BUILDING & ZONING DEPARTMENT
SEWAGF DISPOSAL PERMIT APPLICATION
1. Owner' s Name �J,�v ci fFo /I s i r.7.v
Address S. � � -�� ��-•r a G; . . /.> /
Telephone No.
2. Property location 21, D - /7 ,C i�� y SA pi e u <0.c'� '' Y
3 . Name of person or firm responsible for installing system
Telephone No. 793 -- -vc >
Address 130 Y 4/2 6 ��� P- �/ �/ cf , .7s .iv: /2 ss'<re
4. Number of bedrooms (residential buildings only) 0
5. Daily flow c'D gallons/day
6. Septic tank capacity 7 e v c, • gallons
7 . Topography: flat, rolling, steep
of slope 7,7 j
8 . Nature of soil and depth S 4,,, ', 'i
9. If ground water, bedrock or impervious material is apparent at what
depth does it begin? ft.
10. Percolation test: A is required
B is not required
C If required what is the rate minutes/inch
11. Water supply: municipal, well, other 'j e5co «
12 . Type of system proposed: drywell, tile field, other '� , /�
,o
Any contractor, corporation, individual, etc. engaged in the construction
of a sanitary sewage disposal system who covers the same before inspection,
does not have an approved permit, or varies from the approved application
will be subject to a penalty of $250 as provided for in Section 6 . 010 of the
Queensbury Sanitary Sewage Ordinance.
Date '&f. 1„.7 7
`—nature of
On separate sheet of paper submit a diagram of the proposed septic system
with all dimensions, including distance from any structure, distance from
property' line and domestic water supply, etc. Include all dimensions of
the system itself.
l 0oo oy x/ i'v
/ 0-75 O
Form 3-82
_Down of Queeniurcy
BUILDING and ZONING DEPARTMENT --
Bay and Havi!and Road, R.D. 1 Box 98
Queensbury, New York 12801
TO WHOM IT MAY CONCERN:
RE: BUILDING PERMIT NO. 86-35 —DAVID ROLLESTON/JULIE HARRINTON
LOT 17 LADY SLIPPER DRIVE
THIS IS TO CERTIFY THAT THE DOOR ON THE REAR OF THIS DWELLING,
INTENDED FOR ACCESS TO A PATIO TO BE BUILT IN THE FUTURE, WILL NOT
BE USED AS AN EXIT. THERE IS NOT SAFE EGRESS, IN THAT NO STAIRS
EXIST AT THIS TIME.
I ACCEPT FULL RESPONSIBILITY FOR ANY PERSONAL INJURY THAT
MIGHT ARISE FROM THE USE OF THIS ',EXIT.
_
— SIGNATURE—HOMEOWNER
-DATE / �
!(..1t/,.lt�..1",a)t�itl.atl.1s!%R!l,:ti,,,: „It/,\tl,,.tp2r,!fit!It�;t?.)tr.\tJ,.:_s!?ti\t/"„lst_tL"_,,,..!,".„\t/.. /„!.s!,c)..ti.a,!.., .?i..,tL„:.•)„mi.J.O.?t4)t,!.",,,t(.:tC:fi A(.jt/,.1ti.",,t,_e1: tt.,t,.;t,.,)i
4206893 THE NEW YORK BOARD. OF FIRE UNDERWRITERS
14 2' BUREAU OF ELECTRICITY
I 'A' p nig 41 STATE STREET,ALBANY.NEW YO K,122O.7 '�
t �d;� 03> l� :
Dat)°Y 14® 1986 Application No.on file A R 0 f� A 9 8
�+ THIS CERTIFIES THAT
' only the electrical equipment as described below and T introduced..,,,, by the applicant named on the above application number in the premises of ti
. Sa.gc�iiilore Apt, Lady slipper Zane,Le, Clueensb,,ry, New York ':
.4 in the following location; ❑ Basement ❑ 1st Fl. ❑ 2nd Fl. Section x Outside ��Block Lot 177 ,`�
s. was examined on �'-23 6 and found to be in compliance with the requirements of this Board. •
to,; FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS ':
OUTLETS SWITCHES U Y
INCANDESCENT FLUORESCENT VAPOR AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. r;'.
i ilk'
23 46 18 22 1 -■-■■❑.■. 3
•a DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS P
AMT. K.W. OIL H.P. GAS H.P. A.Ay T. -ANO:t n Al W G_ MAT. AMP. MAT. AMPS. TRANS.® H.P. NO.OF FEET MAT. WATTS ,
Dryer
e: SERVICE DISCONNECT NO.OF S E R V I C E '%
AMP. TYPE mum.
4W 1.0 3W 3 Ar 3W 3,6 4W NO.OFF C CirCOND. OF CC.COND. NO.OF HI-LEG OF HI-LEG NO.OF NEUTRALS OF NEUGRAL '
i;
i'
OTHER APPARATUS:
ii
J: � '-
1-- yoke Detector
:. Electric Heater's- a� K a�'T o
•
3- 1.5K.W.
4- 2.0 K.W.
-6 2- .75 K.W.
-<' 1— o5 KWe
,1 7
( ‘ ... ..d.,. .L'i 2
tv Doi: 425 RD ;:8 Divisi on Road _\
-r. Clais Falls, New York 12803 *)../ BRANCH MANAGER
,'.z; 'i
., 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. ''
o-74-(le't< A7'gY'ie'iei"'7 i-ie-i'l iti-it{ieYitf YtY(( aY'iAY ii-4i—far te'(t7're'4, ie,"iecre ie'recta,"Lral-tiiere,a,",a,"4,"YA\.ido"No ome,"'Noi q�-w"ref'4,❑ " Ai 4%,rocrao- • ,e y,-./i,r
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY WANNER
/`3 , di'
TOWN OF•QUEENSBURY
• Building Department
•
Inspectors Report Date +�
Name d(./G , k/� I/4
Location / I'I
Permit No. X - .3 7 Weather
r/`tf/ Remarks
Excafiaa ti on
Footing Forms
Footing & Piers
Foundation
Cement Coat
. Waterproofing
Backfill
Final Survey .
Framing
Sheathing
Roof Felt � /
Roofing G/ vs \•:\
SidingMasonry Veneer
Rough Plbg. ��
Relief Valves IA0, K
Wall Board .
Ext. Porches V/f No 41 f P4(tjol No-T u 5 ,
Finished Floor Y o ,}%
Interior Trim
Stairs & Railin rsL i p, Y
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures V K.
Gar. Fireproofing * �,�(
Door Closers / 0.k.
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation
Walls
Ceiling
Building Inspector
REMARKS
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G/el IX'% Car,c-f;
�e - pet /D e OGy.
TOWN OF QUEENSBURY
Building Department
Mars Report Date V. id .*
Name 7W 0i2_, NO !fie 57-01
Location r.AD Y t/PP7�i�Z
Permit No. 3(p- S Weather
Remarks
Excatation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves
Wall Board s
Ext. Porches
// :
Finished Floor
Interior Trim 1
Stairs & Railings
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval ,RAJ/0,
Floors
Insulation Foundation
Walls
Ceiling
Building Inspector
REMARKS
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date f
Name
Location
Permit No. Weather
6 Remarks
Excafia ti on
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing 1 t Y
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg. /
Relief Valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railings if
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures /
Gar. Fireproofing /
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation
Walls
Ceiling
Building Inspector
REMARKS
TOWN OF QUEENSBU RY
Building Department
inspectors Report Date _7/3/8a.
Nune (7 'R Iq2 a/ € 37
Location 4.4 ,4'54417PE€
Permit No. 36 A Weather
Remarks
Excavation .
Footing Forms
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
');:\/ 1\1\\\\
Stairs & Railings
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation
Walls
Ceiling
Bui ding Inspector
REMARKS
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date a ` /9'
Name 7G(CA2=IZ .
Location / /41>Y S1�Per IZ
Permit No. q&- 3 5 Weather
Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill i/ PAR-7/4L &,
Final Survey
Framing .
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railings i
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofs g
Door Closers
Chimney
Water Meter In t.
Septic Approva
Floors
Insulation Foundation
Walls
Ceiling
b1
Building Inspector
REMARKS
J.
TOWN OF•QUEENSBURY
Building Department
•
Inspectors Report Date - ,i3 ' 8(.?
Name Pi)rim 1 7(- -e r" R /I e s r d�►
Location 4 4i)r 'L/PPr IZ
Permit No. 3 b —36 Weather
Remarks
Excavation
Footing Forms t/ O K ,
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing •
Sheathing
Roof Felt
Roofing
Siding
. Masonry Veneer
Rough Plbg. 11
Relief Valves
Wall Board •
Ext. Porches
•
Finished Floor X
Interior Trim ;I \
Stairs & Railings Y \
Cellar Dr. Tile r \
Concrete Floors f \
Plbg. Fixtures j
Gar. Fireproofing r
Door Closers I
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation
Walls
Ceiling
c - \
VV
Building Inspector '
REMARKS
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