1986-046 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 19
0\ ir
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
L'TT,P:. OUSE .E.V\
Location
Owner
By Order Town Board
TOWN OF QUEENSBURY
. ,
1' • ,• ••
Building & Zoning Inspector
rRE•TIVE ••INSTA-• PRINTING GLENS FALLS. N Y 12801 IS 181793-5858
I A
TEMPORARY
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date April 21 19 86
This is to certify that work requested to be done as shown by Permit No. 86-46
has been completed. -
This structure may be occupied as a One Family Modular Dwelling
LocationLot 14 Applehouse Lane v West Mountain Park •
,Owner Donna Wassel
TEMPORARY CERTIFICATE OF OCCUPANCY FOR
60 DAYS PENDING FINAL ELECTRICAL By Order Town Board
TEMPORARY STAIRS FROM REAR PATIO DOOR SHOULD TOWN OF QUEENSBURY
BE FULL DOOR WIDTH OWNER MUST ACCEPT
RESPONSIBILITY FROM—INJURIES ARISING FROM '
USE OF THIS DOOR.
Building Fi Zoning Inspector
BUILDING PERMIT
()K, TOWN OF QUEENSBURY No 86-46
WARREN COUNTY, NEW YORK
0
PERMISSION is hereby granted to Donna Wassel w
Lot 14 Applehouse Lane Street, Road or Ave.
OWNER of property located at m
West Mountain Park rD
in the Town of Queensbury,To Construct or place a One Family Modular Dwelling
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 RD #2 Box 135
Glens Falls, New York
2. CONTRACTOR or BUILDER'S Name °
Lamplighter Homes m I
rt
3. CONTRACTOR or BUILDER'S Address - °
G
RD #2 rt
w o
Ft. Edward, New York H 0
m
4. ARCHITECT'S Name
1-t
CD
G
5. ARCHITECT'S Address
0
6. TYPE of Construction— (Please indicate by X)
(X)Wood Frame ( ) Masonry ( )Steel ( ) - - -—
0
S
7. PLANS and Specifications
1
24'x48' per plot plan, specifications and application submitted ,� w
No. including sewage system. THE ATTACHMENT OF THE TWO PARTS MUST BE °
8. Proposed Use APPROVED BY A LICENSED PROFESSIONAL ty
One—Family MOdular DwellingENGINEER.
$5.00 C/O Paid 04
I
$ 84.00 PERMIT FEE PAID —THIS PERMIT EXPIRES Sept. 16 19 86
(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 27th Day of February 19 86
‘79 SIGNED BY ¢, for the Town of Queensbury
Building and Zoning Inspect
•
. TOWN OF QUEENSBURY ,
• .:, • (Space inside block to be filled in by
.' • .WARREN COUNTY, NEW YORK Building Inspector)
Application for Application No.
�� - Permit Issued 19
BUILDING AND ZONING PERMIT 1.,,rmit Expires. . Ig.
• %.unint. District
• \ :due , 1 Work
. THREE (3) Copies of a PLOT PLAN, Drawn to scale •\I'1 ''iced by
•
showing the actual dimensions of the lot to be built Itcqit;ll')CS• •
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 i TOWN O1* EEy Ns? U F
•
DATE I. L J bi, I ...+
A PERMIT MUST BE OBTAINED- BEFORE BEGINNING WORK -�'
ti.,,- , .; - ,n ANSWER ALL OF THE FOLLOWING. ,c� - /J
!� /
The undersigned hereby applies for a permit to do the following work A.M.: P.M.
which will be done in accordance with the description, plans and specifi- 71819110)111.2)1 1O'(liU.2)1. 213 )5`6,
cations, and such special conditions as may be indicated on the permit. `a ° a!1° I . ' '�' ' °I° j��°��hh(
E
The owner of this property is:.
D0Jr A tJi4SYe /..
(NA'':E) (P.O.ADDRESS)
•
The person responsible-for supervision of the work insofar as the Building Code and the Zoning Ordinance apply is:
. .........6 e 0,-... °.+n... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..- . .. a ft,r.4-:.1.).4, i y,,•7 /a 'Z k
• (NAME) IP 0 A.DDRESS)
ti
Name of Builder. 4.'7.lP/r e UT'0_ f/-4'/e S . Address • Z-n. 4.- P-t) r+- 7 E-Juj04/zcl /i,y /z..f z S-
ce
Name of Plumber .i.i`/K ,P Address q • Q - t- 'a `z 1` 6 d+a1 A k-d.,•��•�f i 1--`F-z i
Nante of Mason.lDA:>..e. . .' 3,?•Li.c/ie.0-- Address / ( - hW I S , . 7 .
• Lot Number. . . . / .. . . . Unit Estimated value of proposed work S VS e-v-r?
.Name'ofV' gE C .L,e •� -e0-- Sb4 '- '
Name of Street%9/3?fe K°u S e 1 /44 e Side of street: north 0, east pir, south ❑, west 0
Nearest Cross Street W.eS . . . !?1....�,t..n..Tok....... R-0/k4 Distance from this cross street . . . .0 / Ft.
Property is north
- ,south 0,east 'y , west 0 from Cross Street
_ If on Corner, whi corner, northeast 0, northwest 0, southeast Q. southwest
•
(Designate by marking with an "X" in the correct space.)
,•,.,� NATURE OF PROPOSED WORK OCCUPANCY
"TL Construction of a new building. Main Bu€lfling
.1: ❑. Addition to a.building. Vie-family dwelling Et------
❑ Alteration to a building. Two-family dwelling 0
:.❑ Demolition of a building. -family apartment house ❑
Store building ❑
• -car attached garage ❑
Other:
_ . Accessory Building
One-car detached garage r.::
(• ] Other work. Describe Two-car •detached garage •c-J
Private chicken house Ll
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, sire and setbacks of pro-
posed buildings, and the location of all existing buildings.
• NORTH
Show proposed buildings) in dotted line and existing
•
' !e I-1o't.se . ,.t° ti 1tuilding(s) in solid line.
1 Size of property . . ./ . . . . • . . ft. x /la '%' ft.
- -0
Size and use of existing buildings, if any � g
I-
til a <
W Size of proposed building 7 ft.x . . •I/. ce . ft.
1 Height (from grade to ridge) /S ft.
�, Front yard 5J 4-- el-. i ft
.z:,\ Side yards 1 `� ft. and z ft.
L e i red- me .oP Rear yard 4 It.
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
BUILDING SPECIFICATIONS.,
GJ
Kind of construction: Wood frame, fire safe, etc.? tj ,� g
Will any second-hand lumber be used? nit) If so, for what'
Material of foundation walls 6 or." c li Te? , Thickness / "
- Depth of foundation walls below grade Continuous foundation?
Will there be a cellar? .1 Q -s If so, material of cellar floor . )"-c 2 C
Type of roo ff. _lgpe or flat? Ma erial of roof . .17/t' do ct �- S ,,.. G (6
Size,woodj .
stu x 1 ds " ", spacing /
{ � P g �d "o.c., length �I . ft.
Size, floor beams, 1st floor . . . .:,. " x ", spacing c 4" "o.c., span / - ft.
Size, floor beams, 2nd floor " x ", spacing "o.c., span ft.
Size, ceiling beams "x Y ", spacing ' y "o.c., span / 4/ ft.
Size, roof rafters or beams al- . . . " x U • ", spacing . . . . t/
"o.c., span / ft.
Exterior finish . r`.`9 S 4, "- G -With what material?
Finish of interior walls t2 r.4 �4-
If garage is to be attached, of what material is wall between garage and main building to be constructed?
Is there to be an opening between garage and building?
Kind of heating system . Tip.' c- 1-314 W 1 ' A -c( Oil burner or coal?
Will a flue-lined chimney be provided? ^1 J . Depth of chimney foundation below grade
Height of chimney above roof
Will there be a fireplace? Depth of fireplace hearth
Will a toilet be installed? Lj e
Will a kitchen sink be installed and connected to water supply? Li 6' -S
Water supply(public water supply or pump) P.t 1 ( t
Distance of cesspool from any private well '/' ' feet
Will drainage system be provided with required traps, cleanouts, and vents? �� •S
Town of Queensbury AFFIDAVIT
County of Warren
State of New York
I swear that to.a b..,r of my knowledge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, area true and co.,.•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 the proposed work shall be complied with,whether specified or not,
and that such work is authorized by the owner. ,Q ••
Sworn•to before me this Signature 1`/L
OWNER.OW R'S AGENT,ARCHITECT.C N RACTOR
day of � 19
NOTARY PUBLIC. WARREN COUNTY, N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
•
•
By
o 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 1/ f 2 S9 1--
2 . Type of heat c, 7-/L c •
-
3 . Is the building mechanically cooled? r✓ c�
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 s(2 0 ,
a. Are foundation walls insulated? YES (N1)
1. If YES , what is the R value?
3 . Slab on grade YES 0
a. If YES , what is the R value of insulation around
perimeter of floor?
4. Is basement heated? YES (01
a. R value of insulation
5. Type of insulation
( B. Under .16% Only
1. R value o roof and floors exposed to ambient conditions
2 . R value of exterior walls
3 . R value of glazed area / 2,
4 . R value of doors 2 ,
5 . R value of floors over unheated spaces n,-.,,r'der lf)�
6 . R value of slab edge insulation - unheated slab Al �-
7 . R value of slab 'insulation - heated slab A/A— /
8 . R value of heated basement/cellar walls (above grade) pi 4-
9 . R value of heated basement/cellar walls (below grade) Al''
10 . Type of insulation
C. Controls
1 . Thermostat maximum heat setting 4773C43
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 4g_ eoPe4
2 . R value of pipe insulation
F. Service Water Heating
1. Performance efficiency
2 . Temperature control setting maximum i70
G. For Swimming Pool Only
1 . Maximum heating
Telephone No. �Jc� - 9 (applicant ' 6 signature)
TOWN OF QUEFNSBURY •
BUILDING .& ZONING DEPARTMENT
SEWAGE DISPOSAL PERMIT APPLICATION
•
1. Owner' s Name p4,4ye,96q Alm ' se /
Address r�tV-5n'i tpiOz 2 Be- . /3c
AA , 0,1,„r,-�, Telephone No.
2. Property location qpp/e ,_,j ,,f Sr' G/9" '
3 . Name of person or firm responsible for installing system
tom, ,) b pro he•LTS Telephone No. ? per -yv V /
Address toe 3 7- pid „,..i5g. ,L leu A c(
4 . Number of bedrooms (residential buildings only) 3
5. Daily flow rip* 5 gallons/day
6. Septic tank capacity / 6 v c) gallons
. 7. Topography: , rolling, steep
. �
% of slope
8 . Nature of soil and depth ,,v cl
9. If ground water, bedrock or impervious material is apparent at what
depth does it begin? ,✓`R- ft.
10. Percolation test: A is required
B is not required
C If required what is the rate minutes/inch
11. Water supply: municipal,)
unicipal, ell, other
12 . Type of system proposed: drywell, tile field, other
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 j -4 5— d-& , � G✓� ~7�y� �
c` s ignatu e of appl ica t
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.
Form 3-82
A
• 'eat• • •,! • ,•�- •,- .1.• ,,, •,."-!• • •z.• • ,•. •1-,,• •,. • . • a•,,•, •>. •. • �•..�•�,.-!.a tia .a•4 ���.a�. .� ? •,_fie..•. o.;•,. •,.�•," e- . ,., .•,.,•�_,
..�•_R��t�_�t. -�'--- - '--�- -- -�i._ . _ _t �.--�- -tia a Vi _.._ a � a:,_ • • • • • • • • ��, • �- -- � --� - - � •,- .
• THE NEW YORK BOARD .OF FIRE UNDERWRITERS
1,
: BUREAU OF ELECTRICITY
-; a 41 STATE STREET,ALBANY,NEW YORK 12207
Date June 14, 19 u 8 Application No.on file 0 0 518 4/8 6a A 7 F q 9 7 III
as C.,
.!1; 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
; Waesell Lot :�4 Applehouse Lan QJuoensbury', New York i igle family
F,',zs. in the following location; 1=1 Basement ❑ 1st Fl. ❑ 2nd Fl. outside Section Block Lot
p, ►' was examined on and found to be in compliance with the requirements of this Board.
; FIXTURE I FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS ;' {
�, fECEPTACLES SWITCHES tcutr ;
'.S OUTLETS INCANDESCENT.FLUORESCENT VAPOR AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. •
f. ►; of
XI -C
--c' DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
MAT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT: AMP. AMT. AMPS. TRANS. AMT. H.P. OF FEET AMT. WATTS ,e
-cf i
�, CI
►' SERVICE DISCONNECT NO.OF • S ' E R V 1 C E
AMT. AMP. TYPE EQUIP 1,6'2W 1,B 3W 3 Ar 3W 3%4W NO.OAR gCOND. OF CC.COND.. NO.OF HI-LEG OF HUG NO.OF NEUTRALS OF NEUTRAL
74 :; �i3 I 2c c-u ,/0 2/0'
a ®:c-', tr, OTHER APPARATUS:
2i �;
it ►
"i
_'t �,
6't �, 'i
??ic_o_57 .-.....-J-1-?----..7.-4
p T 7 ``•• qq
'<' 4 Amy Lane No 1 8 4 ,�
4. Glens Falls, EY 12801 2 3 9 BRANCH MANAGER
Pc, - •
lick: - .
-,-: ' 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.
wi ,,C7Ar iAi-re-wrfirc're-mirt.i Y—re-ie7e-re 4,--re-fact -re-iavie-re-ie-i r9. II ® NIE5101=117NinirdiTEIMINMENIME WNW 0
:-.-1rri v pm; RI III I1IIJt_ TICPADT►AClJT THIS rnPY nF CERTIFICATE MUST NOT.RE ALTERED IN ANY MANNER
Jown of Queeniur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR'S REPORT
NAME
LOCATION L_Of
1\-pel.(2.6(AL,,i
/ Permit No. ?(,7 -`7'(�
* * * * * * * * * * * * * * * * * * * * * * *
i� = 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. Fireproof'. g
Door Closers
Smoke Detecto s
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION )
•
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remlarks- (Th ecti. F41,
Bu lding In pe or
6/86 and-v1
own •Of Queenitury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
•
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME (A// 5 --L- - d 1 ` 5Ll.D
LOCATION AWL& WO U54- LA)(/-
' DATE 3`f / PERMIT NO.
SOIL TYPE - :and Loam Clay -
Percolation Test Required? YES -(NO)
Percolation rate - Min/Inch ---
TYPE of SYSTEM:
Absorption field, total length kri;=',
Length of each trench I.r ;/
Depth of trenches
Size of gravel
SEEPAGE PITS-ENumber of) •'?
Size- (_,) ft. X <. ft.
Gravel size
PIPING: Size Type
Bldg. • to tank U" L'
Tank to dist. box I;' {
Dist. box to field/pit., W
Openings sealed? (YES) NO Partial
LOCATION/SEPARATIONS:
Foundation to tank 6 ft.
Foundation to absorption 3c.) ft.
Absorption to lot line .zv ft.
Separation of pits 5 ft.
LOCATION QF YSTEM ON PROPERTY(circle one)
Front Rear - Left side - Right side -
COMMENTS:
SYSTEM USE APPROVED (YES/ NO
1)
1
Building Inspector
01/86 and vl
TOWN OF'QUEENSBU RY
• Building Department
Inspectors Report Date 3/A/C-
Name t /4 S/ 1 -
Locatiow AC I I rfo us 6 ZA-ti&
Permit No. 86 - yc Weather
Remarks
Excatia ti on
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill IV
Final Survey
Framing •
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg. \
Relief Valves \ f
Wall Board
Ext. Porches \ d
Finished Floor ,'
Interior Trim ;;``
Stairs & Railings
Cellar Dr. Tile \ •
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
• Chimney /
Water Meter Inst.
Septic Approval
Floors •
Insulation Foundation
Walls
Ceiling
fif-';114-tASLAA--d---
c:W
s lai 6 Inspector
REMARKS
11)AAA I c►L/M04J g-K16n.1D14._
Ito
TOWN OF QU•EENSBURY
Building Department
Inspectors Report Date 13' ''2 ' ,2 Name (ci,•,. e
Location C � v
Permit No. 6-`f eather
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
Stairs & Railings
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
.............
.-------. . ' -
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-- . •-•"-.". v; - ' 1 ...04, ...4.00 .—.6-7(
GEORGE KUROSAKA JR..P.E. )7 — ��
BUILDING SYSTEMS CONSULTANT
• POST OFFICE BOX NO.660
GLENS FALLS.NEW YORK 12801 •
-
(518)792-1522
13 ARBUTUS DRIVE
01/C. QUEENSBURY, N.Y. 12801
PHONE 51B 792-1522
BUILDING INSPECTOR
Town of Queensbury re: Factory Manufactured Home
Town Hall Installation Certification.
Queensbury, New York 12801 '
•
Attention: Mack Dean
Dear sir,
This is to certify that I have observed and inspected the installation of a
"Factory Manufactured Home"; as defined by the New York State Uniform Fire
Prevention and Building Code, Chapter D - MANUFACTURED HOUSING, Article 2 - '�
FACTORY MANUFACTURED HOMES, as applicable to your local building regulations;
there appeared to be no apparent structural damage to the units, due to or
attributable to the transportation or loading/unloading of the units, herein-
after described as follows:
Date of Installation: 00'L T. 'P
Site Location: Jr47;1PiTilr, Sam /01,010
Community: Town of Queensbury
County: Warren //��
Manufacturer/Supplier: ,eY 2-cei1 P-L -dir-
Address: #940 ? - S'
Insignia Serial No. 9AfixeliP /775
- Plan Approval No. 46,®/fL. cs L' . &4
Manufacturer's Model/Component No.: G !>?4F6P o7 Vt 10. -
Date of Manufacture: ?"
Installer/Supplier: 07,00, 46,49Wir7— 4r0r:cAr-zeilL4
• I have also examined the approved Plans & Specifications for the abovementioned
"Factory Manufactured Home" , and to the best of my knowledge and belief, this
"Home" has been installed in accordance with these approved Plans & Specifications,
and all other applicable laws codes, ordinances,standards &/or regulations.
�� x�RoGY Res:, tfull s mit ed5
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r I �. M '( l
'. . '..,;;I GEORGE KUROSAKA JR., P.E.
s `' "'� U3* NYS PE Lic. No. 35869
cc: , ti
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