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1985-252 CERTIFICATE +DF' C CUPA.N+�`'' TOWN OF QUEENSSURY = , WARREN COUNTY. NEW YORK PBate O c tcY e r_ 19 5 This is to certify that work requested to be done as shown b�yy�Permit No, -- has been completed. p� P� 751A i LJlJti 1 1 C)ne- rar,iil—Y} Dt�'e11in This structure may bed �y� as a Location loot 1Q inev occl po7 low.= P.oad (StvWo . 13 ) Yen1att5c7n [7w her By Order Town Board vroVYN OF QUEENSSURY ?f Buildinig & Zoning Inapecuw R CREILTIVC YN'lT+A rOINTINi1 [SL GMS fALL$ N Y RYeel 144017e1-s650 FF CERTIFICATE %0*2 OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date�rc 1 ,tear 4 19 This is to certify that wark requested to be done as shown by Permit No. has been completed. This straicture may be occupied as a i. 14' r t c: 1 ] r r. i i Location T '7t� TO F ine� �C?rc? ITc1 3 ot• Pnar' ( ,Ft:in F00 "or PTtlttI=- <- n Owner C .i: P- TrTC" %.crT' (7T' C f t^TTF ,w. rr zf By Order Town Board F' !"r,I r�T* TT+^' ( � (� 7 T17`, �. ,r.. T" '�•'Fl ,."'.+•' q-. �..�,�}",. r . L '( n ( ''.i; TOWN OF QUEENSBURY 1 Building d Zoning Inspector i 3 CREATIVE "IM*T A-" FM NTING. au EMS IA,LI.S, N V ago IS i}7f]•1455 ^' d ... dd. I'd Al Vi 4le� Il�l V 41 y _�.1­1 I I IlS. I 1 1 n d .1 1 1 1 w 1 r, 1 14" 1-11 V... 4. %- W. Id -r A 4'd,,r, i —ed did -4.) I. P. p Y, d p ;A Ad ...... .... p I, dd A I.P L p dA d' ddd� N. w p 1p _d,dId I dd d. d5idl dml:d`I I did IL 'A q t 4w 4t d 1.dIIAl.­ .—I A P 4A, r dAd... .... dddI I d dArd Idd.� d d- ;. Oftpy1T/f?NYR10 1. �ifvm6aTI- A, BUILDING PERMIT TOWN OF QUEENSBURY No. 85_ 252 WARREN COUNTY, NEW YORK x m PERMISSION is hereby granted to Ken Mattson :4: rt" OWNER of property located at Lot 19 Pinewood Hollow Road Street, Road or Ave. Q( St . No . 13 ) 0 in the Town of Queens:bury, To Construct or place a One- r arni ly 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 O.ueensbufy Building and Zoning Ordinance. 1 . OVME R'S Address is 64 Blind Rock Road t-� Glens Falls , New York rn b rt rr 2. CONTRACTOR or BUILDER 'S Name tQ Same Fr- 1✓ 'J w {p 3. CONTRACTOR or BUILDER 'S Address q Same 0 CL 0 F - d. ARCHITECT'S Name � 0 B. ARCHITECT'S Address x%U C3. B. TYPE of Construction — IPlease indicate by X1 # Ix1 wood Frame I S Masonry I ) Steel ( S C7 7_ PLANS and Specifications 321x50 ' per plot plan, specifications and application e II No- suUnitted including two-car attached garage and sewage system , B. Proposer! Use I Ir �r One—Family Dwelling $ 5 . 00 C/O Paid Fes.., 5129 . 00 FIERMFTFEEPAID — THIS PERMIT EXPIRES January 1 19 86 r (If a longer period is; required an application for an extension must be made to the Buildingand Zoning in o g Spector of the town of 4ueenstru ry before the expiration date.) Dated at the Town of C2ueensbury this 3rd Day of June ?g 85 SIGNED BY J , for the Town of Queensbury Building and Zoning Inspector TOWN OF +QUEENSBURY (Space inside block its lx• fills•xl in bt WARREN COUNTY* NEW YORK Building Inspt"cuorl Application for Applitation No. P(or-11111 ls,xle"s! 19 BUILDING AND ZONING PERMIT !'r I1T, 11 +.spire+ ] n Yinun;p Ilistri( r olm. lit Worl. ,� �— THREE ( 3 ) Copies of a PLOT PLAN. Drawn to scale showing the actual dimensions of the !o+ +o be built 1t� �r1a1 )( , iv upon, The exact size, and location on the lot of the building to be erected or altered MUST BE SUB- M1TTEf) WITH THIS APPLICATION. � - TOWN OF C2LJEk*NsZ3L1t�Y ._�—c,-� DATE A, PERMIT MUST 8E OBTAINED BEFORE BEGINNING WORK 12 GO E 0 V E l ANSWER ALL CAE THE FOLLOWING, J U4 W' 31985 --- The undersigned hereby applies for a permit to do the following work Aom 13 '`'� p"m. { 3 Li which will be done in accordance with the description" plans and specifi- 7J819 s R L1218141 516 cations, and such special conditions as may be Indicated on +he permit. The a r of this pr rty is: ��}e (S A •LSE) - - - - - - - . WO ADDRESS1 I The persqrs responsi`b,�ie for supervision of the work insofar as the Building Code and the Zoning Ordinance apply is: 1 (RAME) fv O AOORESSI Name of Builder . . .t, . {�. . . . . . . . . , . - . , . - . . . . Address .� E— fit— . . . . . . . . . . NameofPlumber - sxd . . . . k2� � �fJ�ty � . . . . . . . . . _ Address . . . . . . . . . . . . . . . . . . . . . . Name of Mason . . , rt�`— , . . � . . . . . . . . . . . . . . Address - . - . . . . . . . , . - _ I . . . . . . . . . . . . . . Lot Plumber . . . . Unit . . . . . . .. '`� . . - . . . . Estimated value of proposed work S . . � ��--: f 0 � C::> Name of Village ` r _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Street 4 . . .. . . , . , . T .+�-( 1. . . . �� �� . . . . . Side of street: north ❑ . east south ❑ . west Nearest Cross Street . . l �� . . . . . . . ] . . . . . Distance from this ^Toss street . . . Ft . Property is north ❑ , south C3 , east "r,}X, west ❑ from Cross Street If on Corner, •which corner, northeast f 1 , northwest Q , southeast Lam . southwest (Designate by marking with an "X" in the correct space.) NATURE OF PROPOSED 'WORK OCCUPANCY Construction of a new building, Main IiuMing Addition to a building. One-family dwelling © Alteration to a building. Two—family dwelling O 0 Demolition of a building. -family apartment house Store building C] -car attached garage f� Other: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Accessory Building One-car detached garage M Other work. Describe. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Two-car detached garage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Private chicken house Private storage building . . . . . . . . . . . . . . . I - , - Ot her: . . . . . . . . . . . . . . . . . . . . . . . . . , , . . . . . . . . . . . _ . . . 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, site and setbacks of pro- posed buildings, and the location of all existing buildings. Show proposed building(s) in dotted line and existing G'Il Wcarj,� +40L-*� C tkuilding(s) in solid line. Size of property . . . �`� r� . . - . . . ft. x . .. . . .. . . . . ft. NSize and use of existing buildings, if any . . . . • Size of proposed building . . .. . . . , • ft. x , , 5k . . . . . ft. Height (from grade to,.{r�i e) . . . . . .Z�- . . . . . . . . ft. Front yard . . . . . . . 'l . Z. . . . . . . . . . . . . . . I . . . . . . . ft. Side vards . . . . . . . ft. and . . . . f 4' *- . . . . . ft. . . . . . . . . . . . . . . . . . u . . - . . ft. Rear yard . . . . . . # If oncorner, setback from side street , , . . • - � - f Noceto : All diseawccs ore wet, as measurere d from set tter side J line to nearest Bart of building. (OVER) 7 73 -M (cont'd.) BUILDING SPECIFICATIONS. Kind of construction-- Wood frame, fire safe, etc.? �" '•� .. . .. . . . - . ' ' ' ' ' • • ' ' . . . . . . . . . . . will any second-hand lumber be used? . . . -Uc O . . . . . . . If so, for what? . . . . . . . : . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . Material of foundation Walls N. C- . Ct we-.r c- Thickness . t a� • . . . . . . . . . . . . . . grade 7 " '�. . . . . . . . Continuous foundation? Depth of foundation wails below . . `( Will there be a cellar? . . . �. . . . . , . If so, material of cellar floor . - .� . '. .4;<P ... . . . . . . . . . . . . . . . . . . . . . Type of roof. Sloped or flat? . . .Sw ' �.�- Material of roof . . . ¢ .S¢'.t�. + +-" - . . - `�. ti` ~�' ~'�. • . - - - . Sine, wood studs - . . " x . . . . . . . ". spacing . . . . . . C' . . . . ."a.c., length . . . . . ` . . . . . . Size, floor beams. Ist floor . . - . . . . . . . to xG� . . - . - . ". spacing . . . - . . I . . . . . "o.c., span . . . 1 `E . . . . . . ft. Size, floor beams, 2nd flour . . - . - . . . . " x . . . . . . C?. . . , . - " spacing - , . . . . 1 . . . . . ..o.c., span . . . . . QY . ft. Size, ceiling beams . . - . - r a Sir �i x , spacing . . . . . . . . . . . . . "o.c., span . . . . . . . ft. Size, roof rafters or beams '%'• • " x " "o.c., span, spacing . . . . . . . . . , . . . . . . . . . . . . . . . p PC3p With what material? . . . . . . . . . . . . . . . . . Exterior finish . . . . . . . � 4 . . +� , . - . . . . . . . . . . . . . . . . . . . . . . . . . . . . Finish of interior walls . . . . . . . . . . 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 . . . . . . Oil burner or coal? . . . . . . . . . . . . . . . . . . . . . Will a flue-lined chimney be provided? . . . fr•,t7 Depth of chimney foundation below grade . . . . . . . . . . . . . . . . Height of chimney above roof . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . , . , . . . . . . . . . . . . . . . Will there be a fireplace? . . . t . . . . . • . . . . . . . • . . , Depth of fireplace hearth . . . . . . . . . . . . . . . - . . . . . . - . . . Will a toilet be installed? . . . . . �+` . . . . . . . . . - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Will a kitchen sink be installed and connected to water supply? . . . .4 . . . . . . . . . . . . . . . . . . . . . . . . . . . Water supply (public water supply or pump) LA-^r �. , . . L'.l e._j . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . Distance of cesspool from any private well . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . feet Will drainage system be provided with required traps, cleanouts, and vents? - , - . .""( �'— . . . . - y AFFIDAVIT Town of Queenshury County of Warren State of New 'York I swear that to tr. lei C-9f my krKw,ledge and belief the statements nonta' ed in Shia applicatiamI together witls t>He nlwra wr�d gtecificasiolsi sub mitted, are a true and C+v.,. lete statement of all proposed work to bE on the bed p ses and awt : rovisions of the BUILD- ING CODE, THE ZONING ORDINANCE, and all other laws pertalni the pro work h u be oosn i , whether specified or not and that such work is authorized by the owner• Sworn to before me this Signature . . . . .- .. . OWNER. OWd4E.R' AGENT, ARCHIT'fCT. CONTRACTO#i dayof . . . _. . _. . . . .. . .. . . . . . . . . .. . _-. . . .. . . .-. . . 19 . . . . . . NOTARY PUBLIC, WARREN COUNTY, N. Y. SPECIAL CONDITIONS OF THE PERMIT. .. .. .. . .. . ....._. .... . ... . .. .. . TOWN OF QUEENSBURY WARREN COUNTY , NEW YORK pf ISCUjCk>J A*OL O uj �� ►J�O� �� 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 2 . Type of heat 3 . Is the building mechanically cooled ? � aC�4 . Percentage of area of windows and doors 14` 047 A , Over 16 % only 1 . U 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 is the R value ? 3 . Slab on grade YES NO a . If YES , what is the R value of insulation around perimeter of floov ? 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 exposed to ambient conditions 2 . R value of exterior walls - 2 3 . R value of glazed area 4 . R value of doors 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 ) IZ- r � 9 . R value of heated basement/cellar walls ( below grade ) 10 . Type of insulation- AEi (3,C!5� C tots 4-- iZ- Lc, l2 V�:O: ,,D. Vv C . Controls o 1 . Thermostat maximum heat setting "� (? 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 or cooling carrying agent pipe 314-� -A- Z. 2 . R value of pipe insulation yr F . Service Water Heating 1 . Performance efficiency 2 . Temperature control setting maximum G . For Swimming Pool Only 1 Maximum heating Telephone No . ( applicant ' s signature ) TOWN OF QUFF'NSBURY BUILDING & ZONING DEPARTMENT SFh7AGF DISPOSAL PERMIT APPLICATION 1 . Owner ' s Name L6-- 2 Fj t Address &t C p --cr� 40A o _ Telephone No . � - 2 . Property location_. ._ LOT (�+( R S tee—z)r> L.LO Q �2v w�- • 3 _ Name of person or firm responsible for installing system ��J • -� t1a ✓y�- GA« l�rsttiiC� Telephone No . Address t5CA sic ranc .,_ 4 . Number of bedrooms ( residential buildings only ) 50 Daily flow 4<; 0 gallons/day 6 _ Septic tank capacity. (')tD CD gallons 7 _ Topography : flat , rolling , steep $ of slope C7 80 Nature of soil and depth dip -- ft0v65 96 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 . e;7 minutes/inch 11 _ Water supply : municipal , well , 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 2 "� Lau =2 signature of applicant 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 . i Form 3 - 82 � � "� BIN 4s 6 ss THE NEW YORK BOAR©- OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY F"l 41 STATE STREET, ALBANY. NEW YORK 12207 Date October 30 , 1935 Application No. onfile 088421-85 A651078 THIS CERrIF1E S THAT application number in the prOmisee of only she electrical equipment a& deacribed below and introduced � the applicant nonned on the abase Ken Mattson :: Ffnewood Hollow . Glens Falls . New York in the foilawinA location; ® BasementBaeeent ® lot Fl. Brad Fi. GeLxapt� ,C]LLC93cle Section Block Lot was examined era end found to be in complianre with the requirements of this Beard. 10-2^85 RANGES COIaItMGDECICS GVENS p1SHWASFLERS EXHALiST FANS FIXTURE FIXTURES .. ROES :WITCFIES INCANDESCENT FlllGEESCENT w AMT. K. W. AMT. K. W. AMT. K.W. . AMT. K,W. AMT.. 3 fr 28 36 36 28 DRYERS I;iRN 36 MpidRg tUTUN ADPLIANGE FEEDERS SPlCIALREC'PT TIMECL171GK5 � UNIT HEATERS MULTI OUTLET DIINMERS SYSTEMS wMT.- wwTTs AMT. K. W. AMT. AMPS. TRANS. AMT. H. 4. MG, OF FEET TL �+ 1 ryer 3617 S E R V 1 C E SERVICE DroCONNECT NO.OF +. GP HLLEG A w. G. NO. OF NEUTRALS 1�inwu METER 1 A. 2W t A' SW 3 0 3W 3 / �`M E OF kCe,COND. OF CC COi4D. aF HI-LEG AMT. AMP. TYPE EQl1EP. 1 200 CB 1 x 1 4 /O 1 4 /O OTHleae APPARATUS: _ 1- Smoke. Dlatector 1 - 15 a C . 'F _ T . Receptacle y2ectric ROOM 'Remoter : 2- 2 . 0 kw 5- 1 . 25 kw 5- 1 . O kw 1- . 5 kw A.T . Dion Electric i 04 {>r , V i_cw lax i*e BRANCH MANAGER So , Glens Falls , New York 1- 2801 Opp COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. TOWN OF QUEENSBURY Building DeP&rt kept Na tAwAkuoea r.0 G✓a Paraa+ait No..�B — z _ Waaacl.er Remarks Bxca#Ya tion Footin Forms Footing Piers Founda ti on Cement Coat Water roofin gacxfi l l Final Surve Framin Sheathin Roof Felt Roofin n masonry veneer Rory h Pl Relief valves Wall Board Bxt . Porches Finished Flay Interior Trim Stairs & Railin s Cellar nr . Tile Concrete Floats Pl Fixtures Gar . Fire roof-in poor Closers Chimne Water ,Meter Instt . Septic A roval . t Floors f�tm W5 Fouz2da'tldn Insulation Walls Ceilin r Build ng InsPector y REMARKS I TOWN OF QUEENSSURY Building- Departmout Iarepads .-- Data Na==wWill L.a�ewtim em ,Remarks Sxcat>a tx on Footin .Farms Footin & Piers Foundation Cement Coat Water roafin Backf3 3.I Final Surve ncr Sheathin Roof Felt Roofin S3din Masonry Veneer ,Rou h P3 IIP Itel3ef valves 111111 Wall Board Exit . Porches Finished Floor .Interior Trim Stairs & Rallin s Cellar Dr . Tile Concrete Floors P] fm Fixtures Gar . Fire roofin Door Closers Chimne Water Meter .rust . Se tic A roval Floors _ Founda t.ion ...... Insulation Wal2g Ceiling Building Inspector REMARKS �— loe TOWN OF +QUEENSBURY Builctins Diepai.rtment ir�oe: Repcwt n>,t. 7 r v NAIMMA a-AY r+� rr r�7 SO ^) Location �i�7 o �& ulxp n J jol �faj l r / 3 P Na Remarks ExcafYa Lion -i FootiI'lln Forms IIIIII Fvotin & Piers Foundation cement Coat -_ Water soofin Sa cXfil3 - Final Surve Framin Shea thi.n ,Roof Fel t poofin Sidling masonrw veneer Pouch P12>gov Relief Valves Wall Board - Ext . Porches - Finished Floor .Interior Trim Stairs & Railin s Cellar Dr . Tile - concrete Floors - -- Pl . Fixtures -- - Gar . Fire roofin .[door Closers -- Chimney Water Pieter Instip se tic A royal Floors _ Foundation 2nsulat.ion Wa33s _ Ceilin Building Xnspect©r REMARKS TOWN OF CUEENSBURY Buildinar Departmeimt ,+ ry ; = Rat Dote_ 31r' Nwme /1 Permit Nay. R�" a^ �-�- Wentheer Rema rks Excatra ti on Footing Forms Footin 6 Piers Foundation Cement Coat waterproofing Ba ckf.i l l Final Survey Framing Sheathing Roos" Felt Roo.fin siding Masonry 'Veneer Rough Plb . Rel,i of Valves wall. Board ^ . Ext . Porches Finished Floor Interior Trim Stairs s Railings Cellar Dr . Tile Concrete Floors Plbgw Fixtures Gar . Fire roofin Door Closers Chimne Water Meter Inst . Se tic Approval Floors Insulation Foundation wells Ceiling { Building Inspector RRM"KS tia L{/' 11S1 "•'+Tr ��y f^ G ENV FALLS TEL 792-137c � 4i p,. Gp a b- f r.r P � f_ � � t i ff�