6982CERTIFICATE CDF 'OCCUPANCY
TOWN OF QUEENSBURY
CREATIVE "INSTA" PRINTING GLENS rALLS. N Y -12801 I510)733-SESS
i
TOWN .OF QUEENSBURY t (Space inside block to ix- filled in bs"
WARREN COUNTY. NEW YORK Building Inspe-cl4w)
Application for . Application No.
llermit issued 19. .
BUILDING AND ZONING PERMIT 151'rillit Expires.
%1,6 n! District
�;�Itn•,rl 11'nrk,�
THREE (3) Copies of a PLOT PLAN, Drawn to scale It}'-
showin the actual dimensions of the lot to be built
upon, T e exact size, and location on the lot of the
building to be erected or altered MUST BE SUB- . " ' . . ' . . . '
MITTED WITH THIS APPLICATION,
�— 7 _ 8 TOWNt OF QUERNSBURY
DATE
A PERMIT MUST BE.09TAINED BEFORE BEGINNING WORK
ANSWER ALL OF THE FOLLOWING. '_'�- 89
The undersigned hereby applies for a permit. to do the following..wo& t;.f�4., j P.M.
which will be done in accordance with the description, plans and spocifi ` ��'' : �1�L*"i�`��3,���,la
C i A e c u fl ! fl fl e
cations, and such special conditions as may.be indicated on the permit.
The owner of this property is:
-;P'9g '
h?�tri.r,➢ . . . . �`:� 3- Falls rJ
(P.O.ADDRESS) . . . . . . . . . . . . .
The person responsible for supervision of the work insofar as the Build;j#g;Code and the Zoning'Ordinance apply is:
. . . . . . . . ��' 3 Cti?� Ne. . '. . . .cq-�,1. :Frans N'• . 1 ?¢c i
(NAME) (P . . . . . . . . .
.O AOO SSI
Name of Builder. . .5%apt - AS. - A&A L''L--. ... .Address.. ... . . . ...
... . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Name of Plumber. . . Sr ,.t. .A.S. . 4.4 of. . . . . . . . . . . . . . . . . . . .Address . . . . . . . :. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .
Name of Mason. . . . . .Stlp�t. .k,5. . .4.0--??- . . . . . . . . . . . . . . . . . .Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... .
Lot Number. . . . . . . . . . . . Unit . . . . . . . . . . . . Estimated value of proposed work S . � V
Name of Village. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . :• . . . . . . . . . . . . . . . . . . . . . . . .
Name of Street . . . �Y:Zi�-:t? g . . .IAA.4. . . . . . . . . . . . . . . . . . . . Snde of.-street: north O, east. h„ sotith O..west ❑.
Nearest Cross.Street . . . . . . . . . . . . . . . . . Distance from this '-ross street . . . . . . . . . �L�Q. . . . . . : Ft.
Property is north ❑,south ®,east 'vtk, west ❑from Cross Street
If on Corner,which corner,northeast ❑, northwest ❑, southeast C southwest
(Designate by marking with an"X" in the correct space.)
NATURE OF PROPOSED WORK OCCUPANCY
Construction of a new building. Main Building
❑ Addition to a building. One-family dwelling
❑ Alteration to a building. Two-family dwelling ❑
❑ Demolition of a building. • • • • . . -family apartment house E
Store building ❑
. . . . . . . .-car attached garage ❑
Other: . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Accessory Building
One-car_detached garage . L�
❑ Other work. Describe:. . . ... . . . . . . . . . . . . . . . . . . . . . . . . Two-car detached garage
10
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Private chicken house . ❑
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-
NORTH posed buildings,and the location of all existing buildings.
Show Oroposed building(t) in dotted line and existing
LtA-t_e. q_ building(s).in solid line.
T p/az�
�Ys Size of property . . . .? C. . . . , . . . [t: x . . . .T ft.
I -- - ;'3 o` Size and use of existing buildings, if any . . .tJ T___X.. . . .
t '----'
W W
Size of proposed building . . . .3'Q. . . ft.x . . .q�. . . ft.
Height (from grade to ridge) . . . ... . . . . . . . A.0 . . . . . ft.
Front yard . . . . . . . . . . . . . .lf�S. . . . . . . . . . . . . . .
it.
qM
Side yards . . . . . . .
b. . . . . ft. and . . . . . � . . . . . ft.
Rear yard . . . . . . . . . . . . . . . . . . . . AaF. . . . . . . . . ft.
SOUTH If�corner,setback from side street . . . . .. . . . . . . . . . ft..
FNote: 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.?. . . .f{1�nt� . p.�e�?1/ . . ,:, , �I.S/ li 1L
Will any second-hand lumber be used? . N.Q. . If so, for what?.0.. .. .. . . . . . .. . . . . .
Material of foundation walls . . . . . CQr�eft. . . .�/i? . . . . . . . . . . . . . Thickness' ;;�. v
• . . . /.d .S . . . . . . . .
Depth of foundation walls below grade . . . . . . . .`E . . . . . . . . . . . . . . . . . . . . . . . Continuous foundation? . . .
Will there be a cellar? . . . If so, material of cellar floor . . .po.cttj, rn��?
Type of roof: Sloped or flat- VJ . . Material of roof . , . . .Asp4s.M,
Size,wood studs . . . . . . . . . . . . . ..A. . . . 'x . :/a. . . . . . . . . .",spacing . . . . . . . 1� . . . ."o.C., length. . . . . . ft.
Size, floor beams, 1st floor . . . . . . . . . "x : . . . ." aci s p ng . , . . . �.�. "o.c., span . . . .
Size, floor beams, 2nd floor . . . . ev 1A. . . "x spacing. . . . .0: , , g
�' A. . . . . . . . . o,c., an . . . . . .
Size, ceilingbeams . . . . . . . . . . . .o�. . . . . "x . . . . . ."1IZv`' ,", spacing ., ft.
y v/' P g . . . . . ./�. . . .. o.c., span . . . . . ja!. . . . . . ft.
Siie, roof rafters or beams . . . . . .r.��..& . ."x . . . . . . . . . . . .", spacing . . . . . �y. . . • "o.c., span :I:. . . .
Exterior finish . . . .,'�1!� rj , . .`�` , , , , , , , , • , , • , • • , , . . With what material? . . . , �liy l, ,ltitiacn p�s
Finish of interior walls. . . . . . . . . . . tiu.cQ. . ..S.kbPY4,C,k. . „ • . , . • • , • . , . • • , , .
'If garage is to be attached, of what material mall between garage and main budding to be constructed?
. . . . . . . . . . . .1.. .. . . . ..... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . :. . . . . . . . A . . . . . . . . .
Is there to be an opening between garage and building? . . . .41A. . . . . . . , . • , , • , , , • •
Kind of heating system . . . . . .Q.re411 L,6uz- A . . . . . . . . . . Oil Wrner or coal? . . . . . . . . . . . . . . . .
Will a flue-lined chimney be provided? . . . . . Depth of chiihney foundation below grade . . . .�. /A.': . . . . .
Height of chimney above roof. . . . . . . . . . . . . .': . ._. . . . . . . .`. , .. . . . .. . . . . . .
Will there be a fireplace? . . . . ,:. . .J.4. . . . . . . . . :. . . Depth of fireplace hearth . . . . • • • • . • •• . • . • .
Will a toilet be installed? L
Will a kitchen sink be installed and connected to water supply? . . ?. . .
Wz2�• , wA..6'.
Water supply(public water supply or pump) �� - • • •
Distance of cesspool from any private well . . . . . . . . ./dS7. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . feet
Will drainage system be provided with required traps,cleanouts, and vents? C;,
,Town of Queensbury AFFIDAVIT
'County of Warren
State of New York
I swear that to it, v:a r of my knowledge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, are a true and coa. lete statement of all proposed work to be done on the described pmnus and that au ions of the BUILD.
ING CODE,THE ZONING es ORDINANCE,and all other laws pertaining to proposed work shall oompl'ed with,whether specified or not,
and that such work is authorized by the owner.
Sworn to before me this Signature .......�... . .l.� '.
(��4
OWN@R,OWNER'S AGENT,ARCHITECT.CONTRACTOR
... .......... ... ... . . ........day of..................................................19";....
.
. .. .. .............. ....................
NOTARY PUBLIC,WARREN COUNTY, Nj, Y.
SPECIAL CONDITIONS OF THE PERMIT:
r
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 ZWO -5c--(Lt.'vt
2 . Type of heat Q rzfC v' zZ
3 . Is the building mechanically cooled? �; p
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 ONO
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 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 exposed to ambient conditions_
2 . R value of exterior walls
3 . R value of glazed area
4 . R value of doors
5. R value of floors over heated 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)
9 . R value of heated basement/cellar walls (below grade)
10 . Type of insulation
C. Controls
1 . Thermostat -maximum heat setting
D. Duct Systems
1. Is duct systlem -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
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. ���� 0�7 l Clt UL U-Loy
'applicant ' s signature)
BUILDING PERMIT
TOWN OF QUEENSBURY
_ No. 6982
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Bruce E. and Sandra J. Brown `
OWNER of property located at Luzerne Road Street,Road or Ave. n
(D
in the Town of Queensbury,To Construct or place a One—Family Dwelling tmj
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,
R�
1. OWNER'S Address is
R. D. #3
Glens Falls, New York
w
2. CONTRACTOR or BUILDER'S Name C-I
same
to
n
0
3. CONTRACTOR or BUILDER'S Address
same
4. ARCHITECT'S Name
New England Log Homes
r
5. ARCHITECT'S Address N
2301 State St.
P. 0. Box 5056
Hamden, Conn. 06518 '�y
6. TYPE of Construction—(Please indicate by X) 0
a
( )Wood Frame ( ) Masonry ( )Steel k) Leg E;
7. PLANS and Specifications
30 'x48 ' per plot plan, specifications and
No. application submitted including sewage system.
0
8. Proposed Use N
I
One-Family Dwelling
N•
$5. 00 C/O Paid
$ 110. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES February 1 19 82 t7
E
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
N
town of Queensbury before the expiration date.) N
N.
Dated at the Town of Queensbury this 8 th Day of July 1981 LQ
SIGNED BY z for the Town of Queensbury
Building and Zoning Insp for
TOVW OF 0UFrNSDVRY
PUILIDINC AND ZONTNO DrPARTMFI\71,
DAY AND HAVILAND ROADS, R. D. f--1
GLENS PALLS, NFW YORK 12SVI
APPLICATION FOR A PERMIT TO CONSTRUCT, ALTPR OR FNLA-RGF-
A SET-,7A'GF DISPOSAL SYSTEM VITEIN THP TOWN OIL QUEEENSBURY
OCCUPINNT'S IWIF , ypzvkcsL 'e-' -31 &w�j ADDRESS CIA-z-epve 67,r.
TELEPHONE -7 = OWINER'S NAME
ADDRESS ---NUMBFR CYP DFDROOMS—
GARBAGE GRINDER? No (YES OR NO) TOPOGRAPHY: (:rDLIV- , ROLLINC, STFFP,
SLOPE, GENTLE SLOPE, OTHER
NATURE OF SOIL: CLAY, 4 D-IDY 11 LOAM, GRAVEL, ROCKS, E111C.
PERCOLATION TEST WATER SUPPLY: MUNICIPIAL, WFLLP OTHMI
DIAGRMI Or PROPOSED SEPTIC SYSTHIM
IX7
;o
OTHER PERTINENT JINFORUITION
IT IS HEREBY AGREED TH2kT IF THIS APPLICATION AND P12,NfS ARF APPROWD,
INSTALLATION OF SEWAGE DISPOSAL FACILITIES 11TILL BE PIADF IF ACCORDPNCE
WITS DETAILS SHOWN.
DATE_ SIGNATURE OF. APPLICANT.
LAKE GEORGE PARK COMMISSION APPROVAL
(7'd. te)
THE NEW YORK BOARD. OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
41 STATE STREET,ALBANY,NEW YORK 12207,
Date - .- r i1 Application No.on file E,• _�. uF.... q � y
THIS CERTIFIES THAT _ 0 =
only the electrical equipment'as described below and introduced by the applicant named on the above application number in the premises of r
• )....iai � 4" I.ylq .I it C_.f-': .\. }-.'i.�.t. i-� `f9�r-��.-.-11�1i'M1� _.1. •!. .. a
1° in the following location; ❑ Basement ❑ 1st Fl. ❑ 2nd Ft. Section Block Lot
was examined on and found to be in compliance with the requirements of this Board. -
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS ECEPTACLES SWITCHES INCANDESCENT FLUORESCENT MERCURY VAPOR AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. I H.P.
t
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET -AMT. WATTS
SERVICE DISCONNECT NO.OF S E R V I C E -_
METER NO.OF CC.COND. A.W.G. A.W.G. A.W.G.
AMT. AMP. TYPE EQUIP 1,6'2W 1-1 3W 31B'3W 3,0.4W PER AY OF CC.COND. NO.OF HI-LEG OF HIAEG NO.OF NEUTRALS OF NEUTRAL -
OTHER APPARATUS:
0
0
BRANCH MANAGER
0
0
Per
COPY FOR BUILDING DEPARTMENT. TEAS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
TOWN ®F SEE U Y
Bgildamg DePartment
Rem Date�Z
N" rue do �o_O ld/
Permet No. fr 9 k,-q'
Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing �q
Backfill
Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
MasonrH Veneer
Rough P1b .
Relief Valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railin s '
Cellar Dr, Tile
Concrete Floors
PI . Fixtures
Gar. Fire roofin
Door Closers
Chimney
Water Meter Inst.
Septic Approval -
Floors-
Insulation Foundation -
Walls
Ceiling
Building Inspector _
REMARKS
r�l� �`01- �2 : � �
TOWN OF QUEE SBURY
Building Depaatreeat
Inspecton Report Date /0 ,�.�• `:�?
Name
Locatim
Permit No. / G O� Weather
Remarks
ExcaTYa ti on
Foo ting Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing
Sheathing
Roof Felt
Roofing_
Siding
Masonry Veneer
Rough Plb .
Relief Valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railings
Cellar Dr. Tile ,
Concrete Floors
Plbg. Fixtures
Gar. Fire roofin
Door Closers , r
Chimney
Water Meter Inst.
Septic Approval
Floors
insulation Foundation
Walls '
Ceiling
Building inspector
REMARKS
TOWN OF UEENSBURY
Building Department
hopecton Reps ®ate_ -7----7 7
Location_
Permit No. [o 5 8 a Weather
Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing
Sheathing
Roof Felt
Roofing %
Siding
Masonry Veneer
Rough Plb .
Relief Valves
Wall Board d \;
Ext. Porches N
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
TOWN OF QUEENSBURY
Building Department
Report Date
Name
L.ocatim
Permit No. LQ Weather
Remarks
Excatia ti on
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Ba ckfi ll
Final Survey
Framing
Shea thin
Roof Felt
Roofing
Siding
Masonry Veneer
Rough P1b .
Relief Valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railings v
Cellar Dr. Tile /
Concrete Floors
Plb . Fixtures
Gar. Fireproofing
Door Closers
Chimney /
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation
Wa11s
Ceiling
4a,wwo,?
Building Inspector
REMARKS
TOWN OF QUEENSBURY
Building Department
gnwpeetArs Itgs®et Dat
Name_ �-
Loca s
Permit No._ to e18 Weather
Remarks
ExcaTia ti on
Footing Forms
Footing, & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
f'
Masonry Veneer ;f
Rough P1bqr. q"
Relief Valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railings
Cellar Dr. Tile
Concrete Floors
P1b . Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
SepticApproval
Floors
Insulation Foundation
Walls
Ceilin
4L::e_�
Building Inspector
REMARKS
- - --------------- boo �� - ---- -- -- _
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