1986-154 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date Luce 70rh r
This is to certify that work requested to be done as shown by Permit No. 86-154
has been completed.
This structure may be occupied as a One-Family Modular Dwelling
Location Jenkinsville Road
David Vaughn
Owner
By Order Town Board
TOWN OF QUEENSBURY
( Building & Zoning Inspector -
BUILDING PERMIT
TOWN OF QUEENSBURY e
No 86-154
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to
David Vaughn w'
OWNER of property located at Jenkinsville Road Street,Road or Ave. s
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 #1
Glens Falls, New York
2. CONTRACTOR or BUILDERS Name >-
Lamplighter Homes
3. CONTRACTOR or BUILDER'S Atltlrea
RD #2
Ft. Edward, New York o,
4. ARCHITECTS Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by%)
( A Wood Frame ( )Masonry 1 I Steel 1
0
q
J. PLANS and Specificationsw
26'x44' per plot plan, specifications and application submitted
No. E
including sewage system.
B. Proposed Use THE ATTACHMENT OF THE TWO PARTS MUST BE APPROVED
BY A LICENSED PROFESSIONAL ENGINEER. a
One—Family Modular Dwelling F,
$5.00 C/0 Paid
$ 84.00 PERMIT FEE PAID—THIS PERMIT EXPIRES November 1 19 86
(If a longer period is requ ired a h eprbnfor extension must be made to the Building and Zoning inspector of the
town of Dueensbury the beforeexpirexpirationion date.) ❑
co
Dated at the Town of Queensbury this 2��3ttrdq /Day of
April 19 86
SIGNED BY //'etei t.r - ratert^`i for the Town of Queensbury
Building and Zoning Inspector()
TOWN OF QUEENSBURY (Spaceinside block to Ix tilled in b,
WARREN COUNTY. NEW YORK Building Inspector)
\ppl'cad,m No.
Application for P,.,,Ii, Iuued 19
BUILDING AND ZONING PERMIT i twit f.spires in
/i!limp District
01 iii• it \VniL I
THREE 13) Copies of a PLOT PLAN, Drawn to scale '']111F od bV
showing the actual dimensions of the lot to be built It, no,rkf
upon, The exact size, and location on the lot of the
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION.
5 a — I - 32. a y—f7 -y6 DATE 1!nls11 V Li
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK �1'
ANSWER ALL OF THE FOLLOWING. p.l R 2I �
The undersigned hereby applies for a permit to do the following work A, `fq� (bLOk0P-M.
which will be done in accordance with the description, plans and specifi- f I419µl 121314_¢1•
6
cations, and such special conditions as may be indicated on the permit. r Q '3lCL
The owner of this property is:
p,4 ✓,e- . j e d 6 H a - Se. , lc , ,.- t d-1le . ad 6,. Ir. . . . . . . . . _ _
INA'4E1 IPO ADDRESS)
The person responsiblufor supervision of the work insofar as the Building Code and the Zoning Ordinance apply is:
4 Pin.'Pi. C il.T. K Hoene. . . . 2..v.61. FO,CT e'„4)A-,cA! .N.• . . . .=tFz. Off. . .
.
. (NAME) IP0 AOoRPSSI
Name of Builder l4ntY.& G.Kt .$ . . / eat/S ' Address .Z-.R.r1-. . t�u.C. E-d..eliC4r # y ( ire t
Name of Plumber. . . . , +'st e- Address
Name of Mason."PO At-o M.es So ti!'+-7 Address et50 �a*Ke4c< .d+'AT /✓ y flg3 t
Lot Number Unit Estimated value of proposed work$ S. 7 e. d. ?.Q
Name of Village
Name of Street Its-kvie,Sal tll R . .2..o A a Side of street: north ❑, east ❑, south Q. west 7)
Nearest Cross Street Distance from this -rocs street Ft.
Property is north ,south ❑,east iii,west 0 from Cross Street
If on Corner,whi cornea northeast (J, northwest ❑, southeast D. southwest
(Designate by marking with an "X" in the correct ware.)
a--� NATURE OF PROPOSED WORK OCCUPANCY
• ae' Construction of a new building. Main Building
r--
t D Addition a building. One-family dwelling
`I'.
b Alteration to a building. Two-family dwelling
-family apartment house LI
0 Demolition of a building. Store building - Ei
. .tar attached garage -.
Other
Accessory Building
One-car detached garage -
❑ Other work. Describe Two-car detached garage
Private chicken house ,l
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,site and setbacks of pro-
posed buildings,and the location of all existing buildings.
NORTH Show proposed building(s) in dotted line and existing
huilding(s) in solid line.
Size of property /ja ft. x
02aa ft
v c✓/j¢
Size and use of existing buildings, if any . . f
w wi ! Size of proposed building of Id ft,x //V It
y Height (from grade to ridge) / O ft.
} Front yard 95 ft.
1( Side yards 543ft. and . . . . .'r.3. . . . . ft.
•
hRear yard Pa 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
lconed.I
- BUILDING SPECIFICATIONS.,
Kind of construction: Wood frame, fire safe, etc.' (AJ 0 E 4-
Will any second-hand lumber be used? . . . . faf.A II so, for what
Material of foundation walls a.D e-c- t t, TVp p.o, tte ti Thickness . cg' #r
Depth of foundation walls below grade 7 Gd4
Cdntinuous foundation? . . !/ci . . .
Will there be a cellar? ti a S If so, material of cellar floor . . . . C o.m C.it Q T f
Type of roof: Sloped or flat? . . S I V.P e d Material of roof
Size,wood studs a- " x G ", spacing /4 "o.c.,length cit ft.
Size, floor beams, 1st floor a " x /0 ", spacing /te "o c., span I 3 ft.
Size, floor beams,2nd floor " x — ". spacing "o c ,span '._, ft.
Size, ceiling beams 2 " x y ", spacing ,s y. . . ."o.c, span / 3 ft.
Site, roof rafters or beams o. " x y ", spacing ,.1' Y "o.c., span / s/ ft.
Exterior finish ytdoit.zot.Tal I 5 , d. n G With what material? 1.4 a. y (
Finish of interior walls. . .5 Ft e,a moc.I.-
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�d building? A✓ /2
Kind of heating system . .Cie.c.in A.C.- J Oil burner or coal?
Will a flue-lined chimney be provided? N • Depth of chimney foundation below grade . .N/A
Height of chimney above roof N J
Will there be a fireplace? Depth of fireplace hearth . ./7r4.
Will a toilet be installed' . y.e J
Will a kitchen sink be installed and connected to water supply? 9 PJ
Water supply(public water supply or pump) Pa en P
Distance of cesspool from any private well /4 D feet
Will drainage system be provided with required traps,cleanouts, and vents? '9 'e -
Town of Queensbury AFFIDAVIT
County of Warren
State of New York
I swear that to a beafof my knowledge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, are a true and co.,.plete statement of all proposed work to be done on the described premises and that ag ptrmsions of the BUILD.
ING CODE,THE ZONING ORDINANCE,and all other laws pertaining to the pro wor shall be complied with,whether specified or not,
and that such work is authorized by the owner. f,^ ':/ '�,,``// �
Swom'm bel me this Signature ! ,--4„„ ict^L , 7V8 ,
�� �grc OWNER.OW ERSA EN .A WTECTICONTRACTOR
LET T day of _.Aee-, (._. _... 19
NOTARY PUBLIC. WARREN COUNTY. N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
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 // VS/ S'y Pr
2. Type of heat 42/e CPAG . 7
3. Is the building mechanically cooled? r✓
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 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
7z 3 �
2 . R value of exterior walls / 9
3 . R value of glazed area / , 2
4 . R value of doors 1 , d'
5. R value of floors over unheated spaces in //
6. R value of slab edge insulation - unheated slab /✓ /._
7 . R value of slab insulation - heated slab rrfi-
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 f0 u
D. Duct Systems
1. Is duct system installed in unheated spaces? YES 429
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 CoPPpa_
2. R value of pipe insulation ps/A
F. Service Water Ilea1in/
1 . Performance efficiency 9d 1p
2 . Temperature control setting maximum /APO "
G. For Swimming Pool only
1 . Maximum heating y//��� 1 �..(
Telephone No. 7f 3- 7 7 e ,F-t-
(applicant s signa ure
TOWN OF QUFFNSBURY
BUILDING 6 ZONING DEPARTMENT
SEWAGE DISPOSAL PERMIT APPLICATION
1. Owner's Name DiA0p il10 u4N -
Address t t Jc c- /LOT, ftroil a, . F-a Pb,i r(
Telephone No. _.
2. Property location .T.p ,,, k ,eSJ , I/P jzo,4d - ,. c Nn. iduny
3 . Name of person or firm responsible for installing system
(1J.49,M )4e Telephone No. ) ? 2, - OD tej
Address /2m R„_..t. ltoe - Pa 6w-w.S F..AI1S ,a ' v
4. Number of bedrooms (residential buildings only) 3 _.
5. Daily flow 4, O gallons/day
6. Septic tank capacity /p p V gallons
7 . Topography lot oiling, steep
% of slope c� /
6. Nature of soil and depth O _.
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: municipa1,411111 other
12 . Type of system proposed: drywell, tile field, other Cepc4 f. P / rf
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 th -
Queensbury Sanitary Sewage Ordinance. J/
Date "4' /7 -6-6 -- r✓L.�,L/y Cann �2 �'FfjKsz
signature cj1� applica
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.
/000 &It- %A.vIL
Form 3-82 IDCS T O x
4001534 THE NEW YORK BOARD OF FIRE UNDERWRITERS
[frig BUREAU OF ELECTRICITY 3
June 26, 1986 41 STATE STRE ET.ALBANY.NEW voilAda;<Ra
Date Application No.on file A M 66319C
THIS CERTIFIES THAT re J
only the electrical equipment ea ds d crib below end introduced by the Applicant named on the above application number in the premises of
Vaughn, Jenkensville Road, Queensbury, NewYork
x Outside
in the followingl�g�gl96 LJ Basementt El1st Fl. ❑ tnd Fl. Section Block
andb and to be in complianceLot
wasexamined on with the requirements of this Board. I
WWII FIXTURES RANGES COOKING DECKS OWNS DISH WASHERS EXHAUST FANS
OMITSMAC1E5 SWITCHES
INCANDESCENT iIIFLUORESCENTFLUORESCENT �yq pAYNM.• . ICW. AMT. R.W. •AT. R.W. WO. IC.W. MAT. H.P.
as DRYERS FURNACE MOTORS MIME ANDANCE MOM SPECIAL RICH TIME COCKS mu UNIT HEATHS MSULT TBT DIMMERS
.Wl. [.W ql N.V. 6A9 X., YAi, rq A W.G. ANi M1,. M1i. eN15. }RAMS. .W.T. N., NO.OP 1BT MM\. WAtR
g SERVE DISCONNECTWNO.OF S I I V I C I W
_ MU. W.F. TYPE pour, I/]W I S SW 3 N SW 3A SW NO.RC O. . Or CC CWo. No.a moo Of MNld Na.a moms gl',E.,L
1 200 Cb 1 x 1 4/0 1 2/0
_ 7
OTHER AWARAT S:
s
m
AJS Enterprises, INc. �57 _
i 4 Amy Lane Box 184
Glens Falls, NewYork 12801 BRANCH MANAGER
r`e % 1 L r
This certificate must not be offend in any manner;return to the office of the Board if incorrect. Inspectors may be identuf by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN AN MANNER.
TOWN OF OUEENGU
/► GEORGE KUROSAKA JR..F.E.
IEOP � Vz lJ
Wn BURBIRB SYSCE B X NO.660 ILIA i n ,y86
POET ALLS.N BOY RK 120 V
GLENS FALEB.N92-YO2 1300I P.M.
ulm Tealaz3 1 2 3 t 5 6
718191111�11� � .{. �. � .�.
a
13 ARBUTUS DRIVE
%/ OUEENSBURY. N.Y. 12801
e e/ PHONE SIB 792.153i
BUILDING INSPECTOR �b
Town of Queensbury re: Factory Manufactured Home
Town Hall Installation Certification.
Queensbury, New York 12801 C/
Attention: Mack Dean OL "' '- /s/
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: ///e,PG /7 / �
Site Illation: J�iK/HSa t-g., --�& l !i
Community: Town of Queensbury
County: Warren
Manufacturer/Supplier: RI TZ-CRAFT CORP or PA INC.
Address: P. O. BOX 70
MIFFLINBURG, PA 17S44
Insignia Serial No. 47 Z6/.3
Plan Approval No. X/ OP( Z'
Manufacturer's Model/Component No.: ZlirsicQ e2_ af8C- 4 Ate
Date of Manufacture: 4057-/fe1%t
Installer/Supplier: LAMPLIGHTER HONES
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.
•'OF NET:"...
Ei ... 4Resfull s mit ed5
0f KUBO@ {•
^Q' 0i.
_r'ttY O .
al' 13u
Inly } _ di' it GEORGE
-: i GEORGE KUROSAKA JR., P.E.
s ��• NYS PE Lic. No. 35869
cc: a N0,3sss• .?I
5tM7 cv Ya G thee CV-CAW 55
TOWN OF QUEENSBURY
Building Department
inspemors Date 6�/f�9/
Name /%a i,C.vt/
Location rcAflm,c U/GGE Sc*"
Permit No. g6 - /59 Weather
EwN h`nG 9/1 Remarks
ExccaaVation /'�
Footin Forms
Footing & Piers
Foundation
Cement Coat
Water roofin
Backfill
Final Survey
Framin• •
Shea thin. _
Roof Felt
ROofin•
Siding —
Masonr Veneer
Rou•h Pl.. . AMIE
Relief Valves
Eat. Board Aretak
Ext. Porches
Finished Floor
Interior Trim ,4007
Stairs s Railim s ✓d.
Cellar Dr. Tile
Concrete Floors
PI Fixtures
Gar. FireoroofrnDoor Closers
g I/
Chimne
Water Meter Inst.
Se tic A roval
Floors
Foundation
Insulation Walls
Ceilin
Building Inspector
REMARKS
5',sa ra D� ro.e (s) — r
FN,4 eetc.-7a(caa z>J5?-
_loan of Queendbury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road. R.D. 1 Box 98
Oueensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
•
NAME ,/ A-MDLl d tfrint -
LOCATION cflNiC(V5 via-b an-
DATE sieig6 PERMIT NO. gin- IS'-I
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length 2E70•1-.
Length of each trench 5.6
Depth of trenches - 2¢ '(
Size of gravel 3
SEEPAGE PITS{Number of)
Size- ft. X ft.
Gravel size
PIPING: Size Type
Bldg. to tank
Tank to dist. box
Dist. box to field/pit
Openings sealed? YES NO Partial
LOCATION/SEPARATIONS:
Foundation to tank l)_
Foundation to absorption '3r' ft.
Absorption to lot line ft.
Separation of pits ft.
LOCATION • SYSTEM ON PROPERTY(circle one)
Front - CCD - Left side - Right side -
COMMENTS:
SYSTEM USE APPROVED ES NO
Building Inspe or
01/86 and vl
TOWN OF QUEENSBURY
Building Department/
layeeters Repor Date �JL9��^
Name Vigil/ C
Locative MSI//LJ Rb
Permit No. A(o- 15'j Weather
Remarks
Excatation
Footing Forms
Footing o Piers �e�
Foundation
Cement Coat _ ��
Waterproofing
Backfill
Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rou h Plb .
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
Foundation
Insulation Walls
Ceilin
Building Inspector
REMARKS
TOWN OF QUEENSBURY
Building Department
h epeetme Date <! ' 7 Rbs;
' Name !/ U0741
' Location #VKA#V5 EZe- .ler
' Permit No. (n "!S`y Weather
Remarks
FootingiFo ��
Footing Forms
Footing & Piers CPC: .
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
Car. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval ..
Floors
Insulation Foundation
Walls
Ceiling
&tor
REMARKS
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