1986-167 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date March 9 19 _11
aV • ( 0— \ 7
This is to certify that req
uested uu ted to be done as shown by Permit No. 86-167
has been completed.
This structure may be occupied u a
Addition to dwelling - living area
Jay Road and on Glen Lake
location
Donald and Helen Miller
Owner
By Order Town Board
TOWN OF QUEENSBURY
/Zel
Building & Zoning Inspector
t BUILDING PERMIT
TOWN OF QUEENSBURY No 86-167
WARREN COUNTY, NEW YORK
ti
0
and Helen Miller oi
PERMISSION is hereby granted to Donalda
a
OWNER of property located at Jay Road and on Glen Lake Street,Road or Ave. a
in the Town of Queensbury,To Construct or place a
Addition to dwelling (living area) m
at the above location in accordance to application together with plot plans and other information hereto filed and 7
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
F`
1. OWNERS Address is RR #1 Box 1692 H
Lake George, New York
2. CONTRACTOR or BUILDERS Name
same
3. CONTRACTOR or BUILDER'S Addrs '—'
same w
ic
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a
4. ARCHITECT'S Name
C)
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D
7
5. ARCHITECTS Addrs rl
0
6. TYPE of Construction—(Please indicate by XI
I i Wood Frame I )Masonry 1 I Steel 1 1
7. PLANS and Specifications
No. 201x321 per plot plan, specifications and application submitted. y
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H.
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8. Proposed Use H.
One—Family Dwelling (living area added) o
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H O
H.
$5.00 C/0 Paid 0' S
$ 50.00 November 1 86 w
PERMIT FEE PAID-THIS PERMIT EXPIRES 19 0) w
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the rt 0
town of Oueensbury before the expiration date.) D 00
v
of April 86
Dated at the Town of Queensbury this 24th Day19
SIGNED BY %ad 0' ifica'e` for the Town of Queensbury
Building and Zoning Inspector Za
TOWN OF QUEENSBURY (Space inside block to Ix: hiked in by
WARREN COUNTY. NEW YORK Building haptaun)
.\I,pli,atiun No. '
Application for Pignut Issued19
BUILDING AND ZONING PERMIT 1'°"11
0
l'Apire 1"
fillingDiurio
\ slur id U'nrk I
THREE 131 Copies of a PLOT PLAN, Drawn to scale \ppio.,d by e ;
showing the actual dimensions of the lot to be built lorii:.ii kr
upon, The pact size. end location on the lot of the • . . .
building to be erected or altered MUST BE SUB- _
MITTED WITH THIS APPLICATION.
1/ 2 I — a p 1A- 3 -%-v
1 ✓ DUE
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK J J 7 I�J
ANSWER ALL OF THE FOLLOWING. 3f R 2 11986_ FGO.
The undersigned hereby applies for a permit to do the following work A M $S oafI t p*t5-P M.
which will 6e done in accordance with the description, plans and specifi- 71131911011.1112111 ,I3I4I5I6
cations. and such special conditions as may be indicated on the permit.
The owner of this property is: ,
. . .L�cmaNCv .\--14 G^eSR. ...?\Q.. . ..2 Th\ der C' WZ. ! Ok1b5.& , c:.kk. CJ1efne- 3`
IMA`nrl IPo LUDRESS, 1aOyJ
The person responsible for supervision of the work insofar as the Building Code and the Zoning Ordinance apply is:
. . . v.✓.gca.I./IA./0 a IrT 3,9Mrr As yeeVr ADORESSI
�CC,, I,^H�v MMFI
Name of Builder \✓;Prier Address
Name of Plumber. . . .Ea r Address
Name of Mason .61m Address . 6 � be
Lot Number Unit Estimated value of proposed work f 1 .93 0Q4. . . . . . . . . . . . . . . . . .
Name of Village . Z\ &..e.Cr F. Jzrt?f.5e2i:f-f
Name of Street . . .�]Q ('� Side of street: north ❑, east 51)• south 0. west ❑
Nearest Cross Street 2e-k. 294 lea Distance from this rrosa street /00 H.
Property is north 0,south ❑,east $,west 0 from Cross Street
11 on Corner, which corner,northeast ❑, northwest 0, southeast D. southwest
(Designate by marking with an "X" in the correct space.)
NATURE OF PROPOSED WORK OCCUPANCY
❑ Construction of a new building. Main Building
One-family dwelling ❑N Addition a building. Two-family dwelling
❑ Alterationemo to f building. -family apartment house 0
❑ Demolition o(• building. Store building ❑
-car attached garage 0
Other:
Accessory Building ❑
One-car detached garage' , 0
❑ Other work. Describe' •
Two-rat detached garage
Private chicken house ❑
Private storage building 0
Other:
ZONING SPECIFICATIONS. Fill in for new building,or addition to existing building,or a change of occupancy.
1 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
building(s) in solid line.
u fiTN. Size of property ICY ft. x . . ..2f.Z. . . . It.
--c RI Size and use of existing buildin�gRs, if any .2'X.y9. . .
'C z- Srncz " tlw'e2{1,y6-
c;�a M y Size of proposed building -3P . . ft.x `32 ft.
.EHeight(from grade tO ridge) _ ls5-� ft.
1.•� Front yard `i ft.
Side yards . . . �.e ft. and 410 ft.
Rear yard al . 7.1i' ft.
SOUTH If on corner,setback from side street N1/0 ft. -
Nose. All distances are net, as measured from street side
Iine to nearest part of building.
7-73—N
(coned.)
BUILDING SPECIFICATIONS,
Kind of construction: Wood frame,fire safe,etc.s a,rcc A RH-'gt
Will any second-hand lumber be uggd? . . . /.✓P. . . . . . . . II so, for what?
Material of foundation walls . . . . 110d.4'c'D. .C'OiCee7-4,- Thickness . . .St'.!Jc d'
Depth of foundation walls below grade Continuous foundation? $Ir.
Will there be a cellar? . . .YES . . . . . If so, material of cellar floor . C'On!Cetri
TypeSloped �L Material of roof . . . .�%f/I;/N.4%�f}!% <T of roof: or flat? . . .
Size,wood studs 2 "x Y " spacing . . . . /le. . . . . . ."o.c., length 8 . ft.
Size, floor beams, 1st floor 2 . "x /a " spacing . . . ./.4i. . . . . . ."o.c.,span . . . . tee. . . . . . . ft.
Size, floor beams,2nd floor "lc "x ", spacing "o.c.,span ft.
Size, ceiling beams .s'7TAItI. .C'r✓RSrxkt:ei.SS. . . . .", spacing . .?,7 "o.c., span IC, ft.
Site, roof rafters or beams . . .rid adrbx ",spacing 2/t / "o.c., span .3a ft.
Exterior finish O1447 ‘F. OnT?FN1 With what material? .'?Z.£'o06// '4 di-
Finish of interior walls. . . %R . .VS.//t'-tth 'tt/(
If garage is to be attached, of what material is wall between garage and main building to be constructed?
NuT. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Is there to be an opening between garage and building? p7N Ter :3</�F
Kind of heating system tic.r.ln/K Oil burner or coal? Old,
Will a flue-lined chimney be provided?//./. .YCS Depth of chimney foundation below grade '11
Height of chimney above roof AFC. Fr
Will there be a fireplace? . X.I$. .. .'7AL A Depth of fireplace hearth -in i S T/dG y
Will a toilet be installed? . /G.& (Sire. . . /. .).(/s.1746— 5Eari4 SrSseni
Will a kitchen sink be installed and connected to water supply? CX/S.t CAL F
Water supply (public water supply or pump) Pdml'
Distance of cesspool from any private well too feet
Will drainage system be provided with required traps,cleanouts, and vents? 'VS.
Town of Queenshury ) AFFIDAVIT
County of Warren
State of New York
I swear that to it. A,yrof my knowledge and belief the statement.contained in this application,together with the and spedfeadooe sub-
mitted,
mind, D true and ZONING
statement •d proposed work tort be done ro described .all be and that ether p the BUILD-
ING
CODE,THE ZONING ORDINANCE,and ell other Ewe pertaining b prnpord wadi Moll with,whether specified or no.
and that• h work is•uthodrd by the owner.
Sworn to beforeme this Stratum 3n, y ys.
d• I ._U\.1dC`\ . IYO \Q-9- - N .•RC _ .[ONTR•CTOR
O
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 76 G f
2 . Type of heat fill, I/0Ti9ilf
3. Is the building mechanically cooled? /SIG
4 . Percentage of area of windows and doors
A. Over 16% Only
1 . U value of gross area of walls , roof/ceiling and floors
exposed to ambient conditions Ms- 30
2 . Floor over heated spaces (fESD NO
a. Are foundation walls insulated? Lr- NO
1 . If YES, what is the R value? es, y
3. Slab on grade YES (..N2.)
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 Jl`(
5. Type of insulation yll NC lC//P/Y
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 unheated spaces
6. R value of slab edge insulation - unheated slab
7 . R value of slab insulation - heated slab
8. A 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 to
D. Duct Systems
1 . Is duct system installed in unheated spaces? YES
a. If YES , A value of duct installation
b. R value of duct in other areas
E . Piping Insulation ��// ri
1 . Size of hot water or cooling carrying agent pipe u/�/
2 . R value of pipe insulation
F. Service Water Heating
1. Performance efficiency >/
2. Temperature control setting maximum (jl0
G. For Swimming Pool Only
1 . Maximum heating
p
Telephone No. 1� 0-3(O"t I -\QrC U'/) 1.7A si /Z
(applicant ' s (signature)
1C0-5Q81 w0K da.Ha \r�
Calls® afa sir
t. awn of Qurand urn
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR' S REPORT
NAME
LOCATION lriu._
Date aril / a4 Permit No. K G—/G
* * * * • * • • * * * * * * * * * * * • * • •
{/ a APPROVED - YES NO
Footing/Pier Forms
Foundation _
Waterproofing _
Backfill _
Framing _
Roofing _
Siding _
Masonry Veneer _
Rough Plumbing _
Relief Valves
''Ext. Porches eafCTAnAingrazi
Finished Floors _Interior Trim _
Stairs & Railings _
Cellar Drain Tile _
Concrete Floors _
Plbg. —�
Gar.. Fireproofing _Door Closers � '
eke Detectors
Chimney A
INSULATION: =_�
LFloor ation Ir�
Floors Wil
ls
Ceiling /mows
FINAL ELECTRICA INSPECTION �'
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks- l7 g
Oda Itt.ACein
G/Yl�
Building Inspector
6/86 and-vl
own of Queendbury
BUILDSNG and ZONING DEPARTMENT
ay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAMEf ^_ /I
LOCATION 1///` 63 6 z
Date/s2 / Permit✓No'..34 "TO
* * * «A ✓ = APPROVED -
rr��--rrYES J NO
Footing
Pier Forms
Foundation
Waterproofing
Backfill
Framing
✓Roofing 27111
Larding •
Masonry Veneer
Rough Plumbing
belief Valves EJU5T/NG 7-4144- Dr ,C
Wit. Porches r/QT' Datil;
finished Floors p,K
kterior Trim V nn,�
/dtairs 6 Railings £li67/NL CEIA}/l (,W.
Cellar Drain Tile
Concrete Floors
4(bg. Fixtures O
Gar. Fireproofing h/
Door Closers
)..bcoke Detectors 14Cr / 5oi/f0 ✓
Chimney
t NSULATION:
Foundation _ioT to"
0M net p (/
Floors
Walls
Ceiling _ V
FINAL ELECTRICAL INSPECTION N � Yt
DRIVEWAY APPROVAL Y41�IG'�
Final Building Survey
Next scheduled inspection (call when ready)
Remarks- Go at 4l/ Q/`
Dui nctor
6/86 and-vl
co // D /ael84/
flown Of Queenlbury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR' S REPORT
NAME 14.
QIey, yfl JI,e1 _
LOCATION TG1 nl � Id ' C. 1-Q KC
Date /ef /J y(r Permit No. $ G _ ( G7
•
✓ = APPROVED - YES J NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer e
a'Rough Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing /
Door Closers
Smoke Detectors
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks 6,
i
Building Ins ectorigli
6/86 and-vl
tail -Pcj� b15/h& lom//w
Town o/ Queendtury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Oueensbury, New.York 12801
BUILDING INSPECTOR' S REPORT
NAME Dong !4 1- N.e/eH 1fl Jjt>_
LOCATION 1-
J � V\J_ a/ en L..fi/fC
Date R /// / 36 Permit No. 8 (p -1G7
* R * * * * * * * f f * f f * f * * * * * *
✓ = APPROVED - YES J NO
Footing/Pier Forms I
Foundation
Waterproofing
Backfill
l/Framing at{
Roofing ``��
Siding
Masonry Veneer
I Vallvesg
Aeliof ef Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Smoke Detectors
Chimney
INSOLATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
Final Building Survey
Next scheduled Inspection(call when ready)
Remarks- -
V
Building Inspector
6/86 and-vl
Jown of Qucendbury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR'S REPORT
NAME
eD,2. ///111
LOCATION
g.
Date/Jy / Permit No. 86 — 1 (97
* * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES J NO
Footing/Pier Fyiec I
Foundation (2K
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. Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
Final Building Survey
Next scheduled Inspection(call when ready)
Remarks- -
Bui in nspector
6/86 and-vl
bc4 94D 117 ILL It
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