1986-218 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 19
This is to certify that work requested to be done as shown by Permit No. 86-218
has been completed.
This structure may be occupied as a
One-Family Dwelling
Lot 563 Fox Hollow Lane (St. No. 43) Section 14 Westland
Location
Stephen Dew
Owner
By Order Town Board
TOWN OF QUEENSBURY
Building b Zoning Inspector
BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-218
WARREN COUNTY, NEW YORK
Stephen Dew
PERMISSION is hereby granted to
OWNER of property located at Lot 563 Fox Hollow Lane (St. No. 43) Street,Road or Ave.
in the Town of Queensbury,To Construct or place a
One-Family 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. - rr
1. OWNER'S Address is 216 Aviation Road
Glens Falls, New York m
2. CONTRACTOR or BUILDERS Name Elwood Greene
3. CONTRACTOR or BUILDERS Address
44 William St.
Glens Falls, New York
4. ARCHITECT'S Name
0
5
5. ARCHITECT'S Address
0
to
w
6. TYPE of Construction—(Plane Indicate by X) 0
re
(X)Wood Frame I )Masonry ( )Steel 1 1 m
rt
7. PLANS and Specifications o
58'x44' per plot plan, specifications and application submitted
No. including sewage system and two-car attached garage.
8. Proposed Use
One-Family Dwelling no
m
5.00 C/O Paid
$ 178.00 December 1 ig 86
PERMIT FEE PAID -THIS PERMIT EXPIRES ,<
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the O
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 14th Day of May ig 86
SIGNED BY /Y'LLGIe+ a. ��r, for the Town of Queensbury
Building and Zoning Inspector /`�p/p
TO BE COMPLETED BY BLDG. DEPT.
Application No.
awn of Queenihury Permit Issued 19 TOWN OF QUEENSEU:"'
BUILDING and ZONING DEPARTMENT Permit Expires 19
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation SFR-20
Dueensbwy, New York 12801 variance No. ,f No. N�'A MAY 9 1�
Site Plan Review No.
86
Approved by AM. 493••1e�o
?18p91;° * 32I8I4I5IB
APPLICATION FOR p
BUILDING AND ZONING PERMIT 1 "`'''`e 02
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *::*
A,YERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. ANSWER ALL OF THE FOLLOWING.
The undersigned hereby applies for a Building Permit to do the following work which will
be done in accordance with the description, plans and specifications submitted, and such
special conditions as may be indicated
icateI on the Permit.
`
The owner of this property is: AU.
)eu)
P.O. Address 2//0 AJI �I p. ,on A�. t�. G/On5 ,a'--//5 A JY• /2:80/ Tel. 79 Z -0390
Property Location: LOt5V3 PDX /l0//08) LCtne ST.xt . ' 3Tax Map No. '77// / I
Street number or building(blot number
/
Subdivision name (if applicable) We-51/OL•+OG - Sec-71'on /,Y
THE PERSON nRESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
£IWODO( GCano V41 /J, ll,tz.,.,., 57 6/e45`e-11s N,1!/zsrvl 793- 7/1//0
Name .P.O. Address / / Tel. No.
/
Name of builder C 1o000.a 6CE£nc Address 9,/6Ji//,'p.,,.. ,51: �eersic �S Tel. 753-7/41/o
Name of plumber S.n Corheoae Address npouyp:t) %V. Tel. 79 Z- SZ7O
Name of mason 7 h„ Sorb, al Address fiendet FEL ✓eison P,:a5 Tel. 797 -0VSZ
NATURE OF PROPOSED WORK: * ZONING INFORMATION:
)‘Construction of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED,
_Addition to a building * drawn reasonably to scale and attached hereto,
_Alteration to a building * showing clearly and distinctly all buildings,
(no change to exterior dimensions) * whether existing or proposed and indicate all
Other work (describe) * set-back dimensions from property lines. Give
_
* street and number or lot number and indicate
* whether interior or corner lot. Show location
FOR DEMOLITION PERMIT, STATE SIZE AND * of water supply and location and configuration
LOCATION OF STRUCTURES AFFECTED. * of septic disposal area.
*
* COMPLETE INFORMATION REQUIRED BELOW. /,,
* Size of property a;5.7A ft x / O./Oft.
* Existing building(s) Size -- ft X ft.
*
PROPOSED BUILDING AND USE: * Existing building(s) Use ----
SizeSize of new structure .SS ll ft X �Y/ ft *
Foundation-pier/slab/crawl/partial r * Proposed building, distance from property line
(circle one) * '
ft
No. of stories (habitable space) Z * Front yard 4'o ft Rear yard 70 ft
Height (grade to ridge) e_ ft. * Side yards AO ft and 7 �/
* If on corner, setback from side street go ft
If residential, no. of families Sin /e
No. of rooms(excluding lI,b,aths) 9 9 * OCCUPANCY INFORMATION
No. of bedrooms K *
* PRIMARY BUILDING -
No. of bathrooms 2YY • X One family dwelling
Primary heating system (a, {/of'W0.4'Ce * Two family dwelling
Type of fuel a-„...., * Multiple dwelling / Number of units
No. of fireplaces to be installed permanent occupancy
Will a wood stove be installed? }�e s *• Transient occupancy
Central Air conditioning? /Jo * Business
BUILDING STYLE, PRIMARY STRUCTURE * _Industrial
Other
Ranch Contemporary Log cabin *• If addition, what will use be?
Raised ranch Mansion Duplex
Split level Old style Bungalow *
Cape Cod Cottage Other * ACCESSORY BUILDING-
(Colonial ) Row Town House Detached garage/one car/ two car/ car
( CIRCLE ONE PLEASE ) * X Attached garage/one car/ two car/ Z. car
* * * * * * * * * * * * * * * * * Private storage building
ESTIMATED MARKET VALUE OF Other
CONSTRUCTION *
$--/0/ 000 ^
INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
Form BPA 4/86 and-vl
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS: II�� ee nn
Type of construction, wood frame, fire safe,etc. W,,eo 0. reo-vied
Will any second-hand or ungraded lumber be used? If so, for what? ,Jo
Foundation wall material Concc.}G BIoc,k Thickness hp "
Depth of foundation below grade (to bottom of footing) Co '
Will there be a cellar? t:S Heated or unheated? Dnl1eafej, Floor sq. footage 2374 sq ft
Will there be a basement? '/.5 Will any portion be used as living space? NO
(If so, what portion? sq.ft. - - Type of use?
Type of roof - sloped/flat/shed/other$/opj Material of roof P) weorr
Size, wood studs "X " spacing /6 "o.c. length p' ft. i
Joists(floor beams) 1st. floor z "X /0 " spacing /(o "o.c. span /3 eft.
Joists (floor beams) 2nd. floor L "X /p " spacing /(, "o.c. span /3.Oft.
Overlays(ceiling beams) 2, "x ce/S" spacing //o "o.c. spanaLerrft.
Roof rafters 2 "X , " spacing /6, o.c. span /y' ft.
Roof trusses(pre-engineered) spacing "o.c. span ft.
Exterior wall finish !tee Of what material? �LX(o Spr,oe
Interior wall finish Yt"Pr „fO#./I
If a garage is to be attached; describe materials to be used for FIRE SEPARATION:
Is there to be an opening between garage and dwelling? '/t5 tf so will a Fire-rated
door, enclosure, and self-closing device be provided? �e 5
Will a flue-lined chimney be installed? Yes Height above roof 3 ft.
Depth of chimney foundation below grade L/ ft.
Depth of fireplace hearth — ft. -- in.
' Water supply - Municipal or private well /i'f,en,•o,�y/
SEPTIC SYSTEM _ Distance from ANY private well(intluding adjoining properties,VO4e ft.
(A separate application is necessary for any repair or new installation of septic system)
Town of Queensbury
County of warren AFFIDAVIT STATE OF NEW YORK
I swear that to the best of my knowledge and belief the statements contained
in this application, together with the plans and specifications submitted, are a true and
complete statement of all proposed work to be done on the described premises and that ell
provisions of the BUILDING CODE, THE ZONING ORDINANCE, and all other laws pertaining to
the proposed work shall be complied with, wheth specified or not, and that such work is
authorized by the owner.
SWORN TO BEFORE ME THIS Signature
er, owner's agent,arcnxcect,contractor
- day oft 19 X
ELIZABETH D. COLE
Notary Public, State of New York
_'C No. of
8704
Warren
NotaJPublic, Warren ounty, N.Y. County a Marren
y Commission expires .y 30, 19
% # R R R # R R R # R * * * * * * * f # R R R * * * * * * * * * * * * * * * * * * f # * * *
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 Z37:0 $,r
2 . Type of heat (0-5 of W0.7Ler
3. Is the building mechanically cooled? /V f3 �j
4 . Percentage of area of windows and doors /o. 8 %,
A. Over 16% Only
1 . Uo value of gross area of walls , roof/ceiling and floors
exposed to ambient conditions
2 . Floor over heated spaces YES NO
a. Are foundation walls insulated? YES NO
1 . If YES , what is the R value?
3. Slab on grade YES NO
a . If YES, what is the R value of insulation around
perimeter of floor?
4 . Is basement heated? YES NO
a. R value of insulation
5. Type of insulation
B. Under 16% Only
1. R value of roof and floors exposed to ambient conditions
Q- 3$
2 . R value of exterior walls £- tC?
3 . R value of glazed area ie- 2-
4. R value of doors 2 /4T0 /
5. R value of floors over unheated spaces te-/Z
6. R value of slab edge insulation - unheated slab A//iq
7 . R value of slab insulation - heated slab 111 e /&'(p
B. R value of heated basement/cellar walls (above grade) NA-
V. R value of heated basement/cellarfl walls (below
grade) /U2/4-
10. Type of insulation Y� OZrq /A55 Pi1Ew0/1G /�O[yw.
C. Controls J O
1 . Thermostat maximum heat setting So
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 iy! /2 ••
1. Size of hot water or cooling carrying agent pipe '��
2 . R value of pipe insulation NoA/E
F. Service Water Heating qq
1 . Performance efficiency 8 < n
2. Temperature control setting maximum /410 v
G. For Swimming Pool Only Al
1 . Maximum heating ,V /
-� Telephone No. 9A �O 3'7 O (n ` - �"* �
r (a licant ' s signature)
. : cc77
2wn of Queenilury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Oueensbury, New York 12801
SEPTIC DISPOSAL PERMIT APPLICATION
Owner ' s Name 571-e fines b''//ens Tel. 79z-0390
Address tot .SG Fpx Ho 3 %IJ La.H e-
Person/Firm installing system 2;ctna-rd tee Exco..vO4'2' r5
Number of bedrooms (residential only) 171
Total daily flow: (compute @ 150 gal.per bedroom per day)_ 6,00
Topography: flat mEro li - steep - (circle one) Decree of slope 9 R
Nature of soils: Ftandloam-clay- other- Depth &j ft.
Ground water-- at what depth? /0 ' ft.
Bedrock or impervious material--at what depth? —'ft.
Percolation Test - Not recuire Required -Rate 0^1J'- min/inch.
Domestic Water Supply -Municipal' - Well - Other
IMPORTANT!
Or a separate piece of paper, submit a diagram of the proposed septic
system with all dimensions; including distance from any structure,
distance from property lines and distances from any domestic water
supply or shore-line of lake, stream, pond or wetlands. Include all
dimensions of the system itself .
Description of proposed system:
Septic tank size /000 gal.
Tile field- Length of each trench_ SO ft. Total field_ZSb ft.
Size of stone # Z
Seepage Pit (s) Number / Size ftX__ft. Size of stone#
•
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 Town of Queensbury Sanitary
sewage Ordinance.
S gnat re of Applicant Date
01/86 and/vl
Septic System Inspections:
A. All applications for septic system installation,
alteration or repair, as required by the Town of
Oueensbury Sanitary Sewage Ordinance, shall be
submitted to the Building Department at least
24 hours before start of construction and shall
include a plot plan showing:
1) the proposed location of the system
2) location and distance to lot lines
3) location and distance to structures
4) location and distance to any water supply
5) size and dimensions of all tanks, distribution
boxes, tile fields and/or drywells
B. No system shall be covered before inspection and
approval by the Building Inspector. Failure to
comply with this requirement may result in the
uncovering of the system by the installer and a
fine of up to $250.00.
C. An approved copy of the plot plan shall be
available ,on the construction site. Failure
to produce said plot plan at time of inspection
may result in an immediate work stoppage.
D. Should unforeseen problems during construction
prevent proper installation, alteration or
repair of an approved system, a new proposal
must be submitted to the pueensbury Building
Department before further construction .
02 : 3GPh^
Jow,r of Quee„itury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Clueensbury, New York 12801
riie
BUILDING INSPECTOR'S REPORT
NAME <o A„e f o 3
LOCATIONL/ 3 ¢ay /h//CaA,,/a *'
Date /)— / Permit No. Erc, -)/p
1/ - APPROVED - YES / NO
Fro* * *
t Pierarms
Foundation
waterproofing
Backfill
Framing
Roofing 2I
ceding
Masonry Veneer
Rough Plumbing
klief Valves a K ✓
(fit. Porches Not /om Pl i
.45Rished Floors I
etJ� ter io r Trim }
stairs & Railings�k.Qr
Cellar Drain Tile
Concrete Floors
�Plbg. Fixtures n
Vr. Fi reproof ingj�jG rn.a.rl K
£LGor Closers
Coke Detectors 0
%C imney
i"INSULATION:
Foundation �.
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION ,
DRIVEWAY APPROVAL lJ
Final Building Survey
Next scheduled inspection (call when ready
y
Remarks- _ 1 O�
,ti-t
e_ ' g 3
U U 24,51 3 sl
Building Inspector
6/86 and-vl
ea w t, g/ao/8G 9: //a - frt1
J70wn of Queenabury
BUILDING and ZONING DEPARTMENT
Bay and Raviland Road. R.D. I Box 98
aueensbury, New York 12801
BUILDING INSPECTOR'S REPORT
NAME St ¢ D (Ai
LOCATIONt 3 Fe ewLG>' e.
Date L /i, Permit No. U. L2J
* * * * * * * * * * * * * * * * * * * * * *
c APPROVED s YES NO
Footing/Pier Forms _
Foundation
Waterproofing _
Backfill F
V Framing RA
Roofing
Siding
Masonry Veneer fall
Plumbing _
Relief Valves _
Ext. Porches _
Finished Floors _
Interior Trim _
Stairs k Railings _
Cellar Drain Tile _
Concrete Floors _
Plbg. Fixtures
Gar. Fireproofing
Door detect �=
Smoke Detectors
Chimney -
INSULATION: Alll
Foundation
Floors =
Walls _
Ceiling
FINAL ELECTRICAL INSPECTION
Final Building Survey
Next scheduled Inspection(call when ready)
Remarks- -
C •ellar dc.- 'rt
Bui ding nepector
6/86 and-vl
flown o/ Queend1urri
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. I Box 98
Oueensbury. New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME STE-VF- A6L✓
LOCATION rvy FA1Pn9 Rn
DATE 3/7 / 4(0 PERMIT NO. 86— air
SOIL TYPE Loam - Clay -
Percolation� /�
Required? YES lNO
I Percolation rate - Min/Inch -
TYPE of SYSTEM: r IAbsorption field, total lengthrr4VD
Length of each trench SS- uf'
Depth of trenches 7.
Size of gravel_
SEEPAGE PITSENumber of) _
Size- ft. X ft.
Gravel size
PIPING: Size Type
Bldg. to tank 1u VO
Tank to dist. box
Dist. box to field/ry _ partial
Openings sealed? 1IiS��7
LOCATION/SEPARATIONS:Foundation to tank 1 ft.
Foundation to absorption Aft.
Absorption to lot line h—ft.
Separation of pits ft.
ON OF SYSTEM ON PROPER one)
•T
Rear - Left side - -
S:
SYSTEM USE APPROVED
(�/1/y�{4�/�J��N'OO-�'^�'\J
Building Inspector
01/86 and vl
17,76-5
TOWN OF QUEENSBURY
Building Department
Inimmerr Report Date IP7��4,
Name Sre v& - f)MW
iae.0an Fox i4G; ow 4- An F4-12,0-4
Permit No. 86 -]I 8 Weather
Remarks
Excadatlon
Footing Forms
Footing a Piers -
Foundation -
Cement Coat -
Waterproofing -
Backfill ✓ O -,
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 Dz. Tile _
Concrete Floors _
Plbg. Fixtures _
Gar. Fireproofing _
Door Closers -
Chimney -
Water Meter Inst. -
Septic Approval _
Floors
Foundation
Insulation
Bu ding Inspector
REMARKS
X O 5ML C0AnAA, -
f3an�� WUA- ts 13&1(046- B3ytt-KA(
!troy 1 Priblflom /M'
TOWN OF QUEENSBURY
Building Department
lnopeetaa Report` Date s/iV,86
Name
Location 4 k Not COW
Perm No. AG - .119 Weather
Remarks
Eootingion �/1110
Footing Forms (_J�
Footing 8 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
Foundation
Insulation Walls _
"Ailing
[ it° ui i' Inspector
REMARKS
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