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1985-284 CERTIFICATE 01+ COMPLIANCE, TOWN OF QUEENSBURY WARREN COUNTY , NEW YORK Oa to October 18 , 19 85 . V4 - - ' This is to certify that work requested to be done as shown by Permit No . 85 - 284 has been completed . This structure may be used as a Inground pool Location ^L 3 Revere Road Owner Lawrence Dale Sampson 'Pax Map # 125 . - 4 - 20 By Order of Town Board TOWN OF QUEENSBURY r Director of Building R Code Enforcement BUILDING PERMIT TOWN OF QUEENSBUR i No. 85 - 284 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Lawrence Dale qampsnn OWNER of property located at Lot. 20 Revere Street, Road or Ave, C] !a in the Town of Queensbury, To Construct or place a Swimmincf Pool C7 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. G VYNER"S Address is RD # 3 Revere Road 0 Glens Falls , N . Y . a. CONTRACTOR or BUILDER 'S Name Daniel Sprague ' s Mermaid Pools 3. CONTRACTOR or BUILDERS Address t s O rt 294 Broadway Fort Edward , N _ Y . CCp 4. ARCHITECT'S Narne `,U (D C (D F; (6 S. ARCHITECT'S Address O iy !Z 6. TYPE of Construction — (Please indicate by X) ( ) Wood Frame I ) Masonry ; ) steel ( ] 7, PLANS and Specifications 18 ' x36 ' inground SWXnuaing pool ( steel/vinyl ) No. per plot plan and application submitted , B. Proposed Use V Fj- Swimming Pool La I'd 0 O $ 15 . 00 PERMIT FEE PAID --- THIS PERMIT EXPIRES ,January 1 19_$ (if a longer period is required an application for an extension must be made to the Building and Zoning inspector of the town of On son sbury before the expiration date.) Dated at the Town of 0ueensbury th is - y12 th Day of Jurxe SIGNED BY I' V I ad 0 . .,e, for the Town ©f Queensbury Building and Zoning Inspector7� TOWN OF Q►UEENSBURY (tir,aee inside Mork to lw fitted in kn WARREN COUNTY. NEW YORK Building; lnslumcig r) Application for \pplifalion Nm l}C'r ,l1 FF I,:.FFed l9. BUILDING AND ZONING PERMIT } .spires . r �r . THREE ( 3 ) Copies of a PLOT PLAN, Drawn to scaly \ � ,r " r ,� r•rl !,� � + -� showing +he actual dimensions of the lot to ba built upon, The exact size, and location on the lot of the building to be erected or altered MUST BE SUB- MITTED WITH THIS APPLICATION, TOWN CIF QUEENSBURY narF Va 0 A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK J U N i 2 1985 ANSWER ALL OF THE FOLLOWING, A.M: /,� =' re c e The undersigned hereby applies for a permit to do the following work .?I ,a19 0 v 11213141616 im which will be done in accordance with the description, plans and specifi- s _ 11 _ .. s Q cations, and such special conditions as may be indicated on the permit. The owner of this prapert is: /-.�. 0; A, . . . SOOVAPPs .v.Yt. . - . ,�r'C �C ,�K'Gam. . !�' d. . . - . . ,/�r'/.�' ''�-�'--} .�#e!',-.A!r •�."�lZloo(vj (NA"G} IP O ADDRES54 The person responsibiw for supervision of the work insofar as the Building Code and the Zoning Ordinance ap plv i,: . . _S �►.�,�'s�y . . . . . .yr'�4 �. ° . . . .�'a' - . �^� (NAME) fry O AODRESSI �t / Name of Builder . +[ � � iU. . . -RIR -u. . . . . . . . . . - - - ' - - - - Address O'79 'F1 d!g?o !7` SJti �7y . . ./oc�-7.7 _ Name of Plumber . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . - - . . . - - . - . - - . . . . . . . . . . . . . . . . Name of Mason . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . Address . . . , . . . Lot Number . . . . cry . - . Unit . . . . . . . . . . . . Estimated value of proposed work S . . j.Q . . . . . . . . . . . . . . . . . . . . . . Name of Village . . +pQqe-f .. - ri v.�Q.t . . . . G.G>.5 . . . . . . . o. r•, r S . b G+ .,4 .y.' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Street . -W*e,v, eX e. . . A CL . . . . . . . . . . . . . . . . . . . . . Side of street : north X east 0 . south CI . west 0 Nearest Cross Street Vo g4 f . . . }1+?r7 4 . !� 1>+IJlP . . . . . . . Distance from this gross street . . . a? .S. O. , . . . - - l'r . Property is north ❑ , south , east i i , west 0 from Cross Street If on Corner, which corner, northeast L1 , northwest ❑ , southeast southw , (Designate by marking with an "X" in the correct space_) NATURE OF PROPOSED WORK OCCUPANCY 0 Construction of a new building. Main By3Itling C) Addition to a building. C7no4am lv dwelling Q Alteration to a building. Two family mily pa � © Demolition of a building_ -family apartment hove Store building . . -car attached garage L7 Other: . . . . . . . . . . . . . . . . . . . . . . . . . . . . Accessory Building f One-car detached garage Other work. Describe: . Y i t u . . . . . . . . Two-car detached garage �± r Private chicken house �•�..' 1 t'ta .h? I t!L . . . . G1 G .�. . . . . . . / •cF . . .�C: .�Ei ''� ,/r J Private storage building 400001Ay! /'� . . . . . . . . . . . . . . . . . . . . Other: . . . . . . . . . . . . . . ZONING SPECIFICATIONS. Fill in for new building, or addition to existing building, or a change of occupancy. i Indicate on the plot plan street names, the location and size of the property, the location, sure and setbacks of pro- NORTH posed buildings, and the location of all existing buildings. Show proposed building(s) in dotted line and existing lauilding(s) in solid line. Size of property . . . . . . . . . . . . . . . ft. x ft_ Size and use of existing buildings, if any . . . . . . . . . . . . . . . . . . . . . . . . . . . . W K e W Size of proposed building ft. x ft. Height (from grade to ridge) . . . . . . . . . . . . . ft. Front yard . . . . . . . . . . . . . . . . . . . . . . . . . . . . ft. Side vards . . . . . . . . . . . . , . . ft. and . . . . . . . . . . . . , . . ft. Rear yard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ft. SOUTM If an to corner, setback from side street • m sire t ft- Note.-Note: All desranees are xei, as measured from street side line to nearest part of building. �'7 7y{ (OVER) ry " 3, .X f cont'd. BUILDING SPECIFICATIONS.. Kind of construction: Wood frame, fire safe, etc,? . . . . . . . . . . . . . . . . . . . . . . . . . Willany second-hand lumber he used? . . . . . . If so, for what? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Material of foundation walls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . T%ickness . . . . . . . , , . . . . . . . . . . . . Depth of foundation walls below grade - - • • • . • . . . . . Continuous foundation? _ . . . . . . . . . Will there be a cellar? - - . . . . . - . . . . If so, material of cellar floor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Type of roof. Sloped or flat? . . . . . . . . . . . . . Material of roof . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . Size, wood studs . - . . . . . . . . . . . . . . . . . . x . . . . . . . . . . . . _ . . ", spacing . . . . . . . . . . . . . ."o.c., length . . . . . . . .. . . . . . ft. Size, floor beams, 1st floor . . . . - . . . . . . . " x . . . . . . . . . . . . . . . ", spacing . . . _ . . . . . . . . . . "o.c., span . . . . . . . . . . . . . . ft. x spacing . . . . . . . I . . . . . . "o.c., span ft. Size, floarbeams, 2nd floor - . . . . , - . . . . . . . . . . . . . . . . . . . . , . , . . . . . , , - Size, ceiling beams . . . . . . . . . . . . . . . . . . " x . . . . . . . . . . . . , . . ". spacing . . . . . . - - . . - - . . "o.c., span . . . . . . . . . _ . . . . ft. Site, roof rafters or beams . . . . . . . . . , . . " x . . . . . . . . . . . . . . ... spacing . . . . _ . . . . . . . . . ..ox., span . . . . . , . . . . . . . . ft_ Exterior finish . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . With what material? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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? . . . . . . . . . . . . . . . Depth of chimney foundation below grade . - . . . . . . . . . . _ . . . Height of chimney above roof . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ _ . . . . Will there he a fireplace? . . . . . . . . . . . . . . . . . . . . . . . . . Depth of fireplace hearth . . . - - . . . . . . . . . . . _ . . . . . . . . . . . . . . . Will a toilet be installed? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Will a kitchen sink he installed and connected to water supply? . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . . . Water supply (public water supply or pump) . . . . . - . . . . . . . . . . . . . . . . . . . . . . . . , . . , . . . . . . . . . . . . . . . . . . . . Distance of cesspool from any private well . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . feet Will drainage system be provided with required traps, cieanouts, and vents? . . . . . . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . Town of Queenshury AFX IDAVIT County of Warren State of New York I swear that to rr. Ada tof my knowledge and belief the statements oontoined in this application, together with the plans and specifications sub- mitted, are a true and oo.,. lete statement of all proposed work to be done on the desert nd that an }salmons of the BUILD- ING CODE, THE ZONING ORDINANCE, and all other iaws pertaining to w @lull be Tilled , whether specified or not, and that such work i@ outhuorised by the owner. Sworn to before me this Signature . �OW R. O NT, ARCHfT T. CONTRACTOR dayof . . . . . .. . . .. . . . . .. . . . .. . . .... . . . . . . _. . 19. .. . . .. .. . NOYhRY PUB1.1c. WARREN COUNTY, N. Y. SPECIAL CONDITIONS OF THE PERMIT: By .. . . ... . ...... . ..... . . ... .. ..... . . . . ... . . .,,-. . . .... . . . .--... . . ... . .. TOWN OF Ql,I��EENSSU RY Building Department w Par=& No. - weftthe: 1 45 F 00 sterna rJcs Excartia is on Footing Forms Footing B Piers Foundation Cement Coat Water roofi n E� Backe-ill Final Survey -- Framing Sheathing Roof Felt Roofin Sidingr Masorrr Veneer Rou h Pl Relief valves wall Board Ext . Porches Finished Floor .Interior Trim stairs & Railin s Cellar Dr . Tile Concrete Floors Plbg, Fixtures Gar .. Fire roofs.n Door Closers ChImnell Water Meter xnst . Septic AEEroval Floors Insulation Foundation walls Ceilin ---_.._............__•___ A.1 JVLS.LJ J � BuPW ilding Tnsgector REMARKS THE NEW YO► RK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY Fa � 41 STATE STREET, ALBANY, NEW YORK 12207 July 31 , 1985 �PPlication No. on file 084998- 85 A 64508 TI4IS CERTIFIES THAT 77 only the elactrical equipment as described below avid lntro&aced by the applicant nomad on the aboar ap Acoviors number in the premises of L. Sampson , Mere Road, QueensburyP ►dew York in the follateing location; ❑ Basement ❑ 1st Fl. ❑ Vnd Fl. Section 125 Block 4 Lot 20 aces examined an 7/10/85 andfound to be in compliance with the requirements of this Board. - RXTWE Et1IgPT1LCLE5 SWITCHES RXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OLtTLETS JNCANDESCENtl KLICRESCENT y AMT. K. W. AMT. K W. AMT. K.W. AM'F- K. W, AMT. H. P. DRYERS FURNACE MOTORS FUTURE AFMJwNCE FEEDERS ISIPSCIALMVPTI TIME CLOCKS I EELL umir HEATERS MULTI-OUTLET DIIIAMERS K P, - MS AMT. C W. OIL H. P, GAS H. P. AMT. NO. A. W, G. AMT. AMP. AMT. AM . TEAKS. AMT. 5 Cf fFEET PS AMT. WATTS NO. OF = rr SERVICE DISCONNECT NO. OF S E R V I C E AMT. AMP. TYPE EOUIF. 1 R' 2W 1 A' 3W 3 0 3W 3 JP 4W �� GpER�ie'CONO. OF CC COND. �. 4P XFIEG ��H�� NO- OF NEUTRALS OF. WU G. AIL OTHER A"ARATUSs 1- G. F. C. 1 . motors : 1- tip . Th:Ls cexti.flca.te covers compliance at date of Inspection only . Because. of 1 a3 isual = ermi.ror>cments it is advisable to have frequent tests &/or repairs made by rk qualified person. Il�T PEC�1-CO�T IFEE 1'A LaWL G'7.7CC seapson Reverie Road R.D. f3 BRANCH MANAGER Glens Fails , New York 12801 Per COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. u � r M1� +.Y, �. � . 1 Y ■ l � + h o 4