1986-198 . 1
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 19 —
X,\ % 86-198
Th tbertih tothat work requestedbe done as shown by Permit No.
has been completed.
This structure may occupied as a
One-Family Dwelling
Location 1 0 Lyndon Road (Section 4 Rolling Ridge)
Dr. Richard and Lois Udall
Owner
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoning Inspector
. 4 BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-198
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Dr. Richard and Lois Udall
OWNER of property located at Lot 50 Lyndon Road (Rolling Ridge) Street,Road or Ave.
in the Town of Queensbury,To Construct or place a One-Family Dwelling
asl
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.
a
1. OWNER'S Address is
Glen St.
Glens Falls, New York
0
2. CONTRACTOR or BUILDERS Name
Ruggles Construction a
w
a CONTRACTOR or BUILDERS Address
5 Wincrest Drive
Glens Falls, New York
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4. ARCHITECT'S Name rt
O 0 0
0
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5. ARCHITECT'S Address o 0
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6. TYPE of Construction—(Please indicate by X)
lo
QI I Wood Frame 1 1 Masonry I I Steel 1 1 m
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T. PLANS and Specifications
96'x32r per plot plan, specifications and application
No. submitted including sewage system and two-car attached I�..
garage. N.
B. Proposed Use ❑
One-Family Dwelling 0
m
$5.00 C/0 Paid
$ 220.00 PERMIT FEE PAID-THIS PERMIT EXPIRES December 1 1g 86
111 a longer period is required anthe applicationfor extension must be made to the Building and Zoning inspector of the retown of OreWry
uns N before expiration date.) F.
Dated at the Town of Queensbury this
-y,' 7thhh ,gDay/of May 1986 w
SIGNED BY /y' /j [( , Nta-sJ for the Town of Queensbury
Building and Zoning l nspecto
TO BE COMPLETED BY BLDG. DEPT.
Application No.
awn O/ QYeenahur1, Permit Issued 19
\ BUILDING and ZONING DEPARTMENT Permit Expires 19 .-OWN CI:tQ�UiEIE958U W
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation L; Ia l� Lri u U i Ilii
Queensbury, New York 12801 Variance N . 1 U
r Site Plan Review No. APR 2 8 vWc
6J ,. I— APpro d by: /�/\/ ' M. Rnaom2��S� c!°JorV RP.M.
APPLICATION FOR �lA 'M!./L. ?IBI•Y 14L11I2ISI4IgI6
BUILDING AND ZONING PERMIT -
A * * * * * * * * * M • * * * * * * * * * * * * * * * p * * * * * * * * * Y '.,*
A PERMIT 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 on the Permit.
The owner of this property is: /EDE:: ,r I ( l.I AR.ac. 4 Lm s Li pp C. L
P.O. Address l� 11EA1 S / , A ) 5,V f4its. ivy Tel. 74 ?? f/ 34f
Property Location: l ,h TS*fl 'J5 LL4nlZ. F n I D4V Tax Map N,i,nj f/ I /?
Street number or building lot number
Subdivision name (if applicable) 7'n LL14Z lei 1-, 4D-
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
F1U S�QY- it 4iJZ S1'Aysv )ASJt De. 793o r
Na:,e P.O. Address Tel. No.
Name of builder ,4/, /C{ ti. y tµAddress Tel.
Name of plumber C AddressJJI 44:✓.Jb(y-St Tel.
Name of mason ('plw✓r'y Address Tel.
NATURE OF PROPOSED WORK: / ZONING INFORMATION:
onstruction of a new building *
✓C 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 . ) ) ft X S bt ft.
* Existing building(s) Size ft X ft.
*
PROPOSED BUILDING AND USE: * Existing building(s) Use
Size of new structure 1 /* ft X lift *
Foundation-pier/slab/crawl/partial/full * Proposed building, distance from property line
(circle one) *
J * Front yard {js' ft Rear yard /Sz f+.
No. of stories (habitable space) 41'7^ 't
Height (grade to ridge) 2 U * Side yards J s ft and DC
y ft. * If on corner/ se ack from side street It
If residential, no. of families /
No. of rooms(excluding baths) 7 * OCCUPANCY INFORMATION
No, of bedrooms PRIMARY� BUILDING -
No. of bathrooms 2/t *
* I/une family dwelling
Primary heating system Ape khaae 7�^J{.® * ---
Twofamily dwelling
Type of fuel '� L¢C. I' * Multiple dwelling / Number of units
No. of fireplaces to be installed / * ....Permanent occupancy
Will a wood stove be installed? J1lp __Transient occupancy
Central Air conditioning? IA $ . * Business
*
BUILDING STYLE, PRIMARY STRUCTURE Industrial
Other
Ranch Contemporary Log cabin * If addition, what will use be?
Raised ranch Mansion Duplex
9 lit level Old style Bungalow * —
a e Co Cottage Other * ACCESSORY BUILDING-
Colonial Row Town House * Detached garage/one car/ two car/ car
( CIRCLE ONE PLEASE ) * -;:.;Attached garage/one car/ two car/ n. car
* * * * * * * * * * * * * * * * * __Private storage building
ESTIMATED MARKET VALUE OF * Other
CONSTRUCTION $ /l ifre at/�,.y---- *
INFORMATION ON BUILDING
GSPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
.na LPe /b., n 1-v1
BUILDING PERMIT APPLICATION CONTINUED - ,�
BUILDING SPECIFICATIONS: /
Type of construction, • fire safe,etc.
Will any second-hand o- .i - -. umber be used?'/ If so, for what?
Foundation wall material 'P N� 49 6
g hi{o bot cone of Thickness
Depth of foundation below gr a (to bottom of footing) /�o y
Will there be a cellar??4qs Heated or unheated? Floor sq. footage eye sq ft
Will there be a basemen ?,qs Will any portion a use as living space?
(If so, what porti.. / s�.ft. - - Type of use? ��
Type of roof - loped lat/shed/other Material of roof ,4i a id I
Size, wood stud 'x � " spacing"o.c. length ft.
Joists(floor beams lst, loor 7, " 7A " spacing s. span).ft.
Joists(floor beams) 2nd. floor .a "xj n " spacing / "o.c. span /' ft.
'7
Overlays(ceiling beams) "X k sY/acing l‘ "o.c. spany 1Lft.
Roof rafters 7 "X ji, " spacing J. o.c. Span I f ft.
Roof trusses(pre-engineered) spacing "o.c. gpan ft.
Exterior wall finish e .- ��/I6gie9 Of what material? jir/12 . j )�- CB ,p/2
j?
Interior wall finish / f 5 .
If a garage is to be a allied, es itt)e materials to be used for FIRE SEPARATION:
zJ . i3
Is there to be an opening �een garage I. and dwelling? 9,...i• If so will a Fire-rated
door, enclosure, and self-closing device be provided? I/Sj S
Will a flue-lined chimney be installed? /,��� Height above roof 7 / ft.
Depth of chimney foundation below grade 7..y fft.
Depth of fireplace hearth / ft. 0 in.
Water supply - Municipal or private well py. t 4
SEPTIC SYSTEM Distance from ANY private well(including adjoining properties .Yd 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 all
provisions of the BUILDING CODE, THE ZONING ORDINANCE, and all other laws pertaining to
the proposed work shall be complied with, whether specified or not, and that such work is
authorized by the owner.
SWORN TO BEFORE ME THIS Signature__
Own r, owner s agent,a c itect,contractor
day of 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 29 y D .pQ
2. Type of heat Li-c• 6 tip by A /� �7Llf'y"il�H¢
3. Is the building mechanically cooled? /
4. Percentage of area of windows and doors // /''9. 4 !D
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_
4 n
2 . R value of exterior walls g-�
3. R value of glazed area /2- 7
4. R value of doors
5. R value of floors over unheated spaces F. 2 S
6. R value of slab edge insulation - unheated slab
7 . R value of slab insulation - heated slab
B. R value of heated basement/cellar walls (above grade)
9 . R value of heated basement/cellar walls (below grade)
10. Type of insulation F/$5y2 6 C4J c , t44iCJ£7 li ptA fostij
C. Controls
1 . Thermostat maximum heat setting 7 2 °
D. Duct Systems
1 . Is duct system installed in unheated spaces? AO NO
a. If YES , R value of duct- installation i• .5
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_ J!o n°
G. For Swimming Pool Only
1 . Maximum heating
Telephone No.
(applicant ' s signature)
awn of Quecnebury APPLICATION FOR SEPTIC DISPOSAL PERMIT
BUILDING and ZONING DEPARTMENT
Bay and Raviland Road. R.D. 1 Box 98 T• Ql1EENSE+t i t.'
Oueensbury, New York 12801
DATE��I / t4'-
I. s B u
LOCATION OF PROPERTY FOR
INSTALLATION( / 11`, ) 1j�}_C Lei
OWNER'S NAME �oCJ K.U.' tnps Vyj ?IA18I1�"luu�:1i9I14thi .
ADDRESS
CCC���10 Op� U 4, (2CQ TEL
INSTALLER'S NAME IIi.0 ti�- TEL
Number of bedrooms (residential only)
Total daily flow(compute @ 150 gal per bedroom) ( SO
Topography: at - Rolling - Steep slope - (circle one) % of slope
Soil nature: - Clay - Other Depth ft.
Ground water -At what depth? /L ft.
Bed-rock or impervious material - At what depth? I i' ft.
Percolation test -e Required - -Rate min-inch.
Domestic water supply - Municipal Well - Other
Separation - Watersupply(if well) from Septic absorption /DQ ft.
Proposed System: Septic tank /WWO gal. ( Minimun size, 1000 gal. )
Tile Field - Each trench 50ft. Total system legnth 3 C70 ft.
Seepage pit (s) Number of ---. Size each --ft X —ft
Size of stone to be used # fr,L Depth or thickness � ft. ** * * *
* * * • * ♦ * * * * * *
* * *
* *
• *
* * * * * *
* * *
IMPORTANT ! !
On a separate piece of paper, submit a diagram of the proposed system
with all dimensions shown ; including distance from any structure,
distance from property lines and from ANY DOD:ESTIC WATER SUPPLY or
shore-line of lake, stream,pond or wet-lands / Include all dimensions of
the system, itself. } ♦ ♦ }
R * 4 * f * * R * * ♦ • ♦ R f ♦ f } * ♦ } * } R f * R * * * * *
I lave rccd t;2( zeruZo^::one on tD.e re�c, sc side of this s7.rct ari agree
to abide by these and aZZ requirements of The Town of Queensb.ry
Sanitary Sewage lisposoZ Ordinance.
Signature of responsible person
05/86 and/vl
Section II 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 Buildina 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 $250.00.
C. An approved copy of the plot plan shall he
available on the construction site. Failure
to produce said plot plan at time of inspection
may result in an immediate work stoppage.
D. Should unforeseen problems during construction
prevent proper installation, alteration or
repair of an approved system, a new proposal
must be submitted to the Oueensbury Building
Department before further construction.
Ct 1 flown of Queens6 ury
I I BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
l/ Oueensbury, New York 12801
ex
BUILDING INSPECTOR' S REPORT
NAME p r LEI a 1I
� 1
LOCATION �r� i o e —
Date 1 (e /f$_2_ permit No. g� _(98
* + + x * x x ✓*_ APPROVED - YES NO
Footing/Pier Forms
Foundation
Waterproofing Backfill V
Framing __
Roofing
Siding
Masonry V-
Rough Plum. _
Relief Valy. Am
-_
Ext. Porches -_
Finished Floor
Itairsor Trim -_
Cellar & ainli1
Cellar Drain ril MIS
-
ralill
Plbg.Concrete Floors -_
Plbq Fixtures yea
Gar. Fireproofing --
Door Closers
Choke Detectors ___
Chimney
INSULATION: Agalill
Foundation
Floors
Walls ng �!1
FINAL
FINAL ELECTR CAL INSPECTION
DRIVEWAY APP OVAL Will
1/E1na1 Building Survey
-2111
NNext scheduled inspection (call when ready)
Remarks- n
heed
_ev:0 _ /Jte erxe
_pia
Building Inspector
6/B6 and-v1
tir
Jown o� Queenstury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
UJ4 'I
NAME
LOCATION
DATE
*0 PERMIT NO. R
lay
SOIL TYPE - _• lred? YES - NO
Percolation
Percolation rate - Min/Inch
TYPE of SYSTEM: /
Absorption field, total length
Length of each trench
Depth of trenches
Size of gravel_
SEEPAGE PITS{Number of) _
Size- ft. X ____ft. �—
Gravel size - iz Ty""
PIPING: S
�I
Bldg. to tank
Tank to dist. box
Dist. box to field/pit NO r ial
Openings sealed?
LOCATION/SEPARATIONS: ft.
Foundation to tank tion ft.
Foundation to absorp
Absorption to lot line 44.
ft.
Separation of pits APERTY(tircle one)
Front LOCATION OF SY �, - - Right side -
Front - Rear
CG4MENT5;e1
SYSTEM USE APPROVIC
NO
l
B In Inspector
01/S6 and vl
JOwn of q1 /ueenitur%
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Dueensbury, New York 12801
BUILDING INSPECTOR' S REPORT
NAME V' IJA-t-�^
LOCATION
/�
Date—iii "'p/r/t Permit No. Ai - iq8
+ x x + x x + x x x
x x + + + + * * * ✓+_x APPROVED - YES NO
Footing/Pier Forms _
Foundation
waterproofing
Backfill
Ypraming
Roofing _
Siding
Masonry Veneer
vRough Plumbing
Relief. Porches
y==
Ext. Porrches --
Finished Floors TAM
_
Itairsor Trim -
Stairs s Railings -_
Cellar Drain Tile �_
Concrete Floors
Plbg. Fixtures _
Gar. Fireproofing
Door Closers
Smoke Detectors _
Chimney I ■
N SULATT ON:
Foundation
Floors
Walls
Ceiling _
FINAL ELECTRICAL INSPECTION
Final Building Survey
Next scheduled Inspectionlcall when ready)
Remarks- - pjj5ULA-T4'-
A-0o 3CS,,�! �PAN&61 CaafiB
SUP o�� " Awl" rroic 8A-T14
i Notuvrea- Lo.v6 auAu
/14.4-1N Sr,teiC YY24P5 Could
Ig& Su-ciCktoD
Building nspector
6/86 and-vl
TOWN OF QUEENSBURY
Building Department
hrrpectore Report Date s/n/Qt
Name p 'c_ U OA-cc--
Location L+moor/ eta Dm tkl.Lc f2.v -
Permit No. . 4 -t 5 8 Weather
Remarks
Excatation
F.
„ , l
Footing 6 Piers
Foundation p 0 U -0_
Cement Coat
Waterproofing ��t/�11f
Rockall ✓l.%�l_-
Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Vaalves
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railings
Cellar Dr. Tile I^�L,
Concrete Floors � Ci
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation FOunda do».
Walls
Ceiling r
Duil. 'ng Inspector
� pp Arta.
REMARKS
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