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1985-357 (7 /r) CERTIFICATE OF +�7+C+� i.JPAN+�� TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date 19 This is to certify that work requested to be done as shown by Permit No. n 5 _. 3 5 7 has been completed. This structure may be ur_ e- ar a i '. �• eZ:J a ncr ° a" c Location T 04t pdrtv� potter Inc; F 6Owner r r11 } By Order Town Board TMW N OF QUEENSBURY i . 1 Building & Zoning pector F COC^TIVC 'INSTA." "*N"T1NG. GLCMS FA"% BUILDING PERMIT TOWN OF QUEENSIBURY No. 85- 357 WARREN COUNTY, NEW YORK ro PERMISSION is hereby granted to Peter and Peggy Kell c rt ill Lot 5 Pickle H111 Road Street, Road or Ave. OWNER of property located at P) Grant Acres ubdivision in the Town of Q.ueensbury, To Construct or place a , One-F aini ly Dwel1 incx p 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. � "C t . OWNER'S Address is x m I✓ 2. CONTRACTOR or 9UI LDER'S Name Arthur Petrikas '3. CONTRACTOR or BUILDER'S Address 1`1 O pi rt' P . O . Box 74 cri Fort Ann , New York 12827 4_ ARCHITECT"S Name 0 ~' F'S Ct !U X fll fl] G � 6. ARCHITECT'S Address F- r- II C 0 8_ TYPE of Construction — (Please indicate by Xi 0 OO, ( I Wood Frarne I I Masonry { I Steel ( ! 7. PLANS and Specifications 361i ft . diameter one-family dwelling per plat plan No. specifications and application submitted including sewage system . ( Eagles CZest Home) One-Car Attached Garage 10 o nc u e rD $. Proposed Use l One Family Dwelling 0 F.. i� kC $ 5 . 00 c/o Paid. February 1 19 86 £ $ 124 . UU 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 M town of Gueensbury before the expiration date.) July 19 65 n Dated at the Town of Queensbury this 3 t h D a�y�of y SIGNED BY a #�.�e✓_� for the Town of Oueensbury uilding and Zoning Inspector TOWN OF QUEENSBURY L ace inside block to ix* filh*41 it, bN Building insfx^tersr} WARREN CC UN=rY. NEW YORK lt,,, :sit,. APPlication faf s,t,t•tl 19 BUILDING AND ZONING PERMIT '1'it1Yisorir,\1�s ,rh ,�THREE l31 +Copies of a PLOT PLAN. Drawn to scale shaving the actual dimensions of the lot to be built upon, The exact slze, and location ..on the lot of the banding to be erected or altered MUST BE SUB- MITTED WITH THIS APPLICATION,.. r 2v./ 4 t� I 'TOW" OF QLJI�l�;NSBURY �1 nAi [E 0 17 F A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK JUL 1 1985 ANSWER ALL OF THE FOLLOWING. I �^ The undersigned hereby applies for a permit to do the following worst A.INI. ) i` 1• ►�� p,m, which will be done in accordance with the description. plans and specifi- ,?l $l� O . m21314151g cations, and such special conditions as may be indicated on the permit. t The.owner of this 7 prope�y is: lV� • /G}el� - ' . . . . . . . . cv 0 ADDRESS, The person respaysi#�it for supervision of the work insofar as the Building Ct�xie and the Zoning Ordinance apply Is: i JL� �'-1 i�r2Si` 15�.�,w] -`� _', . 1 71.�i327. . ..t [ ise d l . . . . . . . -� -` ' {NAME} .� - - - .,�} {Pb AQCSRESY �t3Q - . �'TRitatHS. I . Address .Ay. v- . ' P`t a ' . . . . . . . . . . . . Name of Builder - . . - . . . Address . . . . _ . Name of Plumber . . Name of Mason . . 0 �7 • 1144y. . . . . . . . . . . . . . . . . . . . . . . . . Address Lot Number . S7 . . . Unit . . . . . . . . . . . . Estimated value of proposed work S 4alrj moo. . . . . . . . Narne of Village . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Street . . f41 /. {! e- G oe � . . . . . . Side of street: north ❑, east , 'south 0 . west Nearest Cross Street . lf7"dr• � _ . Distance from this rross street . . . ''=` Ft. Property is north ❑ . south 0 , east i i , westX ram Cross Street If on Corner,..which corner, northeast 0 , northwest 0 . southeast C1 . southwest (Designate by marking with an "X" in the correct space-) NATURE OF PROPOSED WORK OCCUPANCY Main Building �, Construction of a new building. One-family dwelling F_� Addition to a building. Two-family dwelling 0 © Alteration to a building. -family apartment 'house � [} Demolition of a building. Store building 0 - - - - -car attached garage Other: Accessory Building . . . . . . . . . . . . . . . . . . . . . Cry . . . One-car detached garage � 0 Other work. Describe: . . . . . • . . . . Two-car detached garage . . . Private chicken house . . . . . . . . . . . . . . Q . . . . . . . . . . . . . . . . . . . . . . . . . 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. NORTHL�� I Show proposed building(a) in dotted line and existing pl , 4 tQ huilding(s) in solid line. i ardCaes Size of property . . . . � . . . . . . ft. x . . ma's.--7./ . . . . ft, ' Size and use of existing buildings, if any . • . • . . 'U,LSize of proposed building Sly" Height (from grade to ridge) 2. Cn . , . . . . . , ft. Front yard /. O ft. Side yards . . . . 11,S' . . . . - . ft. and . . . .!/. S. . . . . . . . ft. Rear yard . . . . . . . . . . . . . . . . . . . fx. If on corner, setback from side street . . . . . . . . . . . . . . . ft. Note. Aft distances are net, as measured from street side sour N line to nearest ,part of branding. r� {OVERT r� f r f 3 " ,M - NNNNNOME (cont`d.) BUILDING SPECIFICATIONS., /� Kind of construction: Wood frame, fire safe, etc.? . . . _ . . . 4 �° + Q - - , '+�f Will any second-hand lumber be used? . . . . , . . . . , If so, for what? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Material of foundation walls =? .{!R� + . . . - . . . . . . Thickness /Q. eA.;r,�. , Depth of foundation walls below grade . . . . . . . . . . . . .y- Joe: . . . Continuous foundation? , . , . Will there be a cellar? . . . . . 15-? If so, material of cellar floor . . . . . . . . . . . . . . . . . . . . Type of roof: Sloped or flat? . S4t6aarp . . . - Material of roof . . . . . . . . . . . . . . . . . . Size, wood studs . . . - - . . . . . . . .`1Z . . . . . " x - . . _ . . . . . , . . ", spacing . . . lam- _ . . . _"o.c., length , . . . . . . . . . ft. Size, floor beams, Ist floor . . , - . - , . . . , . " x . . . . . _ . ", spacing . . . . ,e4k . . . . . , "o_c., span r . . . . . . . . . . . . . ft. Size, floor beams, 2nd floor , . . . , . . , . . . x . . . . . . - - . . . . , spacing . . . . /! . . . . . . . "o.c-, span . . . . . . ft. Size, ceiling beams . . . . , . . , . . . . . . . . . . x , . _ I . . & , . . , . ", spacing . . . , f.l'P . . . . . . "o.e. span . . . . . . . . . . . . . ft. Site, roof rafters or beams . . . . . . . . x . . . . . . _ . . . ' , spacing; . . . .+rlG' . . - . . . . o.c,, span . . . . . . . . . . . . . . ft. Exterior finish . . . . 44 .rw4A . . . +� ! . . . . - . - . . . . . With what material? � . . . ,!Nerves Finish of interior walls . . . . - - . . ,4s? r,Aep , . ..t' 40u d. . . . If garage is to be attached, of what material is wall between garage and main building to be constructed? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . , . , . , , , . , . . . . . - - , Is there to be an opening between garage and building? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Kind of heating system . . . , !�!L.R Trm 4 � . . . . . . . . . . . . . . . . . . . . Oil burner or coal ? . . . . . . . . . . _ . . . . . . - . . . . . . . . . . . Will a flue-lined chimney be provided? . . .YES- . . . . . . . Depth of chimney foundation below grade . . . . . . . . . . . . . . . Height of chimney above roof . . . . . . 77� . .I >r: . . . . . . . . . . . . . . . _ . . . . . - - . . . . . _ . . . . - . . . . . . . . . Will there be a fireplace? . _ . . . . . !t . 4'"L . . . . . . . . . . . . . Depth of fireplace hearth . , . . . . . Will a toilet be installed? . Will a kitchen sink be installed and connected to water supply? . . . . !eC . . . . . . . - - Water supply (public water supply or pump) , . . . . - . , . . Distance of cesspool from any private well I- 1. 1 1 ..] . . . . . . . . . . . . . . . . . . . . . . feet Will drainage system he provided with required traps, cleanouts, and vents? _ . . . . Y405�-.5 , . , , , , _ . , , Town of Queenshury AFFIDAVIT County of Warren State of New York 1 swear that to tt: b.W of my knowledge and belief the statements contained in this applieatlan, with the plans and specifications satb- mitted, area true and co- lete statement of all proposed work to be done on the described pre and that all of the BUILD- ING CODE, THE ZONING ORDINANCE, and all other laws pertaining to proposed work uompoled with. wlt saspec fry m, �* and that ouch work is authorised by the owner. w 7f Z��'S 1 Sworn to before me this Signature . . D . . !J . . _ . . . . 1T£CT. CONkTRACTpR say of. . . . . . . . .- .. iAiN�i WN R'S AGENT, AR 19 . . . . . . . . . . ... . . .. NOTARY PUSL,i C, W"AROMN 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 CORE A permit must be obtained before beginning work . .ANSWER ALL of the following ! ,� �re 1 . Gross floor area i cm4/ !2 2 . Type of heat og� C -Tjet c:w 3 . Is the building mechanically cooled ? 4 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 ? 3o 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 ��' C+� � B . Under 16 % Only 1 . R value of roof and floors exposed to ambient conditions. 1Ln- � C`7 2 . R value of exterior walls �1g 3 . R value of glazed areafo� ` 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 s . R value of heated basement/ cellar walls ( above grade ) 9 « R value of heated basement/ cellar walls ( below grade ) lb . Type of insulation Co Controls G+ `' 1 . Thermostat maximum heat setting LLaa D . Duct Systems 1 . Is duct system installed in unheated spaces ? YES NO 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 . R value of pipe insulation F . Service Water Heating 11 performance efficiency. cr 2 . Temperature control setting maximum 'l4 G . For Swimming Pool only. 1 . Maximum heating Telephone No . { applicant ' s signature ) TOWN QF OUEENSSURY BUILDING & ZONING DEPARTMENT SEWAGF DISPOSAL PERMIT PERMIT APPLICATION ] . Owner ' s Name �"r i '4X9 C> 1 06,6 / Address Telephone No . ;� 2 . Property location f i izWL 3 . Name of person or firm responsible for installing system Telephone No . Address 4 . Number of bedrooms ( residential buildings only ) 'J'c.cJ4 5 . Daily flow '7� crallons/day 6 . Septic tank capacity C.3 <�; �7 $ 40c5S #9PJLt5 gallons 7 . Topography : flat ,< rollin , steep of slope so Nature of soil and depth_ S`49 iV Z> `'�l" 9 . If ground water , bedrock or impervious material is apparent at what depth does it begin? ft . 10 . Percolation test : A is required g is not required C If required what is the rate minutes/inch Ile Water supply : municipals well , other -L C _. 12 . Type of system proposed : drywell , •tile fief, other Any contractors 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 Queensbury Sanitary Sewage Ordinance . zz I7ate��/'��1�} ignatur� APscant. 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 . Form 3 - 82 Town v j Quee" 314 " r y BUILDING and ZONING DEPARTMENT Bay and Haviland Road, RX)- 1 Sox 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT 1639 i' ,140 NAME , , IT PrZil�' AE S LOCATION . . [Sate �3r' Permit No . --- f APPROVED - YES NO Footing/Pier Forms Foundation Waterproofing Backfill Framing Roofing Siding Masonry veneer Rough Plumbing Relief valves Ext . Porches Finished Floors . Interior Trim Stairs & Railings Cellar brain 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- - VC0 -%VLf;J%t L W"O IJU41 A3 46-'?' Bijildidg Inspector 5/66 and-vl own o� '�ueen3hetr� BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Oueensbury. New York 12601 BUILDING INSPECTOR ' S REPORT NAME �- L LOCATION Late Permit Now ,� 'j a * * * * * ► * * * soe" * APPROVED YES NO � Footing/Pier Forms Foundation Waterproofing Backfill Framing Roof ing 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- C 15 Gam. ✓r� e�vaozr CD4 . v �-t Build ng Inspector 6/86 and-vl TOWN OF QUEENSSURY Building Department �3 Lue�sa�boes Date_„ Name L.ocatio S Pernmit Noy. - Weather Remarks Excaoaison Footin Forms Footin & Piers Foundation Cement Coat Water roofin Backfill Final Serve Framin Sheathin Roof Felt Roofin Sidin Masanr veneer Rau h PI Relief Valves Wall Board Ext . Porches Finished Floor Interior Trim Stairs & Railin Is Cellar Dr . Tile Concrete Floors Pl Fixtures Gar . Fire raafin Door Closers Chimney__ Water Meter Inst . Se tic A roval Floors Foundation Insulation Walls Cei I In Sui din Inspector REMARKS ..� TOWN OF QUEENSBURY suildins pe vartment Inspe"We Roport Date AZ Peasr:�t Na. r - W,�vaer i V. Remarks Sxca' ti on Foo'tn ' Forms Footln & Piers Foundation Cement Coat Water roof-in BacXfill Final Survs Framin Sheathin Roof Fel t Roofl n Sidin Mason` eer Rou h Pl Relief Valves Wall Bxsarcl 82rt . Porches Finished Floor rnterior Trim j stairs & Railin s Cellar Dr . Tile Concrete Floors PI Fixtures Gar . Fire roofin Door Closers Chimne Water Meter Inst . Se tic A royal Floors Foundation, Insulation Walls Ceili Building TnsPectOr REMARKS TC3'VlfN OF QUEENSBURY Building- Department In"Ho f+ars Report Location 4a r" S cif is t 6.� r c� r7w Permit No. 4K 5 - 3 25 2 Weftther Remarks ExcatYa tion Footing Forms fC).otinq ,fir Piers Foundation c'l" G► l yc. 5c3c (A t Cement Coat Water roafin BaC*fill Final Survey Fraa+in Sheathin ,Roof Fel t Raafin Siding Masonry Veneer Rough P2bgw Relief Valves Wall Board Sxt . Porches Finished Floor x'nterior Trim Stairs & Railings Cellar Dr , Tile Concrete Floors plpg , Fixtures Gar . Fire roofin Door Closers Chine water Meter Inst . SE± tic Approval Floors _ Insulation Foundation Walls _ Cell-ing Building Snspector REMARKS TOWN OF QUEENS13URY Building Department ,,� iarpeebma Report Date Name- Pe i-ems.- 4 P-e cz 5- X AC - S �_ e�altlaer Reins rlcs Lxcatia ts.on FootIngr Forms Footing fir Piers Foundation Cement Coat Waterproofing Backfil l Final ,Surve Praming Sheathing Roof Fel t Roofin Siding Ma-m-WOMIXY Veneer Rough Pl Relief Valves Wall .Hoard Ext . Porches Finished Floor rnterior Trim Staira & RaIlIngrs Cellar Dr . Tile Concrete Floors Pl:L>zW Fixtures Gar . Fire roofin Door Closers Chimne Water Meter Inst . Se tic Approval Floors insulation Foundation Walls' Cei l i _W.. -Hurl Jingr rnspact REMARKS r �, 2Ta _ 4c+ ` 143 IAAMLL t bC► ` y • lr► UN p wool AV Ty