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1986-170 CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK • Dare September 16 Iq E_ This is to certify that work requested to be done as shown by Permit No. 86-170 has been completed. This structure may be occupied as a One-Family Dwelling Location Twin Mountain Drive George H. Burgess Owner By Order Town Board TOWN OF QUEENSBURY ." S2 Buildin` & Zoning Inspector BUILDING PERMIT TOWN OF QUEENSBURY No. 86-170 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to George H. Burgess OWNER of property located at Twin Mountain Drive Street,Road or Ave. m re One—Family Dwellingoc in the Town of Queensbury,To Construct or place a w 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. OWNER'S Address is N R N N 1. CONTRACTOR or BUI LDERS Name John Graham - 3. CONTRACTOR or BUILDERS Address RD #2 Box 133 Hudson Falls, New York 4. ARCHITECTS Name w 5. ARCHITECT'S Address N. (D 6. TYPE of Construction—(Please indicate by X) Wood Frame 1 1 Masonry 1 1 Steel 1 1 7. PLANS and Specifications 241x351 per plot plan, specifications and application submitted No. including sewage system. 8. Proposed Use One—Family Dwelling H $5.00 C/0 Paid 63.00 November 1 19 86 re $ PERMIT FEE PAID —THIS PERMIT EXPIRES Of a longer period is required an application for an extension must be made to the Building and Zoning inspector of the ,y town of Queensbury before the expiration date.) w Dated at the Town of Queensbury this -24th Day of April 19 86 SIGNED BY 77,2O-NJ'- for the Town of Queensbury Building and Zoning Inspector (r2 awn of Queens1ury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, RD. 1 Box 98 Oueensbury, New York 12801 SEPTIC DISPOSAL PERMIT APPLICATION Owner' s Name Gcorje. N. su ye.Sc Tel. 793-35ZW- Address / WM/i/ 4 etiin2Io Dri✓e- x Person/Firm installing system Rusfy ( ),a-'TaJrl Number of bedrooms (residential only) .Z Total daily flow: (compute @ 150 aal.per bedroom per day)_ 300 Topography: flat rolling - steep - (circle one) Degree of slope _% Nature of soils: d loam-clay- other- Depth 2O t- ft. Ground water-- at what depth? ft. Bedrock or impervious material--at what depth? 4C—ft. Percolation Test Not reauired Required -Rate Domestic Water Supply -(Municipal- Well - Other IMPORTANT! On 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_5t> ft. Total field 2oO ft. x Size of stone B (`J,F 'X • Se ' 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. Signatu'te of Appli ant 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 Queensbury Building Department before further construction. 10 BE COMPLETED BY BLDG. DEPT. IL TO C7*` / Application No. Sum DI Q een36Ul'ly Permit Issued 19 BUILDING and ZONING DEPARTMENT Permit Expires 19 ' r. ,' / ' Bay and Raviland Road, R.D. 1 Box 98 Zoning Designation 5 e- la - , ^I�.' Ui d Dueensbury, New York 12801 Variance No. iiJ10,U Site Play��reviewy � �/ �No// /�[/%/per, g9�ry:�O��2 -I .r;'. Approve9�b/` r^"+ /rr�/-c-p4,._ 1 A I I Y' � / I��sl�� . APPLICATION FOR Y�l _ 'g $ 9 r 1 L3 415I6 BUILDING AND ZONING PERMIT 1 i �o rhrwv- * * * * * * * * * * * * * * * * * * * * * * * * * * * i * * * * * * * * * * .:♦ 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: (ien 3 r )I .Ruk q e 55 P.O. Address 7-wily MogNhiAJ .Dv/rE - G/ac.ls AR as, N_`/ Tel. 794-SS94L Property Location: TI•✓/,v /NOUN%,,/A/ rrv✓a. Tax Map No./73 / / /SS,-/ Street number or building lot number Subdivision name (if applicable) THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS: Y ,11 0 h n (2en ham #"a r)ox /.313 N. F G;8.39 7/f i- `/Sea Name P.O. Address ,,T/el. No. Name of builder rob N Gr.ahnm Address SToQeschccL4euee de/ "Tea. 7*7 �jr8.2 X Name of plumber Pl. Tuekee Address ,z)4 Li.Ico/X a/. H. Te1. 7'/7-d// 7lo Name of son t ^ / Address Tel. —yi Lee 7hsNa5 L > GrearfV;lie NV --j6,1. -1,Hv% NATURE OF PROPOSED NORK: * ZONING 'INFORMATION: t 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 /.J O ft X /.J O ft. * Existing building(s) Size -*-- ft X --! ft. * PROPOSED BUILDING AND USE: * Existing building(s) Use Size of new structure �lr} ft X 35ft Foundation-pier/crawl/partial/full * Proposed building, distance from property line * (circle one) * Front yard 6O ft Rear yard /ri/o ft No. of stories (habitable space) / * Side yards 50 ft and 6S ft X Height (grade to ridge) / l ft. * If on corner, setback from side street ----ft If residential, no. of families / No. of rooms(excluding baths) 44- * OCCUPANCY INFORMATION No. of bedrooms a * * PRIMARY BUILDING - No. of bathrooms / * ,X One family dwelling Primary heating system ace vc_ * Two_ family dwelling Type of fuel - * Multiple dwelling / Number of units No. of fireplaces to be installed 0 Permanent occupancy Will a wood stove be installed? Nit! * Transient occupancy Central Air conditioning? NO * _Business BUILDING STYLE, PRIMARY STRUCTURE _Industrial Other Banc 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 ) * ---Attached garage/one car/ two car/ car * * * * * * * * * * * * * * * * * Private storage building ESTIMATED MARKET VALUE OF Other CONSTRUCTION * $_34.¢go INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED! I'cr', EVA 4/S6 and-vl BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATIONS: Type of construction, wood frame, fire safe,etc. Word FrnMt )(Will any second-hand or ungraded lumber be used? If so, for what? No Foundation wall material Caucrett Thickness 8 ti K Depth of foundation below grade (to bottom of footing) fl F-I. Will there be a cellar? /../c Heated or unheated? — Floor sq. footage sq ft Will there be a basement? No Will any portion be used as living space? - (If so, what portion? sq.ft. - - Type of use? ':'Type of roof -44;Z:0/flat/shed/other Material of faqir*, 1347-1�, � Y Size, wood studs .1 "X („ " spacing Ho "o.c. length 3 ft. ✓ xJoists(£loor beams) 1st. floor .— "X — " spacing — "o.c. span -" ft. Joists (floor beams) 2nd. floor "X — spacing — "o.c. span ft. YOverlays(ceiling beams)�;a -"X y- " spacing "o.c. span p')y ft. -'Roof .rafters "X a spacing o.c. span ft. v Roof trusses(pre-engineered) spacrngQ 4 "o.c. span 3l ft. XExterior wall finish 7-/// Of what material? -7),( ()ppL) xlnterior wall finish .ShgP-frork %,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? If so will a Fire-rated door, enclosure, and self-closing device be provided? -Will a flue-lined chimney be installed? No Height above roof - - ft. Depth of chimney foundation below grade --- ft. Depth of fireplace hearth _ ft. - in. Water supply -(Municipal or private well Muaic,�gL. SEPTIC SYSTEM Distance from ANY private well(inc uding adjoining properties/OO ft. 4PRox. (A separate application is necessary for any repair or new installation of septic system) OR Town of Queensbury more, 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 wner. SWORN TO BEF(\R;MF. THIS Signature; r (f •�-"- � -sue Ow&ER �/ / Owner, dwner's ageht,arcnirect,contractor day oq 19_ Notary Public, Warren County, N.Y. * • * * * * * * * * * * * • * * * * * * * * * * * * * * • * * • • * * * * * * * * * * * * * SPECIAL CONDITIONS OF THE PERMIT: Hy 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 $4/-O 5C#tpro Fee% 2 . Type of heat BlocMee. 3. Is the building mechanically cooled? No O�7 t7 y 4. Percentage of area of windows and doors /� 4 0— /3 c20 A. Over 16% Onl 1 . Uo va e of gross area of walls , roo ceiling and floors expose. to ambient conditions 2 . Floor over . eated spaces YES NO a. Are foun• - tion wall - insulated? YES NO 1. If YES what s the R value? 3. Slab on grade S NO a. If YES, w,htt i - the R value of insulation around perimeter of floor? 4. Is basement heated? Y . NO a. .'k value of insulation 5. , Type of insulation B. Under 16% Only 1. R value of roof and floors exposed to ambient conditions_ 32 2 . R value of exterior walls (2qq4, 44 3 . R value of glazed area//// a . Ut, 4 . R value of doors /-7. 5. R value of floors over unheated spaces 6. R value of slab edge insulation - unheated slab /0 7 . R value of slab insulation - heated slab T-- 8. R value of heated basement/cellar walls (above grade) '--- 9 . R value of heated basement/cellarL' walls (below grade) 10. Type of insulation Hi be,P -�a -� C. Controls QCo 1 . Thermostat maximum heat setting cJ D. Duct Systems \l 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 -- ------ - l E . Piping Insulation 1. Size of hot water or cooling carrying agent pipe - 2 . R value of pipe insulation -- -- - -_ . Fy Service Water Heating �W^Lu I (- fled-��Po 1. Performance efficiency copyn-F en P{ y `17 , k o 2. Temperature control settig maximum / /10 G. For Swimming Pool Only 1 . Maximum heating Telephone No. 793 - 3590 N (applicant ' s signature) i INar zr 4017822 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY IR 41 STATE STREET.ALBANY.NEW YORK 12207 Date September 17, 1986 Application No.on file 016735-86 A 667528 = E THIS CERTIFIES THAT and =_ E only the electrical equipment as described below a introduced by the applicant named on the above application number r in the premises of E George Burgess, Twin Mt. Rd., t.T1eensbnry, New Ycrk = in the following Brea Boni ElBasement © 1st FL ❑ 2nd FL OUtSide SLot Section Block was eramined on 8/11/86 and found to be in compliance with the requirements of this Board. s FIXTURE EICWTACVS SWIICMlS FIXTURES RANGES COOLING DICKS OVENS DISK WASHERS EXHAUST FANS OWNS INCANDESCENT FLUORESCENT 'T,r MT. C W. AMI. K.W. AM?. K.W. MIT. K.W. .Mr. H.P. 8 23 7 2 fr E DRYERS FURNACE MOTORS NAM NUANCE REVS SPECIAL RE AMR ME CLOCKS RBl UNIT WATERS MIAINNIY DIMMERS T DMERS Et SYf1M S IMI. tw at x.r. aAt x.r. I. No. .a. AMr. M.F. .Mr. AMn. WAMs. AMr. x.r. rsO.Of FIRT AMr. wAm 1 range 3#6 _ ii- t hie i#10 R = SERVICE DISCONNECT NO.OF MEIN S I I V I C s I M l E .Mr. AW. E ma I/EW IA/ w LW SW Slrw Na% c1COND. acC CPD M.atllo �'M; so.a NEu1M15 M,LY YS 1 200 cb 1 x 1 4/0 1 2/0 OTHER APPARATUS: — 1- gfci = 1- :,poke det Electric Heaters: 3- 2.0 kw 1- 1.5 kw 2- 1.0 kw —7 //f Bill Mien 239 ( ` '� 10 Lupin lane BRANCH MANAGER Glens Fulls, NY 12801 Per This certificate must not be altered in any manner;return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. ((((/� —"own of Quee„atury /�1tl'" BUILDING and ZONING DEPARTMENT _I ` Bay and Haviland Road, R.D. 1 Box 98 Dueensbury, New York 12801 BUILDING INSPECTOR'S REPORT NAME LOCATION 7, 4'� V Date ! D / �� Permit No. sic) 170 0 {/ = APPROVED - YES J NO ler rus 1 Foundation Waterproofing Backfill Fjaming Woofing 19d( (tiding fi K Masonry Veneer _ Rough Plumbing I,if!elief Valves (4)fit. Porches Q. vt. ished Floors nq �',j(wterior Trim ,i VStaixs & Railings A Cellar Drain Tile CCppppe� rete Floors ,�.�. Wcc� • Fixtures AK r. Fireproofing k LiCor Closers (f vibfioke Detectors Drll Chimney INSULATION: Foundation Floors Walls coiling ‘'f\�1nal Building Sury Next scheduled Inspection(call when ready) Remarks- - Building Inspector 6/86 and-vl L'a!/41 MY/76 36/n . Jouin o� Queenatury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME re A1.. /I e.p. LOCATION �.o r /17 ,I Nj'a� rin e, DATE "jerk PERMIT NO. AG -/7(I SOIL TYPE - Sand - Loam - Clay - Percolation Test Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM: Absorption field, total length 'a 5O Length of each trench l SC1 Depth of trenches a Size of gravel_ a 2 — SEEPAGE PITS{Number of) _ Size- ft. X ft. Gravel size PIPING: Size Type Bldg. to tank �_ LPN Tank to dist. box Dist. box to field _y� Openings sealed? ® NO Partial LOCATION/SEPARATIONS: Foundation to tank II) ft. Foundation to absorption g0 ft. Absorption to lot line (Q ft. Separation of pits __ ft. 0 ; ION OF SYSTEM ON PROPERTY(circle one) apRear - Left side - Right side - TS: poi 4 t+, .l,ca rretcr N SYSTEM USE APPROVED 4p NO 1" d'u Building Inspector 01/86 and vl Jown o/ Queen s1ur4 BUILDING and ZONING DEPARTMENT Bay and Haviland Road, RD. 1 Box 98 Oueensbury, New York 12801 SEPTIC DDISPOSAL SYSTEM INSPECTION /,��n1 NAME W ( Id'1 ,04., —Jai 1 -5'114k )A g. LOCATICN7 �'� t A- /(9 DATE , rl / S3PERMIT NO. g ED-47d SOIL TYPE - Sand - Loam - Clay - Percolation Test Required? YES - NO Percolation rate - Min/Inch _ TYPE of SYSTEM: �, ,p� / Absorption field, total l ngthfti{)U Length of each trench (( 8 Depth of trenches Size of gravel_ 2 SEEPAGE PITS{Number of) _ Size- ft. X ft. Gravel size PIPING: S' a TYP� 6�J11'/1M.✓ Bldg. to tank / sat-, Tank to dist. boxl i� 7'(� Dist. box to field Openings sealed? YES NO Partial LOCATION/SEPARATIONS: 1� r Foundation to tank Y` ft. Foundation to s ption ,offt. Absorption to to line 3y4-ft. Separation of p' s _ft. LOCATION OF SY EM PROPERTY(c ircle one) Front - Rear Left side - Right side - C NTS: SYSTEM USE APPROVE:. NO C / 16 ,.,_ , Building I -pector , 01/86 and vl Jown o/ Q.ee„dlury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Oueensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME ```��'''''''��''''��'''''''��A�///�''���""" LOCATION -F /KW ;1,49ry/ Q ` /� '., Date /y i p y permit No. t: ( IO ✓ = APPROVED - YES J 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 Drain Tile Concrete Floors Plbg. Fixtures Gar.. Fireproofing Door Closers Smoke Detector Chimney INSULATION: Foundation Aours l is O.K /Ailing abi FINAL ELECTRICAL INSPECTION Final Building Survey Next scheduled Inspection(call when ready) Remarks- - Buil g Inspector 6/86 and-vl c7 �OTX gown o� Queanf6ury �D BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.O. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR'S REPORT NAME ('y 2d rq a Bury a ST LOCATION f"WI /y h'11` �✓. rp1 Date G(./1s/�'� Permit No. 14 - /70 ✓ = APPROVED - YES I NO Footing/Pier Forms Foundation Waterproofing Backfill " Framing OK 1 Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext. Porches Finished Floors \ ` Intetior Trim Stairs 6 Railings Cellar Drain Tile Concrete Floors Plbg. Fixtures ; Gar. Fireproofing J Door Closers Smoke Detectors Chimney INSULATION: Foundation Floors Walls Ceiling FINAL ELECTRICA4/INSPECTION Final Building urvey Next scheduled Inspection(call when ready) Remarks- - igia„, Building Inspector 6/86 and-vl TOWN OF QUEENSBURY Building Department hupeat ra - Date r. I -Kee Name • Location 7 a.� ' Permit No. fib - 70 Weather Remarks Excavation Footing Forms Footing & Piers Foundation Cement Coat Waterproofing Backfill i//i Oj!, 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 Car. Fireproofing Door Closers Chimney Water Meter Inst. Septic Approval _. Floors Insulation Foundation Walls Ceiling 1/ Building Inspector REMARKS TOWN OF QUEENSBURY Building Department leewetere Report Date S`Zfr`gG Name fj✓V2 (a 6$9 '.. Location Tom./MT- )9 LtdV& Permit No. $C.-1 7 U Weedier Remarks Excapation t / Footing Forms ✓ ® (ter Footing S 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 Car. Fireproofing Door Closers Chimney Water Meter Inst. Septic Approval Floors Insulation FouMation, 1Walls ll Ceiling Buil ing Inspector REMARKS n N Me 1t forges- 34 -3o PU Gtf/toir5;rAK-6-5 5&r An- /2. Powc 3/4Cc- et B,vsaMbtn PowNrt, C-4«. Foit 6AacAiu_ Ia5P6erlaN-