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1986-271 CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK 1 pate October 10 19 Br� /�\ -12 Theis to certify that work requestedtobe done asshown by Permit No. 36-271 has been completed. One-Family Dwelling This structure may be occupied asa Location Lot 564 Fox Hollow Lane (St. No. 41) Brian Custer Owner By Order Town Board TOWN OF QUEENSBURY leete4L( ii!, Zee', Building & Zoning Inspector it 1. BUILDING PERMIT TOWN OF QUEENSBURY No. 86-271 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Brian Custer OWNER of property located at Lot 564 Fox Hollow Lane (St.{I41) Street, Road or Ave. in the Town of Queensbury,To Construct or place a One-Family Dwelling m 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. t. OWNER'S Address is 10 Hummingbird Lane er Glens Falls, New York ro 2. CONTRACTOR or BUILDER'S Name Whalen Const. r -o rt 3. CONTRACTOR or BUILDER5Address rn West Fort Ann, N. Y. 0 4. ARCHITECTS Name O 5. ARCHITECTS Address It cnn• rt 6. TYPE of Construction-(Please indicate by XI oa 14 Wood Frame ( 1 Masonry ( )Steel ( ) 7. PLANS and Specifications ._. 601x34r per plot plan, specifications and application submitted No. including two-car attached garage and sewage system. m 8. Proposed Use One-Family Dwelling g w 4 $5.00 C/O Paid 171.00 PERMIT FEE PAID -THIS PERMIT EXPIRES January 1 19 87 r a. h (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the 7 town of Queensbury ry before the expiration date.) coo Y IC Dated at the Town of Queensbury this'7,yt 3rd June 86 Day of/� 9 19 SIGNED BY )�7 � f.La for the Town of Queensbury Building and Zoning Inspector 5 if' 0 TO BE COMPLETED BY BLDG. DEPT. C7 // _Application No. ✓Own of gQueendbury Permit Issued 19 BUILDING and ZONING DEPARTMENT permit Expires 19 �TO1W(�N OF(� QUEENSBU.T' Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation d LL LS l� (j V' Ie: (�-1 Oueensbury, New York 12801 Variance No. c:, tl IY Lo U -7 —1 3/ Site Plan Review No. � /7� .� L � ��y�"�Q� / ! — /"- I Approved by: AM Pdry�yR��f.�91171. 4 .PM APPLICATION FOR 7I3191? L11121314I5Ie h' BUILDING AND ZONING PERMIT — * * * * • a * * * * • • • ♦ * * * * * * * * * * * a * * w * * r ♦ ♦ n * r ►::• 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 indicateda� on the Permit. /Q The owner of this property� yI is: tr P*" VAQ $ 'e \(a � 45f'ea- P.o. Address 10 1TIAVNwP, nJ'142✓ Laps-L 9 Tel. 7q - I2-K0 Property LocationrLR Fo)( 140LLw o 1--lJ ' mar S414 Tax Map No. 77 / / / L 31 Street number or building lot number Subdivision name (if applicable) THE PERSON RESPONSIBLE TOR SUPERVISI?pN OF WORK AS RFrARDS BUILDING CODES IS: (A/InaLeN 1 c s+ lit- F)- A- 73, Pica . la3-.507 % Name II /I P.O. Address . I Tel. No. Name of builder ((11!10Li 1-, /xlc1?5 F Address Wr F1- A .}, Tel. '14 3 - so-n Name of plumber 7j Gl� G,oT- 1'(.' Address Cokafp y0(, ,� e... Tel. Name of mason LA", &)1 „Jir7 Address Oh I N A/ Tel. NATURE OF PROPOSED WORK: ZONING INFORMATION: X 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 FOR DEMOLITION PERMIT, STATE SIZE AND * whether interior or corner lot. Show location of water supply and location and configuration LOCATION OF STRUCTURES AFFECTED. * of septic disposal area. * * COMPLETE INFORMATION REQUIRED BELOW. * Size of property /sqx apt ft XJ(1,O p)3ft. * Existing building(s) Size ft X ft. * PROPOSED BUILDING AND USE: p „ * Existing building(s) Use 620,r( $ 28 e S' - - : . .-w structure 6D,O' ft X * Foundatio, pier/slab/crawl/partia f* Proposed building, distance from property line (circle one) No. of stories (habitable space) 2 *• Front yard 30 ft Rear yard /Q� ft Height (grade to ridge) a 6 / ft. * Side yards 5-0 ft and J ft * If on corner, setback from side street NJ4- ft If residential, no. of families No. of rooms(excluding ba,t.hs) /f * OCCUPANCY INFORMATION No. of bedrooms rf * No. of bathrooms 3 * PR14ARY BUILDING - Primary heating system G/15 I4/CT hynott * 1' -"-e family dwelling of fuel * Two family dwelling Type4-s Multiple dwelling / Number of units No. of fireplaces to be installed I * Permanent occupancy Will a wood stove be installed? ('(D * ** _Transient occupancy Central Air conditioning? N Business BUILDING STYLE, PRIMARY STRUCTURE * _Industrial Ranch Contemporary Log cabin * Other * If addition, what will use be? Raised ranch Mansion Duplex Split level Old style Bungalow * Ca•- d Cottage Other * ACCESSORY BUILDING- Row Town House * Detached garage/one car/ t.,• car CIRCLE ONE PLEASE ) * ✓Attached garage/one car/ / car * * * * * * * * * * * * * * * * * * _Private storage building ESTIMATED MARKET I7ALUE O * Other CONSTRUCTION $.. /gth�� 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: Type of construction, .od frame fire safe,etc. Will any second-hand or ungraded lumber be used? If so, for what? 100 Foundation wall material 10 T3�.[r.K Thickness to'' Depth of foundation below grade (to bottom of footing) Fa" Will there be a cellar?*s Heated or unheated? /00 Floor sq. footage 024W sq ft Will there be a basement? (.40 Will any portion be used as living space? 1J0 (If so, what portion? sq.ft. - - Type of use? I II Type of roof - ope flat/shed/other Material of roof F�6cp G[icc Sh ihy bre Size, wood studs "X 4 " spacing IL, "o.c. length Q ft. �i Joists(floor beams) 1st. Floor ,2 "x 10 " spacing 1 (, "o.c. span (3'"/ ft. Joists (floor beams) 2nd. floor E "X in " spacing /(, ' "o.c. spanT5F47Tft. Overlays(ceiling beams) "X " spacing "o.c. span ft. Roof rafters L '•X� " spacing o.c. span ft. trusses(pre-en ineered s L ` f 4 pacing q'�C� "o.c. span(, ft. txters.,s wu11 nish 4 A L 10- ,v-L Of what material? 7,1\,-e_- Interior wall finish )1(7- If a garage is to be attaphed, degcrl)F materials to be used for FIRE SEPARATION: sls" Y1 .c_ Is there to be an opening between garage and dwelling? yts If so will a Fire-rated door, enclosure, and self-closing device be provided? U.s Will a flue-lined chimney be installed? '?es Height above roof Z ft. Depth of chimney foundation below grade gjd ft. Depth of fireplace he h A ft.,2(, in. Water supply - unicipal or private well SEPTIC SYSTEM Distance from ANY private well(including adjoining properties (p0 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 YORX 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 MW ,n/CQ La- 14 lE/ —' Owner, owner's agent,arcnirect,contractor /.S day of „5 19 8V Notary Public, Warren County, N.Y. * * * * * * * * * * * * * * * • * * * * * * * * * * * * * * * * * * * * * * * * * * * * * SPECIAL CONDITIONS OF THE PERMIT: By L '3 Jown of Qufenslury APPLICATION FOR SEPTIC DISPOSAL PERMIT BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 /- Oueensbury, New York 12801 DATE s//�/ lc& LOCATION OF PROPERTY FOR INSTALLATION �1.0 fox rfCYGoct2 I„ OWNER'S NAME m k MArs �jro-,.I ( fi S'1'er CC`� ADDRESS /O {�wm MI Ali 134 J q TEL 3/ 3 '4? fto INSTALLER' S NAME j4,; 5 TEL TEL -iN)! Number of bedrooms(residential only) I Total daily flow(compute @ 150 gal per bedroom) Goa Topography: Rolling - Steep slope - (circle one) % of slope_ Soil nature- - Loam - Clay - Other Depth_ ft. Ground water -At what depth? 4I+ ft. Bed-rock or imperviou at rial - At what depth? .1.0 ft. Percolation test - Not require - Required - -Rate min-inch. Domestic water supply Municipal Well - Other Separation - Watersupply(if well) from Septic absorption /01) ft. Proposed System: Septic tank /ttO gal. ( Minimun size, 1000 gal. ) Tile Field - Each trench $D ft. Total system legnth ;.,y - ft. Seepage pit(s) Number of _pp- . Size each Affkft Xft / Size of stone to be used # Depth or thickness - ft. h IMPORTANT ! ! *4 * 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 DOMESTIC WATER SUPPLY or shore-line of lake, stream,pond or wet-lands . Include all dimensions of the system, itself .* # * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * I have read the regulations on the reverse side of this sheet and agree to abide by these and all requirements of The Town of aueensbury Sanitary Sewage Disposal OrdinanceT �1,, � k/' Signature of responsible person y_�"`�(� LA-44 '^' Date S/IS/“, 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. TOWN OF QUEENSBURY • WARREN COUNTY , NEW YORK i 1 Application for : BUILDING PERMIT IN COMPLIANCE UITH THE NEW YORK STATE ENERGY CONSERVATION CODE A permit must be obtained before beginning work. ANSWER ALL of the following: //,, 1 . Gross floor area GVEd 2 . Type of heat /y/}5 • 4/ (,JQ T[✓e ;?:/ ' 3 . Is the building mechanically cooled? NO 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 _ 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 R - a } 2 . R value of exterior walls �1R -Ti 3 . R value of glazed area 2 , 9( 4. R value of doors /I 1 5 . R value of floors over unheated spaces k - II 6. R value of slab edge insulation - unheated slab (Z - II 7 . R value of slab insulation - heated slab 114 8. R value of heated basement/cellar walls (above grade) /1-/3 9 . R value of heated basement/cellar walls (below grade) Q •Il 10. Type of insulation (L(n(r((D/ cimtf GLtfs C. Controls / p 1 . Thermostat maximum heat setting 53S D. Duct Systems 1. Is duct system installed in unheated spaces? NO a. If YES , R value of duct installation 1( b. R value of duct in other areas team, E . Piping Insulation 1 1 . Size of hot water or cooling carrying agent pipe 3 2 . R value of pipe insulation 12' 1 / F. Service Water Heating 1 . Performance efficiency 2. Temperature control setting maximum Pi So C. For Swimming Pool Only 1 . Maximum7 - % �(/ heating nnJ/!�// II Telephone No. -?"1// ' 71,iSk Wi --- (applicant ' s signature) 7 ;iIQQ eregiaKW° // " Yw �own of Qeensbury BUILDING and ZONING DEPARTMENT Bay and Haviland Road. R.D. Oueensbury, New Yo12801 Re; rise ectlb.h ft/.. BUILDING INSPECTOR' S REPORT CA Cr< NAME rl ( LOCATION Lp"r At o Ho /a W h„.„ , Dao '„ /�_ Permit No.2.(� . — * * - * * * x + * * * ** * * * * x * * - YES NO * * * �/ = APPROVED Footing/Pier Forms i Foundation _ Waterproofing 111111_ FBraming _ Framing _ Roofing _ Siding _ Masonry Pluming Rough Plumbing 11111 Relief Vrch _ K Ext. hed Fl 0111 es Fnnerior Floors . Interior Trim MPS `(Cell 6 Railings Cellar Drain Tile Mill Concrete Floors _ Fixtures aI . Gar. Fireproofing yDoor Closersoke yetectoChimney INundaTIOI Fo undationFloors Walls INAL CAL INSPECTION Iwo FINAL ELECTRildiI Survey.. Building � leX ection(call when ready) Next scheduled Insp Remarks- - Heed EL. ^ ` , Building Inspect 6/B6 and-v1 41/lldG a � '" down o Quee„s6u,y BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Oueensbury, New York 12801 C/a jns,pcerldh BUILDING INSPECTOR'S REPORT NAME /- (,r'n CUS16- LOCATIONwi`e Datej2 fib. Permit No. G "a 2 * * * * * * * * * * *= * * * * * * * * * * * V/ = APPROVED - YES NO Footing/Pier Forms I Foundation Waterproofing Backfill ' Framing 1121 Roofing Siding _ Masonry Veneer _ Rough Plumbing rI Relief Valves _ Ext. Porches IMPFinished Floors w_ 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- - No 5-rea15- ger T-10 °ooK- I3L-hrc Ooolt CtriAGG Oo0K, Bui ding maps for 6/86 and-vl 1Ib 4' Jown of Queenilury BUILDING and ZONING DEPARTMENT Bay and Haviland Road. R.D. 1 Box 98 Oueensbury, New York 12801 BUILDING INSPECTOR' S REPORT NAME Cuirc LOCATION rustl401/ew Datej. /2AL_ permit No. `L / * * * * * * * * * * * * * * * * * * * * * * * 1/ v APPROVED - YES NO Footing/Pier Forms _ Foundation Waterproofing _ Backfill �� ✓Framing f'}���1' +�M Roofing Siding M$sonry Veneer ✓ ough Plumbing i�vtnig1iall= Relief Valves _ Ext. Porches Finished Floors _ Interior Trim _ Stairs 5 Railings _ Cellar Drain Tile _ Concrete Floors Plbg. Fixtures Gar. Fireproofing _- Door Closers Smoke Detectors 111110 Chimney WM INSULATION: Foundation =;- Floors Walls Ceiling FINAL ELECTRICAL INSPECTION _ Final Building Survey Next scheduled Inspection(call when ready) Remarks- - J f n _ . Building Inspector 6/86 and-vl c7 Jown of W(ueenaury BUILDING and ZONING DEPARTMENT Ili Bay and Haviland Road, R.D. 1 Box 98 I Dueensbwy, New York 12801 I SEPTIC DISPOSAL SYSTEM INSPECTION NAME aOr F // STtinD — LOCATION DATE t_l___134 SanPERMIT N0. QGSCILE - Sand - Loam - Clay -_ Percolation Test Required? YES - NO Percolation rate - Min/Inch _ TYPE of SYSTEM: Absorption field, total length Length of each trench Depth of trenches�- Size of gravel_ SEEPAGE PITSENumber of) _�- Size- ft. X __ft. — ____--- Gravel size PIPING: Size Type Bldg. to tank Tank to dist. box __ Dist. box to field/pit __ Openings sealed? YES NO Partial LOCATION/SEPARATIONS: ft. Foundation to tank —ft Foundation to absorption f Absorption to lot line t. Separation of pits LOCATION OF SYSTEM ON PROPER ')circle rcle Clue-1- Front - Rear - Left side - ' 9 - CCMIENTS: a,,e,/�/j - A U ; / NO SYSTEM USE APPRO i ` Building Inspector 01/86 and vl lib ' h -flown of Queenalury BUILDING and ZONING DEPARTMENT Bay and Haviland Road. R.D. 1 Box 98 Oueensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME t1 1/1--,i/ (c) 5 LOCAT I ONE LC Q v /- DATE / PERMIT NO. A (Y �J SOIL TYPE - Sand - Loam - Clay -_ Percolation Test Required? YES - NO Percolation rate - Min/Inch - TYPE of SYSTEM: r Absorption field, total length- — Length of each trench clor Depth of trenches Size of gravel_ SEEPAGE PITS{Number of) ______— Size- _ft- X _—ft- Gravel size PIPING: Size Type Bldg. to tank Tank to dist. box Dist. box to field/pit Openings sealed? YES NO Partial LOCATION/SEPARATIONS: ft. Foundation to tank ft. Foundation to absorptio ft. Absorption to lot line ft. Separation of pits LOCATION OF SYSTEM ON ROPERTY(Circle one) Front - Rear - Left side - Right side - COMMENTS:,4 6n— a_ 6e/ pim recr— SYSTEM USE APPROVED YES N/ Building Inspector 01/86 and vl /6a9 TOWN OF QUEENSBURY Building Department Specters Report Date 6/3/0 Name Cu57-E12_ 2y Location my ADOL(/aM) Permit No. 4(0 - & i Weather Remarks Excavation Footin• Forms Footin. & Piers Ad / Foundation Cement Coat Water.roofin• Backfill Final Surve Framin• '.. Sheathin. Roof Felt VIM _ Siding - Masonr Veneer Rou•h P1.•. Relief Valves Wall Board Ext. Porches Finished Floor Interior Trim Stairs & Raili •s 4 Cellar Dr. Tile Concrete Floors Pl.. . Fixtures Gar. Fire.roofin, Door Closers Chimne Water Meter Inst. Se tic A royal Floors Foundation Insulation Walls Ceiling Building Inspector REMARKS 4. 3I v. p r / b N r3,(43, 56, b v iir 3 O N 1/37, 754 sQ rr) C01 ��` C - N Zvi 4-: ti Cco,,,,, r}'. .Ns.-,_.-.. 0.A--\ZL.,3 Al o/ i IIc:65 0. dI,kIVN0N..2 •,30,4."o1°;t 4<,. )•,F N.1,S,,g-,eCa,4.,1't•••• t‘abq,.-.o.c i,„<t IP 2e-e/`0 T`,o t,o s7 .,.lit,,—i_..31_ fr7__r__„t"-_i,,i_ qb 1 5i 5 a=24.3.bz• / 51 ai's Nam' en� B 100.° O yr �' V ( , 569 s4 r' ui / , '<b,ba 71— A ,,_7,_ ,;, __..,_; h h it� 2. h 3�) � o -" / �-, _ G i�I,. ft• - q51 • 0 ?3'J34- SQ. Fr) it) o♦� ti \ N I I Is 2 ( 35,-06 • FL )- ' u 0 0 \... N. ; non / o C � I � • y 1 �` , bh \ • ya P / C O h Ere _ I ^JfNT`y _ _ i . O . • Tn -- I - r / o 0 F rr- _ o • -I' � •Prota.ted ire- � eys» re/K � / )om ... _ -- F 11