1986-345 CERTIFICATE OF OCCUPANCY
TOWN 'OF QUEENSBURY
- WARREN COUNTY, NEW YORK
• Date August 27 19 86
, lam
This is to certify that work requested to be done as shown by Permit No. 86-345
•
has been completed..
One-Family Dwelling
This structure may ,be occupied as;a
Location Lot 53 Willow Road (St. No. 6)
Martin C. Mosher
Owner
By Order Town Board .
TOWN OF QUEENSBURY
/11
•
Building W Zoning Inspector
. a
BUILDING PERMIT
TOWN OF QUEENSBURY rNo. 86-345
WARREN COUNTY, NEW YORK •
PERMISSION is hereby granted to Martin C. Mosher
OWNER of property located at Lot 53 Willow Road (St. No. 6) Street, Road or Ave.
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in the Town of Queensbury,To Construct or place a One—Family Dwelling rt
at the above location in accordance to application together with plot plans and other information hereto filed and p
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is 15 Greenway NorthEn
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Glens Falls, New York
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2. CONTRACTOR or BUILDER'S Name
same
3. CONTRACTOR or BUILDER'S Address
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rt
same cn
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4. ARCHITECT'S Name o H.
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
(X)Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications 0
No. 26'x52' per plot plan, specifications and application submitted
including sewage system and two—car attached garage.
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8. Proposed Use F''
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One—Family Dwelling
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CD
$5.00 C/O Paid
$ 143.00 PERMIT FEE PAID —THIS PERMIT EXPIRES January 1 19 87 ora
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 24th Day of June 19 86
SIGNED BY 7ikLe441Q_ for the Town of Queensbury
Building and Zoning Inspecto�
TO BE COMPLETED BY BLDG. DEPT.
Application No.
own of Queenitury Permit Issued 19 TOWN OF QUE NSBURY
BUILDING and ZONING DEPARTMENT Permit Expires 19 Ipl E y V E 0
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation
Queensbury, New York 12801 Variance No. A
j (i 1 y} 6
Site Pla eview No. }} ��J�� ✓�
,6 -9-5 Approv A.M. V P.M.
718b °P12}r. '. 2 3)41516
APPLICATION FOR 01
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BUILDING AND ZONING PERMIT
* * * * * * * * * * * * * * * * * * * * * * * * * * * * *
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.
•
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The owner of this property is: I�/ A ( % / A
P.O. Address 45-- ky, _/,_ a -iti-4-1YvQ-d_.-u Ld Tel. 79 - /a.s-e,
Property Location: `A_ t •4 ��? ,..2J X,c„ pL . C Tax Map No. yQ/ N$3
4'69 Street number or building lot number
Subdivision name (if applicable) /f Lv �°�. � �� / ( 1i, `c.1,v4.,.F
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THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
' 1A h 1,Z) G • /--u ice,_. &- z-,-i.�,,f . 7 9� - / a o
Name P.O. Address Tel. No.
Name of builder , , Address Tel.
Name of plumber .,.,„J Address Tel.
Name of mason �w,,,,,-- Address Tel.
NATURE OF PROPOSED WORK: * ZONING INFORMATION:
Y 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
*
LOCATION OF STRUCTURES AFFECTED. of water supply and location and configuration
* of septic disposal area.
*
* COMPLETE INFORMATION REQUIRED BELOW.
* Size of property /3 D ft X /74 ft.
* Existing buildin (s) Size ft X ft.
PROPOSED BUILDING AND USE: * Existing building(s) Use
Size of new structure 6, ft X.S--Z ft- *
Foundation-pier/slab craw7 /du partially * Proposed building, distance from property line
(circle one)
*• Front yard _�'O ft Rear yard R5 ft
No.' of stories (habitable space) * Side yards • ,_6"- ft and 2-7z.0 ft
Height (grade to ridge) oZ 0 ft. * If on corner, setback from side street ft
If residential, no. of families /
No. of rooms(exclue ng baths) 7 * OCCUPANCY" INFORMATION
No. of bedrooms *
* PRIMARY BUILDING -
No. of bathrooms a /42 „, / One family dwelling
Primary heating system
Type of fuel e=� t, Two family dwelling.
No. of fireplaces to be installed / * Multiple dwelling / Number of units
Will a wood stove be installed? Lp- * 1/Permanent occupancy
Central Air conditioning? �?� * Transient occupancy
* Business
BUILDING STYLE, PRIMARY STRUCTURE Industrial
Ranch Contemporary Log cabin * Other.
Raised ranch Mansion Duplex * If addition, what will use be.
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 ) * yt Attached garage/one car/ two car/ a- car
* * * * * * * * * * * * * * * * * * Private storage building
ESTIMATED MARKET VALUE OF * Other
CONSTRUCTION *
s D ,,.
•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, wood frame, fire safe,etc.
Will any second-hand or ungraded lumber be used? If so, for what? 1L,-
Foundation wall material /DLn-r,� Thickness
Depth of foundation below grade (to bottom of footing) (p p
Will there be a cellar? 7�.�,,/Heated or unheated? L,1,,,•�u eiT 4 Floor sq. footage 7d'D sq ft
6
Will there be a basement? ? coi Will any portion be used as living space? %2.47-714_,
(If so, what portion? sq.ft. - - Type of use?
Type of roof -(sloped/flat/shed/other Material• of roof .i,F,
Size, wood studs "X L/ " spacing , "o.c. length f' ft.
Joists(floor beams) 1st. floor oZ "X /v " spacing /Le "o.c. span /3 ft.
Joists (floor beams) 2nd. floor aZ "X /D " spacing / , "o.c. span /3 ft.
Overlays(ceiling beams) 7 "X 6 " spacing /6 "o.c. span/3 ft.
Roof rafters �Z "X d7 " spacing /6 o.c. span ft.
Roof trusses(pre-engineered) spacing c,7471 "o.c. span oZ / ft. ,, c.4 y_ y ‘-n•u-G1 • r71-17
Exterior wall finish y h1.,,•,/ > Of what material?
Interior wall finish //�" / ����
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? `7-4 If so will a Fire-rated
door, enclosure, and self-closing device be provided?
Will a flue-lined chimney be installed? ?/ Height above roof a ft.
Depth of chimney foundation below grade j ft.
Depth of fireplace hearth ft./6 in. l �
Water supply - Municipal or private well -/• ,)-,� ,/, _f
SEPTIC SYSTEM _ Distance from ANY private well(including adjoining properties ft.
(A separate application is necessary for any repair or new installation of septic system)
Town of Queensbury AFFIDAVIT STATE OF NEW YORK
County of Warren
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. //JJ
SWORN TO BEFORE ME THIS Signature '✓2/(4_ -.-,•,J •
Owner, owner's agent,arcnitect,contractor
day of 19
Notary Public, Warren County, N.Y.
*'* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
SPECIAL CONDITIONS OF THE PERMIT:
By
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WARREN COUNTY , NEW «PORK • J/�/ctiGGc��
Application for ' BUILDING PERNIT IN COMFLIAN'CE WITH THE NEW YORK
STATE ENERGY .CONIERVATION CODE
A permit must be obtained before beginning work.
ANSWER ALL of the following'
1 . Gross floor area - 1 2'C�
2 . Type of heat __. . �C t��
3 . Ia the building mechanically Cooled? Nq 8
4 . Percentage of, area of windows and doors ., cI" of.
A. - Over 16t Only r
1 . Uo value of gross area of walls , roof/ceiling and floors
exposed to. ambient conditions
- i
2. Floor over heated spaces YES NO
a. Are foundation walls insulated? . YES NO
. 1 . If YES, what is the R value?
a
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• On.•l.y
1. R value of roof and floors exposeA to ambient conditions
' 2 . R value of exterior walls
3. R value of glazed, area 240
4 . " R value of doors . V,5c1.
5. R value of floors over heated spaces II
6.• R value of slab edge insulation - unheated slab V\JA
7. R value of slab insulation - heated slab V
'T UU
8. R value of heated basement/cellar wills (above grade)_ j_
9. R value of heated basement/cell°ar w.a,lls (below grade)
10. Type of insulation .
C. Controls
1 . Thermostat maximum heat setting
D. Duct Systems -
1 . Is duct systhm installed in unheat3d space*? YFS : NO
a-. If Y-ES , r-R value of duct installAtion ,
b. Rvalue of duct in other areas r
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 jS v1D
2. Temperature control setting maximum 1 O
G. For Swimming Pool Only . ',t„ '
1 . Maximum heating 'r
r►---.
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'e ephone.. No. 9o7 - ias—v • '+ ,. • Li97 ( G .
N . . . (applicant ' , signature)
awn o f Queenil urty
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL PERMIT APPLICATION
Owner's Name /rl Ci ,� C - /'Lc� /��t, Tel. 7 9-z -
Address /,----A- Z6Pi,-u ,c- �7 1�
UI
Person/Firm installing system YY7 Q,)>_,T,f
Number of bedrooms (residential only)
Total daily flow: (compute @ 150 gal.per bedroom per day) z7/ 0
Topography• flat rolling - steep - (circle one) Degree of slope %
Nature of soils- sand-loam-clay-other- Depth ft.
Ground water-- at what depth? ft.
Bedrock or impervious material--at what depth? ft.
Percolation Test - Not required / Required -Rate min/inch.
Domestic Water Supply -(unicip )- 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 on wetlands.. Include all
dimensions of the system itself.
Description of proposed system:
Septic tank size 0 gal.
Tile field- Length of each trenchaD ft. Total field/YO ft.
Size of stone # �.
Seepage Pit(s) Number / Size ftX ft. Size of stone#
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.
4
Signature of Applicant Date
01/86 and/vl
Septic System Inspections:
•
A. All applicationd for septic system installation,
alteration or repair, as required by the Town of
•
Queensbury 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 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 Queensbury Building '
Department before further construction .
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�n57J�1 THE NEW YORK BOARD. OF FIRE UNDERWRITERS
J. BUREAU OF ELECTRICITY . .
�; 41 STATE STREET,ALBANY,NEW YORK"12207
el; Date Application No.on file e t r� r
l October 2, 1986 017406-86 A R G 3 73 1
�. THIS CERTIFIES THAT
'-'c only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
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Posher corist. coe; Willow•? St., Glens Fal is(;'Ne:v7 York
a=
FE in the following location; D:Basement MI 1st Fl. 111 2nd Fl. OUtS1Ca Section Block Lot c-J
was examined on 8; 9/-,-- and found to be in compliance with the requirements of this Board.
( L1 l
FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT-FLUORESCENT /A�EAC,ppl' _ AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
EE
18 42 21 17 1 3 fr
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS SELL UNIT HEATERS MULTI-OUTLET DIMMERS
MT AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. - AMT. AMP. AMT. AMPS. TRANS. A . H.P. NO.SYSTEMSOF FEET AMT. WATTS
i range 3.i 6 o
1 dryer 3 0 10
1 CI
SERVICE DISCONNECT NO.OF S E R V I C E
AMT. AMP. TYPE METER 1.t2W I 3W 3,9 3W 3,B•4W NO.OF CC.COND. A.W-G. NO.OF HI-LEG A•W G. NO.OF NEUTRALS A-W-G- ®
EQUIP• PER 8 OF CC.COND.- OF HI-LEG OF NEUTRAL
ch 1 ,,: 1 4/0 1 2/0
OTHER APPARATUS:
......—
Elec. Heaters: 2-
zz
v 1.5 kwo e
1•- gfCi • 4- 1.0 kw I
1- smoke dei 2-• .75 kva
d
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_• , aRA Elec;. Co. 239 ®_
4:t44,: 7 Birch Lane BRANCH MANAGER to"
X: Glens Falls, NY 12801 .3=
Per - - lO
�; 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. KJ
i(-iii ie YiYY. -iiiY'iiiY iiii-4(Y.f-4-cit-Cie-i.Y'ielgi-isi-iiY'iAY-i.f iiii-iii-iiii YiiYYiY-ia?YeYabYYsi•-ieC-ie-ie(7tfYA :im-re•i.'•iai ti .iAcre re'reerio YA.rik 7Al-ri w"iivv•iei-iev-J1i-rip .;,fir%.i'
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
_own of Queeniur1
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION L f •
^ w„!/20
`l �f/
Date 812-7/ c---C Permit No. V - 3'�5
* * * * * * * * * * * * * * * * * * * * * * *
= APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding !�
Masonry Veneer
Rough Plumbing 1 /
Relief Valves \ f 1 �/
Ext. Porches `. 1�
Finished Floors .
Interior Trim �{
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures
Gar.. Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION:
Foundation jorA.,tt- ( 7-4—t(OK
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION /
ina Building Survey j/
/iV&) -i )i-0US7i
Next scheduled Inspection(call when ready)
Remarks- -
A D. /A-L CC/ /V (C4G hi-0 (1S
CiC.) - 0 IC milk 4, A
4/AIL
Building Inspecto
6/86 and-vl
�a l JVot of�6 5 : a 114/7
Jown of Queenitury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME Aar/
LOCATION (/T 57f3 a)i //d ki go
DATE #4)/ / PERMIT NO. -3f S�
SOIL TYPE - and Loam - Clay -
Percolatio Tes equired? YES 7-(1b
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length 127
Length of each trench 6-,j
Depth of trenches
Size of gravel _ _
SEEPAGE PITS{Number`of)
Size- ft. X ft.
Gravel size
PIPING: Size
idpe
Bldg. to tank ( t CS
Tank to dist. box —74.77 2_7`c
Dist. box to fields• '"t q-1r -7-7/
Openings sealed? /® ' NO Partial
LOCATION/SEPARATIONS: /
Foundation to tank `Q ft.
Foundation to absorption 2z; /ft.
Absorption to lot line /6 ft.
Separation of pits ft.
LOCATIOOF�SYSTEM ON PROPERTY(circle one)
Front(( Rear�y- Left side - Right side -
COMME -2- 7Y.-e-14)61-6 1,4-4]4--
SYSTEM USE APPROVPI / N�
Buil8ing Inspe or
01/86 and vl
flown o/ Queeniurcy
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME ,/V] (�. ►�'"�-r.�_
LOCATION --3 LO niQ.
Date 1-/j� / Permit No. 7/..
APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill •
tIcaming `S..R,(�►0 -44 ( 41-213 / L"
Roofing
Siding
Masonry Veneer
`"Rough Plumbing ®,K,
Relief Valves
Ext. Porches
Finished Floors f
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures
Gar.. Fireproofing / \
Door Closers
Smoke Detectors / \
Chimney
INSULATION: / v
Foundation
Floors
Walls
Ceiling •
FINAL ELECTRICAL INSPECTION
Final Building Survey
Next, scheduled pection(c 11 when ,.xea�_.a�)
Remarks- - /ye
far .0M/N. , .w.
Pam° 4_,frez-4:6
6o/
Building Inspector
6/86 and-vl n/&-O ;J 2(DG- ! Af -
•
TOWN OF QUEENSBURY
•
Building Department
pport Date � /1 8
Nun 5-
Location <'O7 5 /J/t Z- U R)
Permit No. j'' '"h0'`r R' Weather
J6— Remarks
Excavation
Footing Forms C�-� i�
Footing & Piers j� Olt
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing •
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves
Wall Board 11
Ext. Porches \ /
Finished Floor `A
Interior Trim /
Stairs & Railings \
Cellar Dr. Tile !'' \
Concrete Floors !
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney •
. Water Meter Inst. '
Septic Approval
• Floors
Insulation Foundation
Walls
Ceiling
Building Inspector
REMARKS
MARTIN a MOSHER .
15 GREENVIAY, NORTH
GLENS FALLS, NY 12801
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