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1985-585 CIO Paid CERTIFICATE OF OCCUPANCY TOWN OF QUEENSSURY WARREN COUNTY, NEW YORK Orl�} Hate 19 /. - `�1 This is to certify that work requested to be done as shown by Permit No. S 5 - 58 5 has been completed. This structure may be occupied as a ONE FAMILY MODULAR DWELLING q Locarion ROUTE 149 Owner Q"UEENSBURY COUNTRY CLUB , INC . By Carder Town Board TOWN OF QUEENS$URY Building & Zoning Inspector CAe A TWC "STA PA 1ftT1"Q. QLCN5 PU Lus MY 1 280 1 If 10�793-3435 BUILDING PERMIT TOWN OF QUEENSBURY No. 85 - 585 KD WARREN COUNTY, NEW YORK too un PERMISSION is hereby granted to Queensbury Country Club, Inc . �t OWN E R of property located at Route 149 Street, Road or Ave. f"] in the Town of Queensbury, To Construct or place a One-Family Modular Dwelling at the above location in accordance to application together with plot plans and. other information hereto filed and rF approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. +� f] t_ OWNER'S Address is RR # 1 Box 1494 � Lake George , New York H 2. CONTRACTOR or BUILDER'S Name Ken Collette 3. CONTRACTOR or BUILDER'S Address Hudson Falls , New York 4. ARCHITECT'S Name !;d 0 rr ro 5. ARCHITECT 5 Address ,p 410 6. TYPE of Construction — (please indicate by X) [ M wood Frame ( } Masonry [ } Steel ( 1 7. PLANS and Specifications 24 1 x4 01 per plot plan , specifications and No application submitted including sewage system . THE ATTACHMENT OF THE TWO PARTS MUST BE APPROVED BY A o TNEER . � S. Proposed Use I *rJ 5� Cone-Family Dwelling N N $ 5 _ 00 C/o Paid $ 7 0 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES May 1 1986 (If a longer period is required an application for an extension must be made to the BuildingZoning and g inspector of the I-.J town of CSueenslwry tMsiore the expiration date.) H F�- Dated at the Town of Queensbury this 1 Oth Day of _ October 19 8 5 %JQ SIGNED BY //'JC [ems (C2 . �,2� for the Town of Queensbury o 9 Building and Zoning Inspector TOWN OF Q►UEENSBURY (Space inside block to Ix, filled in bw WARREN COUNTY. NEW YORK Building ln:sprc•torl A�p tt Applicationcation No, Itcation i�� f*e, I1, il issti(A 19 BUILDING AND ZONING PERMIT I'rr,,, it F NI-Pires . It7 /i �iimiv Dis) rirl THREE (tii'1 Copies of a PLOT PLAN. Drawn to scale showingg the actual dimensions of the lot to be built upon, The exact size, and location an the lot of the building to be erected or altered MUST BE SUB- MITTED WITH THIS APPLICATION. �_ • tat TOWN Q[]Er=NSE3Uf2Y I)ATF A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK IE 0 Fit lY E 1} II ANSWER ALL OF THE FOLLOWING. � The undersigned hereby applies for a permit to do the following work d y ere which will be done in accordance with the description, plans and specifi- cations, and such special conditions as may be indicated on the permit. 7� 8I tx 1 2 3 4� 6i �fi1;7 le The.owner of this property is + . �IwrA+.�) IP O. ADD RESSI The person responsibie for supervision of the work insofar as the Building Code and the Zoning Ordinance apply is: . . �. . . . . . . . . . . . . . . . . . . . . . . . . . . , - . - . . - cwA. . . . . - . t ) " aoor+Esss Name of Builder -le�. J� Address . . . R Nameof Plumber . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . Address . , . . . - - . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . - - . Name of Mason . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . Lot Number . . . , , . . . . . . . Unit . . . . . . . . . . . . Estimated value of proposed work 3 . . `* ;' . . . . . . . . . . . . . . . . . Nameof Village . . . . . . . . . . . . . . . . . .r . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . ,cam . . Name of 'Streetu.*G/Gt7 �?..: 4 . -' . Side of street : north 0, east 0 , south west 0 Nearest Cross Street j4pe T J - - - - . • . Distance from. this gross street . . . . Ft. . .� Property is north ❑ , south , east Vi , west El from Cross Street If on Corner, which corner, northeast U . northwest ❑ . southeast ❑ . uthwest (Designate by marking with an "X"' in the correct space.l NATURE OF PROPOSED WORK OCCUPANCY Construction of a new building. ! gl(r4 A Main B'tstitiing 0 Addition to a building. One-Family dwelling .Two-family dwelling; M Alteration to a building. Q ❑ Demolition of a building. -family apartment house ❑ Store_ building ❑ . . . . . - - - -car attached garage ED Other: . . . . . . . . . . . . . . . . . . . . . . . . Accessory Building One-car detached garage © Other work- Describe: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Two-car detached garage Private chicken house Private storage building 0Cher: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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, sire and setbacks of pro- NORTH posed buildings, and the location of all existing buildings. 41— Show proposed building(s) in dotted line and existing %uilding(s) in solid line. k Size of property 4�3%5'4) . . • . . ft. x ft. ty _ Size and use of existing buildings, if any . . . . . • . • • • • • . �`• . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . All m Size of proposed building= AxT.. Ft. x . 49//P t . . . . ft_ Height (from grade to ridge. . . . . . . . . . . . . . • . . . . . ft. Front yard .Q . . . . , . ft. Side yards . . ,et . ... . . . . . ft. and . . . . . . . . . ft. / . . �/'�' . . , , Rear yard . . . . . � . . . . . . . . . . . . . ft,. . . SOUTH 11 on corner, setback from side street . . . . . . . . . . . . . . . ft. . . .Note: All distances are lost, as measured from street side line to nearest part of building. ry (OVER) f ' !r7 3 "m (cont'd. ) t i- BUILDING SPECIFICATIONS. 1y t y`k Kind of construction = Wood frame, fire safe, etc.? , . . . . . . . . . Willany second-hand lumber he used? . . . .A` P . . . . . . . if so, for what? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . Material of foundation walls . . . . .c'94e-. 4%4w 4. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Thickness . . . . . . . . . . . . . . . . . Depth of foundation walls below grade . 40 . ,Fr . A "eTA-0. . ' ~• '' t`s'� Continuous foundation? .*Y"4:='s- - . Will there be a cellar? . - - - . . If so, material of cellar floor 4�70Wj::' . . . . . . . . . . . . . . . . . . . . . . . . . . Type of roofw Sloped or flat? . . . . . . . . . . . . . . . . . . Material of roof . . . . . . . . . Size, wood studs . . . . . . . . . . . . . . . . . . . . " x . . . . . . . . . . . . . . . ", spacing . . . . . . . 4 . . . . . ."o.c., length . . . . . . . .. . . . . . ft. Size, floor beams, Ist floor " x . . . . . . . . . . . . . ... spacing . . . . . . . . . . . . . . "o.c., span . . . . . . . . . . . Size, floor beams, 2nd floor . . . . . . . . . . 4 5 spacing . . . . . . . . . . , . . . "ox_, span . . . . . . . . . . . . . . ft. Size, ceiling beams . . . . . . . . . . . . . . . . . x . . . . . . . . . . . . . . . " , spacing "o.c., span . . . . . . . . . . . . . . ft. Side, roof rafters or beams . . . . . , . . . . . " x . . . . . . , . _ _ _ , spacing _ . , _ _ _ , . . . . "o-c., span . . . . . . . . . . . . . . ft. Exterior finish . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . With what material? . . . . Finish of interior walls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 . . If garage is to be attached, of what material is wall between garage and main building to be constructed? . . . . - - 41/e. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . _ . . . . . . _ . . . . . I . . . . . . . . . . . . . . . . . . Is there to be an opening between garage and building? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Kind of heating system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Oil burner or coat? . . . . . . . . . . _ . . Will a flue-lined chimney be provided? . . . . . . . . . . . . . . . Depth of chimney foundation below grade . . . . . . . . . . . . . . Height of chimney above roof . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Will there be a fireplace? . . . . . . . . . . . . . . . . . . . . . . . . . Depth of fireplace hearth . . . . . . . . . . . . . . . . . . . _ . . . . Will a toilet be installed? . . . . . . . . . . . . . . . . . . . , . . . . ". . . . . . I . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Will a kitchen sink be installed and connected to water supply? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Water supply (public water supply or pump) . . . . . . . . . . . . . . . . . . . . . . - - • - - - - - . . . . . . . . . . . . . . . . . . . . . Distance of cesspool from any private well . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . feet . . . . . . . . . . . . Will drainage system be provided with required traps, cleanouts, and vents? . . . . . . . . . . . . . . . . 4 . . . . . . . . . . . . . . . _ . . . Town of Queensbury AFFIDAVIT County of Warren State of New York I swear that to tr. Ibci a of my know wedge and belief the statements contained in this application, tobether with the t►Wno and apecificatiuna m wb milted, area true and co., lete statement of all proposed work to be done an flue desrxibed premsaes and that anions of the BUILD- INCr CODE, THEZONING ORDINANCE, and all other laws pertaining w� work sh be co specifued or not, and that such work is authorized by the owner• Sworn to before me this signature . QW . UWmER'S A E • Y. CQNYR ACTOR dayof. . .. . . .. . .. .. . . .. . . . . . . .... . . .. . ... . . .. . . .. . . 19. . . . . . NOTARY PUBLIC, WARREN COUNTY, N. y. SPECIAL. CONDITIONS OF THE PERMIT: By . _ _ . .... .. .. . . . ... . . . . . . . . .. . .. . . ..... . . . .. .. . . .... . . ... . .. ._ . .. .,_. TOWN OF QUEENSBURY WARREN COUNTY , NEW YORK ,: ,I �. Application for : BUILDING PERMIT IN COMPLIANCE WITH THE NEW YOR STATE ENERGY CONSERVATION CODE A permit must be obtained before beginning work . ANSWER ALL of the following . 10 Gross floor 2 . Type of heat 3 . Is the building mechanically cooled ? . 4 . Percentage of area of windows and doors 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 10 % If YES , what is the R value ? 3 . Slab can grade YES NO a . If YES , what is the R value of insulation around perimeter of floor ? 4o is basement. heated ? YES NO a . R value of insulation 5 . Type of insulation Under 16 % Only y �--/ 1 . R value of roof and doors exposed to ambient conditions_ 2 . R value of exterior walls - # G 3 . R value of glazed area 4 . R value of doors 5 . R value of floors over heated spaces t « I& 6 . R value of slab edge insulation - unheated slab 7 . R value of slab insulation - heated slab „eee . R value of heated basement /cellar walls ( above grade ) ", - 9 . R value of heated basement/cellar walls ( below grade ) 100 Type of insulation C . Controls o 1 . Thermostat maximum heat setting _ D . Duct Systems 1 . Is duct system installed in unheated spaces ? YES NO a . It YES , R value of duct installation b . R value of duct in other areas A4 41T E . Piping insulation 1 . Size of hot water or cooling carrying agent pipe 2 . R value of tripe insulation F . Service water Heating le Performance efficiency 2 . Temperature control setting maxi um / G . For Swimming Pool Only / 1 . Maximum heating A11zf - T e l e p h o n e N a r ( appllLwafftls signature ) loy'e� TOWN OF QVEENSBURY BUILDING & ZONING DEPARTMENT SEWAGE DISPOSAL PERMIT APPLICATION 1 . Owner ' s Namey2�, Address T ! 'A/5 Telephone No . 2 . Property location 3 . Name of person or firm responsible for installing system Telephone No . /�'" 42 3C 7 Address C 9 . Number of bedrooms (residential 'buildings only ) 5 . Daily flow . k ee) r) gallons/day 6 . Septic tank capacity gallons 7 . Topography : flat , rolling , steep $ of slope 8 . Nature of soil and depth 4 cc 9 . If ground water , bedrock or impervious m terial i,s apparent at what depth does it begin? _ ,. 19Aor4� ,q,,�- ,rr ;4. �ft . 10 . Percolation test : A is required 8 is not required C I equlred what is the rate [5 - �.e' minutes/inch 11 . Water supply : municipal , well , other. &nfr {0�(/'� 12 . Type of system proposed : drywell , the field , other 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 Queensbury Sanitary Sewage ordinance . gn ture or applicarlt On separate sheet of paper submit a dia ` of the proposed septic system with all dimensions , including distance rom any structure , distance from property line and domestic water supply , etc . Include all dimensions of the system itself . Form 3 - 82 ©� -- t THE NEW YORK BOARD OF FIRE UNDERWRITERS SUREAV 012 ELECTRICITY Fig 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date January for 1986 Application 1vo. "file 101437/85 THIS CERTIFIES THAT 721730 .. only the electrical equipment as described belote and introduced by the applicant named on the IsborHE application number in the promises of Eugene Smith [[--Farm to Market Road. Queenbzryr New York _— in thefollowing location; LJ Basement [71 Ist Fl. ❑ 2nd Fl, Out51de Section Block - Lot _ was examined on 11-14-$5 and found to be are compliance with the requirements of this Hoard. . FIXTURE RECEPTACLES sVY17CHE5 FIXTURES RANGES CCri?KING DECKS OVENS DISH WASHERS EXHAUST FAhIS- OUTLETS INCANDESCENT FLUORESCENT v AMT- K. W. AMT- K. W. AmT. K.W. AMT- K- W_ Amr- H- P. DRIIERS FURNACE MOTORS FUTURE APPLIANCE FUDERS jSPffaALR*C-PTj TIME CLOCKS I UN17 HEATERS 1AULTI-OUTLET DIMMERS AMT: K. W. OIL M. 7. OAS H. P. AMT. N4. A- W. Cr. AmT_ AMp. Mh.T. AMPS. TRANS. AmT. H. P- SYSTEMS AMT- WATTS NO. OF PEST SERVICE DISCDNNC-CT MO. OF S E R V 1 C E Mona AMT. AP. TYPE EDP. 1 X 2W 1 N 3W 3 X 3W 3 Jr 4W NO- CR$COND. OF CC COND. NO. OF HI-LEG „LE r Na. OF NEUTRALS OK r ft R M U1 AL 1 00 C/B 1 x I I I l 1 #2 AEA OTHER APPARATUS: - — Eugene Smith Farm to Market Fzc ad RD 1 .Box 1494 Lake Gearger New York 12845 Pe This certificate must not be altered in any manner; return to the office of the Board if incorrect. inspectors may be I Mifi thei dentiols. TO'IRiIN OF QUEENSSURY Building Department larapere aas Repa'! Data Ib /;2 .. S Na�ee - 0 6 ► Lroeatia�a Perrngii�k No. � �' - .s- s 5 'Weather Remarks SxcatYa t 2,012 Footancy Forms Footin Is Piers Foundation Cement Coat Water roof%n Bacxfill Final Surve Frami.riXy IF Shea thin Roof Felt Roofin Sidin Masonru veneer Rou h Pl Relief valves Wall Board Laxt . Porches liiiiiiiii11 Fi.ni shed Floor .Interior Trim Stairs B Railin s Cellar Dr . Tile Concrete Floors Pl . Fixtures Gar. Fire raofi.n Door Closers Chimne Water Meter Anst . Se tic A royal Floors Foundation, kk 3nsulatlon iyalls _ _ Ceilin �r' y ngr rns e t Bus dsng Inspector REMARKS 4000532 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITYan y fj 88 JOHN STREET, NEW YORK, NEW YORK 10038 (� �j _ Dote Decemb r 5 , 198 CJ Appiieation No. on file ]. 0 ^0713-85 N 7 1 9 4 G 6 _ THIS CERTIFIES THAT only the electrical egaipment as described below and introduced by the applicant named on the above application number in the premises of � QL�bury Cc ut try Club , Farm to Market Road v Gleras Falls , *ew 'York in the following location; ❑ Basement N ]at Fl. ❑ 2nd Fl. outgidO Section Block Lot was examined on 11/11 /85 and found to be in compliance with the requirements of this Board. FIXTURE RCEPTACLES SWITCHES FIXTURES RANGES COOKWG DECKS OVENS [HSH WASHERS EXHAUST FANS OUTLETS INCANDESCENT . FLUORESCENT Yw AMT. K- W- AMT- K. W. AM7. K.W. AMT. K- W- DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECPT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERSSYSTEMS .'". AMT. K. W. OIL H. P. GAS H. P. AM7. No, A. W. G. AMT. AMP. AMT. AMPS. TRANS. AMT. H. P, I NO OF FEET AMT. WATTS SERVICE DISCONNECT NO. OF S E R V L C E AMT_ AMP. FTpE METER 1 ,9 2W 1 0 3W 3 0 3W 3 ,e AW No. CG. CONO. A. W. G. NO- OF HI-LEG A. W' G- NO- OF NEUTRALS EOUIP. PER 1R' OF CC. CONS. OF HVLEG C1F NEUTRAL rt I 200 CB 1 x 1 4/4 � 2/E3 OTHER APPARATUS: Saul W. Corhatas„ 39 11 Potter Rf'FS3d Can e` oort , Ww York 12831 GiE IS M. MANAGER 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. TOWN OF CUEENSBURY Building Department le a R"Kwt Date 1Q 3 Names L'Nf G Laaral�e�a Weather Rema rkS Excavation Footin Forms pootin & Piers Foundation Cement Coat Water roof-in ,Bacxfill Final Serve F,rami n Sheathin Roof Felt Roo an Sid%n Mason-VU Veneer Rou h PI Relief Valves Wall Board Ext , Porches Finished ,Floor ,interior Trim Stalrs & Railin s Cellar Dr , Tile Concrete Floors pl Fixtures Gar . Fire roofin Door Closers Chimne Water Meter Tnst . _. Se tic A roval Floors ----- Fou._ nd tion �.... rnsulat.ion Walls Cei2 in Sui ing r,nspector REMARKS TOWN OF COJEENSBURY Building- Department iarpm*W& Ntewart Date oo 7 Permit. No. S weather Remarks ExcatYa ti on Footing Forms .Footing & Piers Foundation Cement Coat Water rooffing Baclrfill Final Survey Framing sheathIn Roof Felt Roofin Sidin Masonry Veneer Rough P1 Belief valves fall Board Xxt . Porches Finished Floor Interior Trim .stairs & Railings Cellar Dr . Tile Concrete Flours Pl . Fixtures Gar . Fire roofin Door Closers Chime Water Meter Inst . Septic Approval Floors Insulation Foundation Walls " _ Ceilin e� 4C) Building Inspector REMARKS e. 4 � �I p /sc> r- / 1krA4 S i r r � s A i i f r�