1986-524 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date December 11 iq 86,
/rA -
I D
This is to certify that work requested to be one as shown by Permit No. 86-524
has been completed.
One-Family Dwelling
This structure may be occupied as a
Lot 26 Willow Road (Ste 'Nod 49) The Pines of
Location
queensDury
Owner Norman. Ouellette
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoning Inspector
BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-524
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Norman Ouellette
OWNER of property located at Lot 26 Willow Road (St. No. 49) Street, Road or Ave.
The Pines of Queensbury •
in the Town of Queensbury,To Construct or place a One—Family Dwelling
at the above location in accordance to application together with plot plans and other information hereto filed and 0
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. 0
1. OWNER'S Address is 26 Elm St.
Hudson Falls, New York
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2. CONTRACTOR or BUILDER'S Name same
3. CONTRACTOR or BUILDER'S Address
same
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4. ARCHITECT'S Name b �'
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X) rt
( X)Wood Frame ( I Masonry ( )Steel ( ) 0
7. PLANS and Specifications
No.
26'x64' per plot plan, specifications and application submitted
including two car attached garage and sewage system.
8. Proposed Use
One—Family Dwelling o
$5.00 C/O Paid
$ 164.00 PERMIT FEE PAID—THIS PERMIT EXPIRES March 1 1987
(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.) E
Dated at the Town of Queensbury this 28th Day of August 1g 86 N
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SIGNED BY � � for the Town of Queensbury
Building and Zoning Inspector J
TO BT:: COMPUTED LY f3LDG. DEFT.
c� Application No. . `TOWN OF QUEEN99U'i Y
Down of Quenit ur y Permit Issued 19 N.
BUILDING and ZONING DEPARTMENT Permit Expires 19 H -- P !'�' ltr.
• Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation
Queensbury, New York 12801 Variance No. AUG 4 416
Site Plan Review No. � (6y.°:*(1-)ii,Apt...'
9d _ 8 - aG � Am. 1` I •-
Approved by: 8190V`� -1213141516
APPLICATION FOR C0/V8/1,
BUILDING AND ZONING PERMIT 1 ,..
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
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: i?/n/'/ niz(__G-F'j.i
/ ()i •
P.O. Address 6 £L/-/-7 577Q4C T /,i,,A ay} /,9 J /?A Y/ Tel. 77 S/o
Property Location: o_6 /,i/,GG O Li/ 40 Sing 1 c( Tax Map No. W/ /
Street number or building lot number
Subdivision name (if applicable) T//Z P,`iv . $ O f VU,v''i+/S 7
i
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
/2/72 / v' D(I e- l•r—d: Wr, FM . 5..% FF� A/,/' 7/r--0.5/(�
Name P.O. Address Tel. No. .
Name of builder S/?A/I Address Tel.
Name of plumber i /f M✓ Address Tel.
Name of mason • ,5/7/72 e Address Tel:
NATURE OF PROPOSED WORK: * ZONING INFORMATION:
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(9 ft X (70 ft.
•
* Existing building(s) Size ft X ft.
PROPOSED BUILDING AND USE: * /�
* Existing building (s) Use
Size of new structure a(o ft X q ft *
Foundation-pier/slab/crawl/partia ul * Proposed building, distance from property line
(circle one)
No. of stories (habitable space) * Front yard S ft Rear yard ft
Height (grade to ridge) a/ ft. * Side yards a 5' ft and y0 ft
If residential, no. of families * If on corner, setback from side street ft
No. of rooms(excludingbaths) $ * OCCUPANCY INFORMATION
No. of bedrooms
3 * PRIMARY BUILDING -
No. of bathrooms `K One family dwelling
Primary heating system a9-1?rG * Two family dwelling
Type of fuel
Multiple dwelling / Number of units*
No. of fireplaces to be installed / * Permanent occupancy
Will a wood stove be installed? iv0
•
Central Air conditioning? NO. * 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 * .
Cap d Cottage Other * ACCESSORY BUILDING-
Colonial Row Town House * ' Detached garage/one car/ two car/ car
( CIRCLE ONE PLEASE ) * Attached garage/one car/ two car/ 1L car
* * * * * * * * * * * * * * * * * * _ Private storage building I
ESTIMATED MARKET VALUE OF * Other
CONSTRUCTION $ g6i 07d f C"
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. l✓/C)�f 1,/2/9//)...c
Will any second-hand or ungraded lumber be used? If so, for what? AW
Foundation wall material GOrvCA.‘7--A- Thickness e //
Depth of foundation below grade (to bottom of footing) 6
Will there be a cellar? ys Heated or unheated? (/ark 70 Floor sq. footage /O y ' sq ft
Will there be a basement? yo Will any portion be used as living space? A/D'
(If so, what portion? sq.ft. - - Type of use?
Type of roof - sloped/flat/shed/otherS64,2 Material, of roof ,V 6-/fS 5 s, ./cc
Size, wood studs .2 "X " spacing a y "o.c. length ' ft.
Joists(floor beams) 1st. floor "X /p " spacing /o "o.c. span ft.
Joists (floor beams) 2nd. floor "X /a " spacing � "o.c. span /Y ft.
Overlays(ceiling beams) "X " spacing "o.c. span ft.
Roof rafters "X " spacing o.c. span ft.
Roof trusses(pre-engineered) spacing "o.c. span a 7 ft.
Exterior wall finish C-Z--"e/0//47S Of what material?
Interior wall finish / S h`F!7 T Afo c/<
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
54 1 DC`/ZE COW S/¢fFTRoC/C
Is thereto be an opening between garage and dwelling? YG5 If so will a Fire-rated
door, enclosure, and self-closing device be provided? y/S
Will a flue-lined chimney be installed? 65 .Height above roof ft.
Depth of chimney foundation below grade ft.
Depth of fireplace hearth /f ft. in. r
Water supply - Municipal or private well /? far, (--
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.
SWORN TO BEFORE ME THIS Signature_ _
day of 19 •
Owner, owner's; agent,arcnitect,contractor
•
Notary Public, Warren County, N.Y.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
SPECIAL CONDITIONS OF THE PERMIT:
•
By
. sown of .Queensburty APPLICATION FOR SEPTIC DISPOSAL PERMIT
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801 - DATE q- / % ,6
LOCATION OF PROPERTY FOR INSTALLATION G 4/, 00t,,/ , .D/f- .
OWNER' S NAME 01,4)47/22A„✓ Z (0'. .// --
ADDRESS R6 �m S 7--- .Lff T /T a,/5,4 fGe5 TEL 7ter---Os/U
INSTALLER' S NAME /6l � C. 74- 12V TEL
f/ .
Number of bedrooms (residential only)
Total daily f low(compute @ 150 gal per . bedroom) a e2
•
Topography: Flat - Rolling - Steep slope - (circle one) % of slope F
Soil nature: Sand Loam - Clay - ,Other Depth ft. :
Ground water -At what depth? ft.
Bed-rock or impervious material - At what depth? - ft.
' Percolation test - Not required - Required - -Rate 1,k 14 min-inch.
•
Domestic water supply ' Municipal Well - Other
Separation - Watersupply i-f w.e-1 from Septic absorption -- ft.
Proposed System: Septic tank /0(00 gal. ( Minimun size, 1000 gal. )
Tile Field - Each trench ' ' . ft. Total system legnth ft.
d." -r-a;
. Seepage pit(s) Number of Size each /4 ft X ft L4/ 0 ST „,,,�'",�
Size of stone to be used # ' .3 . Depth or thickness ft.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
IMPORTANT ! !
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
r
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 Queensbury.
•
Sanitary Sewage Disposal Ordinance .
Signature o fresponsible person & ��
Date VV/4
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 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 Oueensbury Building '
Department before further construction.
•
fG/v 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 5 0 G /r
i
2 . Type of heat %Wf" C •
3 . Is the building mechanically cooled? ,mil/
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?
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
2 . R value of exterior walls f2 -/
3. R value of glazed area , 1
4 . R value of doors - I/ •
5 . R value of floors over unheated spaces
6. R value of slab edge insulation - unheated slab -7—
7. R value of slab insulation - heated slab
8. R value of heated basement/cellar walls (above grade) S
9 . R value of heated basement/cellar walls (below grade) ('
10 . Type of insulation IC /.5Z,4 G/4-Ss -/e, 76 r`t2
C. Controls —o
1 . ' Thermostat maximum heat setting
D. Duct Systems
1. Is duct system installed in unheated spaces? YES /ISOY}
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 -4,(vv�/
2 . R value of pipe insulation �/
F. Service Water Heating
1. Performance efficiency
2. Temperature control setting maximum /3'5-O
G. For Swimming Pool Only
1. Maximum heating �-
Telephone No. 77f X/O
(applicant ' s .signature)
_town o/ Queniar1
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME OU L rit—
LOCATI ON /16 0 2 (� W tcccd IZ(p .
Date `L /St Permit No. 3 - S12 y
* * * * * * * * * * * * * * * * * * * * * * *
✓ = ' APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing 691
,
Masonry Vene.
Rough Plumbing
elief Valves
t. Porches C9,c
(.Finished Floors
/Gterior Trim �
airs & Railings (9,r
Cellar Drain Tile
Concrete Floors
La5lbg. Fixtures
r
Fireproofing D•
L55or Closers O,R
(bgmoke Detectors c�,K
imney D,K
//fl JULATI ON:
sundation d2A
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION Paix.ea,vwCz
DRIVEWAY APPROVAL 0
J Building Survey
Next scheduled inspection (call when ready)
Remarks-
P4176
Building Inspector
6/86 and-vl
_own o/ Queenilur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR' S REPORT
NAME Due(/91(eNoimA4-_}
LOCATION ,C,O 7672, 6 io1//0/42.1
`t,Ki✓! Q r()S !�
Date J 1 / / Permit No.
* * * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
)Framing z ( r ) L�
Roofing
Siding
Masonry Veneer
pRough Plumbing 0e-
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
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-
frt
u,/,04
Building Inspector
6/86 and-vl
ia,e // /1 -.
_Down of Queeniur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSALI SYSTEM INSPECTION
NAME /J()rML( 61 LJ hcbp
LOCATION (€ - c & t )1181 ) Zd
DATE ii/ 4/ b PERMIT NO. 8 CD --Dci.y.
SOIL TYPE - _ 1. Loam - Clay -
Percolation Test Required? YES -NO
Percolation rate - Min/Inch 0-
TYPE of SYSTEM:
Absorption field, total length c)
Length of each trench yU, 1/O•4O 4 5' y5 02
Depth of trenches .62 J .
Size of gravelc,N
SEEPAGE PITS{Number of)
Size- --ft. X -ft.
Gravel size
PIPING: Size Type
Bldg. to tank Li" z()
Tank to dist. box / i
Dist. box to field/ •
Openings sealed? YES NO Partial
LOCATION/SEPARATIONS:
Foundation to tank /()�ft.
Foundation to absorption c !ckeft.
Absorption to lot line a[)--tft.
Separation of pits /L, ft.
LOCATION S YSTEM ON PROPERTY(circle one)
Front 411Mag, Left side - Right side -
COMMENTS:
SYSTEM USE APPRO ED ® NO
KiEedurt
• Building Inspector
01/86 and vl
awn of Queeni1ur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING' INSPECTOR ' S REPORT
NAME y�
C/ y1
LOCATION 2(a ft1220"`-)
Date �l,�6p' / Permit No. 3G 2.Y
* * * * * *. * * * * * * * * * * * * * * * * *
— APPROVED - YES / NO
ting/Pier Forms nq:
Foundation
Waterproofing
�B-3ckfill akk
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 Detectors
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling •
FINAL ELECTRICAL INSPECTION
Final Building Survey
Next scheduled Inspection(call when ready)
Remarks- -
Building Inspector
6/86 and-vl
.Jouin Of Queen ibur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION—;24 6,0,t/Z0 / `r_
5-01
Date c /y / c5-c Permit No. r
*
� � ✓ = APPROVED - YES / NO
1Footing/Pier Forms (Q K�
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 Detectors
Chimney /
'ti
INSULATION: \\
Foundation /
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
Final Building Survey
Next scheduled Inspection(call when ready)
Remarks- -
lib41 Cae,r1,_ ;24.„
tAA476/Lit
Building Inspector
6/86 and-vl
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