1986-575 -.
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
March 30 19 7
Date 8
Rqr.i.
This is to certify that work requested to be done as shown by Permit No. 86-575
has been completed
ONE FAMILY DWELLING
This structure may be occupied as a
LOT 586 FOX HOLLOW LAND (ST. NO. 22)
Location
RICHARD ROZELL
By Order Town Board '
TOWN OF QUEENSBURY
_:ger Building &Yoning Inspector
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 86-575
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Richard Rozell
OWNER of property located at Lot 586 Fox Hollow Lane (St. No. 22) Street, Road or Ave.
C)
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
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. %:
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1. OWNER'S Address is 19 Fox Hollow Lane
Glens Falls, New York
2. CONTRACTOR or BUILDER'S Name
same
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3. CONTRACTOR or BUILDER'S Address rn
same
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4. ARCHITECT'S Name F- x
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5. ARCHITECT'S Address m R3
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6. TYPE of Construction—(Please indicate by X) o•
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(x)Wood Frame ( ) Masonry ( )Steel ( )
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7. PLANS and Specifications 0
32'x70' per plot plan, specifications and application submitted
No. including sewage system and two—car attached garage.
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8. Proposed Use
One—Family Dwelling
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$5.00 c/o ty
$ 192.00 PERMIT FEE PAID—THIS PERMIT EXPIRES April 1 19 87
(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.) Qq
Dated at the Town of Queensbury this 15th Day of September 19 86
SIGNED BY for the Town of Queensbury
Building and Zoning Inspector
0 TU es CUML'LLiTLU. SY ULUL,. DEFT. I
e7 D Application-No. -. - . -- c, �.1
• Jown of ueesesb:a�Y �r.IrI- � —
Permit Issued 1y `= tv l LBUILDING and ZONING DEPARTMENT Permit Expires 19 3 �` r I 1 1l, !'=.�.•
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation
Queensbury, New York•12801 Variance No. ... '-' : 1C.4:if"
Site Plan Review No. r-c � .
a( � � g vGAroved ° �bt _. ,gg � a
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APPLICATION FOR 1,,- , cid
BUILDING-. AND ZONING PERMIT ���
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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: R f cd oQ . ia: -//
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P.O. Address rl ��7( f4 /c L� 0—-� �0 Y) Y / Zi'O/ Tel. 75'r�!e-2/�
Property Location:• L I l4 /,,//o••.,Lo--e St ,4 a'1%,• Tax Map No. / /
Street number or building 'ot number
Subdivision name (if applicable) I,iJec1 ( ` 6 is
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS; -
. (?( .,c-e—A .1/ . /, ,i.,, /44., 6---c. (Q-dVy (zo/ (- 6-) 2S1-zff/i
Name '. P.O. Address Tel. No.
• Name of builder IZG /ICor�// Address 19)37/4/o>,6-4 ()=,NY r v/ Tel.(S70 7S
Name of plumber it • Address 'i Tel. r, -
Name, of mason Address "" Tel. tr
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 w• whether interior or corner lot. :Show location
LOCATION OF STRUCTURES AFFECTED. * of water supply and location and configuration . i
of septic'disposal area.
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* COMPLETE INFORMATION REQUIRED, BELO)J
* Size of property Iz2--''(�2ZyI� ft /X ft.
* Existing building(s) Size ft X ft.
PROPOSED BUILDING AND USE: * /�Q
* Existing building(s) Use •
Size of new structure .3 e ft X 70 ft *• • .
Foundation-pier/slab/crawl/partial 4 * Proposed-building,/ distance from property line
(circle one) *
No. of stories (habitable space) 2_ * Front yard 0 ft Rear yard //S ft
Height (grade to ridge) 2£l ft. * Side yards �.5' ft and -z ��� ft
If residential, no. of families /
* If .on corner, setback from side street ft
No. of rooms(excluding baths) id' * OCCUPANCY . INFORMATION
No. of bedrooms
* PRIMARY BUILDING -
. .No. of bathrooms Z) * One fam •
ily dwelling
Primary heating system 4 �-
4 ,
Type of. fuel 0.s * Two family dwelling
No., of firepl es to be installed / * Multiple dwelling / Number of units
Will a wood stove be installed? ri20 * _c Permanent. occupancy
Transient occupancy . •
*
Central Air conditioning? yes Business
*
BUILDING STYLE, PRIMARY STRUCTURE * Industrial
Ranch Contemporary Log cabin * OtherIf addition, what will use be?
Raised ranch Mansion Duplex . *
•Split level Old style Bungalow * .
Ca a Cod .Cottage • Other * ACCESSORY BUILDING-
Colonia9 Row Town House * ' Detached garage/one car/ two car/ - car
/( CIRCLE ONE PLEASE ) * 1, Attached garage/one car/ two car/ L car
* * * * * •* * * * * .* * * * * * * * • Private storage building
• ESTIMATED MARKET VALUE OF * Other
CONSTRUCTION
INFORMATION ON BUILDING SPECIFICATIONS, ON` REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
Form BPA 4/86 and-vl • .
BUILDING PERMIT rPPtICATIOD! 'CONTIPi�3rD -
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BUILDING SPECIFICATIONS:
Type of construction; wood frame, fire safe,etc. 1v �
Will any second-hand or ungraded lumber be used? If so, for what? 'i20
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Foundation wall material G--c (dGLS Thickness /0
Depth of foundation. below grade (te.bottom of footing) T=4 '
Will there be a cellar? &/cs Heated or unheated? f Floor sq.. footage ,2 1v sq ft
Will there be a basement? 54Ar _ Will any portion -be- used as living' spade? AAJ
(If so, what portion? ' sq.ft.'"- - Type of use? '
Type of roof - sloped/flat/shed/other s(or.e Material of roof slv.5L
Size, wood studs Z "X CI " spacing /(o "o.c.. 'length _, ft.
Joists(floor beams) 1st. floor "2 "X /c) . " spacing //, "o.c. span /64-1`�ft. •
Joists (floor beams) 2nd. floor Z "X /d " spacing /6 "o.c. span v+YW ft.
Overlays(ceiling beams) "X " spacing "o.c. span ft.
'! '
Roof rafters "X
spacing o.c. span ft.
Roof trusses(pre-engineered) spacing 2e/ "o.c: span 3 z ft.
Exterior wall finish 5.7�5- Of what material? /✓1t�
Interior wall finish s�-.,
If a garage' is to be ttached,• describe materials to be used for FIRE SEPARATION:'
Is there to be an opening between garhge and dwelling? yes If so will. a Fire-rated
door, enclosure, and self-closing device be provided? 'eS .
Willa flue-lined chimney be installed? yes Height above roof 3 . ft.
Depth of chimney foundation below grade ( ft.
. Depth of fireplace hearth / ft.O in.
Water supply - Municipal or private well Gait"is ,m, '
SEPTIC SYSTEM Distance from ANY private well(includiny adjoining properties -- ft.
(A separate application is ,necessary for any repair or new 'installation of septic system)
• Town of Queensbury A F F I D A V. I T STATE OF NEW YORK County"of Warrpn
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I swear that to the best of my . kn.o'wledge 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 Ilertaining to
the proposed work shall be complied with, whether specified or. not, and that such work is
authorized by the owner. y
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SWORN TO BEFORE ME THIS Signature,_
Owner, owner's age t,arcnitect,contractor
day of 19
Notary Public, Warren County, N.Y. V . •
* -* * * * * * * * * * * * * * * * * * * .* *;"* * * * * * * * * * * * * -* * * * * * * * * * *
SPECIAL•CONDITIONS Cr THE PERMIT:
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By (.rf?1 .
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 Z '/ , •
2 . Type of heat �-SG..S .M,7
3. Is the building mechanically cooled?
4. Percentage of area of windows and doors /p . Z 9 ,
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
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B. Under 16%. Only
1. R value of roof and floors exposed to ambient conditions
2 . R value of exterior walls /C- �,�
3 . R value of glazed area /� 3, �j
4. R value of doors / /1/. 4,
5. R value of floors over unheated spaces /ll #6. R value of slab edge insulation - unheated slab d 69
7. R value of slab insulation - heated slab Ain-
8. R value of heated basement/cellar walls (above
grade) g...8
9. R value of heated basement/cellar walls (below grade) R-9
10. Type of insulation ricesq newle&
C. Controls
1 . Thermostat maximum heat setting 8704
D. Duct Systems
1. Is duct system installed in unheated spaces? YES oln
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
2 . R value of pipe insulation ^faN[
F. Service Water Heating
1. Performance efficiency 5',j!e�
2. Temperature control setting maximum /9p"
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G. For Swimming Pool Only
1. Maximum heating /
Telephone No /d 75 //
(applicant ' s signature)
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awn of Queenilury APPLICATION FOR SEPTIC DISPOSAL PERMIT
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801 DATE 9 / -3j4:1
LOCATION OF PROPERTY FOR INSTALLATION 4)/ set F // ,/ / _ D
-OWNER' S NAME Vactd,c,e_ i 'D2e.•/4/7
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ADDRESS 19 L fI//cam L _ • TEL.CS/S) 75rn,
INSTALLER' S NAME Sow P TEL //
Number of bedrooms (residential only) 4/
Total daily flow(compute @ 150 gal per bedroom) G?-
Topography: F1 t - Rolling - Steep slope - (circle one) % of slope
Soil nature. Sand' Loam - Clay - Other Depth ft.
Ground water -At what depth? ----- ft.ft.
Bed-rock or impervious material - At what -depth? ft.
Percolation test -kleNot required. - Required - -Rate min-inch.
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Domestic water supply - Municipal Well - Other -
Separation - Watersupply(if well) from Septic absorption ft.
Proposed System: - Septic tank /cOO gal. ( Minimun size, 1000 gal. ) •
Tile Field - Each trench 50 • ft. Total system legnth - 'Zsd ft.
Seepage pit(s) Number of . Size each ft X. ft
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Size of stone to be used # g\ Depth or thickness ( "d - 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
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 f responsible person • / /
Date / � d
05/86 and/vl •
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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:
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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. •
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D. Should unforeseen problems during construction
prevent proper installation, alteration or
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repair of an approved system, a new proposal
must be submitted to the Queensbury Building
Department before further construction.
G cci z e/ 3/3cca/Y'7 - " Y�
_/otun of Queentur1
BUILDING artd-ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
�1LinY -e-t( --ov CG/0
BUILDING INSPECTOR ' S REPORT
NAME /ei GA 1 2 e//
LOCATION 4, l .se'e Ed rn//42.1
Date 3/3o / S/ Permit No. 86-57
* * * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES / 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 Detectors
✓ i
Chimney 44.0-L, 01.8✓hh • /—
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL -
Final. Building Survey
Next scheduled inspection (call when ready)
Remarks-
,
Building Inspe or
6/86 and-vl
C Z-� d 3 51 P`7 9;/ 4
_town of Q ee n.i ury
• BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbu , New York 12801
do ( ns,pec-r(Chi
BUILDING INSPECTOR ' S REPORT
NAME I)
LOCATION l ar-5dG) Fox. /I-d//akv LPL/!) e
Date 3/a7 / if7 Permit No. W-575-
* * * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding •
Masonry Veneer
Rough Plumbing
Relief Valves D(
Ext. Porches
Finished Floors 1 ,
InteriorTrim )(
Stairs & Railings X
Cellar Drain Tile
' Concrete Floors
Plbg. Fixtures 'X
Gar. Fireproofing
Door Closers 1>k
Smoke Detectors
Chimney
INSULATION:
Foundation
Floors t
Walls
Ceiling
FINAL ELECTRICAL INSPECTION U/- l f d-j/
DRIVEWAY APPROVAL
Final Building Survey I
Next scheduled inspection (call when ready)
Remarks- / ,
!J
a'/I l/ �a l( G� y� • '7'('.I/1 "V //Z
/!!1/d/6 't- `.4dl i�e'yr
1 P1,-1OVL' I in 9 C/4-'1/
Building Inspec r
6/86 and-vl
Call eCe / a /a 9 /3
awn of Queeniturcy
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME ( c k Glwd R . .i/
LOCATION 1_07- 536 Fox go/laay Arch _e
Date 0-41 / 5,(0 Permit No. -,,j fs
* * * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer �a
X Rough Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings f
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-
Buil ing Inspecto
6/86 and-vl
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date
Name rJ7
Location Lo,—S Fc 4' l
Permit No. 16 - 5 7 7 Weather
Remarks
Exca)ation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
anal Survey
/ Framing 0
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
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation.
Walls
Ceiling�
B ilding Inspector.
REMARKS
C 4 II- 4' f a7 J3-e )
_Jocun 01 cueenjur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME
LOCATION Z.— Or 6 FoX /-/a// owe 1Gh C_
DATE/(/R Jam/eyG PERMIT NO. (. s
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total le gth
Length of each trench
Depth of trenches
Size of gravel' ,
SEEPAGE PITS4Number off)'
Size- ft. X ft.
Gravel size
PIPING: Size Type p
Bldg. to tank Z 1 � Z/0
Tank to dist. box G/r( f
Dist. box to field/pit , , /
Openings sealed? 'YF ES ) NO Partial
LOCATION/SEPARATIONS:
Foundation to tank / 2° ft/
Foundation to absorption _`'`ft.
Absorption_to lot line ft.
Separation of pits ' ft.
LO ON OF SYSTEM ON PROPERTY(circle one)
ont - Rear - Left side - Right side -
ENTS:
\\)(\\
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SYSTEM USE APPROVED 'YE NO
'If,
• Building Inspoc•tor f
01/86 and vl
// 7/6 c /7 /4dc
_locun o Queenitury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION bi- S8 c,
Date �v/1 Permit No. 'b'(,
* * * * * * * * * * * * * * * * * * * * * * *
APPROVED - YES/ NO
Footing/Pier Forms ,�-•� 1( Q
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
INSULATION:
Foundation
Floors
Walls
Ceiling �\
FINAL ELECTRICAL INSPEC ION
Final Building Survey
Next scheduled Inspection(call when ready)
Remarks- -
Building Inspector
6/86 and-vl
Jown o/ Qucenilur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME 1'g67.-da, !` i !cY
LOCATION FL tJ 'CP (oW c7,9,U-c..2
Date /J ermit No.
* * * * * * * * * * * * * * * * * * * * * * *
APPROVED - YES / NO
Footing/Pier Forms
Foundation 7
)<Waterproofing
VBackfill
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 j
Ceiling
FINAL ELECTRICAL I SPECTION
Final Building Survey
Next scheduled Inspection(call when ready)
Remarks- - ``pp
e-e
Bu 1ing nspe or
6/86 and-vl
c_a t; q cc`� 131Le a • 3 d
.bean o/ Queeniburcy
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME I< k-0 Z P 1
LOCATION Ldf S�� rd6 Hi, !I put
Date 7 / 1 / v6 Permit No. V. -S 7S
* * * * * * * * * * * * * * * * * * * * * * *
i� = APPROVED - YES / NO
✓Footing/Pier Forms 1 q �.-t 01 K
Foundation 5 ,.a
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
INSULATION: /
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
Final Building Survey
Next scheduled Inspection(call when ready)
Remarks- -
(474/13
Building Inspector
6/86 and-vl
Ca. QI--d cc//sly
.own of Queeniturj
BUILDING and ZONING DEPARTMENT
Bay and Havilarid Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR' S REPORT
NAME R c, K R o z I I
LOCATION L or s- S 4 ,Co e. H-allow L-shvt
Date cl A 5- / ` Permit No. 8 4 -S7S
* * * * * * * * * * * * * * * * * * * * * * *
= APPROVED - YES / NO
Footing/Pier Forms I ��
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing s'
Relief Valves /
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Til
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- -
16)
, 23,
Building Inspec •r
6/86 and-vl
ti
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