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1987-017 CERrnIEWArM OF UPAN%t`a.%."v1r TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Sri Dat 19 T%is is to cent* that work requested to be done as shown by 'Permit No, has bees coU44ett& D nc Rarnkk\A �u l This stnumure may be ooG. as ■ Lecodaw CkrMw By Order Town Board 1rOwN OF QUEEN SDU 2Y Building & Zoning Inspector CURRATIVC "INSVA Pal"TIMG. GLENS FALLS. N T I Rao f iS 107791-5656 BUILDING PERMIT TOWN OF QUEENSBURY No. 87-17 WARREN COUNTY, NEW YORK cn w PERMISSION is hereby granted to Sandra Brown c+ .1 m OWNER of property located at Lot 116 Sugar Pine Road 'Street, Road or Ave. W 0 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. 1 . OWNER'S Address is 0 6 rt F" i� 2. CONTRACTOR or BUILDER'S Name �"�.. ON Joe Roulier (Dr. N N rr. s fh 3. CONTRACTOR or BUILDER'S Address Cleverdale , New York 12820 F � IC C7 0 � O lb ¢x 4. ARCHITECT'S Name CD P sn .- v' cn n `-C 5_ ARCHITECT'S Address ;] +a v 6. TYPE of Construction — (Please indicate by XI ( *Wood Frame I ) Masonry 1 Y Steel I I ?. PLANS and Specifications No. 28 ' x64r per plot plan , specifications and application submitted m Including sewage system and two-car attached garage . 8. Proposed Use `C One-Family Dwelling m r $5000 C /O ` $ 164 . 00 PERMIT FEE PAID - THIS PERMIT EXPIRES August 1 1987 I I t 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 27th ,r; flay of January19 87 SIGNED BY id�.-f� for the Town of Queensbury Building and Zoning Inspecto TO BE COMPLETED BY BLDG. DEPT . Application No . _lown oueendbure Permit issued 19 BUILDING and ZONING DEPARTMENT Permit Expires 19 Say and Haviland Road, R. D. 1 Box 98 Zoning Designation ` 1r �► , Queensbury, New York 12801 Variance No . rt� �� � Site Plan Review No . 0 -- RECEIVE© JAN 23 197 8 (} Approve by : i 14 Gig APPLICATION FORi :KJ 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 . The _owner-of this-property is : c✓ ..J P . O. Address r - //ice � � ✓ i r. c �r� c.,. - G'� /' Tel . jor �7 Property Location : Tax Map No . Street number or building /lot }number Subdivision name ( if applicable) _ A,, � c Ca 'c Ic 04� ss�� e�'� ' THE PERSON RESPONSIBLE FOR SUPERVISION OF W AS REGARDS/ BUILDSlNG` rCODES IS i' Name J `� © / P . O. Addre s Tel * No . Name of builder., /e ,�[ c, �.. Crr .�' Address Tel * Name of plumber C_ �' r.. + Address_�e�!r�,��� . _ ._suet Tel. . -�y� y Name of mason Address S 'Otze- ' ..1 . !! Tel . 9?- 00 7 Z NATURE OF PROPOSED WORK : * ZONING INFORMATION : to'o� 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 whether interior or corner lot . Show location FOR DEMOLITION PERMIT , STATE SIZE AND * of water supply and location and configuration LOCATION OF STRUCTURES AFFECTED . * of septic disposal area . * COMPLETE INFORMATION REQUIRED BELOW . * Size of property a ft X / .?d ft . Existing building ( s ) Size ft X ft _ PROPOSED BUILDING AND USE : * Existing building ( s ) Use Size of new structure 'Zir ft X46aft 'IwF Foundation-pier/slab/crawl/parties ul * Proposed building , distance from property line ( circle one ) ,� Front yard v �. C7 ft Rear yard = ft No . of stories (habitable space ) * Sides yards ft and _ .7 3 £t Height ( grade to ridge ) y1^�/' fto if on corner , setback from side street ft If residential , no . of families Z No . of rooms ( excluding bat' h/s ) ' * OCCUPANCY INFORMATION No . of bedrooms 7 ,� 1-- *. PRIMARY BUILDING - No . of bathrooms system S" t!r� r-�— * One family dwelling Primary heating 4-- Two wa family dwelling Type of fuel �" * Multiple dwelling / Number of units No . of fireplaces to be installed / Will a wood stove be installed? fc * Permanent occupancy Transient occupancy Central Air conditionings *, 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 Ca d Cottage Other ACCESSORY BUILDING- olonlal Row Town House Detached garage/one car/ two car/ car { CIRCLE ONE PLEASE ) * _Attached garage/one car4:nw:o car * * * * * * * * * * * * * * * Private storage building ESTIMATED MARKET VALUE OF 'Other CONSTRUCTION " INFORMATION ON BUILDING SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETEDI �Form BPA 4/86 and-vl BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATIONS : Type of construction , wood frame , fire safe , etc . _ p ,C/X/ '000 <. Will any second-hand or ungraded lumber be used? If so , for what ? Foundation wall material p,,f � c .� a Thickness /a / 04� Depth of foundation below grade ( to bottom of footing ) Will there be a cellar?A/a Heated or unheated? Floor sq . footage sq ft Will there be a basement? S Will any portion be used as living space? ( If so , what port ' �> sq . ft . - - Type of use? Type of roof sloped lat/shed/other Material of roof Size , woad stu " X IFspacing� /�"o . c . length ep ft . Joists ( floor beams.) 1st . floor ..e "X_ Zo spacing /� "o . c . span�ft . Joists ( floor beams ) 2nd . floor +' ^ "X 00. 0 IF spacing_,.,"o . c . spank/.,## ft . Overlays ( ceiling beams ) .e ^"X " spacing.,,ejL 'o . c . span / yf _ft . Roof rafters FIX I] spacing o . c . span ft . Roof trusses (pre-engineered) spacing "o . c . span_�p ft . Exterior wall finish Z .a. Sr . , r Of what material ? eeclav Interior wall finish ,r r. V , & If a garage is to, 14a attached , describe materials to be used for FIRE SEPARATION : is there to be an opening between garage and dwelling? c s If so will a Fire-rated door , enclosure , and self-closing device b provided? 5 Will a flue-lined chimney be installed? dam Height above roof ft . Depth of chimney foundation below grade �,f"' 11�p , Depth of fireplace hearth / �ft . <f in . � Water supply - Mun icipal or pr ivate well J /�..u�#e e . Asa 46' SEPTIC SYSTEM Distance from ANY private well ( inclu ng adjoining properties ft . (A separate application is necessary for any repair or new installation of septic system) Town of Queensbury County of Warren A F F I D A V I T STATE OF NEW YORK 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_� 'Owner , owner ' s a nt , arcnite � ontractor day o f 19 Notary Public , Warren County, N . Y . * * * * * * * * * * * * * * * * * * * * * * * * * * * * * IF * * * * * * * * * * * * * * * * SPECIAL CONDITIONS OF THE PERMIT : By 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 : 14 Gross floor area 2 . Type of heat C'cc'i c 3 . Is the building mechanically cooled ? Percentage of area of windows and doors��r / ` L, 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 heater'!. ? YES No a . R value of insulation 5 . Type of insulation B . Under 16 % onlyw 1 . R vale of roof and .'Floors exposed to ambient conditions 2 . R value of exterior walls 3 . R value of glazed area 4 . R value of doors 5 . R value of floors over unheated spaces_ _ 60 R value of slab edge insulation - unheated slab -- 7 . R value of slab insulation - heated slab -- $ . R value of heated basement/ cellar walls ( above grade ) g . R value of heated basement/cellar walls ( below grade ) 14 . Type of insulationCss a �r�� .. C . Controls 1 . Thermostat maximum heat setting I7 . Duct Systems 1 . Is duct system installed in unheated spaces ? YES NO 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 F . Service Water Beating 1 . Performance efficiency 2 . Temperature control setting maximum , ryp G . For Swimming Pool Only 1 . Maximum heating Telephone No . 4s 'elL/ / 'T `� ( a.PplIcant signature ) APPLICATION FOR SEPTIC DISPOSAL PERMIT DATE LOCATION OF PROPERTY FOR INSTALLATION 5 Owner's Name : __ r � 0G4 , / Telephone: �✓/�+ Address: //�_ �; R, . z .,., Installer's Name: �reo•4 rr Ze>.✓S r�^ Telephone: Number of bedrooms (residential only) Total daily flow (compute @ 150 gal per bedroom) Topography: circle on Fl Rolling Steep Slope % of slope Soil Natuve: circle one: San Loam Clay Other / Depth: feet Ground Water: At what depth? . a — feet Bedrock or Impervious Material: At what depth? _ t - - feet Percolation test: circle one. t r� eguireff,-:3required { rate min. inch. Domestic water supply: circle one Mun~ ici a Well Other IF domestic water supply is a Well.: Separation: Watersupply from Septic absorption -- feet PROPOSED SYSTEM: Septic Tank gal. (minimum size: 1 ,000 gal.) TILE FIELD: Each Trench 5 �d feet / Total system length,,..* ' D feet SEEPAGE PIT(S) : Number of -- o -- / Size each feet by feet Size of stone to be used # Depth or Thickness /'f �. feet IMPORTANT ...Please...LiST NEW EQUIPMENT TO BE INSTALI.EI] (over) Section Il Septic System Inspections: A. All applications 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, the fields and/or drywells 13. 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. Co 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 Queensbury Building Department before further construction. I have read the regulations above and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Es:sposal Ordinance. Signature of responsible person; Date: Town of Queensbury Building and Code Department Bay at Haviland Road Queensbury, New York 12801 (518) 792--5832 SETTLED 1763 . HOME OF NATURAL BEAUTY . . A GOOD PLACE TO LIVE --/ouvn c�� '�eeeen3�urr� . BUILDING and ZONING, DEPARTMENT Bay and Haviland Road, R. D. 1 Box 9a Queensbury> New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION ,r21 NAME TLg S Ya�1 I1YIr LOCATICJN LGT- / l b Spa S � f�+ n -c Pm BATE PERMIT MCI . `7 ,/ ``7 SOIL TYPE - Sand - Loam - Clay - Percolation Test Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM: .Absorption field , total len9 th Q Length of each trench Depth of trenches Size of gravel SEEPAGE PITS*N_umber of) Size- ft. X ft , {Gravel size PIPING : Size Type Bldg. to tank Tank to dist. box 48 Dist. box to field . Openings sealed? r► ES/� NO Partial LOCATION/SEPARATIONS . Foundation to tank -� f t, Foundation to absorption t , .Absorption to lot line ftk Separation of pits ft. Mf�+T OF SYSTEM ON PROPERTY �Ccircle one) - Rear - Left side - Right side - TS ; SYSTEM USE APPROVED ES NO Building Inspector 01/86 and vl /,�1} 1! BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. G. 1 Box 88 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME LOCATION C7atm Permit LIZ / Footing/pier Forms APFRC)VED YES NO 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 Daor Closers Smoke Detectors Chimney INSULATION : FC]un d a t i on Floors Wails Ceiling FINAL ELECTRICAL INSPECTI0N # DRIVEWAY APPRO L Filial Building Survey ivText scheduled lnspeetion (call when ready Remarks- . C41, Rui ding Inspector 6/8b and-ul IQn3Lsfll'f BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R-D. 1 Box 98 Oueensbury, New York 12801 BUILDING INSPE TOR ' S REP20RT NAME / � � r_ocarrlary r / /' Date/ Permi ✓ =Footing/Pier Forms APPROVED - YES NO Foundation waterproofing ackfIII Framing fIng Siding Masonry Veneer ),'Baugh Plumbing a "' r 'Relief Valves Ext . porches Finished Floors Interior Trim, Stairs & Railings Cellar Drain 'Tile Concrete Floors Plbg . Fixtures Gar . Fireproofing Door Closers Smoke Detectors Chimney INSULATIc7N : Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey. Next scheduled inspection (call when ready) Remarks- l✓ � u�` r"'L'Z. .grey+ Buils3ing 6/86 Inspector and-vl aev" o/ Q+ fLiPEn .3FiI, ry BUILDING and ZONING DEPARTMENT �gVBay and Haviland Read, R. D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTORtS REPORT NAME :5 ex „ d r rl /war y it LOCA�rTt,IION Date T / Permit No . (� ,�/ -/'4�7 ✓ = APPROVED - 'YES NO yG Footing/Pier Forms t 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 INSPECTION Final Building Survey Next scheduled Inspection ( call when ready) Remarks- Af Bui !fdj-ncr Insp tar 6/86 and-vl YY 13UIL DING and ZONING, DEPARTMENT Bay and Haviland Road, R. Q. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR * S REPORT NAME VOCATION f -} Date / /� Permit No . - / Footin APPROVED - YES NO g/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 Chimney rNSULATIoN : � Foundation - af C'la�d e C Floors Walls Ceiling FINAL ELECTRICAL INSPECTION Final wilding survey Next scheduled Inspection ( call when ready) Remarks- veo oil 16 Building Inspector — 6/86 and-vl � /acurf IQ BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Queensbury, New York 12801 BUILDING - INSPECTOR ' S REPORT NAME LOCATION , r Date/ ✓ = APPROVED - YES NO #,orootingf_ Farms Lon jr Foundation i Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough, Plumbing Relief Valves Ext . Parches 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 ,_ lnspection ( call when ready ) Remarks- 1 Building Inspector 6/86 and-vl BUILDING DEPT. COPY OF APPLICATION FORM 46-ELe NEW YORK BOARD OF FIRE UNDERWRITERS, Ft LE THIS COPY WITH BUILDING DEPT. WHEN REQUIRED. TEMP. ill DATE + ! I CITY OR ,,,A _ f VILLAGE r � .✓�, (, ..+ ' /TOWNSHIP ✓ COUNT-1f STREET ROAD AND POLE NO. .✓ NO. BETWEEN WHAT TWO PREMISESLOCATED •' °'K �. }SECTION BLOCK COT OCCUPANT'S BUILDING - NAME ,,,,/ /' OCCUPANCY q OWNER'S NAME AND ADDRESS „ �!/ TEL. # SUPPLIED /7 By /r' ,,: FROM THEIR f—� ,.,�r -..,� OFFICE BUILDINGolt�is DEFFCTS NEW OLD ❑ is NEW V000AODITIONAL 0 REMOVED ❑ LIST BELOW ALL EQUIPMENT WHICH YOU iNSTALLED NUMBER OF OUTLETS Lamp R Ia�es4lwliss MOTORS HEATERS CIRCUITS OFFICE USE Loear ONLY tion Side Atwch't H-P. tv. A.W.G. Gelling Wall Reammis Switch Fesedant Btackat No. Type Each Ne. Enth NO. GauBa INSPECTION o Out- side Bob- bow Baer n..nx Is: FI. 2nd Fl. 3rd FL REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: DO NOT USE THIS SPACE. This appi"tion is intended to covet the abore-lkited equipment to be inspected but if at elate of inspection them at Iound additional equipment not above listed, Visa am sathorized to make the inspection and adjust the fae xe civw r the additional equipment, as provided by the applicant. SIZE OF ELECTRIC SIGN TOTAL MAINS FEEDERS LAMPS WATTS CHARACTER EXPOSED GAS TUBE SIOf4 OF WORK CONCEj5LER TRANSFORMERS OF VA WORK TO BE ,� INUMBERI {CAPACITYI STARTED /v /EA ETE t SIZE OF SIGN SERVICE OVE AD UNDERGROUND MAKER ENTERS OF SIGN IGUILDING INSPECTION REQUESTED ON OR AS NEAR AS POSSIBLE NEW OLD AVOID DELAY BY Ca IVINO FULL AND ACCURATE INFORMATION. ALL SPACES DATE OF ^^� MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. APPLICATION '� •� J PRINT NAME A D ESS NAME OF APPLICANT o� ., jC .e'" _ _ OF APPLICANT SIGNATU RE 'a r.. '% STREET ADDRESS ,ef� yle -- '�' TELEPHONE # CITY OR ,,+` ! �}f C0 tya LICENSE NO_ POST OFFICE C P�.+Y'�^' r.7 C � COD�.Z 1 Z ¢ WNEN APPLFCABLE GB EL (REV_ ,Les) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING - . _ r OE D OULIER Nome Improvements and Maintenance BOX 301 CLEVERDALE, N.Y. 12820 (518) 656-3544 r S C I dy L44 =; r .r C