1987-055 +CERTIFI+CA.TE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 19
S02 (1 - 1 - 93
This is to ify that work requested to be done as shown by Permit No. 87-55
has been completed.
This structure may be occupied as a _ _ -- _- -_ - One-Family Dwelling
1.�[lCatifJty Fort Amherst Road
C7wner .Anthony Cirino
By Order Town Board
TOWN OF QUEENSBURX
Building & Zoning Inspector
BUILDING PERMIT
TOWN OF QUEE 'NSBURY
No. _ 87-55
WARREN COUNTY, NEW YOIRK
PERMISSION is hereby granted to Anthony Cirino
Cr
OWNER of property located at Ft . Amherst Road Street, Road or Ave_ 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 n
r•
approved and in compliance with the Town of Queensbury Building and 'Zoning Ordinance. o
t_ OWNER'S Address is
2. CONTRACTOR or BUI LDERS Name
Howland Canst . �
3. CONTRACTOR or BUILDER'S Address
Star Route Box 140
Glens Falls , New Yorkrp
a
4. ARCHITECT'S Name m
C3.
5. ARCHITECT'S Address
6. TYPE of Construction — IPtease indicate by X}
[ xl Wood Frame S } Masonry l ) Steel [ i
C7
D
7. PLANS and Specifications
No.
70 ' x6O ' per plot plan , specifications and application submitted ,
p
including two-car attached garage -- City of Glens Falls sewage syst m .
11
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8. Proposed Use p
E
One-Family Dwelling
F;
S . 00 C / O-- �
$ 157000 PERMIT FEE PAIL! — THIS PERMIT EXPIRES Oct . 1 1g 87
Ilf a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of ❑ ieensbury before the expiration dated
Dated at the Town of Queensbury this 6th Day of March 19 87
SIGNED BY / �'i _ for the Town of Queensbury
BuiIdIng and Zoning Inspectoorrf' e�
-------ems-w. —�-
TO BE COMPLETED BY BLDG . DEPT.
7otvn O/ QldeenjCr ftry Application No .
Permit Issued 19
BUILDING and ZONING DEPARTMENT Permit Expires 19
Bay and Havifand Road, R. D. 1 Box 98 Zoning Designation
Oueensbury, New York 12801 Variance No .
Site. Plan Review No * E, F V d . d. -
G --
Approved by :
APPLICATION FOR
PUILDING 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 .
--.....-.....---------------------------------......................___-......................
1
The owner of this property is . 'ef�f z�fiz 2 .
P . O. Address Tel .
Property Location : faf '-,. Tax Map No „ CK- 1 - 1
Street number or building lot number
Subdivision name ( if applicable)
T PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS :
Name ,+f n P . O . Address Tel . No .
Name of builder /f '`r� L�F,✓� �.�%.uts � _Address 2,,,,- Tel . ; .
Name of plumber Address Tel .
Name of mason Address Tel .
NATURE OF PROPOSED WORK : w ZONING INFORMATION :
.2LConstructlon of a new building +r 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 ft X ft .
Existing building s ) Size ft X ft .
PROPOSED BUILDING AND USE : Existing building ( s ) Use
Size of new structure ft X 6. e) ft
Foundation-pier/slab craw partial/full " Proposed building, distance from property line
(circle one )
Front yard f5-L;) ft Rear yard Pt
No . of stories (habitable space ) / * Side yards /T ft and ft
If residential , no . of familiee
Height ( grade to ridge ) , ft . * If on corner , setback from side street ft
s
No . of rooms ( excluding baths ) r' OCCUPANCY INFORMATION
No * of bedrooms ?
PRIMARY BUILDING -
Pr of bathrooms Z ' z ,� one family dwelling
Primary heating system /�
Type of fuel Two family dwelling
No * of fireplaces to be installed Multiple dwelling / Number of units
Will a wood stove be installed? itJc Permanent occupancy
,�
Central Air conditioning? -iL Transient occupancyBusiness
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 ) * Attached garage/one car two cart car
_Private storage building
ESTIMATED MARKET VALUE OF * Other
CONSTRUCTION
INFORMATION ON BUILDING, SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET , TO BE COMPLETED !
Form SPA 4/86 and-vl
BUILDING PERMIT APPLICATION CONTINUED
BUILDING SPECIFICATIONS .
Type of construction , wood frame , fire safe , etc . 4e z .�) ZZQ, z=
Will any second-hand or ungraded lumber be used? If so , for what ? ns
H'
Foundation wall material C, , Thickness
Depth of foundation below grade (to bottom of footing ) .yr
Will there be a cellar? ,rfG Heated or unheated? Floor sq . footage sq ft
Will there be a basement? A2�,, Will any portion be used as living space?
( If so , what portign2_ sq . ft . - - Type of use?
Type of roof - slope flat/shed/other Material of roof
size , wood studs__, _- ' X'_6L- spacing_! "o . c . length ; ' ft . $ f
Joi. sts ( floor beams ) lst . floor 2 " X f " " spacing.__"o . c . span /�ft .
Joists ( floor beams) 2nd . floor "X " spacing "o . c . span ft .
Overlays (ceiling beams ) "X if spacing "o . c . span ft .
Roof rafters "X " spacing o . c . span ft .
0.
Roof trusses (pre-engineered) spacing � . r "o . c . span r ft. 3�
Exterior wall finish , fJ �x ��t C _ Of what material?
Interior wall finish
If a garage is to Yge attached , describe materials to be used for FIRE SEPARATION :
Is there to be an opening between garage and dwelling?�ih. If so will a Fire-rated
door , enclosure , and self-closing device be provided? >
Will a flue-lined chimney be installed? A.JG Height above roof ft . ,r
Depth of chimney foundation below grade - -~ ft .
Depth of fireplace hearth / ft . � in .
water supply - Municipal or private well
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)
l
Town of r7sseensbury p F r 1 T D A V T T STATE OF NEW YORK
County of warren C'i C_ 1
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 . ^ �7 f
SWORN TO BEFORE ME THIS Signature �!_r � -___ ___-__--
bwner , owner ' s agent , arcnixect , contraoto-r
day of 19
Notary Public , Warren County , N . Y .
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 :
1 . Gross floor area
2 , Type of heat /' x ri
3 . Is the building mechanically cooled ' � oowoG�
4 , Percentage of area of windows and doors
A . Over 16 % Only
1 . U value of gross area of walls , roof/ ceiling and floors
o
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 ?
3e 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
Be Under 16 % Only
1 . R value of roof and floors exposed to ambient conditions.
le 3 fr• � P
2 . R value of exterior walls LIC/
3 . R value of glazed area 0C Z
4 . R value of doors ' !
5 . R value of floors over unheated spaces
6 . R value of slab edge insulation - unheated slab
7 . R value of slab insulation - heated slab
Be R value of heated basement / cellar walls ( above grade )
9 . R value of heated basement /cellar walls ( below grade ),
10 , Type of insulation
C . Controls
10 Thermostat maximum heat setting
D . Duct Systems
1 . Is duct system installed in unheated spaces ? YES NO
a . I £ YES , R value of duct installation
be R value of duct in other areas
E . Piping nsulati I on
1 . Size of hot water or cooling carrying agent pipe
2 . R value of pipe insulation
F , Service Water Heating
1 . Performance efficiency
2 . Temperature control setting maximum
G . For Swimming Pool Only
1 . Maximum heating
Telephone No .
applicant ` s signature )
THE NEW YORK BOARD OF FIRE UNDERWRITERS
O01744 BUREAU OF ELECTRICITY
j f 41 STATE STREET, ALBANY. NEW YORK 12207 _
hate August 5 . 1987 Application .Va. on file 010782-87
THIS CERTIFIES THAT 0
665
only the electrical equipment as described &&law aaad introd"ced by the applicant named on the above appiicatiora neamber in the preenises arf
Cirino ,r �F.t . Amherst Rd4 , Glens Falls , N-'Y �e
in thefolhjawinlf location; I -r Basement ® ist F!. ❑ .tnd Fl. attic out 'de Section Block Lot E
was examiraed ors 7 /14 /87 andtoured to be in compliance with the requirements of this Board,
FIXTURE FIXTURES RANGES COOVANO DECKS OVENS f]ISH WAS►#RS EXHALtST FANS
OUTLETS EPTACLES SWITCHES INCANDESCENT nUONSCEN'T AMT. K. W. AMT. K. W. MAT.
28 57 23
DRYERS FURNACE MOTORS FUTURE APPUANCE FEEDERS SPECIAL EEC'" TIME CLOCKS UNIT HEATERS MULTI-OUTLET pIMMERs
AMT. K. W. OIL H. P. GAS Ii, P_ AMT. NO. A. W. O. AMT. AM►. AA1►. AMPS. TRA/+IS. AMT. N. ►. *YSTEMS AMT. WATTS
NO. OF PEE!'
rang, 3 6
x hw 30 o
SERVICE DISCONNECT No, or ry'e-S 1% R V 1 C E
METIER AMT. AMP. T7rE 1 'w 2W 1 X 3W 9 �CONb. OP CC COMP. NO. OF MIr tEG OF"YN LEG N4. OP NEUTRALS OF M EUMAX
x 20C! Cb x
OTHER APPARATUS:
RE
Me
1-»8=oke detector
Brian, R. Meu7Cs , Inc . � � /1,
BE
PO Box 3206 `� BRANCH MANAGER
Glens Falls , NY 12801 �
Per
This certificate must not 12e altered in any manner; return to the office of the Board If incurred. Inspectors may be idanti#lad by choir credentials.
>E
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
Jown ca�' 'Qrueens �tcrt�
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Oueensbury, New York 12801
BUILDING INSPECT R ' S REPORT
SAME L t ,tizt .y c�
LOCATION 14 1�r _P s r ram/ 1>
Date / y Permit NO . '!
✓ = APPROVED - YES NO
Footing/Pier Fo
Foundation
Waterproofing
Backfill
F rami.ng
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext . Porches
Finished Floors _
Interior Trim
Stairs & Railing
Cellar Drain
Concrete Floes
Plbg . Fixtur s
Gar . Firepr offing
Door Close s
Smoke Det tars
Chimney
INSULATIO
Foundatio
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAIL .w
XFinal Building Survey�T
Next scheduled inspection ( call when ready )
Remarks-
Building Inspector
6/86 rnd-vl
/oex+rt O/ Quee" 3Aurtit
BUILDING and ZONING DEPARTMENT
Say and Haviland Road, R. D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION `
Date57 " �7 Permit No .
✓ = APPROVED - YES NO
Footing/Pier Forms
Foundation
Waterproofing
BarCx6 l I
gaming
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
Wall s
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready )
Remarks- P Q �fj` Q
ee
�^-'"�+�.�'C.t.�,�
Building Inspector
6/86 and-vl
_Jvcvn 0/ Queenshury
BUILDING and ZONING DEPARTMENT
Bay and Wawiland Road, R. D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME Yl Ir1 %
LOCATION
Date _._.-/! [ Pao rm�i t No , C! I V- •u�
Me' = APPROVED - YES No
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
,)Wough Plumbing
Relief Valves
Ext . Porches
Finished Floors
Interior Tram
stairs & Railings_
Cellar Drain Tile
Concrete Floors
Plbg . Fixtures
Gar . Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION
Foundation
Floors
Wa l I s
Ceiling
FINAL ELECTRICAL INSPEC."TION
0RIVF.WAY APPROVAL
Final Building; Survey
Next scheduled inspection (call when ready )
Remarks-
Building Inspector
6/86 and-vl
flow" 1I
BUILDING and ZONING DEPARTMENT
Bay and Naviland Road, R. D. 1 Box ga
Queensbury, New York 12601
BUILDING INSPECTOR ' S REPORT
NAMELJt ' b, �rxrc..a5
LOCATION
Date- 'Permit No . 717 -s
k 51�65 ✓ = APPROVED - YES NO
Footing/Pier Forams
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 '—
IN S U LAT I oN
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICA INSPECT N
DRIVEWAY APPROV
Final Building urvey
Next scheduled inspection (call when ready
Remarks-
Building Inspector
6/86 and-vl
BUILDING DEPT. COPY OF APPLICATION FORM 48-EL, NEW YORK BOARD OF FIRE UNDERWRITERS.
FILE THIS COPY WITH BUILDING DEPT, WHEN REOUIRED,
TEMP. ! DATE
CITY OR
VILLAGE
TOWNSHIP COUNTY
STREET AND NO. OR
ROAD AND POLE NO, "x �"'� r' POLE NO.
BETWEEN WHAT TWO ,y
CROSS STREETS ISMt�LLS �/ ..-.�.- ,jar
PRECATED� /a /s�� SECTION f'" BLOCK � LOT •'"� r
OCCUPANT'S r.. . BUILDING .�
NAME 'r" - OCCUPANCY
OIWNE WS NAME ?
AND ADDRESS TE L_ #
CURRENT
SUPPLIED ,�r c� '^
8Y .Jl �'r FROM THEIR IG .7
OFFICE
B WUlLOiNG DEFECTS
IS NEW OLO ❑ Is
ORK NEWAKC ADDITIONAL ❑ REMOVED Q
LIST BELOW ALL EOUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETS Nix of Fiirivra 8 CIRCCUUITTS, OFFICE USE
Lthcr ax o FixituaOlas MOTORS HEATERS
tjay ONLY
CaRlny Will! Rttapago Switch Pandsnt Brooke[ No. Type H_P. Wrtss A.W.O.
aeaP'h Eaclh NO- Eaoh me. Caine INSPECTION
out-
side
Bob-
base
Brtr
mans
Iet Fl,
2nd Fe.
Srd Fl.
REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: DO NOT USE THIS SPACE.
This application is intended to cover the abo listed aqujpmant to be inspected but if at time Of inspection Them is Ia rbd additional equipment not abeva listed,
Yeti are sutherized to make the inslsaction and adjust the fee to cover the additional equipment, seprovjdel by the applicant.
SIZE OF
MAINS ELECTRIC SIGN TOTAL
MAINS FEEDERS LAMPS WATTS
CHARACTER EXPOSED GAS TUBE SIGN
OF WORK CONCEALED TRANSFORMERS OF VA
WORK TO BE {NUMBER 1 (CAPACITY 1
STARTED COMPLETED SIZE OF SIGN
SERVICE OVERHEAD UNDERGROUND MAKER
ENTERS
OIN OF SIGN
INSPECTION REQUESTED
ON OR AS NEAR AS
POSSIBLE NEW � OLD
AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES DATE OF
MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. APPLICATION
PRINT NAME D ADDRESS SIGNATURE
NAME OF p i; I I �, .
APPLICANT , f' r'...J f/r('i• = /r :^ /` . _ iF\ OF APPLICANT._.ap
STREET ADDRESS t ✓ .4 +�` - •i TELEPHONE
CITY OR _.
'M.ST 21P OFFICE y/ / %" .1 i� f LICENSE NO..
CODE .+"rWHEN APPLICABLE
' =PARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING
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