1986-608 1.
•
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 19
7-r3)
This is to certify that work requested to be done as shown by Permit No. 86-608
has been completed.
This structure may be occupied as a Addition to one family dwelling
Assembly Point'1Road
Location
Owner ' Herman P. Shires
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoning Inspector
BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-608
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Herman P. Shires
OWNER of property located at Assembly Point Road Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Addition to dwelling (living area) rD
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. p
1. OWNER'S Address is RD #1 •
Lake George, New York
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2. CONTRACTOR or BUILDER'S Name
Robert J. Benware
3. CONTRACTOR or BUILDER'S Address
38 Grove Ave.
Glens Falls,New York
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address 0
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6. TYPE of Construction—(Please indicate by X)
(X*Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
No. 30'x35' per plot plan, specifications and application submitted y�
including sewage system. a.
1-6
8. Proposed Use H.
One-Family Dwelling (living area addition)
0
$5.UU C/U
S
77.00
$ 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 pUq
town of Queensbury before the expiration date.)
H.
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Dated at the Town of Queensbury this 19th Day of September 1g 86
H.
00
SIGNED BY //lila a-® for the Town of Queensbury
1-1
Building and Zoning Inspector (
113
TO BE COMPLETED BY BLDG. DEPT.
Application No.
own of Queenilury Permit Issued 19 OWN OF QUEE,x1 8URY
BUILDING and ZONING DEPARTMENT Permit Expires 19 C ,� p�
Bay and Haviland Road, R.D. 1 Box i Zoning Designation ` ' E 1,
Oueensbury, New York 12801 Variance No. Dii
Site P R- View No SEf a 5 9 n
APpro debS.lt . 2'9--(-` i) I4.F . •
APPLICATION FOR ���./s.' 718191;0)1 ` ��12,r3Ifl5"i
alC-3 1pCc_ h
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: NERrn'AN , SN9/RES
P.O. Address D11( - Bax 1317 ,- ,AKE I2EO26 TNY /.2$4S Tel. 641, -9'4z
Property Location: /asS'Ema,LY �t of ntr-oA.p Tax Map No. 7 / / / z‘
Street number or building lot number
Subdivision name (if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
-RoRERT S-ENWAKE .38. 6Ro AVE, 6uENS47Ru-s Ny /.8oI 798 -/s6,/
Name P.O. Address Tel. No.
Name of builder �( .3. EilwArte Address 38 ( rzotE 1,9UF_, Tel. 798-As-To/
Name of plumber IEeN CEL, srE Address RD / ,,a-rrr,U /91,«.s 'R,p, Tel. 7q a - 3o0 7
Name of mason T ,E'N[ai4,e6 Address Tel.
NATURE OF PROPOSED WORK: * ZONING INFORMATION: '
Construction of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED,
X 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 slot 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 /O0 ft X VOO ft.
* Existing building(s) Size 12. ft X 38 ft.
PROPOSED BUILDING AND USE:
* IR`X2 4 `
* Existing building(s) 'Use Z>wEL....hv
Size of new structure 30 ft X 3s- ft
GARq6E
Foundation-pier/slab/crawl/partial 4 * Proposed building, distance from property line
(circle one)
No. of stories (habitable space) 1 * Front yard la() ft Rear yard Z ft
Height (grade to ridge) j-� ft. * Side yards 2s( ft and 21 ft
* If on corner, setback from side street ft
If residential, no. of families I
No. of rooms(excluding baths) 4 * OCCUPANCY INFORMATION
No, of bedrooms 2 • *
No. of bathrooms /
* PRIMARY BUILDING -
Primary heating system /4.I,ti/,�y,y0log * X One family dwelling
Type of fuel On- * family dwelling
No. of fireplaces to be installed -- * Multiple dwelling / Number of. units
Will a wood stove be installed? NO * X Permanent occupancy
Central Air conditioning? A/Q * `transient: occupancy
* Business
BUILDING STYLE, PRIMARY STRUCTURE . Industrial
l':117T112;)
Contemporary Log cabin * Other 'ed ranch Mansion Duplex * If addition, what will use be? alF�kiw, —
Split level Old style Bungalow * �'�FE'r'�NV��' /v/N(�
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 car/ car
* * * * * * * * * * • * * * * * * * * ' Private storage building
ESTIMATED MARKET VALUE OF * Other
CONSTRUCTION $ '3 q ,` *
tg,0v
INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED}
Ponn BFA 4/80.% ma-vI
BUILDING SPECIFICATIONS:
Type of construction,( ood frame) fire safe,etc.
Will any second-hand or ungraded lumber be used? If so, for what? Aj d .
Foundation wall material"Poemlep GoiqcreFTC/.$&ock.Thickness /2 '' fop"
•
Depth of foundation below grade (to bottom of footing) t' '
Will there be a cellar? /?!O Heated or unheated? Floor sq, footage sq ft
Will there be a basement? y s Will any portion be used as living space? J'J X 141' FArniicy ,1,7 .
(If so, what portion? sq.ft. - - Type of use? 4"�r,I B,,, _ 4,0e,teK Sfiop
Type of roof - sloped flat/shed/other Material. of roof p-iecRC,kilf,T SSNm,64c
Size, wood stu s "X 4 " spacing /(o "o.c. length ft.
Joists(floor beams) let. floor ,Z "X /p " spacing /(o "o.c. span /S ft.
Joists (floor beams) 2nd. floor "X " spacing "o.c. span ft.
Overlays(ceiling beams) 2 "X (, " spacing /6, "o.c. span ft.
Roof rafters 2 "X 1z " spacing /4, o.c. span 30 ft.
Roof trusses(pre-engineered) spacing "o.c. span ft.
Exterior wall finish Woo.b Of what material? T f// ��yWoob - a.-
��
Interior wall finish E - 'ocK
If a g rage is to be attached, describe materials to be used for FIRE SEPARATION:
A/ A
Is th re to be an opening between garage and dwelling? f'J O If so will a Fire-rated
door, enclosure, and self-closing device be provided?
Will a flue-lined chimney be installed? No Height above roof ,2 ft. O
Depth of chimney foundation below grade ft. �•K��T7 6 Depth of fireplace hearth 2. ft. Q in.
_I?
Water. supply - Municipal or private well --- aitIAT
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. truc 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 y - .&_,
---
Owner, owner's
s agent,arcnitcontractor
day of 19 •
Notary Public, Warren County, N.Y, •
SPECIAL CONDITIONS OF THE PERMIT:
N
By
sown of Qucen3tury APPLICATION FOR. SEPTIC DISPOSAL PERMIT
BUILDING and ZONING DEPARTMENT - w
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801 • DATE /
•
LOCATION OF PROPERTY FOR 'INSTALLATION i six9P
SS 6/i7,$L Y 7 O /v 7 cO/4.D — 7-,/-2.1c,
OWNER' S NAME i4Flmju SHitees -
ADDRESS /}/ - ox 13_ ) ki9K6 6Eolt66/ Ny /2pS4bJ TEL (pS6 - 9RV2
INSTALLER' S NAME,O. ERA J � era/uJArtE TEL 79B467o/
Number of bedrooms (residential only) 4
Total daily flow(compute @ 150 gal per bedroom) . (Q00
Topography: Flat -( 11inc3)- Steep slope - (circle one) % of slope
Soil nature. Sand Loam - Clay - Other Depth ft.
Ground- water -At what depth? ft. Nome Ervcoc1NTEREb 4T 8 '
Bed-rock or impervious material - At what depth? ft.
Percolation test - Not required - Required - -Rate min-inch. •
Domestic water supply - Municipal - Well - Other 1,A.,KE,
Separation - Watersupply(if well) from Septic absorption ft.
Proposed System: Septic tank O 0 O gal. ( Minimun size, 1000 gal. )
Tile Field - Each trench „5-0 ft. Total system legnth ,R,Sj ft.
Seepage pit (s) Number of . Size each ft X ft
Size of stone to be used # Z ' Depth or thickness 1 ft.
IMP* *OR*TANT*. * ! '* * * * * . * * * * * * * * * * * * * * * * * * * * * * * * * * *
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 reaulations 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 of responsible person �� - vl�'
Pc1 _ - 06
05/86 and/vl .
•
Section II Septic System Inspections;
A. All applicationg for septic system installation,
alteration or repair, as required by the Town of
Queensbury 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:
1) the proposed location, nf 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 Queensbury Building
Department before further construction.
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: ((
d
1 . Gross floor area IC (J
2 . Type of heat FOE', ()1L P-Ilu) 1-1.1,J . AsEaWlei
3 . Is the building mechanically cooled? Mc)
4 . Percentage of area of windows and doors 1h : v2/6
A Over 16% Only
1 . U value of gross area of walls , roof/ceiling and f ors
exposed to ambient conditions
,2 . Floor ov`r heated spaces YES „..„NO�
a. Are foundation walls insulate-a? YES NO
i
1 . If YES, what is the Revalue?
3 . Slab on grade YES NO
a. If YES , what ism he\R value of insulation around
perimeter of."-floor? \.
4 . Is bas a mt heated? YES NO
a. Revalue 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
3 . R value of glazed area
4 . R value of doors '1)t� ,-k°'t s� Pam( z
5. `R value of floors over unheated spaces (3
6. R value of slab edge insulation - unheated slab
7 . R value of slab insulation - heated slab
8. R value of heated basement/cellar walls (above. grade)
9 . R value of heated basement/cellar walls (below grade) 0
10 . Type of insulation .Mt >-<2.(rj( cf--, 1 1) iCpp1=aS i l•�•- &� i- C
a E
•
C. Controls
1 . Thermostat maximum heat setting Cr
D . Duct Systems
1 . Is duct system installed in unheated spaces? YES NOi
a. If YES , R value of duct installation
b. R value of duct in other areas
E . Piping Insulation ��/,��1I
1. Size of hot water or cooling carrying agent pipe
• 2 . R value of pipe insulation (?)
F. Service Water Heating
1. Performance efficiency 1E-f>G/[f
2 . Temperature control setting maximum
G. For Swimming Pool Only
1 . Maximum. heating \!
Telephone No. 7q& - M( / Rerkjc) ,(7,wa,
(aPPlicat ' s signature)
!{;Aft:sP1.A:•A.J& . iS ��e fin.. "- ti�7,1G ,!."A....e.,!,, Pr:. 1Ri i.).a"i; etr l..? .a . S).,4.1n,1"!-I.C�P�ei...1,9!Si.a�i.TSi. iS)..iSi t-1cRi..iSi,,S, P!.1•,-? E
�,
THE NEW YORK BOARD. OF FIRE UNDERWRITERS
4 -
� 17
' �:OG�:�S1 BUREAU OF ELECTRICITY r.
if _41 STATE STREET,ALBANY,NEW YORK 12207
' September 2, 19"U APPlication No.on file 2„)6
1 Date 025541-86 . A �7 )
�i THIS CERTIFIES THAT
'i, only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
t
i
�- HerMan Shires, 4oenb15; Point Rd.,, Sucre rsbury, NY
"' in the following location; Basement ❑ 1st FL- ❑ 2nd Fl. CiUt3 a Section d Block, Lot26 Lo =
►A, was examined on and found to be in compliance with the requirements of this Board. ! E
7/23/87 =
�' FIXTURE f FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS ;:
z t,, OUTLETS ECEPTACLES SWITCHES INCANDESCENT FLUORESCENT A+�EACUMr AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
A' DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS I BELL UNIT HEATERS MULTI-OUTLET DIMMERS Lo
SYSTEMS
M
jl AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS
L
WI SERVICE DISCONNECT NO.OF -S E R V I C E
k
tk. AMT. AMP. TYPE EQ4. LBp 1,B'2W 1 0 3W 3,B'3W 3,B'4W NO.OF C irCOND. OF A. •COW. ND.. NO.OF HI-LEG _ OF HI--LEG NO.OF NEUTRALS Op NEUTRAL
5 1 200 eh 1 I 4/0 1 2/0F.
- 1. I I —
. OTHER APPARATUS:
—
0
1;
Robert 1 eEI2C/37^£1
_ �7 LLB -
�, 3 C3.0` C Avenue9
_ • GFalls, 1 BRANCH MANAGER
+- /
- Per JI 'I�f k .o
_ ._..
c
T4;. 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. MO
+-- -- VI'--Y,Y'C I f=f-i f_--S" -t CY fY-1-7 YS Y'1 i'l r7 Y i'Y`I i',/iv?. .'i' i f'i i'i,v c'i f'i?'i :'r,.. i''i Y'i i'i 'i i'i i'i?'i Y'i Y'i f'i?i i'i-'1'-ci t'i Y'i i"i 'i F'i `i i
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. -
awn of Queenibitry
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
•
SEPTIC) DISPOSAL SYSTEM INSPECTION
NAME 5 /'�!lie Cr
LOCATION 5i7,( fT
a
DATE �l �1/ 7 PERMIT NO. (R0 -- (p C9 0
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length
Length of each trench
Depth of trenches SO
Size of graver �? ft,463
SEEPAGE PITS{Number of)
Size- ft. X ft.
Gravel size
PIPING: Size; Type
Bldg. to tank f
Tank to dist. box _ ,
Dist. box to field t� :. 1
Openings sealed? 40 NO Partial
LOCATION/SEPARATIONS:
Foundation to tank ft.
Foundation to absorption ft.
Absorption to lot line ft.
Separation of pits ft.
LOCATION OF SYSTEM ON PROPERTY(circle one)
Front - Rear - Left side - Right side -
COMMENTS:/ e77% ' ZA I-"'I!) t -
SYSTEM USE APPROVED./ NO
•
Bu' ding Inspec or
01/86 and vl
G r° //Cc/ t /K730--g
1.
_lown o/ Queenibury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. !1 Box 98
Queensbury, New York 12801
SEPTICC DISPOSAL SYSTEM INSPECTION
NAME / 12y h��n �! I i e
LOCATION / -S,S eh, 4 ly
DATE Way4. PERMIT NO. u J6 - 6ffg
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length
Length of each trench
Depth of trenches '
Size of gravel_
SEEPAGE PITS-fNumber of)
Size- ft. X _ ft.
•
Gravel size
PIPING: Size Type
Bldg. to tank c7,7
Tank to dist. box .VVI ' /4•-5 y-,M !t pce
Dist. box to field, 4/"
Openings sealed? YES NO Partial
LOCATION/SEPARATIONS:
Foundation to tank ft. Ems)
Foundation to absorption 2—aft.
Absorption to lot line
Separation of pits /Jj4ft.
LOCATION OF SYSTEM ON PROPERTY(circle one)
Front -PeaJ- Left side -('Right side •
-
COMMENTS:
/17 d'44.4_,‘L
SYSTEM USE APPROVED YES NO
Building Inspector
01/86 and vl
C C /I A' cP iiJa / 61 1/.' ys'-
own o/ Queenitury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR' S REPORT
NAME 2�
h � I hi i--PJ
LOCATION 4'5-5 ems,ay Jar. 0 a--c/
Date /r1• 8L Permit No. op
* * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
/•Framing Z.----'�
"
Roofing ,
Siding
Masonry Veneer
Rough Plumbing jiJ
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile /
Concrete Floors :/\K-\\
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-
•
Bui1 ing Inspector
6/86 and-vl
Jown of Queen4ury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING NSPECTOR' S REPORT
NAME
LOCATION � �vi
Date /M / `. f` Permit No. 00 �Qg
* * * * * * * * * * * * * * * * * * * * * * *
= 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
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks- )
{
it g3 ,p 'c I q;
Building Inspector (J
6/86 and-vl
;4°,z 4,�•W7 CO134
_town o/ Queeni4ur1
144dCA®®� BUILDING and ZONING DEPARTMENT
((XI�` Bay and Haviland Road, R.D. 1 Box 98
t��17 ' Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME �L-s
LOCATION /��C41
•
Date 7/3/ VG Permit No. !'$t_ 1 0
* * * * * * * * * * * * -* * * * * * * * * *
✓ = APPROVED:- YES / NO
Footin• 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
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
Final Building Survey
Lc
Next scheduled Inspection(call when ready)
Remarks- -
Building Inspector /
6/86 and-vl
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