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1987-042 f i ` CERTIFICATE OF 0 CCLTI'ANCAJL7 TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date jx-Lly 29A 19 57 This is to certify that work requested to be done as shown by Permit No. 87-42 i has been completed. This structure may be Ned as a One- Faintly Dwelling y pnldr� Pine. . T.nrcaciort Lot 22 Pinion Pine Lane and Gan Coesrt in SectioLi I Van Howe St . No . I Van Court csLate� Owner Yvon Gregoire By Order Town Board TOWN OF QUEENSBURY j I'` ,,..,,•' CC"Building & Zoning InsPector i -�- T H M P 0 k A k Y CERTIFICATE CJF OCCUPANCY I TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK i D.cr July 243, 57 14 I This is to certify that work requested to be done as shown by Permit N&.7-42 i has been completed. i f This structure may be occupied as a ONE-FANILY DWELLINt� i LocxNon Lot 22 P:i,uion Pine Lane. ti Van. Court In Section I Van Bowe Estateca St . No . 1 Van Court Ohvner Yvon Grego I re i TE?:iPUP.AiY C: i(3 ISSURRDF0 : 30 Days It'F3+DII4G Li.1.CTk :-CAL k NSPF.�.'Tf0N. By Order Town Board i TOWN OF Q'UEENSDURY i Building a Zoning InsPector '� +. r BUILDING PERMIT TOWN OF +QUEENSBURY No. 87_42 WARREN COUNTY, NEW YOR K �c c PERMISSION is hereby granted to Yvon Gregoire car Lot 22 pinion Pine and Van Court Street. Road or Ave. n OWNER of property located at q o , an our One—Family Dwelling i in the Town of Queensbury. To Construct or place a ro 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 . OWNE R's Address is 64 Burgoyne Road Saratoga Springs , NY 0 R 1%J N r3m. CONTRACTOR or BUILDER'S Name same rh �d R7 rt tj ry K3 r+ nz c` O O 'mot CONTR ACTflR or BUILDER S Address rp same C c � w 4. ARCHITECT'S Name o o m sEc n 0 n D ri7 P. tot C 5. ARCHITECT'S Address rt ro m C'3 0 C n rt 6. TYPE of construction — (Please indicate by X) IX) wood Frame ( 1 Masonry I 1 steel I 1 1. 7. PLANS and Specifications 24ions per plat plan , specifications and application submitted No. including two-car attached garage and sewage system . xn I S. Proposed Use N• One-Family Dwelling �- �c $ 5 , 00 C 0 Sept . 1 19 87 t%+ $ 150 . 00 PERMIT FEE PAID - THIS PERMIT EXPIRES w llf a longer period is required an application for an extension must be made to the Building and Zoning inspector of the S33 town of Queensbury before the expiration date.l th Day of Feb . 19 87 Dated at the Town of Queensbury this 25��yy� SIGNED BY ,/ / ! for the Town of Queensbury Building and Zoning Inspector TO BE COMPLETED BY BLDG . DEPT . cca�rr Application No . 7.._ O/ Queel igury Permit Issued 19 TOWN WN 0 BUILDING and ,ZONING DEPARTMENT Permit Expires 19 ; Say and Haviland Road, R. D. 1 Box 98 Zoning Designation ! �U+•�t l f Queensbury, New York 12801 variance No . FEB Site Plan Review No . 2 O Approved by : � yi � �-L31RYF"' ak 1C)OL7E j2gE". APPLICATION FOR BUILDING AND ZONING PERMIT A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION . ANSWER ALL OF THE FOLLGWING . 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 : P. O. Address 0e / t Tel . Property Location ; + rirfax Map No . Street number or building lot Aumber Subdivision name ( if applicable) `'+ ti* -67� zi JI/A PJ. ZA ZiE.Fw THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS : Name P . O . d ss Tel . No . Name of builder " Address �{ �,.,�� �/f'C+ Cel . ,w`9 " • 4V 4 Name of plumber _9�e Address 400� Tel . +Z►g '„ZtleZ7D Name of mason 11,rd V,Zolm ? Address Tel * 6 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 whether interior or corner lot . Show location FOR DEMOLITION PERMIT . STATE SIZE AND * of water supply and location and configuration LOCATION OF STRUCTURES AFFECTEDw of septic disposal area . * COMPLETE INFORMATION REQUIRED BELOW . Size of property � r+ �=w'��"`.,,• ft X ft _ * Existing building ( d) Siae ,rr�, Aft X ft . * PROPOSED BUILDING AND USE : * Existing building ( s ) Use Size of new structure -�q-ft X_-' ft Founda t ion-pier/slab/c rawl/part ial7tr9P Proposed building , distance from property line (circle one ) No . of stories (habitable space ) * Front yard , 'f ft Rear yard ft Height ( grade to ridge ) Aj"w _ ft , * Side yards ,/ +I '" ft and x / ft If residential , no . of families / * If on corner , setback from side street .M4 ft No . of rooms ( excluding baths ) 7 * OCCUPANCY INFORMATION No . of bedrooms � T Now of bathrooms IL Y3 - * PRIMARY BUILDING - Primary heating sy teem * One family dwelling Type of fuel_ * Two family dwelling N - * Multiple dwelling / Number of units o . of fireplaces to be installed Will a wood stove be installed? ' * -w Permanent occupancy d Tra nsient occupancy Central Air conditioning? a„�►,. �.- * Business BUILDING STYLE,, PRIMARY STRUCTURE * Industrial Ranch ontemporaryYLog cabin * Other If addition what will use be? Raised ranch Man is on�'� Duplex * ' Split level Old style Bungalow Cape Cod Cottage Other * ACCESSORY BUII.DING- Colonial Row Town House * Detached garage/one car/ t car { CIRCLE ONE PLEASE } * Attached garage/one cart wo car ^ u car �..._-- * * * * * * * * * * * * * * * * * * Private storage building ESTIMATED MARKET VALUE OF * Other CONSTRUCTION $ y 40 0 400 INFORMATION ON BUILDING SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET , TO BE COMPLETED ! Form EPA 4/86 and-vl BUILDING PERMIT APPLICATION CONTINUED BUILDING SPECIFICATIONS : Type of construction w od frame fire safe , etc . Will any second-hand or ESed lumber be used? If so , for what ? rr Foundation wall material !C Thickness G'd Depth of foundation below grade (to bottom of foot ' ng ) Q of Will there be a cellar? Heated or unheated? r � Floor sq. footage f�j7p O sq ft Will there be a baseme —Will any portion be used as living space .;, ( If so , what portion? _sq . ft . - - 'Type of use? Type of roof - slope /flat/shed/other Material of roof Site , wood studs �' " X _ '" spacing f G "o _ c , length ft Joists ( floor beams ) 1st . floor 02= -"X�."' spacing_, /L '"o . c . span ! „ ft . Joists ( floor beams ) 2nd . floor a "X f 6 ' spacing L(L""o . c . span� ft . �l "+ Overlays (ceiling beams ) '"X _" spacing _" 'o . c , spank "+ £t . Roof rafters 'X " spacing_ ZV o . c . span ft . Roof trusses (pre-engineered) spacingA " o . c . span�g-� ft . Exterior wall finish Meg Of what material ? Interior wall finish f & .......... If a garage is 'to be attached , describe materials to be used for FIRE SEPARATION : JV Is there o be an opening between garage and dwelling? mod- If so will a -Fire-rated ��ww%0 door , enclosure , and self-closing device be provided? �"" Will a flue-lined chimney be installed? _ Height above � ft . Depth of chimney foundation below grade�ft , Depth of fireplace hearth ft . in . Water supply Municipa or p ivate well SEPTIC SYSTEM ` Distance from ANY private well ( including adjoining properties , eft . (A separate application is necessary for any repair or new installation of septic system) Town of Queensbury 'Y l 1T County of Warren A F F I D A 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 ___- -- ---- 0______d Owne owner ' s agent , a: c, A .tect, contractor - day of 19 Notary Public , Warren County , N . Y . SPECIAL CONDITION'S OF THE PERMIT : 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 , 3 , is the building mechanically cooled ? 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 ? 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 Be Under 16 % Only osed to ambient conditions 1 . R value of roof and floors exp rr � 9 J�v 2 . R value of exterior walls 3 . R value of glazed area y/ ` 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 S . R value of heated basement/ cellar walls ( above grade ) - 9 . R value of heated basement/cellar walls ( below grade ) 10 . Type of insulation 9 Co Controls pd 1 . Thermostat maximum heat setting D . Duct Systems �1 10 is duct system installed in untreated spaces ? YES C�a a . If YES . R value of duct installation b . R value of duct in other areas E . Piping Insulation l� 10 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 l4F© G . For Swimming Pool Only 1 . Maximum heating Telephone No . ' �P �OTappllcantls s ' nature ) .�.� a ` OW00U40y APPLICATION FOR SEPTIC DISPOSAL PERMIT DATE ,! tr ,./ LOCATION OF PROPERTY FOR INSTALLATION . IPZ � "c Owner's Name: Telephone: Address: ppte%f Installer's Name: A—W (e' � " Gr. Telephone: Number of bedrooms (residential only) _ _ -- Total daily flow (compute @ 150 gal per bedroom) Topography: circle one Flat ) Rolling Steep Slope $b of slope Soil Nature: circle one: Sand Loam Clay Other / Depth: feet Gx. ound Water: At what depth? feet Bedrock or Impervious Material: At what depth? _ feet Percolation test: circle one x4f require required / rate KO T^ min, inch. Domestic water supply: circle one: Municipa Well Other IF domestic water supply is a Well: Separation: Watersupply from Septic absorption _ i(&` feet PROPOSED SYSTEM: Septic Tank /01a Q gal. (minimum size: 1 ,000 gal.) TILE FIELD: Each Trench feet / Total system length ,Z© +0 feet SEEPAGE PIT(S) : Number of / Size each feet by feet Size of stone to be used # _ / Depth or Thickness feet IMPORTANT' ...Please...LIST NEW EQUIPMENT 70 BE INSTALLED * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * sae * * * (over) Section II 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 Z4 hours before start of construction and shall include a plot plan showing: 1 .) the proposed location of the system Z.) 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 $Z50.00. G. 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 Disposal, Ck%lin.ance. Signature of responsible person: Date: �i Town of Queensbury Building and Code Department Bay at Haviland Road. Queensbury, New York 12801 (518) 79Z-5832 SETTLED 1763 . . . HOME OF NATURAL BEAUTY . . . A GOOD. PLACE TO LIVE 4 rr flown a/ Q"eerrsbury BUILDING and ZONING DEPARTMENT Bay and Havikand Road. R.D. i Box 98 Oueensbury, New York 12801 BUILDING INSPECTORS REPORT NAME i yQ LOCATION Date / Permit No . ApPROVED* -* YES* NO Footing/Pier Fory sy 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 t,Auoke Detectors Chimney INSULATION Foundation Floors walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY AP'PROVAI._ Final Building Survey Next scheduled inspection {ca11 when ready* Remarks- midi Inspector 6/86 and-vi awn o BUILDING and ZONING DEPARTMENT fl kl� Bay and Haviland Road. R.D. 1 Sox 98 Queens4urY. New York 12801 BUILDING I SP' ECTOR ' S REPORT y NAME C '�'�r• � r���i' LOCATION I3ate_'���/ Permit No APPROVED - YES NO Footing/Pier Forms Foundation Waterproofing Backfill Framing ins �of Ing siding ' masonry Veneer Rough Plumbing _ Welief Valves LmExt . Porches '"rinished Floors ` LTRterior Trim stairs & Railings Cellar Drain Tile �, o.,�rete Floors `'L�] bg . Fixtures ' CGar . Fireproofing 4L ti5oor Closers Wa@ 4-Smoke Detectors ` Lehimney IerNSULATION : undation Floors lls ceiling AwT INAL ELECTRICAL INSPECTION DRIVEWAY "FROVAY'----�' Final Building Survey Next scheduled inspection (call when ready Remarks- /,p/C a s f Bui Ing I ector 6/86 and-vi awn v� �eeeerrs� urr� BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. i Box 98 Queensbury, New York 12801 BUILDING INSPPE�CTOR ' S REPORT NAME LOCATION! Date �2 / Permit No . APPROVED - YES NO Footing/Pier Fo Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief valves Ext . Porches Finished Floors Interior Trim Stairs & Railin �. Cellar Drain To a __...._ Concrete Floo Plbg . Fixtur Gar . Firepr fing Door Close Smoke Det ors Chimney /%aN SULATION Foundation Floors walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection (call when ready Remarks- Building Inspector 6/86 and-vl BUILDING and ZONING DEPARTMENT Bay and Navitand Road, R_b. 1 Box 98 /Quue�ensbury, New York 12801 SEPTIC DISP SAL SYSTEM INSPECTION NAME LOCATION ON L6 11' G2I0- m >eOIDATE PERMIT NO. SOIL TYPE - and Loam - Clay - Percolatio Required? YES Percolation rate - Min/inch © , ' TYPE of SYSTEM: Absorption field , total length Length of each trench Depth of trenches Size of gravel_ SEEPAGE PTTS4Number of) _ Size- ft. X ft. — - --- Gravel size - - YF PIPING : Six Type Bldg . to tank G22.0 Tank to dist. box Dist. box to field/ Openings sealed? NO Partial LOCATION/SEPARATIONS : Foundation to tank tCl ft_ Foundation to absorption ft . Absorption to lot line Aft4` Separation of pits ft. Lj0CATFront O y Lef TEMt ON PROPERight side one) Front ear Left side - Right side - CCIKMEN SYSTEM USE APPROVEr( Y NO Building Inspector 01/86 and vl �Jnwn o� �iteen .s6e�r� BUILDING and ZONING 'DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT r NAME LOCAT l4N Date f Permit No . - ' ,� * * * x * * r * w « � * r sr • * ,r a : * * � ✓ = 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 Brain Tile Concrete Floors Plbg . Fixtures Gar . Fireproofing Door Closers Smoke Detectors Chimney VINSUT.ATION : Foundation Floors I/Woa11. s OK I tQx<iling + FINAL k:oLECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building. Survey Next scheduled inspection (call when ready Remarks- _ 4' ' i Building Inspector 6/86 and-vl mull Q Y11s 1k7 � .f. v/ Queensfi// ury BUILDING and ZONING DEPARTMENT Bay and Haviiand Road, R. D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME )/ y6 LOCATION Date //5 /f _ hermit NO . yA I ✓ - APPROVED YES No Footing/Pier Forms Foundation Waterproofing 8ackfill ]K 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 Coifing FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection ( call when ready Remark :s- �UM6 Building Inspector 6/86 and-vl e'.Gt f d ;Y � BUILDING and ZONING DEPARTMENT Bay and Haviiand Road, R. D. 1 Box 98 Queerisbury, New York 12801 BUILDING INSPECTOR ' S REPORT NA'r'IE�'�/ LOCATION �, 7 � ,� f i ra r dh �v► Date.3/ �f 7 Permit No . ✓ = APPROVED - 'YES NO Footing/Pier Forms Foundation Waterproofing ackfill �51 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 . Fi xeproofing 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 C d r{ s� rQ 31 alcc �7 q // ._ J©wn o/ Q"eeny6ury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D_ 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME V8V1 G Yego I M- E= ' C F IO LcT 72 "Z j'i n 'iort 17x h c �Gf � .t � r (A � n _ Date. _/ Permit No . ✓ = APPROVED - 'YE 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 Final Building Survey Next scheduled Inspection ( call when ready) Remarks- - L SO Building Inspector 6/86 and-vl awn u/ Q44een66ury BUILDING and ZONING DEPARTMENT Bay and Havikand Road, R. D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME n e c d 1 r � LOCATION 1,6 ac Pniisn Pin G I/ G.w•I" Date 5 / Permit No . APPROVED - S No Footing/Pier Forms q qr 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- - � /r ' a L! 15'Eoy/ [ as Building Inspector 6/86 and-vl d r x, 4 � r t t� r { or '( mow.._..., 1r � S� l a a 22 cat G � r 2 '3 - r .r.P� _-� _ _ =1 - �� , �� . ��i ��� - -- - ---� i 1 J � i �� � � ,, � I `� Y�