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1987-025 r r f CERTIFICATE OF OCCUPANCY '' TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Y Date June 18 19 67 This - 25 is to certify that work requested to be dune as shown by Permit No. 87 has been completed. oue-Vmll This structure may be occupied as a I1we1t ing fZ7 i Location i6eb "IASi1. Fox Hollow Lane (St . No . 10) Weatjand ::eotlo t 15 Owner Simeon and Eileen leen Savitz By Order Town Board TOWN OF QUEENSSURY Building & Zoning Inspector I i I - BUILDING PERMIT TOWN OF QUEENSBURY No. 87-25 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Simeon and Eileen Savitz OWNER of property located at Lot 580 Fox Hollow Lane ( St . No . 10) Street, Road or Ave. cn Y• in the Town of Queensbury, To Construct or place a One—Family Dwelling v 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 . 01AWER'SAddressis RD #Z West Mt . Road � Queensbury , NY N ro m 2. CONTRACTOR or BUI LDER'S Name Robert Ruggles w rr N 3. CONTRACTOR or BUILDER'S Address 5 Wincrest Drive Queensbury , NY r Cf3 iJ] O 4. ARCHITECT'S Name n rr rt H v, Y• t4 07 O O O rr� o 5. ARCHITECT'S Address to O PS . ro o P�r7 r 0 6. TYPE of Construction — [Please indicate by XI ! Wood Frame { } Masonry ! ] Steel { } m 7. PLANS and Specifications No 32 ' x90 ' per plot plan , specifications and application submitted including two-car attached garage and sewage system . 8. Proposed Use O One-Family Dwelling ro w H• $5 . 00 C /O c $ 192 . 00 PERMIT FEE PAILS - THIS PERMIT EXPIRES August 1 1987 llf a longer period is required an appiication for an extension most be made to the Building and Zoning inspector of the town of OLmensbury before the expiration date.) r, Y• Dated at the Town of Queensbury this 30th �/Day,.o^f (January 19 87 � SIGNET] BY zle 6,0 ' /^' for the Town of Queensbury Building and Zoning Inspector TO BE COMPLETED BY BLDG . DEPT . // Application No . own otxeert3hur Permit Issued 19 BUILDING and ZONING DEPARTMENT Permit Expires 19 4 TOWN OF 4� ' Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation Queensbury, New York 12801 variance No . tea La U 11 / ] Site P Review N J04 } ' 1 Appro d by . AAL APPLICATION FOR 718 213)41516 a / R 7 V 1 a 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 . The owner of this property is : / } r utgJ A Z j Li L e, ,y_/ _'Ld tz J " J' F . O. Addressrt. r 1 11 r � � Tel . � xr� Ds Property Location : I-y Tax Map No . Street number or building lot number Subdivision name ( if applicable) kAr F.�-r L „d ,•, �' G7�,, � ..._�,1 � THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS : Name P . O. Address Tel . No . Name of builder i F y3 Address c„!. -- Tell Name of plumber S, Address �� L(s Tel . r } Name of mason ., ; 1 GZ ;� y „� Address sty � tag ��� • Tel . NATURE OF PROPOSED WORK : ZONING INFORMATION : _ onstruction 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 SIDE AND whether interior or corner lot . Show location LOCATION OF STRUCTURES AFFECTED. of water supply and location and configuration of septic disposal area . x COMPLETE INFORMATION REQUIRED BELOW . Size of property / ,� 4? ft X. 'iiape� ft . Existing building ( s)' Size ft X ft . PROPOSED BUILDING AND USE : Existing building ( s ) Use Size of new structure ;�ft X4) 0 Foundation-pier/slab/crawl/partial/ ull Proposed building , distance from property line ( circle one ) No , of stories (habitable space) Front yard ft Rear yard 146 ft Side yards 7 ft and s ft Height ( grade to ridge ) / C fL If on corner , setback from side street ft If residential , no . of families / No . of rooms ( excluding baths ) _ * OCCUPANCY INFORMATION Noo of bedrooms 3 '" No . of bathrooms PRIMARY BUILDING — � � - * :25 e family dwelling Primary heating system e.sf& Type of fuel � Two family dwelling lac No . of firepes to be installed * Multiple dwelling / Number of units Permanent occupancy Will a wood stove be installed? Transient occupancy Central Air conditioning? '� t 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 ape Cod ; Cottage Other * ACCESSORY BUILDING- Colonial Row Town House * Det_aLched garage/one car/ two car/ car ( CIRCLE ONE PLEASE } 'e attached garage ne car/ wo carY car * * * * * * * * * * * * * * * * * * _Private storage building1. N ESTIMATED MARKET VALUE OF * Other CONSTRUCTION $ / .2 dt 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 , etc6 will any second-hand or ungraded lumber be used? If so , for what? Foundation wall material Thickness Depth of foundation Belo grade (to bottom of footing ) _ ,�� -� -• Will there be a cellar? c-g i __yHeated or unheated? 44Z yd Floox sq. fog- stage :;7 6 f1 �SLsq ft Will there be a basement . t Will any portion be used as living space? ( If so , what porti ? / sg . ft . - - 'Type of use? Type of roof sloped Flat/shed/other Material of roof .4 s +V t-l.ra z. _ Size , wood st "� 'X !� " spacing �/ 1_ "'o . c . length €t . '0*0Joists ( floor beams ) 1st . floor '"XLi�a " spacing ) ,d , "o . c . span ft , Joists ( floor beams ) 2nd . floor 7 IN ) 6 spacing "o . c . span�i ft . Overlays ( ceiling beams ) "x_P" spacing-2- "o . c . span f (a £t . Roof rafters -'�L "x l []" spacing /�f o . c . span ft . Roof trusses (pre-engineered) _ spacing "o . cl span..2,,:? ft , Exterior wall finish /],a r ,� of what material? Interior wall finish If a garage is to be att hed , describe materials to be used for FIRE SEPARATION : Is there to be an opening between garage and dwelling? tdcLe If so will a Fire-rated door , enclosure , and self-closing device be provided?> Will a flue-lined chimney be installed? Height above Mbbf _ ft , Depth of chimney foundation below grade ft . Depth of fireplace hearth. �G- ft . !n . Water supply - Municipal or' priva a well SEPTIC SYSTEM _ Distance from ANY private well ( includ 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 er , OWner ' S agent , arcna.uect , Contractor - 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 areammmmmmb� � L- i 2 . Type of heat 3 . Is the building mechanically cooled ?_ 4 . Percentage of area of windows and doors A . Over 169: 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 S . Type of insulation Be Under 1646 Only 1 . R value of roof nd floors exposed to ambient conditions 2 . R value of exterior walls_ _ % + 3 . R value of glazed area -- 4 . R value of doors - S . R value of floors over unheated spaces 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 ) IO . Type of insulation ) fir C> a � � ,77 C . Controls 1 . Thermostat maximum heat setting__ _ D . 'Duct Systems 10 Is duct system Installed in unheated spaces ? YES a , If YES $ R value of duct installation 0) 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 Heating 1 . Performance efficiency 2 . Temperature control setting maximum G . For Swimming Pool Only 1 . Maximum heating Telephony No . 7���L., ( a plxcant ' s signature VMY&U*1 if APPLICATION FOR SEPTIC DISPOSAL PERMIT I7IATE 2 /-77 LOCATION OF PROPERTY FOR INSTALLATION I Owner's Name: i x Telephone: P. Address: _ / �� —�f'_,LL4 G iiE: Installer's Name: j I t { CI _ r clzF>�,V Telephone: Number of bedrooms (residential only) low Total daily flow (compute @ 150 gal per bedroom) p 4e) Q Topography: circle one: Flat Rolling Steep Slope % of slope _ Soil Nature: circle one: Sand Loam Clay Other / Depth: feet Ground Water: At what depth? A-? f eet Bedrock. or Impervious Material: At what depth? � feet Percolation test: circle one: not required required / rate min. inch. Domestic water supply: circle one: Well Other Municip IF domestic water supply is a Well: Separation: Watersupply from Septic absorption feet PROPOSED SYSTEM: Septic Tank ,/ ZEZ;�- gal, (minimum size: 1 ,000 gal,) €e,�rrEecl s3atem length_ _#'eet SEEPAGE PIT(S) : Number of -. f --�/ Size each Weet by " reet Size of stone to be used # '` / Depth or Thickness ` feet 3 IMPORTANT ___Please...LIST NEW EQi7IPMENT TO BE INSTAi_ ED (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 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 50 size and dimensions of all tanks, distribution boxes, the fields and/or dryweils 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. I have read the regulations above and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disoosal Chs4inance. Signature of responsible persons 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 I' lueeny�aura/ T 90 n Of �,r„►� L"PE-9XgTMEN and Z oad. R.D. i gcax g24 BLlIL[]lf1G 12 g0i Ray and Na"aln York ❑ueensbury , REP(]RT S 01 1� gU14pING ItgSPECTC7R t+f AME � OGpTIR { / perm* * * * * NO E'ootin9/P}ex Forms Roof 3.n9 ��. Si.dirk'3 yeneer�-----��'-�� outpj.UVkbint3 -�'�- Rellef Valves gxt . porches Finlsh'ed 'Floors Ix,ter !or fixim Stairs t&'arri e Cellar Floors ConcreFiXtureS_� Pl'lx3 • r-- in9� f�-r----- Gar , FIre-proof 'or Closexs_�-- � �--- Sma]ce Detectors CYsilnne TIC �,ouxyclati4n Floors Wa3.ls T�CRI` Ii3SFECTS'��----�'�� �n 1W Bui d inV xve�_.---�-�� t scheduled ins17 ecrion call whey' ead9 Next e r" ikermarlrs- 'e" , R r , pyuildin9 Inspector 6/86 ��vl flown ol �rreC� n36 �t/'e� BUILDING and ZONING DFPARTMEN'f gay and NavNand Road* FLO. 1 13OX 98 pueensburY, New York 12801 SEPTIC DjSp0 SAL SYSTEM IN5PECTION NAME_ LOCAT I ON,"m...a� -- PERMIT NO - �_ L"►AT'E SC>IL "TYPE Sand - Loam _ clay NO so-mperc TYPE Test Required? 'YES Percolation rate - Min/Inch TYPE Of SYSTEM: length AbeorPtion field , total Len�3th ch trenc I I Depth of tren siz ravel e�f-- SEgPAGR PITS�Numb Size - ft. X LQfto Gravel szze Size Type P IP ING : 1/ to tanx - C Bldg - -=1 - • � Tank to dirt . box Dist . box to field E --G Partial ()peninc3s sealed? YE Y,acATxor1 /sAT I.IS : ft C' K- Foundation to tan 4 A4--'- t . n ft . Foundation to abso ft 'Q ��_ Absorption to lot l i --- -f t -lo Separati an of pits Q ,E TY (cirC1B one) 4CATICSL3SYSTFM _ Right side Front _ ea Le£t ide CCKVIEN TS : As Ab 5y5*TEM USE APPRCIVBD YES No Building yr,sp&k ctor 01/86 and v1 u�y BUFLENI q{rd t:g.NIN th A,RTNIf"1VT Bay and Wavitl��lid Ro'id Box 98 Quepnsb NeW Yolk 1;2801 SEPTIC C IVO YSi" INSPECTION NAME LOCAT I ON DATE � J / PEWIT Nd .� SCSI. TYPE - Sand - Loal" - Clay -_ Percolation Test gec;ui,red? YES - NO Percolation rate - min/''inch _ TYPE of SYSTEM% Absorption fieldr total length Length of each trench eype Dep th of trenchesSize caf gravel'SEEPAGE PITS4NUmber of)Size- ft. xft.Gravel sizePIPING : Size Bldg to tank 'Dank to dirt . box Dist. box to field/ NO Partial Openings sealed? YES LOCATION/SEPARATION S = f t. Foundation to tank ft . Foundation to absorption ft. Absorption to lot line ft. Separation o pits LOCATION TENS ON PROPERTY (Circle one] Front Fzear left. side Right side - C�tMEN SYSTEM USE APPROVE YES NO B 18 ng Inspector of/$f+ and v1 c�77 �1 r ` ,_,Icrwn ra �upens6 �,ere� BUILDING and ZONING DEPARTMENT Bay and Haviland Road, Ft-D. 1 Box 98 pueensbury, New York 12601 BUILDING INSPECTOR ' S REPORT NAME LOCATICON 1 permit No * _* YES NO APPROVED Footing;/pier Forms Foundation Waterproofing B Ir.f i.-�`ra�mi ng Roo f i.ng Siding Masonry Veneer L�ugh plumbing Relief Valves Ext . porches Finished Floors Interior Trim Stairs & Railings Cellar brain Tile Concrete Floors PlbAg . Fixtures Gar . Fireproofing Door Closers Smoke Detectors chimney INSULATION Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey. Next Scheduled Remarks- (calf rwhen ready ) Remarks- �� -) 0A I-4 1"Ale ace �-5S JY�3G © r" wo Building Insp ctor 6/86 and-vl Ie * 7 1 r _Down o. Q" eensburry SUILDING and ZONING DEPARTMENT i Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ` S REPORT NAME LOCATION Date -/ _ Permit NO . APPP'OVEL]* -*YES* NO Footing/pier Forms Voundation Waterproofing Sackfill 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- Building inspector 6/86 and-vl 121 6��Tr /J�cb7� /M� vrJ 49 r' Goa//a P. ..Jc►wrt or! �teeenl3hur+r� BUILDING and ZONING DEPAIRTMENT Bay and Haviland Road, R. D. 1 Box 98 Oueensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME K7. 1 �i fs LDS I��i V/ 7"? LOCAT I OTi �+j'RP 0 X 140 L L 0 al=2 Date/ Permit No OPO� APPROVED - YE NO {Footing/Pier Forms Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext , Porches Finished Floors Interior Trim r Stairs & Railings Cellar Drain Tile Xd Concrete Floors Plbg , Fixtures Gar . Fireproofing Door Closers Smoke Detectors Chimney INSULATION : Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY "PROVA Final Building Survey Next scheduled inspection (call when ready ) Remarks- &jt LiQ i lt, & `j - `�i'iyf+f ✓�" TI / Builf3ing Inspector 5/86 and-vl