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1987-192 y _ y I y � ' I V CER.TIFI V.A'TE CIF '.�J CCUPA►.NC Y' TOWN Of +QUEENSBURY I WARREN COUNTY, NEW YORK r �- 19 8 December 2 , +�y Date 11 87-192 This is to certify that work requested to be don't as shown by Permit No. has been completed, 71 l y ^����� 1 This structure may be occ 1pVe'"'L a One-Family Dwe ing Location south side Round Pond road Sa vacior R� Owner By Order Town Board TOWN OFQ, UEEENNSSUURY Building & Zoning Inspector ti I s . r 0 R A R y CERTIFICATE +C7112 OCCUPANC'Y'' TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK act . Date 19 — This is to certify that work requested to be done as shown by Permit No. &7- 192 has been c4ompleted. One--Fa,D7ki1:: Dwelling This structure may be occupied as s Location Sout1k Side Round Pond. Road Salvador Runso Owner 1'F,i-i:rijsl O.Y C /o ISSUED FOR 30 DAYS By Order Town Board PENDING FIN;�LL Ei_,EC TRiCF�L TC)WlV OF QLIEENSBURY Cr-- Building & Zoning Inspector BUILDING PERMIT TOWN OF QUEENSBURY No. 87-192 WARREN COUNTY, NEW YOR K rn w C Salvador Russo w PERMISSION is hereby granted to 1' C7 south side Round Pond Road Street. Road or Ave. OWNER of property located at One—Family Dwelling °1 m in the Town of Queensbury. To Construct or place a a at the above location in accordance to application together with plot plans and other information hereto filed anti approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. i . OWNER'S Address is RD #2 Box 18 � Queensbury , NY 12801 to 0 G 2. CONTRACTOR or BUI LE3ER5 Name McCormack Industries , f' �d 0 G [s. 3. CONTRACTOR or BUILDERS Address 'rb 7 Sarella St . m Glens Falls , New York � 4. ARCHITECT'S Name S. ARCHITECT'S Address O ru 6. TYPE of construction — Iplaase indicate by X) 1 Iv { 10 Wood Frame I ) Masonry i i Steel t I -c 7. PLAINS and Specifications 40 ' x$0 ' per plot plan , specifications and application submitted No. including sewage system and two-car attached garage GQ as S. Proposed Use One—Family Dwelling $5 . 00 C /O November 1 19 87 $ 178 . 00 PERMIT FEE PAID - THIS PERMIT EXPIRES IIf llao�nge 1�� its rYerlQlutredd a appl c�of r So ?xte nsion must be made to the Building and Zoning inspector of the the 22nd flay of April 19 87 Dated at the Town of Queensbury this SIGNED BY •` t7 for the Town of Queensbury kl Bucing and Zoning Inspector TO BE COMPLETED BY BLnr� . nEPm _ TOWN OF 4;It..fIFr:dSRUR` rr Application No . �� f�' �� fla vrt O leeBPaJl ury Permit Issued 19 14L'1T'11,.(11 BUILDING and ZONING DEPARTMENT Permit Expires 1D Bay and Haviland Road, R. D. 1 Box 98 Zoning Designation { ' AIR II jy ! Glueensbury, New York 12801 Variance No . } �p site Plan Review No . 13UIILDI N� } .�c CODE; DEFT (g -� C3 • ' Approved by : ► e. r+>� �l I�� -� APPLICATION FOR CAl 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 : , P . O. Address % t.LM 1��f ')f 7 Tel . Property Location : 2C o ""� � r 4 J iLc ft,2 r . _ Tax Map No . Street number or building lot number Subdivision name (if applicable) THE 'PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS : Name P . O. Address Tel . Now Name of builder I Address - Tel . �7 ` � 74C i f� s 1�lPC Y1 )c _ 7�f Name of plumber i7�: Ai .b � Address Name of mason {'sY `7 7 y� ! r1 �i Address , , -Tel . {, i NATURE OF PROPOSED WORK : * ZONING I NFORMAT I CN : �Constructian of a new building A PLO 'E T FLAN MUST BE pRpARED 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 T�{ '.} "t ft X C}c: ft . " Existing building ( s ) Size ft X ft " * PROPOSED BUILDING AND USE : * Existing building (s ) Use Size of new structure L ft X 10 ft Foundation-pier/slab/crawl/partial full ' * Proposed building , distance from property line (circle one ) * Front yard 1Cp� _ft Rear yard Z I :` ft Now of stories (habitable space) t * Side yards o --ft and L ft I Height ( grade to ridge ) "[ ft • * If an corner , setback from side street ft If residential , no . of families Now of rooms (excluding baths ) _ OCCUPANCY INFO RMATIOItiI Now of bedrooms PRIMARY BUILDING Now of bathrooms One family dwelling Primary heating system f-4 3 L ' 7 �' * Two family dwelling Type of fuel Multiple dwelling j Number of units No . of fireplaces to be installed_ I * permanent occupancy Will a wood stave be installed? na; y Transient occupancy Central Air conditioning? _ r * Business BUILDING STYLE, PRIMARY STRUCTURE Industrial _ * Other itanch Contemporary Log cabin If addition , what will. use be? Praised ranch Mansion Duplex Split level Old style Bungalow Cape Cod Cottage Other ACCESSORY BU-1LDTNG- Town House * Detached. garage/one car/ two car/ car Colonial Row car * /Attached garage/one car/ two car ( CIRCLE ONE PLEASE ) �-� - * private storage building ESTIMATED MARKET VALUE OF Other CONSTRUCTION INFORMATIONS ON BUILDING SpECIFICA'TIONS , ON REVERSE SIDE OF THIS SHEET , TO BE COMPLETED ! Form BPA 4/86 and-vl BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATIONS : Type of construction , wood frame. , fire safe , etc . � 1 Will any second-hand or ungraded lumber be used? If so , for what ? Foundation wall material r ,.="•' Thickness ; Depth of foundation below grade (to bottom of footing ) Will there be a cellar ? E .; Heated or unheated? L r.� Floor s footage Will there be a basement `x' g � h ' t r ft r�,�Wi.Zl any portion be used as living space? ( If so , what portion? sq . ft . - - Type of use? Type of roof - sloped/flat/shed/other - . � C.l'bf tW Material of roof .•, , spacin Size , wood studs g_ , moos . length x �..5.,> Ft . 3oists ( floor beams ) 1st . floor e '"x � t " spacing "o . c . span-ft . Joists ( floor beams ) 2nd-.-�lczar Pox of spacing "'o . c . span Et . Overlays ( ceiling beams ) Fix "' spacing •"o . c . span ft . Roof rafters "X It spacing o . c . span ft . Roof trusses (pre-engineered) spacing "o . c . span ft . Exterior wall finish_ �' 7 l c ' Of what material ? Interior wall tinis i � �.- Ii a garage is to be attached , describe materials to be used for FIRE SEPARATION : Is there to be an opening between garage and d ellin g? r y If so will a Fire-rated door , enclosure , and self-closing device be provided? Will a flue-lined chimney be installed? Height above roof Depth of chimney foundation below grade[, y ft . " ft . Depth of fireplace hearth_ �`Eta n . Water supply - Municipal or;'Private well ` SEPTIC SYSTEM _ .Distance from ANY private wel es t ( includin ad " oinin (A separate application is necessary for any repair or new installationeoflseptic system) Town of Queensbury County of warren A F F I D A V I T STATE OF NEW yOR.K 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 CORE , THE ZONING ORDINANCE , and all other laws pertaining to the proposed work shall be complied with, whethex-� pecified or not , and that such work is authorized by the owner . 1 SWORN TO BEFORE ME THIS Signature L caner, owner " s %`� of agent arc i ect, contractor + day _ �� ..—,.,l9 � Ll Notary Public , Warren County , N . Y . It * * * * * * * * * * * * * * * * * * It * * * * w » mr ,k * * * : * ,r * * 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 f. of lowing er 1 . Gross floor area -Ll -� " 2 . Type of heat�C )U— 3 , is the building mechanically cooled ? 4 . Percentage of area of windows and doors 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 heated ? YES NO a . R. value 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 wall;}s J E 3 . R value of glazed area 4 . R value of doors {� . " ( _ T 5 . R value of floors over unheated spaces `6 . R value of slab edge insulation - unheated slab J � 4 ( P) 7 . R value of slate insulation -- heated slab { � f S . R value of heated basement/ cellar walls ( above grade ) 9 . R value of heated basement / cella/�.r, walls (below grade ) ld . Type of insulation l t'") LC' L 1 C . Controls c 1 . Thermostat maximum heat setting D . 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 oc cooling c,,,44rry* ing agent pipe ` : . 2 . R value of pipe insulation_ .f � F . Service Water Heating_ 1 . Performance efficiency L, 2 . Temperature control setting maximum G . For Swimming Pool Only - l . Maximum heating� < -r Telephone No , _ r i ,( { ' pplicant ' s si ture } WCORMACK`1irFDUSTRIE S 7 S2rella Street GLENS FALLS, NEW YORK 124 BUILDING and ZONING DEPARTMENT Bay and Haviiand Road, R.D. 1 Box 98 Oueensbury, New York 12801 SEPTIC DISPOSAL PERMIT APPLICATION Owner ' s Name f� { - �% � ti Tel Address i ; , `�� �C�J� � :;, .' �� � ;�^•� --E Person/Firm installinc7 system Number of bedrooms ( residential only) -- -f'_- Total daily flaw : ( compute @ 150 aal . per bedroom per day ) Tcpographv : flat -E" roll nz g - steep - ( Circle one ) Degree of slope Nature of sails : Csand-loam-clay- other- Depth ft . Ground water-- at what depth? ft . Bedrock or impervious material--at what depth? f t . Percolation Vest - Not reauired Required -Rate min/ inch , Domestic Water Supply - Municipal. -r W le 1J - Other IMPORTANT ! On a separate piece of paper , submit a diagram of the proposed septic system with q1I dimensions ; including distance from any structure , distance from property lines and distances from any domestic water supply or shore - line of lake , stream , pondor wetlands . Include all dimensions of the system itself . Description of proposed system : Septic tank gal . Tile field- Length of each trench ft . Total field ft . Size of stone # - R Seepage Pit ( s ) Number___L Sizel -ftX_ ft . Size of stone# Any contractor , corporation , individual , Stc . , engaged in the construction of a Sanitary Sewage Disposal system , who covers the same before inspection , does not have an approved Permit , or varies from the approved application , will be subject to a Penalty of $ 250 as provided for in Section 6 . 010 of the Town of Queensbury Sanitary sewage Ordinance . - r� - i1jnature of Applica t , Date ~ McGORMACK INDUSTRIES 1 /8 6 md /v 1 f Sarella Street GLENS FALLS, NEW YORK 12801 Septic System Inspections : A . All applicationd for septic system installation , alteration or repair , as reciru fired by the Town of Oueensbury Sanitary Sewage Ordinance , shall be submitted to the Buildinu Department at least 24 hours before start of construction and shall include a plot plan showinq : 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 B . No system shall be covered before Lnspectic.)n 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 plat plan shall be . availableton 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 . 1 awn 0 IQ N 'UILDING and ZONING DEPARTMENT Bay and Haviland Road, R,D_ 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOK REPO PT NAME �^' ?r�/];00 G LOCATION Gate Lr f., Permit No . 27—lz7L t""0 APPROVED - YES NO Footing/Pier Forms Foundation Waterproofing Backfill Framing Roofing Siding Masonry Vene r Rough Plumbin Relief Valves Exte 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 ELEC CAL INSPECTION RIVEWAY A ROVAL final Buflding Survey Next scheduled inspection ( call when ready Remarks toe - 0; Buil 9 Inspector 6/86 and-vl T /■ ,_./own o� �upc�►z3fiurt� BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D_ 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME r"r7 JO(`" LOCATION DATE I�ERM IT NO. SATE 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 Y Size of gravel_ SEEPAGE P TS{Number of) Size-SEEPAGE X - ft , x' _ Gravel size - PIPING : Size Type Bldg * to tank Tank to dist. box Disto box to field/ Openings sealed? YE NO Partial LOCATION/SEPARATIONS : Foundation to tankft. Foundation to absorption 40 ft . Absorption to lot line Separation of pits ft. LOCATIONN STEM ON PROPERTY (circle one) Front - Rear Left side - Right side - CCImm ITT SYSTEM USE APPROVED YES NO Building Inspector 01/86 and vl ._ Ic,cerr� a Qeeeer� sbur BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 , Oueensbury, New York 12801 BUILDING INSPECTORR ' S EPORT NAME G'l"68 rh /"- Cl `✓ `✓ LOCATION ecru, Date 3 f permit No . _ ►�' �L�_ ✓ APPROVED - YES NO Footing/Pier Forms Foundation Waterproofing B}c]cfill gaming Roofing Siding Masonry Veneer (,ACugh 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 r Ceiling FINAL ELECTRI AL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection (call when ready Remarks- ..,-. Build ' g Inspector +6/86 and-vl _'.lneun 0 Queen3 ury BUILDING and ZONING DEPARTMENT Bay and Hawiland Road, R. D- 1 Box 98 oueensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME LOCATION Date ermit No . rX 1 ►' 9 'a ✓ = APPROVED - YES o kooting/Pier Forms Foundation "Waterproofing ,�kfill 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 i FINAL ELECTRICAL INSPECTtiON ___ I)RIVFFIAY APPROVAL Final Building Survey. Next scheduled inspection (call when ready ) Remarks-- - _ e Rui ldin InspF t 6/86 and-vl F � , ,/ own o/ Queen36urey BUILDING and ZONING DEPARTMENT Bay and Haviland Road, 11 0. 1 Box 98 Queensbury, New York 128+01 BUILDING INSPECTOR ' S REPORT � NAME �/ ` ,+"�7 r f'r •Ji�1 LOCATION -j-ir,, ey/ Cl Date11.X--3-1-F7 Permit No . $ '1 -- `IA ✓ APPROlVFrIoe- YES NO Footing/Pier Forms F /[YY Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves East . 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 inspection (call when ready ) Remarks- Building Inspector 6/86 and-vl BUILDING DEPT, COPY OF APPLICATION FORM 46-EL, NEW YORK BOARD OF F1RE UNDERWRITERS, FILE THIS COPY WITH BUILDING DEPT. WHEN REO''UIRED. ! .. TEMP. if DATE yy3 +7 E - ,,, yam+., TOWNSHIP COUNTY STREET AN NOR O.O NO. ROAD AND POLE NO POLE NO BETWEE�.FµI....F.I..AT TYVD PREMISE LOCA IE yC Q .�. Wp� j CLN& y� SECTION BLOCK LOT PREMISES LdCATEO� f t 3— 'T"� IT OCCUPANT'S BUILDING NAME C 42 OCCUPANCY OWNER'S NAME ANO AppRES5 k6rtb TEL. # FROM THEIR OFFICE dd �{�g WORK DEFECTS NEW lL]s OLO © IS NEW ADDITIONAL E] REMOVED E] LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED No. of NUMBER OF OUTLETS Lamp Receptacles MOTORS HEATERS CI RC ITS OFFICE USE Loco• ONLY. iknl Side Atteeb't H.P. Watts A.W.O. Coiling Wall Recep'Is Switch Pendant Bracket No. Tvpo Each No. Eat No. QeuYr INSPECTION Out- side Sub- base Base ment 1st FI. 2nd FI, 3rd Ft. REMARKS; LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: DO NOT USE THIS SPACE, This application is intended to cower the above.listed equipment to be inspected but If at wimp of inspection there is found additional equipment not above listed, you are authorized to make the inspection and adjust the fop to Cores the addi ti*net equipment, as provided by the applicant, SIZE OF ELECTRIC SIGN TOTAL MAINS FEEDERS LAMPS WATTS CHARACTER EXPOSED GAS TUBE SIGN OF WORK CONCEALED TRANSFORMERS OF VA WORK TO BE INUMBERi (CAPACITYI STARTED COMPLETED SIZE OF SIGN SERVICE JOVERHEAD UNDERGROUND MAKER s ENTERS OF SIGN > BUILDING. INSPECTION REQUESTED ON OR AS NEAR AS POSSIBLE NEW OLD AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION.. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. PRINT NAME AND ADDRESS NAME O F - DATE OF APPLICANT S6�, _ a}t 1a-- �� � Al aAPPLCAT ION . STREETADDRESS + lk sy ?43 r D TELEPHONE * + 9-2� ' 7 qO:) CITY OR C e—rEN Y" Js..i 1 s_'. 1YY"- ZIP LICENSE NO- POST OFFICE — .'� F'� �T'f..+6.1T J a t CODE LICEN 4E NO- ABLE da EL (REV. 1/e5) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING 7d! EfA1 :1 hPO.7wi �y aft N y f ?? M2 y� w / ,Cdlvty y dot' v� o- 401 k so a arr� 'd SI'77 rt tl7. AI $2 6? !� _ U z ` , t a• v S ? w � . vW f �� �' J I a V J rf1 y yj or G i ov / `aw . f w - fft i p 1 rf Sf •� 4y � � !�.r.r. nvrirlg/rS f iM , �� .j` u (Sf�� A [A dim �l -�-1 . . ,•,« 'r .s . r