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1987-278 /' CERTZF`I.CA.TE OF CM+C+C�.�TI'A N ' vJL TOWN OF QUEENSSURY WARREN COUNTY, NEW YOR} K�� 4J�C-T�a -Rl a 5 , ��, 87 ' Date 87-278 This is to certify that work requested to be done as shown by Permit No. cleted. has been omF Gne-Fnmi3 1 ing This structure may be occupied as a Marion Ceverciale IFason Rcroracis nv an e s COwner By C]rder Town Board TOV1, N OF QUEENSBURY r -' Building & zoning Inspector BUILDING PERMIT TOWN OF +QUEENSBURY No. 87_27 $ WARREN COUNTY, NEW YORK PERMISSION is hereby granted to David Sanders ree OWNER of property located at Cleverdale /Mason Roads Street, Road or Ave. w F.. in the Town of Queensbury, p One-Family Dwellkn A' To Construct or lace a at the above location in accordance to application together with plot plans and other information hereto filed and w approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. a ri m [3. WNER'S Address is 29 Pershing road rt Glens Falls , New York M m ONTRACTOR or BUI LDEWS Name Adirondack Contracting G1 CONTRACTOR or BUILDER'S Address Sort 159 R C Star Route fp Glens Falls , New York. w I— m 4_ ARCHITECT'S Home m O r'b 5. ARCHITECT''S ss C`Addre N GY. oa 6_ TYPE of Construction — (Please indicate by X) (X) Wood Frame I ) Masonry { I Steel { ) Cr 7. PLANS and Specifications No 26 ' x39 ' per plot plan , specifications and application submitted including sewage system . w S. Proposed Use Per Var . 1228 and Site Plan Rev . 8-8 �-e One—Family Dwelling �G m r• $5 . 00 C /O December 1 19 87 40 $ 105 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES Ilf a longer period is required an application for an extension must be made to the Building and Zoning inspector of the town of Queensbury before the expiration date.) Dated at the Town of Queensbury this 19th _Day of May 19 87 SIGNED BY � for the Town of Queensbury Building and Zoning Inspector ? f To BE COMPLETED BY BLDG . DEPT . � i / APIPI i rh t i c-)rn N" .✓jown 01 Quee+►li Permit Tssued - - - 19---- --.- - -. Tr1L"JN OF elrF =iV�>c r BUILDING and ZONING, DEPARTMENT Permit Ex)_dtes 1`I 1� L Bay and Haviland Road, R.D. 1 Box 98 Tc,n i � ic3 T1r # �pri� #: i «n LV LQueensbury, New York 128U1 Variance No . /"� ��— II1l ■� It�,r f Site Ilan Review No . 1TIHS 151987 1 3 j Approved by : BUILDING a CODE DEPT. APPLICATION FOR t " " try f ' b7 D 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 i owner of thisA�property is : P . O. Address O�`G 1 >Y' 111�f �i �1-`y��{� / 1 es. , z � Tel . Property Location . � �4��Q C � C+ "ply .-- 1�C r F# ,� t �a r tax Map Street number or buil+'ding of number Subdivision name ( if applicable) THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS % Name P . O . Address Tel . No . Blame of builder Vro ( c4t5b .Address / �`� `� �r . Tel . (a Name of plumber �+��. k w , 4� Address y�tiQ �. - Tel . _ Name of mason t Address k. , � 2�2 r, uAt.. _Tel . - 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 chancre 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 (Q© ft X 160 ft . * Existing buildings ) Size Xft - PROPOSED BUILDING AND USE :. � Existing building ( s ) U e size of new structure 2­`40 ft x ft Foundation-pier/slab craw partial/full Proposed building , distance From property line (circle one ) C �. Front yard ft Rear yard ft No , of stories (habitable space) Side yards ft and Height ( grade to ridge ) t . * if on corner , stback from side stree t-_ _ ft If residential , no . of families No . of rooms ( excluding baths) OCCUPANCY INFORMATION No. of bedrooms ,R, 17RI,,,��ARY BUILDING - No . of bathrooms �. 4 One family dwelling Primary heating system 4ec { alse a rc Two family dwelling Type: of fuel A-� Multiple dwelling / Number of units No , of fireplaces to be installed - � k� * Permanent occupancy Will a wood stove be installed? Crz' Transient occupancy Central Air conditioning? A16 —Business BUILDING STYLE, PRIMARY STRUCTURE industrial ,r.�-�� ,� _Dt her Ranch CrContem�orar`ly Log cabin if addition , what will use be? Raised ranch Mansion Duplex 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 car/ car * * * * * * x * r * * * * * _Private_ storage building ESTIMATED MARKET VALUE OF � —Other - CONSTRUCTION INFORMATION ON BUILDING SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET , TO BE COMPLETED ! Form BPA 4/86 and-vl I BUILDING PERMIT APPLICATION CONOVINUL;D - BUILDING SPECIFICATIONS : Type of construction , (12: od frame fire safe , etc . Will any second-hand or- ungraded lumber be used? If so , for what ? fi Foundation wall material Thickness <5ri Depth of foundation below rode ( to bottom of footing ) ' -- _ Will there be a cellar? Heated or unheated ? Floor sq . footage -- sq ft Will there be a basement? Will any portion be used as living space ? { If so, what portion? sq , ft . - - Type of use? Type of roof - s o e fiat/shed/other Material of roof + r. ,� sf Size , wood studs�� X `" spacing_''o . c , length �j ft . Joists ( £Zoor beams ) Zst . floor Z ^x�'" spacing«"o . e . span f"g £t . Joists ( floor beams ) 2nd . : `lour 2 "x /p spacing �r _"o . c spanft . Overlays {ceiling beams } 2 "*x_ - s}pacing�/�"a , c . span5 d ft . Roof rafters Z "x_1 Z spacing--,f(�� _o . C . span .20 ft . Roof trusses (pre-engineered) spacing " o . cl span ft , Exterior wall finish hx CA.�, ,.ti, =� r.�,.g c pf what material ? F tV Interior wall finish If a qamagmr to be attached , describe materials to be used for FIRE SEPARATIO" : Is thefe to be an openirig between garage and dwelling? If so will a Fire--rated door, enclosure , and scaZ£-closing device be rovided? will a flue-lined chirrrr•ey be installed? Height above roof ft _ Depth of chimney foundation below grade ft . - Depth of fireplace hearth ft . in . Water supply - MxLipsl.Z or prteli� � E'. _.. SEPTIC SYSTEM _ Distance from ANY private well { including adibinlnq properties ft . (A separate application is necessary for any repair or new installation of septic system) Town of Queensbury �y 7 rr�y �Yr County of 'Warren A 1 F F D A I T STATE OF NEW YORK Z 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 a: 1 proposed work to be done on the described premises and that al. ] provisions of the BUILD_ NG CODE , THE ZONING ORDINANCE , and all other laws pertaining to the Proposed work shall be complied with, wFzether specified or not , and that such work is authorized by the owner . SWORN TO BEFORE ME THIS Signature_ day of Owner , owner ' s age t , arcnitect , contractor 19 Notary Public , Warren County , N . Y . SPECIAI, CONDITIONS OF THE PERMIT : By -----------------------------------.... TOWN 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 wm�wwww /jV4 2 . Type of 'heat aer'±C 1'e, - 3 . Is the buildings mechanically cooled ? } 4 . Percentage of area of windows and doors Z � 'f+ Z2 ----- A . Over 16 % Only 1 . U value of gross area of walla , roof /ceiling and floors 4 exposed to ambient conditions = R0 2 . Floor over heated spaces YES NO a . Are foundation walls insulated ? YES NO 10 % if YES , what is the R value ? 3 . Slab on grade YES . a . if YES , what is the value of insulation around perimeter of floor ? 4a is basement heated ? YES -r:0 a . R value of insulation 5 . 'Type of Insulation�rX _a, fi '� d � f►,u+�� �, '� os7�»+� 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 5 . R value of floors over heated spaces 6 . R value of slab edge insulation - unheated slab 7 . R value of slabmins ulation - heated slab 8 . R value of heated basement. /cellar walls ( above grade ) 9 _ R value of heated basement /cellar walls (below grade ) low Type of insulation C . L. ontrois �„� � 1 . Thermostat maximum heat setting - D . Duct systems 1 . Is duct system installed in unheated spaces ? YES NO a . If YES , R value of ducat installation b . R value of duct in other areas E . _piping Insulation 10 sIze of hot water or cooling carrying agent pipe / 7 2 . R value of pipe insulation__ I0Al F . Service Water Heating 1 * performance efficiency 13 Gr 2 . Temperature control setting maxiurt m� ogo G . For SWimmin Pool OU, 1 . Maximum heatingn - - No Telephone . `� ' 6 ` ! /�C ► ' ( applic� t� na re ) 5•IA 'n a Qu er" Ja ry APPLICATION FOR SEPTIC DISPOSAL PEWIT &VILDING and ZONING DEPARTAAENT say and Haviland Roo d. R.D. 7 Box 9B _ Ouerzsbury, New York 12801 DATE �✓{ 1 - d '3' / LOCAI ) ON OF PROPERTY FOR IN57 /- LLATION �• �� � �� � / Y_ i. OWNER ' S NAME G V CG'� s�.. �- 5 1�� • ADDRESS ]' - YCa + TF1 J INSTALLER ' S NAME Aa , ca c-,..C.L ��' � .ti yG.-� TEL � [� Zb Number of bedrooms ( residential only ) �3 Total daily flow ( compute @ 150 gal per bedroom) � S Topograpby : flat - Rolling - Steep RYope) - ( circle one ) '% of slope ,/ O ;zS Soil nature : Sand 1Loa1a CZa - Other Depth_ d -/ O ft . Ground water -At what depth? J.c , f t. Bed-rack or impervious material - At What depth? ft . Percolation test - Not required - Required - -Rate - ,ip lain-'inch . Domestic water supply - Municipal on, Well - Oth+er_ Le�Lc. r Separation - Watersupply ( if well ) from Septic absorption Proposed System : Septic tank +la71b gal. . { l�linimun size , 1000 gal . ) Ti11le 1e2 - - ch tre ;: ch S"C ft . Total system lecnth eft . Seepage pit ( s ) Number of size each ft X ft Size of stone to be used Depth or thickness ft . 3 MPORTANT ! ! on a separate piece of paper , subunit a diagram of the proposed system with s11 dimensions shown ; including distance from any structure , distance from property lines and from ANY DOMESTIC WATER SUPPLY or share - line of lake , streame pond or wet � landse2nclude all dimensions of r the system , itself . r * r r • ♦ r w • r r ♦ M # ♦ r i # * # ♦ * ♦ M # • • * # * • ♦ ! # ♦ * 1 ^. 7 • a:_ L ; i` t= • 2: S. : T: T ;: [ Y. 4CY•fE C '4 COG )' CE to a2, 1' 2c- f trc P a� aki2 c 7 7 vecuirerrentr, cf The Tovr: of CUeC11s ury ScTva: tczr;l 5C ' r� cc i. : � �tc � cT Or � rcr �; ct . 05l66 and / vl Section IT Septic System inspections : A . All Applications( for septic system installation , alteration or repair , as recuired by the Town of pueensbury Sanitary Sewage ordinance , shall be submitted to the Buildina Department at least 24 hours J?efore start of construction and shall include a plot plan showing . 1 ) the proposed locatlon epf 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 I3 . NO system shall be covered before inspectic n and aPProval by the Building Inspector . Failure to camPly with this requirement may result in the uncovering of the system by the installer and a fine of up to $ 250 . 00 . Co An approved copyr 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 mint be submitted to the ¢ueensbury Buildingr ' Department before further construction . r BVOwn of Qjeenji "ry ILCING and ZONING DEPARTMENT f Bay and Haviland Road, R.D. 1 Box 98 y Queensbury, New York 12801 6 '" BU ILDING INSPECTOR ' S REPORT NAME LOCATION , � .4 + i �1-�,•r�,�/(r Date fG� f�/ , ~'/ Permit No . : 7- � r?f - x * * x * x x * * *#,,."krt APPROVED*-*YES* No Footing/Pier Forms Foundation Waterproof ng Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves ct . Porches / J�[F'inished Floors I� tnterior Trim tairs & Railings Cellar Drain Tile Concrete Floors Plbg , Fixtures Gar . Fireproofi.n Door Closers Smoke Detector Chimney INSULATION : Foundation Floors Walls Ceiling VXINAL ELEC RICAL II3SPECTIOtQ DRIVEWAY APPROVA11 - Final Building Survey Next scheduled inspecclon (call when ready) Remarks- t Boil ing Inspector 6/86 and-vl 4016187 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY F—nlg 41 STATE STREET, ALBANY, NEW YORK 12207 October 200 1987 Application ,vo. onfile 013025 / 87 A 697343 THIS CERTIFIES THAT oniy the eiectricnl equrpment " described behfte and intnodaaced by the applicamt aaoaeaed on the adwroe application number in Cho prom tea of David Sauderapreeo Cloverdale Road 4 Mason Road , Queensbpry , New York ?e in the following location; [At Basement [�L let F1. 1:1 2nd Ft. OO t s td o Section 1 301sck 2 Lot 1 was examined on 1 O / 1 / 8 7 and found to be in compliance with the requirements of this Roard. PIXTURR PTACIEZ SWITCHES FIXTURES RANGES COOKINQ OECKs OVENS DISH WASHERS EXHAUST FANS (?LITII!TS INCANDESCENT FLl1GKESCEW AMT. I K. W. I AMT, I K. W. AMT. K.W. AMT, K. W. AMT, I M. P. 16 48 18 1G 2 1 2 Fr DRYERS FURNACE MOTORS FUTURE APPUANCE PEROERS SPECIAL RIEVIPTI TIME CLOCKS SM UNIT HEATERS WATI-OAITLET DIMMERS 3YSTRMS AMT. K. W- OIL M. P. GAS MP_ AMT. Na. A. W. G. AMT. AMP- AMT. AMPS. TRANS. AMT. K r NO. OP PEST AMT. WATTS 1 HaWT e I 1 N SERVICE DISCONNECT NO. OF E R V 1 C E _ AMT. AMP. TYPE EQUW, 1 .e` 21W 1 X 3W 9 X 3W 1 3 .0 4oW PER!'CONp. Or CC tCG1 o No. oP HI-LEG of MI-IEC. NCF, OF F/EUIRAIS OF P EUYRA4 1 200 CB 1 x 1 4 / 0 1 2 / 0 OTHEIt AMARATUS: 1 - Smoke Detector Adirondack Contra Sox 159 Star Route glens Falls * New York 12801 BRANCH MANAGER Par 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. COPY FOR BUILDING DEPARTMENT, THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. � . f U/©cvn [3etec+rrs6etrt�r fo j 0 i 1 BUILDING and ZONING DEPARTMENT I f Say and Hav'riand Road, R.D- I Box 98 Queensbury, New York 12801 f SEPTIC DISPOSAL SYSTEM INSPECTION NAME LOCATION DATE --.G[- 1,EZ PERMIT NO. Z / ` A::✓ SOIL TYPE ndnd am clay Percolation Rd Re ed? YES - N Percolation rate - Min/Inch _ S TYPE of SYSTEM: Absorption field , otal length Length of each tre h Depth of trenches Size of gravel SEEPAGE er f) Size- _ f - — Gravei ize PIPING : e Type Bldg . to tank. ,�eV4'e"6�G7 Tank to list . box Dist. box to f ield/ '' c,c7 CAD SiFf Openings sealed? S NO Partial LOCATION/SEPARATI Sx Foundation to t ft. Foundation to ab orption ft:+ Absorption to 1 t line t . Separation of its t.TEM.nt S TE flPERTY � ie ones rant. Rear Sid r e t Side - Right side - TS : SYSTEM USE APPRO'V'ED ~ YESI NO Buildi g Inspector 01/86 and vl I /f fawn o/ Q"een .36ury 7 BUILDING and ZONING DEPARTMENT ,g Bay and Haviland Road, R.D. 1 Box 98 Oueensbury, New York 12801 BUILDING INSPECTOR * S REPORT NAME 2 LOCAT ION,/` 61r./a1 Date /" Permit NO , APPROVED - YES NO Footing/Pier Forms Foundation Waterproofing B kfill �ami ng Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext , Porches Finished Floors Interior Trim stairs & Railings Cellar Drain Tile Concrete Floors Plbg . Fixtures Gar . Fireproof ' g Door Closers Smoke Detecto v0 s Chimney INSULATION Foundation Floors Walls Ce i l ii.ng FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection (call when ready Remarks- Bui ing IndpLEcEtor 6/86 and-vl _7aev" o/ Queens6ury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTORrS REPORT NAME t- - eav � L0 CAT ION f �!�=� +�,�► G►�L� �/�!`���" RUS Date-20 Permit ✓ — APPROVED - YE NO Footing/Pier Forms foundation aterproo€ing 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 DRIVE14AY APPROVAL Final Building Survey _...._� Next scheduled Inspection {call when. ready Remarks- Build3 Inspector 6/B6 and-vl �,,y�rl � �� ._J'aet.r� o� �ueenshure� UI f �` BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R-D. 1 Box 98 a • Clueensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME ,47 LOCATION Date G1 / Permit No . ✓ APPROVED - YES vi; oting/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 APPROVA1 . Final Building Survey _ Next scheduled inspection (call when ready ) Remark/s/J-j C] u Buildin Inspector 6/86 and-vl