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1987-338 w �+ 4 CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date November 18 , 19 �. C) This is to certify that work requested to be done as shown by Permit No. 5 8 has been completed. This structure may be occupied as a One-Family Dwe-M ng Location _ Lod 593 F of ow Laze CSt . ox No * 9 Section 1.5 , Westland d SubriivIslon finer James ri . Doug,rey By Order Town Board TOWN OF QUEENSBURY —� Building & Toning Inspector BUILDING PERMIT TOWN OF +QUEENSBUR.Y -� No, 87-338 WARREN COUNTY, NEW YORK z C7 PERMISSION is hereby granted to James M. Dougrey V OWNER of property located at Lot 593 Fox Hollow Lane ( St . No . 9 ) Street, Road or Ave. Section 15 , Westland Subdivision l in the Town of Queensbury, To Construct or place a One- Family Dwelling in 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 Oueensbury Building and Zoning Ordinance. t . OWiNERZ Address is Box 1744 - Sullivan Place Lake George , New York 12845 2. CONTRACTOR or BUILDER'S Name Steven Kelly w m rA 3_ CONTRACTOR or BUILDER'S Address 15 Willow Road Queensbury , New York 12801 tz� 0 00 4. ARCHITECT'S Name m tic 5. ARCHITECT'S Address cn r 0 o S7 rt rt Y• Ln 6. TYPE of Construction — (Please indicate by XI } n MU a (X) Wood Frame { ) Masonry ( } Steel ( 1 X ( 0 m a 7_ PLANS and Specifications co r+ rt N 91rx37 ' per plot plan , specifications and application submitted No. including sewage system and two—car attached garage & w cq � 8. Proposed Use ro One—Family Dwelling W C n w m w $5 . 00 C/O r $ 227 . 00 PERMIT FEE PAID - THIS PERMIT EXPIRES .Ian . 1 19 88 � (If 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_) C7 m Dated at the Town of Queensbury this 10th Day of June 19 87 � ,r� w SIGNED BY ad [ [ . , for the Town of Queensbury Building and Zoning Inspector p, w TO BE COMPLETER BY BLDG & DEPT. Application No . 40F Q6:PFr.E dS;,_ =sv 7©sun 0J Queenigury Permit Issued 19 BUILDING and ZONING DEPARTMENTpermit Expires 19 Bay and Haviland Road, R. D. 1 Box 98 Zoning Designation Vd Queensbury, New York 12801 variance No. JUN 9 1987 Site Plan Review No . i 77 r7 a Approved by t BUILDING & CODE DEPT, � - ' e 5- : � APPLICATION FOR �(E C' 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 ! ie s�:� I, ! tykI �tlfZJ P . O. Address ! � 0 ok F d q1- ^ p �vj I"�cra r r+ - ,� %e Tel Property Location : �y SS/ '� /i C�` Tax Map 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. Adc1ress Tel . No . Name of builder (Zjy �C- K�e I _ Address /g"► yy Tel . !La kV% Cs Name of plumber — —�- Address� Tel . Name of mason Address Tel . NATURE OF PROPOSED W RK : * ZONING INFORMATION : Gam. 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 lanes . 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 propertyi, - ft X ft . * Existing bulld±ng ( s ) Size X ft . PROPOSED BUILDING AND USE : r r Existing building (s ) Use Size of new structure ^ft x ft * �0 t✓(=r Foundation-pier/slab/crawl/partaa ful * Proposed building, distance from property line ( circle one ) No , of stories (habitable space) Z. * Front yard '�3 4�p ft Rear yard ft Height ( grade to ridge ) + ft • * Side yards ft and ft If residential , no . of families t ,�. * If on corner., setback from side street ft No . of rooms ( excluding' baths )� 14 * OCCUPANCY INFORMATION No4 of bedrooms ''7� No , of bathrooms " * PRIMARY BUILDING Primary heating system_ 1F� * One family dwelling T - * Two family dwelling Type of fuel Number of units No . of fireplaces to be installed * Multiple dwelling / Will a wood stove be installed? AIQ * Permanent occupancy * Transient occupancy Central Air conditioning? A10 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 Cape- Cod Cottage Other * ACCESSORY ermol onaa Row Town House * Detached garage/one car/ two car/ car ( CIRCLE ONE PLEASE ) * Attached garage/one car a car 61 * * * * * * * * * * * * * * * Private storage building ESTIMATED MARKET VALUE OF * Other CONSTRUCTION INFORMATION ON BUILDING SPECIFTCATTONS , 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 , (A) 0C?qT? i5g) ,I Cr Will any second-hand or ungraded lumber be used? If so , for what? Al p Foundation wall material #=;' ER , ifO✓aG l e 1G e. Thickness e? tor Depth of foundation below grade (to bottom of footing ) r• Will there be a cellar? 7_ E S Heated or unheated? Aow AaA&x Floor sq. footage Z4#/J<2, _sq £t Will there be a basement? YC.6 Will any portion be used as living space? 'Oye* ( If so , what porno ? sq . ft . - - Type of use? Type of roof - 1 pe a +-rh,�.a:/�=e: Material of roof Size , wood studs '"?C^ ' •' spacing length - ft . Joists ( floor beams) lst . floor _"•X_ / O " spacing 1d+m"o . c . span��ft . . toasts ( floor ]creams) 2nd . floor �, '"X�"" spacing�""o . c . span.,4'ayfft . overlays ( ceiling beams ) IF a spacing l Ce ""o . c . span },p £t. Roof rafters `^X�"" spacing -o . co span ft. Roof trusses (pre-engineered) spaci.ng *'o . c . span�ft . Exterior wall finish C e.p Of what material? ►/Z X (o, 44; rt.** 4 Interior wall finish -� If a garage is to be attach d describe materials to be used for FIRE SEPARATION : Is there to be an opening between garage and dwelling? YCS If so will. a Fire-rated door , enclosure , and self-closing device be provided? will a flue-lined chimney be installed? 5 Height above roof �„ ft . Depth of chimney foundation below grade�_ft . - Depth of fireplace hearth / �ft . in . Water supply - Municipal or private well SEPTIC SYSTEM Distance from ANY private well ( incliidi.ng adjoining properties j+„�"O ft . (A separate application is necessary for any repair or new installation of septic system) Town of A F F I D A V I T STATE of NEW YORK eensbury Warren County off 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 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 ORIDINANCEr 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 � day of 19 owner s gent , arcnlzecE , c ractor - Notary Public , Warren County, N . Y . * * * * * * * * * * * * * * * * * . * * * * * * * * * ik . * * * * * * IF * * SPECIAL CONDITIONS OF THE PERMIT : BY i 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 : ,r^ 1 . Gross floor area r Z 413 2 . Type of heat As Gl.S rr rr 3 . Is the building mechanically cooled ? /VG7 4 . Percentage of area of windows and doors_ , 407r SR ! 8 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 Y10 if YES , what is the R value ? 3 . Slab on grade YES NO ae 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 oNNNNNN 1 . R value of roof and floors exposed t+ ambient conditions_ " 2i 2 . R value of exterior walls _ 04e . 19 3 . R value of glazed area k moo 3t �3 4 . R value of doors! )ZO "P, Z9r 5 . R value of floors over unheated spaces 3c> ---- 6 . R value of slab edge insulation on unheated slab IN N 7 . R value of slab insulation - heated slab - ,,,,, �� //_,,,,, s . R value of heated basement/cellar walls ( above grade ) jV & 9 . R value of heated basement/cellar walls ( below grade ) �f15f 10 . Type of insulation 8bBrCG► 6L rT 2 me rb0-r2+ ' 7 C . Controls 1 , Thermostat maximum heat setting D . Duct systems 1 . Is duct system installed in unheated spaces ? YES ae If YES , R value of duct installation be R value of duct in other areas E . Piping insulation 1 . Sire of hot water or cooling carrying agent pipe ! 2 . R value of pipe insulation F . Service Water Heating 1 . Performance efficiency. $ 't+ No 2 . Temperature control setting maximum lGdf) dp - G . For Swimming Pool Only NNNNoo 1 . ,Maximum heating r ' Telephone No . { ppl cant s ssig ure ) t7etvft 6f QeZftd&0V APPLICATION FOR SEPTIC DISPOSAL PERMIT DATE e, / LOCATION OF PROPERTY FOR INSTALLATION 1tyK Z. Owner's Name: _ _�� I YY� P S i--~' � /4y',�2 F'Cj Telephone: 22 �Q Z Address: — Lut # < 5e �- x Lto (19 elt I L2 Installer's Name: Telephone: Number of bedrooms (residential only) Total daily flow (compute @ 150 gal per bedroom) Topography: circle one: Flat < Rollin Steep Slope % of slope Soil Nature.* circle one. and Loam Clay Other / Depth: feet Ground Water: At what depth? Z& -tf- feet t' Bedrock. or Impervious Material: At what depth? _ Z 7` feet Percolation test: circle one: not a uir required / rate Cr min, inch. Domestic water supply: circle one: unicipal Well Other _ IF domestic water supply is a Well: Separation: Watersupply* from Septic absorption _ feet PROPOSED SYSTEM: Septic Tank Z90c> gal. (minimum size: 1 ,000 gal.) TILE FIELD: Each Trench feet / Total system length '3Caa feet SEEPAGE PIT(S): Number of / Size each feet by feet Size of stone to be used # Depth or Thickness feet I M P O R T A N T ...Please...LIST NEW EQUIPMENT TO BE INSTALLED (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 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 $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 Disposal Ordinance. Signature of responsible person. 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 � 01Q � ownoueensburl BUILDING and 70NING DEPARTMENT Bay and liaviland Road. R.D. 1 Box 98 Queensbury, New York 12801 /tBUILDiNG INSPECTOR ' S REPORT NAME LOCATI N Bate 6'.IS— / Permit No . -cfl'� APPROVED - YES NO Footing/Pier 'Forms Foundation waterproofing Backfill Framing Roof ing Siding Masonry Veneer Rough Plumbing Relief Valves Ext , Porches Finished Floors Interior Trim Stairs 5 Railings Cellar Drain Tit Concrete 'Floors Plbg . Fixtures Gar . Fireproo ng Door Closers Smoke Detect rs Chimney INSULATION : Foundation Floors Walls— Ceiling FINAL ELECTRICAL INSPECTION _ DRIVEWAY APPROVAL Final Building, Survey Next scheduled inspection Ccall when ready ) Remarks- L3 it ing Inspector 5/B6 and-vl BtJILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME LOCATION {� DATE I Ufa/A PERMIT NO ., 1205 d SOIL TYPE - Sand - Loam - Clay Percolation Test Required? YES - NO Percolation rate - Min/Inch _ TYPE of SYSTEM: Absorption f iel total length Length of each t ench Depth of trenche Size of gravel- SEEPAGE PITS#dumb of ) Size- ft. X _ ft. Gravel size PIPING : ize Type 13ldg . to tank Tank to list. box Dist . box to field it Openings sealed? YES NO Partial LOCATION/SE'PARA CNS : Foundation to k ft- Foundation to sorption ft . Absorption t lot line ft . Separation o pits ft. LOCATION OF SYSTEM ON PROPER Y (circle one) Front - Re - Left side - Ri ht side - CCMMENTS : SYSTEM USE APPROVE /YE NO Buil�Inspector 01/86 and vl f L7 f / Q�fllt O/ ItPE'l13t7fL!'! WUILDING and ZONING DEPARTMENT Say and Haviland Road, R. D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME DATE /U IV PERMIT NO. SOIL TYPE ORRequired? Loam - ClayPercolati YES Percolation rate - Min/Inch TYPE of SY TEM : Absorption field , total le gth Length of ach trench Depth of t nches ' Size of gra el_ p _ SEEPAGE PIT Number of) jF- Size- ft. X _ ft Gravel size PIPING : Size Tyne Bldg . to tank. _ Y^ Tank to dist . bo qw Dist . box to flel t ^ r Openings sealed? YE NO Partial LOCATION/SEPARATI S Foundation to ta jft. Foundation to ab orpti aioft . Absorption to 1 t line ozko ftk Separation of p is ft . LOCATION TEM ON PROP TY (circle one) F ront Rear Left side - ght side - C C IKMEN Age dL-Fie SYSTEM USE APPROVED YES NO Building Inspector 01/86 and vl BUILDING and ZONING DEPARTMENT [ , Bay and Maviland Road, R.D. 1 Box 98 10 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME ---9:! OF LOCATION Date/ d Permit No /► 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 & Railin Cellar Drain Ti e Concrete Floor Plbg . Fixture Gar . Fireproo ing Door Closers Smoke Detect s Ch ' mney CTT TAT I Udd Foundation Floors Walls r Ceiling FINAL ELECTRICAL INSPECTION „���������.�..� DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection ( call when ready ) Remarks- Building Inspector 6/86 and-vl ���� _,lpwn a� �etPens6ure� UILDING and ZONING DEPARTMENT a � Bay 0 and Haviland Read, R. D . 1 Box 98 Id,` Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT Q, NAME LOCAT I ON Date4 ell "'r ' Permit No . ✓ = APPROVED - YES NO Footing/Fier Forms Foundation waterproofing Backfill yFraming Roofing Joe Siding Xonry Veneer gh Plumbing Relief Valves Ext . Porches Finished Floors Interior Trim Stairs & Railing Cellar Drain eN if Concrete floors Plbg . Fixtures Gar , Fireproofing Door Closers Smoke Detectors Chimney ✓1'NSUTAA`I'ION Foundation Floors V�a11. s FINAL ELECTRIC INSPECTION I)RIVEWAY APPROVAL Final Building Survey. Next scheduled inspection (call when ready ) Remarks- Building Inspector 6/86 and-vl �7 ■ ,� ur awn C1l Qff L'F'!! l 3 y Lf` BUILDING and ZONING DEPARTMENT ` l Bay and Haviland Road. R.D. 1 BOX 98 r] 3 Queensburyr, New York 12801 1 SU1LDING INSPECTOR ' $ REPORT NAME i V 2 LOCA ONL gate?� � Permit No . /'�~ �� APPROVED - YES NO Footing/Pier Forms Foundation Waterproofing 7ckfill � aming 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- G) W4,o Q L�3csr Building Inspectors 6/86 and-vl t.•.��� .70tvn n/ QueensEsury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME y Kao. Dt h LOCATION Permit permit No . ✓ = APPROVED I XTS 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 YX Plbg . Fixtures Gar . Fireproofing Door Closers Smoke Detectors Chimney INSULATION : Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION � DRIVEWAY APPROVAL Final Building Survey 4 T� Next scheduled inspection (call when ready ) Remarks- ." Building ,r nspec tar 6/86 and-vl cam■ In +'3� ° / '3: 61> 4L4,,J�_._ ✓OW1t 0/ Q" eenj "rry BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTORtS REPORT NAME �--- VJo �� qqr � LOCATION Lot- "^ 3 alt `-"- " Date La / -�`� Permit 140 . _ ��_ roop ✓ = APPROVED - NO Footing/Pier Forms Foundation waterproofing sackfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext . Porches Finished Floors or 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 APPROV Final Building. Survey Next scheduled inspection (call when ready ) Remarks- B lcrxrrg Inspector 6/86 and-vl _.+row" of Qu ee" .1 "r y BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Queenshury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME 7tz: �- LOCATION Date r /_ Permit No . (2 !- 13 poting/Pier Farms Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext . Porches Finished Floors Interior Trim Stairs & Railings A Cellar Drain Tile Concrete Floors Plbg . Fixtures Gar , Fireprocsfing Door Closers Smoke Detectors Chimney I N SU I.AT I ON Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection (call when ready ) Resnax s- A',' ^ J Al ZIP Building nspector 6/86 and-vl f� ;✓''� ._,.louvre o� �ta ,een � 6eerr� BUILDING and ZONING DEPARTMENT Bay and Naviland Road, R.D. 1 Box 98 IAQuaensbury, New York 12801 woe BUILDING INSPECTOR ' S REPORT NAME LC) CAT I Nj �� Data , f �/ � Permit No . ✓ � APPROVED - YES NO Footing/Fier Forms Foundation Waterproofing Back £ ili Framing Roofing Siding Masonry 'Veneer Rough Plumbing Relief Valves Ext . Porches Finished ours Interior T im Stairs & ilings Cellar Dra ' Tile Concrete Fl ors Plbg . Fixtu s Gar . Firepro fing Door Closers Smoke Detecto Chimney INSULATION Foundation Floors Walls Ceiling FINAL ELECTR AL INSPE TON� DRIVEWAY APP OVAL Final Buildi g Survey Next schedu ed inspection (cai whe ready ) Remarks- elf 1f7C° Building Inspector 6/86 and-vl l� awn 0 ,Q Qmeenshisr BUILDING and ZONING DEPARTMENT rf Ba and Haviiand Road, R.D- 1 Box 98 Queensbury. New York 12801 G BUILDING INSPECTOR ' S REPORT NAME 9�11�1r� LOCATION e-9 Date !!� / f Permit No . ✓ = APPROVED - YES NO Footing/Pier Forms Foundation Waterproofing Backfill Framing Roofing Siding MasonrAFlo Rough Relief Ext . P Finishs Interi Stairs Raili gs Cellar Drain Ti e Concrete Flor>rs Plbg . Fixtures OYA Gar , Fireproofin Door Closers Smoke Detectors Chimney INS01"11,TION : Foundation Floors Walls CeilinJAPROVAL FINAL AL INSPECTION DRIVEWAY�t.nal Survey Next scheduled inspection. (call when ready ) Remarks- Building Inspec r 6f85 and-vl SC 00 oo it. t, r LUG 4A ~1 � 'yL 10 '---- r � � `l\ • ! 1 V i f � r h ti y { So { �V 8 6 0 Al . 73 , DR all Aoo :.: ., ..+