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1987-472 CERTIFICATE OF OCCUPANCY TOWN OF QUEEN58URY i WARREN COUNTY, NEW YORK d Date 19 _ This is to certify that work requested to be done as shown by Permit No. 87- 47 i has been completed.. Oe-a�^} ; Orte—Family L'rwelng Tleis structure may be occupied as a Location4 Cobblestone Dr . i Keit:. & Kathleei3 Jablonski. Owner i By Order Town Shard 7OWN OF QUEENSBURY et i Building H Zoning Inspector I i BUILDING PERMIT TOWN OF QUEENSBURY No. 87-472 WARREN COUNTY, NEW YORK hl h & K i PERMISSION is hereby granted to Ket Kathleen Jablonski 4�- l OWNER of property located at 4 Cobblestone Dr . (Lot #6) Street, Road or ,Ave. -- in the Town of Queensbury, To Constructor place a One—Family Dwelling o 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 . OWNER'S Address is 417B Ridge Rd . Glens Falls , N . Y . 12801 x ro N• 2. CONTRACTOR or BUILDER'S Name rxy Precision Builders rr 3. CONTRACTOR or BUILDER'S Address � 1--4 22 Orchard St . m Glens Falls , N . Y . 12801 4. ARCHITECT'S Name c• N O x _ - µ 6. ARCHtTECT'S Address 4 C] 6_ TYPE of Construction — (Please indicate by X) A0 � C cS r3' ( XI Wood Frame l ) Masonry { I Steel { ) . m �t cn rot rt 7. PLANS and Specifications M 0 �s [o No. 40 ' x 48 ' per plot plan , specifications and application including b septic system and two—car attached garage . S. Proposed Use PLANS IN DRAWER. One—Family dwelling 0 $5 . 00 C /O m 3.9Q . -- 00 February 1 , 88 � $ PERMIT FEE PAID PERMIT EXPIRES 19 m lIf a longer period is required an application for an extension must be made to the Building and Zoning inspector of the Y town of Queensbury before the expiration date.) Dated at the Town of Queensbury this 23rd Day of July 19 $7 N SIGNED BY ,/cC .,�C. c . 'ez or the Town of Queensbury Building and Zoning Inspector TO BE COMPLETED BY BLDG . DEFT. I GO _lotur� ou[eert3huM Application No . S 7 � y Permit Issued 19 u _- BUILDING and ZONING DEPARTMENT Permit Expires 19 Bay and Ha^viland Road, R. D. 1 Box 98 zoning Designation Queensbury, New York 12801 Variance No . Site P Revie 4�j i, ed rl. ..err' APPLICATION FOR { `,'7 f� Q(� BUILDING AND ZONING PERMIT F46 vV& piki © - 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 : F] 77,/ oe Li�jV A�det&VSKI P . O . Address YI7lr &146 R40 64E1v5' E-AL.tS µrArP 7 3�25'� 28CS/ Te I -a ,+697 �Hp•ire Property Location : </' Cpe°SBCESTt'J/y p,P1✓ GOT # Tax Map street number or building lot number Subdivision name - (if applicable) L/ lIt/�tT /GL_ THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS : ) 7;zl .2Lat6Ae#5 kr s�'/a.�3 /1�L . r'.� L IVS- Aw.�r s N 12801 792-��97 Name P . O. Address Tel . No . Name of builder ?? C1,S10K.1 Address 2 F.L. +- ci.N 5t C, F " \4 . el . Name of plumber < r LaR,35 < ) Address M11�41 Tel . ZZ. - Z�j Name of mason f�r2c1Sti0 na P,U�4S7 �5 Address ?? p ISbA-2}� C� fit~ T Y +� - Tel * -,q 3 - Ig9 `i MP, I7 Ur3 P'f\1A\ _ 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 AFFECTED . of septic disposal area . * COMPLETE INFORMATION REQUIRED BELOW . �/ Size of property_ ,/V(O ft X 901 ft . Existing building ( s) Size ft X ft . * PROPOSED BUILDING AND USE : '" Existing building ( s ) Use Size of new structure ft XLft Foundation-pier/slab/crawl/partial u1 Proposed building , distance from property line ( circle one ) No . of stories (habitable space ) ': * Front yard ft Rear yard ,/SIO ft Height ( grade to ridge ) 25 ft . If residential , no , of families Side yards 3 ft and Js-, ft f If on corner , setback from side street ft No , of rooms ( excluding baths ) -7 OCCUPANCY INFORMATION No , of bedrooms . 7 No . of bathrooms cxr2 PRIMARY BUILDING - Primary heating system EC>S"'cC.V /yk»• One family dwelling Type of fuel L2�TRIC. Two family dwelling No , of fireplaces to be installed * Multiple dwelling f Number of units j Permanent occupancy will a wood stove be installed? VET * Transient occupancy Central Air conditionings 7c S * Business BUILDING STYLE, PRIMARY STRUCTURE � Industrial Ranch Cantemporary Log cabin * Other Raised ranch Mansion Duplex * if addition , what will use be? 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 f two cam car Private storage building ESTIMATED MARKET VALUE OF * 'Other CONSTRUCTION co INFORMATION ON BUILDING SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET , To BE COMPLETED ! 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 areaSCJ 2 , Type of heat 3 . Is the building mechanically cooled ?. S m 4 . Percentage of area of windows and doors it 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 floo37 ? 4 . Is basement heated. ? 'YES - NO a . R value of insulation 5 , Type of insulation J s . Under 16 % Only 1 . R value of roof and floors exposed to ambient conditions. —3 2 . R value of exterior walls ~ 1 °J 3 . R value of glazed area 3 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 - 8 . R value of heated basement/ cellar walls ( alcove grade ) 9 . R value of heated basement/cellar walls ( below grade ) 10 . Type of insulation �1 r3 � �2C� LPL co Controls 1 . Thermostat maximum heat setting D . Duct Systems 1 . Is duct system installed in unheated spaces ? CYES NO a . If YES , R value of duct installation Q b . R value of duct in other areas 9c- - - - - - 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 14C)l G . For Swimming Pool Only 1 1 . Maximum heating f�t ) A Telephone No . �7G}�L- 2r c) -2 t> \ L ( applic ' s signature ) tatw own cazaw4ty APPLICATION FOR SEPTIC DISPOSAL PERMIT DATE GG/ 2 2 _ / LOCATION OF PROPERTY FOR INSTALLATION 'LOr --O Ga 'L3t!"[ fUl'WT VALL VEVk.t-( �E: kM Owner's Name : Telephone: Address. E-P -1,� N%t;L k-Va01 Installer's Name: 'S"Efj>,\ C.E Telephone: Number of bedrooms (residential only) . �:B Total daily flow (compute @ 150 gal per bedroom) Topography: circle one: Flat Rolling Steep Olope of slope ;7e "70/p Soil Nature: circle one: an oam Clay Other / Depth: feet Ground 'Water: At what depth? 'Hi�r ' feet Bedrock. or Impervious Material: At what depth? . } ` } feet r Percolation test: circle one: (not required required / rate min. inch. Domestic water supply: circle one: Municipal el Other IF domestic water supply is a Well: Separation: Watersupply from Septic absorption _ [ �� feet PROPOSED SYSTEM : Septic Tank �M_.._ gal. (minimum size: 1 ,000 gal.) TILE FIELD: Each Trench S 0 feet / Total system length 2S 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 TO BE INSTALLED * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * (over) we THE NEW YORK BOARD OF FIRE UNDERWRITERS, BUREAU Of= ELECTRICITY �ULG 41 STATE STREET, ALBANY, NEW YORK 12207 Cate AP I%. 2t3 , 1983 Application •Va. onfile cl._'Uli20/ 87 A 714740 THIS CERTIFIES THAT only the electrical aquipment as described betaw and i ntroch&c ad by the applicant named ors the above applicatiars namber in the preasimw of Ic:EITh & KAT?i EN I33.ON i P 4 W #f LESTO;4iE ijRIVE F RD l , GLENSFALLS r E YOR in tlsefollosvinE lacationT B nt Set Fl. Bnd Ff. OUTSIDE Section 5lf Stock 5Cot1 1 0 10" was examined on 4 / 5 /88 and found to be in compliance with the requirements of this Board. u FIXTURE FIXTURES RANGES ICOOKING DECKS I OVENS I DISH WASHERS EXHAUST PANS OUTLETS NOTACIRT' SWITCHES INCANDESCENT I FLLKMSCENT v AMT. K. W. AWL K. W. AWL K.W. AMT. K. W. AMT. H. r. 27 1 . 3 4 FR DRYERS FURNACE MOTORS FIXTURE ArruAncs HEDEns srnaAL**vrt TIME CLOCKS BELL UNIT HEATERS MULTI.pL D&MMERS Olt H_ A. (lj AS H. P_ AMI. NO, 4. W. 4- AMT. AMP. AM7. MOOS, TRANS. ^mT. N. P, SYSTEM UTS .ET AMT. WAM MO, OF FEET 1 RANGE #b DRYER # 10 SERVICE DISCONNECT Mo. Cw E R V I C E AMT. AMP. TM 1 ..► ZW } ,e` yyM 30 3W 9.1r 4W "0' PE4 �t'��D OF CC- ND. OF HFLEG OF H LEG 1�0. OF NEUTlAIS OF NEU RAI 1 '2 00 c b 1 Y ff OTHER AMARATUSc .Q404,L IL 1— LUO AXP HEAT PUMP 7 O FCT 2, SiM 219►^ 5a i[3tKE U::Tlrc:Tc1lxS KE0jTli Ct iC.B.THT.EEN Jt7BT C)NS!{S �' ! 4 COBBLESTONE DRIVE RU # 1 239 • BRANCH MANAGER GLENS FAA" S , NEW YORK 1 801 Per 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. J J45 BUILDING and ZONINCa 'DEPARTMENT Haviland Road. R.D. I Box 98 �r pue nsbury. New York 12807 prNG INSPECTOR ' S DEPORT NAME LQCAT ION Date Permit No . * « APPROVED - YES NO Footing/pier Forms Foundation Waterproofing Backf ill Framing Roofing Siding Masonry Veneer Rough. plumbing Relief Valve Ext , porches Finished Floa interior Trim - Stairs & Railin ------ Cellar Drain Tile �- concrete Floors -----�- p1bg , Fixtures Gar , Fireproof ' g Door Closers Smoke Detect s Chimney IN SU I ATI ON Foundation Floors Walls Ceiling FINAL EL CTR.ICAL INSPECTION IVEWAY PPROVAL Ainal Bui ding Survey Next scheduled insp ecti (call when ready on , Remarks- /� "+ �/ Building Inspe r 6/86 and-vl BUILDING and zot-11NG DEPARTMENT gay and Havifand Road. R - D. 1 Box 98 Queensbury. New York 12801 SU I LDING INSPECTOR ' S REpOR7���^✓ NAME LOCATION Perymnit No Cate * * * * * * * * * * * * * * * * * * *APPROVED - TES NO 1,00ting/Pier Farms roundation Waterproofing Backfill }gaming Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext . Porches r finished Floors Interior Tr Stairs & Rain gs Cellar Drain T3 e Concrete Floors --------- Plbg . Fixtures Gar . Fireproofing Roar Closers Smoke Detectors t ey N S S.7 LAT I ON Foundation Floors Walls Ceiling FINAL EI E TRICAL INSPECTI DRIVEWAY AYFROVAL -- Final 8 lding Survey--- Next scheduled inspe, ttan (Gall when ready ) Remarks- Building Spector 6/86 and-vl _.!Dorn o� �eeeen36trre� BUILDING and ZONING DEPARTMENT Bay and Hauiland Road. R .D. 1 Box 98 (]ueensbury. New York 12801 SEPT'ICC DISPO L 5Y TEM INSPECTION NAME *J / v // f/ '+ I LOCATION 7 :./ `'jne DATE 1' S / PERMIT NUJ._ SOIL TYPE - Sand - Loam - Clay - Percolation Test Required? YES - NO i Percolation rate - Min/Inch - TYPE of S STEM: r Absorption fieldf total length 2) Length of a ch trench > 0 Depth of tire ches_ Size of grave ' •- — SEEPAGE PITS{ er of) _ Size- ft. Gravel size �— PIPING : S z Type Bldg . to tank Tank to dist . box Dist. box to field/ Openings sealed? ES �7 NO Partial LOCATION/SEPARATI S Foundation to t `+:ft. Foundation to a sorption = �ft . .Absorption to t line ft - Separation of its ft. LOCATION OF S STEM ON pROpERTY, (cirCle One) Front - Rear - Left side g s' de CC14MENTS : SYSTEM USE APPROVED YES O Buxldin Inspector 01/86 and vl "/o uv'n of Queen 31 tt r y BUILDING and ZONING DEPARTMENT Bay and Hauiland Road, R D- 1 Box 98 aueensbury, New York 12BOl BUILDING INSPECTOR ` S REPORT NAME LOCA 1 ON / /rt ►ti ] 1 L3c1teIC� �L�__ / 1�1 Permit No . * * * * * * * * * * APPROVED - YES No Footing/Pier Forms Foundation Waterproofing Sackfill jpf'aini n g Roof ing Siding Masonry Venee L,R6ugh Plumbing Relief Valves Ext . porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg . Fixtures Gar . Fireproofs Door Closers smoke Detector Chimney INsuLATION c Foundation Floors Wall : Ceiling FINAL ELECTRICAL IIISPECTION� DRIVEWAY APPROV Survey Building Next scheduled inspection (call when ready } Remarks- Building Inspector and-vl c� ee,,�.(y-fie 0 a t !' of BUILDING and ZONING DEPARTMENT Say and Haviland Road, R.D- i Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S/ REPORT NAME �!J� '� lL" ' . �€73 � S1L�ry LOCATION t Y Yr Date <�> -/ o7 / permit No . a_ �J * * * * * * * * *�► * APPROVED YES NO Footing/Pier Forms ^ Foundation waterproofing Backfitl Framing Roofing Siding Masonry veneer Rough plumbing Relief Values 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 INSPECTIOI3 DRIVEWAY APPROVAT Final Building, Survey, Next scheduled inspection Ccal1 when ready Remarks- Build ng Inspector y/86 and-vl ,_,Iow►r D� �ieBer# 3 �t+t+'t� BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D, i Box 98 Oueensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME ^ LOCATION / vr/f or Date ( / Perin t No . dr yt * * * it * * �ir it * : ,t ,► * se tit #e yt A APPROVER No �ting;/Pier Forms Fo .__ undation Waterproofing gackfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief valves Ext . Porches Finished Floors Interior Trim stairs & Railings cellar Drain Tile Concrete Floors Plbg , Fixtures Car . Fireproofing Door Closers smoke Detectors Chimney INSUI.ATION : Foundation Floors Walls Ceiling FINAL ELECTRICA NSPECTION DRIVEWAY APPROV Final Building Survey Next scheduled inspection (call when ready+ Remarks- I f f r Building Inspector 6/86 and-vl ING and ZONING DEPARTMENT (JI J{ By and Haviland Road, R.D. 1 Box 98 ` Queensbury, New York 12801 oe �IL. DING INSPECTOR ' S REPORT NAME t° LOCATIO/N Date.z. +` Permit NO * APPROVED NO - CAr,0�oting/Pier Forms Foundation waterproofing Rackfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext , Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete 'Floors Plhg , Fixtures Gar . Fireproofing Door Closers Smoke Detectors Chimney INSULATION Foundation Floors walls Ceiling FINAL ELECTRICA 1N5E'E9-;TI+DN __.� .... DRIVEWAY APPROVkL — Final Building Survey Next scheduled inspection (call when ready ) r Remarks. J Building I spector 6/86 and-vl BUILDING DEPT, COPY OF APPLICATION FORM 48-ELe NEW YORK BOARD OF FIRE UNDERWRITERS. FILE THIS COPY WITH BUILDING DEPT. WHEN REQUIRED. TEMR • DATE CITY DR (�G" /1/ ,+ r`1�, - I E r!` ` y G'dr''/�.C'�'� Al VILLAGE TOWNSHIP,STREET AND Mb. OR �?` TdW/U COUNTY ROAD AND POLE NO e..fiL' :G�L`C- �C�/1�J� /t ,r!� f POLE NO_ BETWEEN W"AT TWO _ PREMISE STREETS LQATSO? I�,1' �/ts' f . �/9"/r.�a.J it s �+� PREMISES LOCATED? L'^��"' " SECTION BLOCK LOT ANTIS BUILDING OFOCCUPANCY OWNERS NAME ,.y y"y ,,+,� AND ADDRESS / � ff �F /T!?_Cj VZ7 TEL. * 6, d? t-UU R R SIT / +" a' s SUPPLIED BY U. FROM THEIR yf�.s OFFICE SUILDINd WORK DEFECTS IS NEW OLD © IS NEW Nit ADDITIONAL 0 REMOVED ❑ LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED & BRANCH NUMBER OF OUTLETS LampR leceptaclea MOTORS HEATERS CIRCUITS OFFICE USE Lie ONLY tlm Side Atfach't M.P. Wam A.W.G. C.aiIklY Wall Reeep'la Switch Pendent Bracket NowType Each No. Each No. G,w" INSPECTION out- aide S.ob- bese Baer- mart tat FBI aid Cl. - 3 REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOV ' DO NOT USE THIS SPACE. This application is Intended to cover the abave•listed mwipmenl to be inapeoted but if at time of inspoinion there is found additional equipment not above listed. you are authorized to make the inspection and adjust the fee to cover the additional equipment, as provided the applicant. SIZE OF ELECTRIC SIGN TOTAL MAINS FEEDERS Q LAMPS WATTS CHARACTER GAS TUBE SIGN OF WORK CONCEALED TRANSFORtAIFASOF VA WORK TO BE INUMBERI [CAPACITYY STARTED '.j.z- COIMPLET D AL SIZE OF SIGN SERVIC€ OVERHEAD UNDERGROUND MAKER LE ENTDR 5' / OF SIGN INSPECTION REQUESTED ON OR AS NEAR AS POSSIBLE NEW OLD AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES DATE OF 7 MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. APPLICATION— PRINT NAMyE" AND A DyRESS �/ NAME OF �` � « " ` '�C ' i''�r3'L X SIGNATURE { ,,p^,y� j /�,-/'�/� DF APPLICANTAPPLa( , STREET ADDRESS t f'"✓l"-�L E 'fL � " ` u` IF TELEPHONE CPOST OFFICE .�? ltr /1�� �+++ if -. f 1I ZIP J r� 4. �l LICENSE PLI j zip WHEN APPLICABLE 46 EL (REV. I/ae) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING