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1987-450 w _ti r e f CERTIFICATE OF OCCUPAN C"Y TOWN OF +QUEENSSURY WARREN COUNTY, NEW YORK Date /10 A /r /� 19 = DUA This is to certify that work requested to be done as shown by Permit No. 87-4550 has been completed. This structure may be occupied as a one-Famlly Dwelling Location X A V lehause Lane Ismael Velez Garner By Order Town Board TOWN OF QUEENSBURV i Building b► Zoning Inspector � - BUILDING PERMIT TOWN OF QUEENSBURY No. 87-450 WARREN COUNTY, NEW YORK x 0 PERMISSION is hereby granted to Ismael Velez 00 OWNER of property located at12 Applehause Lane Street, Road or Ave. 1 in the Town of Queensbury, To Construct or place a One—Family Dwelling 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 . O WN E R"S Address is Apt . # 1103 Regency Park Apts . Glens Falls , N . Y . 12801 2. CONTRACTOR or BUILDERS Name m Michael 5chusteritsch a c 3. CONTRACTOR or BUILDER'S Address N 13 Lady Slipper Lane 14 N Queensbury , N . Y . 12801 d. ARCHITECT'S Name k r—• N S. ARCHITECT'S Address 'v ro 0 sr S. TYPE of Construction — (Please indicate by X) In ( wood Frame ( ) Masonry { ) Steel ( } w m 7. PLANS and Specifications No.26' x 48 ' per plot plan , specifications , and application including sewage system and attached 2 car garage . B. Proposed use One—Family Dwelling ro l �d au $5 . 00 C/o �$ �- $ 129 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES February 1 , i9 (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.} N I� Dated at the Town of Queensbury this 15tL Day of July 19 87 ri UQ SIGNED BY _ f �+'/ &'e4& 424" for the Town of Queensbury Building and Zoning Inspector �� TO BE COMPLETED BY BLDG . DEFT . _ c� /I Application No . _lawn o /] Qtteen .s6ury Permit Issued 19 BUILDING and ZONING DEPARTMENT Permit Expires 19 a � �J Bay and Haviland Road, R.D. 1 Box 98 zoning Designation ��u {{{���111 ��ry` Queensbury. New York 12801 Variance No . 1]1� `]I Site Pla view No . ; BUILDING &. CDL?E DEP Appro / '`�' IJ whoAPPLICATION FOR 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 pr perty is : P . O. Address Tel . Property Location : Tax Map No . Street number or ildi lot number Subdivision name ( if applicable) THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS : Marra Address Tel . No . r Name of builder Address , &— Tel . Name of lumber � ddrei it Tel . r{ Name of mason Address { ` Tel . r. NATURE F 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 heretor Alteration to a building " showing clearly and distinctly all buildings , � (no change to exterior dimensions ) whether existing or proposed and indicate all Other wont (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 J&IQ ft X /,w' * ft Existing building ( s) Size ft X ft . >F PROPOSED BUILDING AND USE : Existing building ( s ) Use Size of new structure £t x ft Foundation-pier/ slab/craw arti /full roposed building , distance from property line (circle one ) _ Front yard ft Rear yard f©.,? ft No . of stories (habitable space ) Side yards - ft and ft Height ( grade to ridge) %� ft • if on corner , setback from side street ft If residential , no . of families No . of rooms ( excluding baths ) * OCCUPANCY INFORMATION No , of bedrooms PR BUILDING - No , of bathrooms �— One family dwelling Primary heating systemi".e Two family dwelling Type of fuel Multiple dwelling / Number of units No . of fireplaces to be installed Permanent occupancy Will a wood stove be installed Transient occupancy Central Air conditioning? � Business BUILDING STYLE, PRIMARY STRUCTURE * Industrial �. Ot he r Ranch Contemporary 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 * * * * * * * * * * * * * * * * * Private storage building ESTIMATED MARKET VALUE OF _ " Other CONSTRUCTION $ INFORMATION ON BUILDING SPECIFICATIONS . ON REVERSE SIDE OF THIS SHEET , TO BE COMPLETEDI FOiiu, u Y/$U and-vl - 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 area 2 . Type of heat Z 3 . Is the building mechanically cooled ? � Jr 4 . Percentage of area of windows and doors A . Over 16 % Only 1 . Uc value of gross area of walls , roof/ ceiling and floors exposed to ambient conditions 2 . Floor oxer heated spaces YES a . Are foA ndation walls insulated ? Yam.. NO 1 . I Y7s5 , what is the R value ? 3 . Slab on grade Y ( NO a . If YES , what isyalue of insulation around perimeter of floor ? _ 4 . Is basement heated ? EYES NO a . R value of insulation 5 _ Type of insulation B . Under 16 % Only 1 . R value of roof and floors expos-mod to ambient conditions. 2 . R value of exterior walls 3 . R value of glazed area. 7 ' - 4 . R value of doors r i 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 ( above grade ) 9 . R value of heated basement/ cellar walls ( below grade ) _ `> 10 . Type of insulation- � C . Controls 1 . Thermostat maximum heat setting_ 7-:L D . Duct Systems —1 1 . Is duct system installed. in unheated spaces '? YES CNO a . If YES , R value of duct installation 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 Telephone No . "Kr' " 1 c ( applicant ' s slignature ) APPLICATION FOR SEPTIC DISPOSAL PERMIT DATE 2• _� I LOCATION OF PR PERTY FOR IN ALLATION J�{ J� Owner's Name: Telephone: 44 Address: w Installer's Name: _ Telephone: Number of bedrooms {residential only} _ Total daily flow (compute @ 150 gal per bedroom) Tapograph3r_ circle one: Flat olling Steep Slope % of slope f Soil Natxme: circle one: Sand Loam Clay Other / Depth: r feet ar Ground Water: At what depth? FZI feet Bedrock or Impervious Material: At what depth? i feet Percolation test: circle one: not required required J rate min. inch. Domestic watex supply: circle one: Municipal ell Other IF domestic water supply is a Well: Separation: Watersupply from Septic absorption _ feet PROPOSED SYSTEM: Septic Tank gal. (minimum size: 1 ,000 gal.) TILE FIELD: Each Trench feet { Total system length feet SEEPAGE PIT(S) : Number of / Size each feet by 42 feet Size of stone to be used # I Depth or Thickness �_ feet IMPORTANT ...Please...IAST NEW EQUIPMENT TO BE INSTALLED (over) awn ofueeshure� BUtL,DING and ZONING DEPARTMENT ox 9B Say and Haviland Flew YorkQ18B01 QueensburY. I BUJ LC1NG INSPECTO MIS , E ORT /f! NAME a� LOCATION �_/ �` Permit No . Dat,e APPROVED - YES NO , 1�oatingfPier Forms waterproofing nackf ill I ramj-ng Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext , Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain `rile _.-----�' Concrete Floors Vlbg - Fixtures Gar . Fireproofin Door Closers smoke Detectors Chimney INSULATION Foundation Floors walls ON FINAL Ceiling- F' INAL ELECT CAL _NSPECTI UV- VSWAY APPR(WAL inal Building Survey c,a7i.1 when ready ) Next scheduled inspection C r Remarks- c Fuilding Inspector �,� g� and-vl BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.O. 1 Box 98 Oueensbury, New York 12801 SEPTIC, DISPOSAL SYSTEM INSPECTION LOCATION �/ PERMIT NO . DATE SOIL 'TYPE - Sand - Loam - Clay Percolation Test Required? YES " Percolation rate - min/inch _ TYPE of SYST Absorption f3. Id . total length Length of eac trench Depth of trenc es Size of gravel SEEPAGE PITS-T3 f t. X Size- - _ Gravel size Size T P IP JNG : Bldg . to tank L _�- Tank to dirt . box Dist. box to field NO Parti 1 Openings sealed? YE LOCATION/SEPARATION F �, ft. Foundation to tank t ' Foundation to absor 10 t. Absorption to lot ne ft. Separation of pits LOCATION OF SYS (OWN (circle one) PRO R Rear - L t side - Right side Front _ r SYSTEM USE APPROVED YES NG+ Building InsP ct'O'r Ol/66 and vl flown of Q,4een y0r "ry BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. i Box 98 Queensbury, Nee York 12801 BUILDING INSPECTOR ' S REPORT NAME LOCATION Date^ Permit No - Q APPROVED YES xNO Footing/Pier Forms Foundation Waterproofing Backf i l l Framing Roofing Siding Masonry 'Veneer Rough Plumbing Relief Valves Ext . Porches Finished Floor Interior Trim Stairs & Rai ngs --- Cellar Ora! Tile Concrete F rs Plbg . Fixt res Gar . Fireproofing Door Closers Smote Detectors chimney JooTNSULATION : Floors Walls - J Ceiling FINAL ELECTRICAL IbISPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection (call when ready) Remarks- �srcn Building nspectvr 6/e6 and-vl 4.,locur+ o� '�ieeenstrurc� 13UILDING and ZONING DEPARTMENT Say and Haviland Road, R.G. 1 Box 98 Queensbury, New York 12801 BUILDI INSPECTO ' S REPORT NAME E„/ CF , t'. 5T i t LOCATION Date ► �' Or .1 ,% Permit No * * * * * * * * * y * APPROVED _ YEg� NO Rooting/Pier Forms 11// Foundation waterproofing Back.f ill Framing Roof ing 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 Detractors chimney INSULATION : Foundation Floors walls Ceiling FINAL ELECTRICA INSPECTION DRIVEWAY ,APPROV Final Building urvey� Next scheduled inspection (call hen ready ) w Remarks-/4<9Ao � L --�G5tPr1f2 I rrz q`4� %`�III�J"i JUCa pwt�,Ur . Building In ctor 6/a6 and-vl BUILDING DEPT. COPY OF APPLICATION FORM 46-EL, NEW YORK BOARD OF FIRE UNDERWRITERS. FILE THIS COPY WITH BUILDING DEPT. WHEN REQUIRED. 7EMP: N DAME elrX aR 7 T VILLAGE - =Y _ _ �:;,Jfi. ' TOYYPISFIIP COUNTY STREET AND NO. OR _ _ - ' y'. �1 ROAD AND POLE NO. ....�+� '" - r' '+.? POLE NO. BETWEEN WHAT TWO - CAGES,$TREETSIS " PREMISES LO[:ATED7 SECTION BLOCK LOT OCCUPANT'S BUILDING NAME I i,` OCCUPANCY OWN EJI"S AND ADORESSMt'�' ++ ge-kc" -Z_ /k c r. .f . r'�: �: i .��i ! !is �' TEL. * CURKLN ` S PPLIED i! II---1I FROM THEIR OFFICE II--�� DEFECTS IIssLlILO1NG _ NEW I_I OLD0 FORK NEW © ADDITIONAL ❑ REMOVED I_.1 LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED M NUbBER OF OUTLETS No, Raaepodes Fliclarive B MOTORS HEATERS CIRCUITSBRANCH OFFICEUSE Low ONLY Ile" Sda. At1&mot H.P. Wane A_W_G. DxllirQ yn,B R .•y Stealth Pwrlr.x Bracket No, Type Eedl No. Each No. G,,,,B„ INSPECTION Clut- alde r -_ Sus "barn r dnrd IIt Ft. 2" Ft f FL- REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: DMD NOT USE THIS SPACE. This application is intended to cover to abeve-Iisted equagansant to he ingy tad but it at tinlvs oI inspection there is Toured vakditid-no' aqui pmarttt net above 1"xfad, V tru are aotttori:ed to snake the inape"ion and adjust the tam to ro..t the additional aquiptnent. ax provided by the applicant. SIZE OF ELECTRIC SIGN TOTAL MAINS FEEDERS LAMPS WATTS CHARACTER '•' "� 1EXPOSED GAS TUBE SIGN / OF WORK ,� . --+ CONCEALED TRANSFORMERS OF VA WORK TO BE 1NUMBERI ICAPACITYI STARTED COMPLETED PIZE OF SIGN SERVICE OV HEAD UNDERGROUND MAKER ENTERS OF SIGN _ BUILDING INSPECTION REQUESTED ON OR AS NEAR AS POSSIBLE NEW El OLD AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES DATE OF MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. ,F le, F APPLICATION PRINT NAME AND ADD,R rcSS - ._„/ J NAME OF r./ SIGNATURE APPLICANT_ .. yr�OF APPLI ClLCiT '"' STREET ADO"ESS TELEPHONE CITY OR } + .+. ZIP /� , - t IsICENSE NO_ POST OFFICE ' '- CODE �_E' . P VMEN APPLICABLE rp A6 EL (RE - 1/86) SEPARATE APPLICATION MUST BE F ED FOR EACH SEPARATE BUILDING gED AR�yi �S RP EDW; ' !F T � T yF �15910 OF 2/74