1987-449 Y
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CERTIFICATE OF O(O.DC _I FANCY
TOWN OF QUEENSBURY
WARREN COUNTY. NEW YORK
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Date October 219
This is to certify that work requested to be done as shown by Permit No. 67-449
has been completed.
structure may ou ' as Oise—Family F3we 1 ing
This s!* .� an'Ptrt un
Lot 14 Pi:tion Pine Lune ( St . No . 94)
anon
gb
I are construction
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By Order Town Board
TOWN OF QUrE'ENSBUR.Y
j Building 6 Zoning Inspector
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P OR'"}tA ii Y
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
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WARREN COUNTY, NEW YORK
October 19 , o17
Date 19
This is to certify that work requestedto be done as shown by Permit No. 87 449
has been completed.
This structure may be occupied as a 0)ie-Rair.i_1y 1.Uwu1ling
Location i..ot 14 Pinion Pine Lane ( ut . itio . � 4 )
red uirey Can� rructican
Owner
Liii J 11, i By Order Town Board
Y' J.t A1 . Eul1' M: 1GA1 ,
'I`OWN OF QUEENSSURY
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Building $ Zoning Inspector
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CITE A TIVE -IMST A'- FMANTIM6, 6L ENS FALLS. M V !zoo is 1 W;70]�5434
BUILDING PERMIT TOWN OF QUEENSBURY No. $7-449 �.
WARREN COUNTY, NEW YORK a
PERMISSION is hereby granted to Gregoire Construction e
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OWNER of property located at Lot 14 Pinion Pine Lane (St . No . 24) Street, Road or Ave.
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in the Town of Queensbury, To Construct or place a One—Family Dwelling
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1 _ OVYNER'S Address is
64 Burgoyne Rd .
Saratoga , N . Y . 12866
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2_ CONTRACTOR or SU1 LDE R'S Name o
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same
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3. CONTRACTOR or BUILDER'S Address 0
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same H
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4. ARCHITECT'S Name 0
S. ARCHITECT'S Address
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B. TYPE of Construction — (Please indicate by X) E
to I�
{ wood Frame { ) Masonry { ) Steel { I O
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7. PLANS and Specifications rrt Fck
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No. 24 ' x 68 ' per plot plan , specifications and application submitted °" @
including sewage system and two-car garage .
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B. Proposed Use ro
One-Family dwelling
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$ 5 . 00 C /O a
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$ 143 . 00 PERMIT FEE PAID - THIS PERMIT EXPIRES February 1 19 88 1
(If a longer period is required an application for an extension must he made to the Building and Zoning inspector of the g
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 15th Day of July 19 87
SIGNED BY :1
....E'er- 7C.� for the Town of Queensbury
Building and Zoning Inspector Oo
TO BE COMPLETED BY BLDG . DEPT .
�j / Application No .
- /nw►� oueendhuMl Permit Issued 19
BUILDING and ZONING DEPARTMENT Permit Expires 19 raWN Chi= 0.` ULE+N4k-
Bay and Haviland Road, R. D. 1 Box 98 Zoning Designation
Oueensbury, New York 12801 Variance No . ��"�d Lh LI LL1I
Site Plan Review No .
( � �L\ Approved b JUL 131987
(7` APPLICATION FOR
BUILDING Bc CODE DEFT.
EU I LD I NG 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 : C Lam -- / �
P . O. Address CTe a Tel . � 10F �I. e 6 44?
Property Location : ax Map No . /
Street numbeje or bcu�ild g lot number
Subdivision name ( if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK. AS REGARDS BUILDING CODES IS :
Name P . O. Address Tel . No . r,
Name of _builder �r,vcarAddress f � t.. r�,-s,.�re �g12 � c 'el -� .{ 'ti f " 4 - ----
Name of plumber aJ2_. Address Tel . r,,r37 — ' d
Name of mason Address Tel .
NATURE OF PROPOSED WRK : ZONING INFORMATION :
e< 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 lest number and indicate.
whether interior or corner lot . Show location
FOR DEMOLITION PERMITr 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 Gz�ft x�ft .
* Existing buildings) Size �'crr-R ft x ft .
*
PROPOSED BUILDING AND USE : * Existing building ( s ) Use
Size of new structure �y ft
Foundation-pier/ slab/crawl/partial * Proposed building , distance from property line
(circle one ) ' e
yy Front yard 9 � ft Rear yard ft
No * of stories (habitable spacy ) KAIV T ft
Height ( grade to ridge ) 26'- F f ft . * Side yards e street ft
ft and _
If residential , no . of families / If on corner . setback from side
No . of rooms ( excluding baths ) " OCCUPANCY INFORMATION
No. of bedrooms
*No . of bathrooms PRIMARY BUILDING -
�- �- * One family dwelling
Primary heating system * Two family dwelling
Type of fuel__
No . of fireplaces be installed r * Multiple dwelling j Number of units
Will a woad stove be installed . /1/d * _...-Permanent occupancy
* Transient occupancy
Central Air conditioning? * Business
BUILDING STYLE PRIMARY STRUCTURE * Industrial
Ranch Contemporary Log cabin * Other
if addition , what will use be?
Raised ranch Mansion Duplex
Split level Old style Bungalow
Ca e Cod Cattage Other * ACCESSORY BUILDING-
2 Row Town House * Detached garage/one car/ two car/ car
( CIRCLE ONE PLEASE ) * Attached garage/one car/ wo ca�rr_ �1 _car
* * * * * * * * * * * * * * * * * * Private storage building
ESTIMATED MARKET VALUE OF * Other
CONSTRUCTION
INFORMATION ON BUILDING SPECIFICATIONSr ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETEDS
Form BPA 4/86 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 ZZ90
2 . Type of heat a-z �
3 . is the building mechanically cooled ? rid f
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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
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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
Be Under 16 % Only
1 , R value of roof and floors exposed to ambient conditions
2 . R value of exterior walls. /q
3 . R value of glazed area J� 1
4 . R value of doors / � f
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 ) f�
9 . R value of heated basement /ce/llar �w,a/lls ( below grade ) r
10 . Type of insulation
C . Controls c� a
1 . Thermostat maximum heat setting
D . Duct Systems �-- •,
1 . Is duct system installed in unheated spaces ? YES &T>
a . If YES , R value of duct installation
b _ R value of duct in other areas
E . Piping Insulation � � r
1 . Size of hot water or cooling carrying agent pipe
2 . R value of pipe insulation
F . Service Water Heating r
1 . Performance efficiency Fa
2 . Temperature control setting maximum_
G . For Swimming Pool Only
1 . Maximum heating
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Telephone No . 5 / " L.' !G'
pplicant ' s s3 oGrture )
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AP^PLICA77ON FOR SEPTIC DISPOSAL PERMIT
DATE Z,/ Z
LOCATION OF PROPERTY FOR INSTALLATION jr_` eelr
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Owner's Name: p ,dry Telephone* r am t� Ga y
Address: _ G- r{ � +�,Gy Iry
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Installer's Name: �"G "-a. elephone: / 90 T
Number of bedrooms {residential only) 3
F
Total daily flow (compute @ 150 gal per bedroom)
Topogrraphy: circle ones lat Rolling Steep Slope 90 of slope
Soil Nature: circle one: (S7 Loam Clay Other / Depths feet
Gwound Water: At what depth? feet
Bedrock or Impervious Material: At what depth? _ feet
Percolation test: circle one: no=required required / rate W-92Tmin. inch.
Domestic water supply: circle one: Municipal ell Other
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption IQ 4n feet
PROPOSED SYSTEM: Septic Tank e27404:3 gal. (minimum size: 1 ,000 gal.)
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TILE FIELD: Each Trench .50 feet / Total system length r24 O feet
SEEPAGE PIT(S) : Number of / Size each feet by feet
Size of stone to be used # 4 / Depth or Thickness ,` feet
I M P O R T A N T
...Please...LIST NEW EQUWMENT TO BE INSTALLED
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
(over)
.Jcrcvn a� '�ueens �urt�
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road. R. D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME �, y
L0CATI0N QX
Date permit No .
✓ =Footing/Pier Forms APPROVED YES NO
Foundation
Waterproofing
Backfill
Framing
Roofing
S-iding
Masonry Ven er
Rough Plumbi g
Relief Valves
Ext . Porches
Finished Floor
Interior Trim
Stairs & Railing
Cellar Drain Tile
Concrete .Floors
Plhg , Fixtures
Gar , Fireproofin
Door Closers
Smoke Detectors
Chimney
INSULATION
Foundation
Floors
Walls
Ceiling
FINAL ELEC CAL INSPECTION
D IVE'WAY AP ROVAI��
anal Build g Survey
Next scheduled InspectI., (call when ready
Remarks-
6l85 and-vl
Building spector
j �! -�' ..Jc�u�ri o� �eteer7s �ure�r
r� BUILDING and ZONING DEPARTMENT
1 Bay and Havifand Road, R. D. 1 Box gS
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME
LOCATION
DATE o Z I —z PERMIT NO .
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES -
Percolation rate - Min/Inch
TYPE of SY TEM:
Absorption field , total lengrtJ
Length of a ch trench
Depth of tr nches
Size of grav 1
SEEPAGE PITS umber of)
Size- ft . ft
Gravel size ,o
PIPING : iz Ty e f
Bldg . to tank
Tank to dirt . bo - - ---
Dist . box to fiel
Openings sealed? ES O Pa tial
LOCATION/SEPARATI
Foundation to t k (i t.
Foundation to a sorpti n ft .
Absorption to of line ft.
Separation of its ft.
I' '
OF STEM ON PRO RTY (circl�e one)
Fron - Rear - Left side - ight side -
TS :
SYSTEM USE APPROVED YES NO
Bui ng Inspector
01/86 and vl
�l�b / n a'� �ueens6urr�
BUILDING and ZONING DEPARTMENT
111 y� Bay and Haviland ,Road, R. p. 1 Box 98
qf"T/y- Oueensbury. New York 12801
BUILDING INSPECT€] R ' S REPORT
NAME
LOCATION
Date ? / / Permit. No
✓ = -
Footing/pier Farms APPROVED YES NO
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext . porches
.Finished .Floors
Interior Trim
Stairs & Railings
Cellar Drain Til
Concrete Floors
Plbg , Fixtures
Gar . Fireproof g
Door Closers
Smoke Detect s
Chimney
C.G^Z'�I S U I.AT I ON
Foundation
Floors
t<al1. s
J,A!,'e'i I i n 9
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Filial Building Survey
Next scheduled inspection (call when ready)
Rena r ks-
6/$6 and-vl
Building Inspector
eyl
7 / BUILDING and ZONING DEPARTMENT
J/
40 Bay and Haviland Road, R.D. 1 Box 98
` Oueensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
�TION J r Permit No .
2O
-
Footing/Pier Forms. APPROVED ES NO
�undation
t,,4fa terproo f ing
�f i 11
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves _..... _.
Ext . Porches
Finished Floors Interior Trim
Trim - "y
Stairs & Railin
Cellar Drain Ti e
Concrete Floor
Plbg . Fixture
Gar . Firepro ing
Door Closer
Smoke Dete ors
Chimney
INSULATION
Foundatio
Floors
Walls
Ceiling
FINAL .ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey pp
Next scheduled inspection (call when ready)
Remarks-
6/85 and-vl Building Inspector
,/�,„,q � 1 ._./Overt G►� �L[Pk'I1 .f (� ttrr�
y ! BU4LDING and ZONING DEPARTMENT
Bay and Haviland Road, R. D. 1 Box 98
Oueensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCp� TION
Ica ! �
a A/'
Date" f /�' Permit No .
✓voting/Pier Forms APPROVED Y NO
Foundation
waterproofing
Sackfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext , Porches
Finished Floors
Interior Trim
Stairs & Railin
Cellar brain a "'
Concrete F1 s
Plbg . Fix res --
Gar . Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION :
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVA �, ,_
Final Building Survey
Next scheduled inspection (call when ready
Remarks-
8ui an Inspector
6/SFi and-vl
j � xBUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R_p, 1 Box 98 `
uLeensb,,rNewk 12801
�! v ' �l p jQ
I UIL . REPORT
E
n ��`!
Date / Permit No . ' e-
oati.ng/Pier Forms ~ APPROVED - NO
Fou.n da t ion
waterproofing
Sackfill
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 I SPECTION
DRIVEWAY APPROVAL
Final, Building Survey
Next scheduled inspection (call when ready)
Remarks- 0)
5/86 and-vl Building I spector
INEEN
BUILDING DEFT. COPY
IRE UNDERWRITERS.
THIS COPY WITH SUt DING DEPT. WHEN REQUIRED f
P. ft WkTE J
VICITY
.' j c• J - TY,R stlllP , +`• •1' I-J P COUNTY
STREET AND NO. OR POLE NO,
ROAD AND POLE NO. i -
BETNfEEN WHAT TWO BLOCK L07 �i�
CROSS$TRE ETS IS SE TION
PREMISE T£D BUILDING
OCCUPANT'S f _ �, .f:. N f.- OCCUPANCY F y
NAME ;/' . t....�.
664E R'S NAM r TEL.
AND ADDRESS ; a. �_• r" ti" �•{ :^ .•+ / '
t.L
SUPPLIED , f FROM THEIR y - e_ OFFICE
By DEFECTS
BUILDING ��--1i YMC]RK REMOVED 0
IS
NEW ® OLD iJ IS NEW ADDITIONAL
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
of fixtusae It MOTORS
OFFICE USE
N4
NUMBER OF OUTLETS Lernp Raceptaelw MDTORs HEATERS CIRCUITS ONLY
H.P. Vh" NM A.W.Q. INSPECTION
Sion CaYini Wall R+raP'h W m
Swih Peta Brae nt ka t No. Type Each N4' EachGw/oa
Out-
side
save
Brie
mat
1st FI.
xnd FI.
9td Fl.
REMARKS-. LIST OTHER ELECTRICAL DEV ICES NOT SET FORTH ABOVE.
DO NOT USE THIS SPACE•
.1 ant to be inspected but it at time of inspection them is found additional atlu+pme t not. abore Iistad,
This Ay1r"lth do K to make
IO cower t on and aAuw the lo4 to coeK the addtional equipment, a► Provided by the apph"nt.
you ore authorized to mske the inspaatr ELECTRIC SIGN TOTAL
WATTS
SIZE OF LAMPS
MAINS PEEPERS
EPOSED GAS TUBE SIGN
TRANSFORMERS OF VA
CHARACTER CONCEALED
Of WORK INUMBERI ICAPACITYI
WORK TO BE COMPLETED SIZE OF SIGN
STARTED
SERVICE OVERHEAD UNDERGROUND MAKER
ENTERS OF SIGN
iLDING
INSPECTION REQUESTED El OLD i
ON OR AS NEAR AS NEW
POSSIBLE
AVOID DELAY BY GIVING FULL AHD ACCURATE INFORMATION. ALL SPACES DATE OF �
„ f/
MVST BE FILLEO IN OR APPLICATION MAY BE RETURNED. APPLICATION 1 0
,
PRINT NAME AND ADDRESS *I/' SIGNATURE r
NAME OF .r '� __ r - .r _ r �• OF APPLIC
APPLICANT..��
TELEPHONE #
STREET ADDRESSZIP LICENSE NO,
CITY OR _ :Z r� y �:: ; r•' r; i'{r,� CODE '`��+�F' —WHEN APPLICA$LE
POST OFFICE F^ w [J
as EL (REV. I/aG) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING
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