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1987-527 1 CERTIFICATE C]►F OCCUPANCY J TOWN Of QUEENSSURY f WARREN COUNTY, NEW YORK i Date October ,Q . 19 's This is to certify that work requested to be done as shown by Permit No. 7 "5 7 has been completed. I i This structure may be occupied as a Fa fmyfiye la ing 1 +1 &c /f 6 C7 H i tl icier_ F' i lamr . � • • 1�1 l�- �\ LAicarion �wlleer�� j Denise Ferguson Owner I f By Order Town Board TOWN OF QUEENSBURY Building & Zoning Inspector I I 1 I BUILDING PERMIT � TOWN OF QUEENSBURY No. $7_527 � � WARREN COUNTY, NEW YORK �o PERMISSION is hereby granted to Denise Ferguson I OWNER of property located at Lot 40 Hidden Hills Dr . Street, Road a Ave. in the Town of Queensbuly. 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. OWNER'S Address is 24 Meadowbrook Rd . � m Glens Falls , N . Y . 12801 N. w M 2. CONTRACTOR or BUI LDE R 'S Name P:] to H Lancette Construction o m 0 3_ CONTRACTOR or BUILDER'S Address 105 nix Ave . Glens falls , N . Y . 12801 t� 4. ARCHITECT'S Name sa.S. ARCHITECT'S Address M m r- x 6_ TYPE of Construction — (Please indicate by X) t0 ~ m (xl Wood Frame I I Masonry I i Steel { 1 rWl N• C Cb 7. PLANS and Specifications No. 65 ' x 26 ' per plot plan , specifications and application including septic system , attached two—car garage and driveway permit . ' 8. Proposed Use O One—family Dwelling sn $5400 C/O $ 136 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES March 1 , 19 88 p m Ilf a longer period is required an application for an extension must be made to the Building and Zoning inspector of the F. town of Queensbury before the expiration date.) tj °4 Dated at the Town of Queansbury this 12th 1,,�� _ Day August lof ,r-� 19 87 SIGNED BY / �" / Q.G..+� f e' • A �7 � for the Town of Queensbury Building and Zoning Inspector /_ 70 / TO BE COMPLETED BY BLDG . DEPT . Application No . O6VI't o "evn5g"ry Permit Issued 19 _rCi way i l ; 4C, 5'i�3L BUILDING and ZONING DEPARTMENT Permit Expires 19 Bay and Haviland Road, R. O. 1 Box 98 zoning Designation lair r ; i f Queensbury, New York 12801 variance No . , ++ Site Plan Review No . JUL 2 Df 0 Approved by - BUILDING & CODE DEFT ~� APPLICATION FOR BUILDING AND ZONING PERMIT G ' A PERMIT MUST BE OBTAINE❑ 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 : oewisc �L60^j{ P . O. Address .z'f' �i JA �L , T_ 1'� r Tel . �j "T'T Property Location : G 1 ( 5 ( i��` +" / Tax Map No . Street number or building lot number ! Subdivision name ( if applicable) THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS : 14. Name P . O. Address Tel . No . Name of builder Q IF (' i,' & j^C- Address / K *490 l�� - a Py Tel . 3 '- 0``f Name of plumber J pn/ th1C� i Address Tel . ' ����- Name of mason- /MAY /�} �1 Address HL .e �Tel . NATURE OF PROPOSED WORK : * ZONING INFORMATION : X 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 / �,a-!5� * Size of property ft x-110F -ft . Existing building ( s ) Size ft x ft . * PROPOSED BUILDING AND USE : * Existing building ( s ) Use Size of new structure j ft x Foundation-pier/slab/crawl/partial ful Proposed. building , distance from property line (circle one ) Front yard 3t) ft Rear yard t 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 ( excludin�hs ) OCCUPANCY I NFORMAT I O!V No . of bedrooms PRIMARY BUILDING - No . of bathrooms beo�one family dwelling Primary heating systemPGFZ. jd2� 4 +} * 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? /VO * * Transient occupancy Central Air conditioning? /k/O Business * BUILDING STYLE, PRIMARY STRUCTURE Industrial Other- 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- Cc-olonial-3 Row Town House * —y�-Detached garage/once car/ �r/ Carn� ( CIRCLE ONE PLEASE ) * V Attached garage/one car/`+/trwo ca car * * * * + * * * * * * * * * * _Private storage building ``^ TMATED MARKET VALUE OF * Other " CTION - _ ?,L 00 - -- - - - - - - - _ - N ON BUILDING SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET , TO BE COMPLETED ? I/86 and-vl l BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATIONS : Type of construction , wood frame , fire safe , etc . AA0,D) Will any second-hand or ungraded lumber be used? If so , for what ? /4+I Foundation wall material Toy'WD QQN t f Thickness Depth of foundation below gra to bottom of footing) � Will there be a cellar? P or usxheated? ' i r gQbFloor sq. footage ") sq ft Will there be a basement? ill any portion be used as living space? ( If so , what portion? sq . ft . - - Type of use? Type of roof slo a /flat/shed/other Material. of roof EIW1R;C+45k5 5 Face-s Size , wood studs " X 6 " spacing "o . c . length � ft . .foists ( floor beams ) 1st _ floor 29 "X_ �.-�" spacing�l�`"o . c . span ft . .Toists ( Floor beams ) 2nd . floor " X__ I - " spacing__A."o . c . spanl' 4 ft . Overlays ( ceiling beams ) "X " spacing "o . c . span ft . Roof rafters "X ON spacing O . C . span €t . Roof trusses (pre-engineered) spacing "o . c . span. ft . Exterior wall finish Of what material? Interior wall finish _ ,2 t` _ _ S,M-E-F�-�OC L� If a garage is to be attached , describe mart( ials to be used for FIRE SEPARATION : Is there to be an opening between garage and dwelling? 'YIF5 If so will a Fire-rated door , enclosure , and self-closing device be provided? /^l 5 Will a flue-lined chimney be installed? /[ a Height above roof ft . Depth of chimney foundation below grade ft . Depth of firepl th ft . in . Water supply Municipa or private well SEPTIC SYSTEM _ nce from ANY private well ( including adjoining properties ft . (A separate application is necessary for, any 1r►epair or new installation of septic system) Town of Queensbury County of Warren Y A F F I D A I T STATE OF NEW YORK 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 ORDINANCE , 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 . ram/ SWORN TO BEFORE ME THIS Signature _--� ~ �s!_� _ Owner , owner ` s agent , arenicect , contractor - day of 19 Notary Public , Warren County , N . Y . SPECIAL CONDITIONS OF THE PERMITt � By 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 follolwiin.�go / 1 . Gross floor area 2 . Type of heat__,_._E4. r 3 . Is the building mechanically cooled ? - /VQ 4 . Percentage of area of windows and doors /Q A . Over 16 % Only i . U value of gross area of walls , roof / ceiling and floors a 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 floor ? 4 . Is basement heated ? YES NO a . R value of insulation 5 . Type of insulation B . Under 16 % Only 1 . R value of roof and floors exposed to ambient conditions_ _ " sga- - 2 . R value of exterior walls 3 . R value of glazed area . ?, 4 . R value of doors 'W � 5 , R value of floors over unheated spacesu o� 6 . R value of slab edge insulation - unheated slab � 1�f 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 102iC2C-L.W'QP> Co Controls ,. 1 . Thermostat maximum heat setting D . Duct Systems 1 . Is duct system installed in unheated spaces ? YES NO a . If YES . R value of duct installation- -b . R value of duct in other areas �r E . P !21 *g Insulation 1 . Size of hot water or cooling carrying agent pipe 2 . R value of pipe Insulations F . Service Water Heating 1 . Performance efficiency /a 2 . Temperature control setting maximum G . For Swimming Pool Only 1 . Maximum heating Telephone No . �rT3 caF f¢l�( ��� ( pplicant ' s signature ) %Y&UOL Of APPLICATION FOR SEP'ITC DISPOSAL PERMIT DAB /r _ / a, :Z LOCATION OF PROPERTY FOR INSTALLAnON /�'�/(,�L �j Owner's Name: !J�.Q�"Ifi1 C�`jC1e+k.E Telephone: � " � 3 Fq Address: If71rzl ik ►aFR2 [ A)Y Installer's Name: :1'6'V42 / FIB d, ,S0AJS Telephone; s Number of bedrooms (residential only) Total daily flow (compute @ 150 gal per bedroom) �f`,y�#� Topography: circle one : Flat Rollin Steep Slope. % of slope/r0 Soil Nature: circle one: San Loam Clay Other / Depth: feet Ground Water: At what depth? 7 feet Bedrock or Impervious Material: At what depth? feet Percolation test: circle one: not required required / rate 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 4TLo gal. (minimum size: 1,000 gal.) TILE FIELD: Each Trench A;—p _. feet / Total system length _� feet SEEPAGE PIT(S) : Number of / Size each 4R feet by CO feetLC) olf � .- Size of stone to be used # o:2 - / Depth or Thickness anw== feet IMPORTANT ...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 2.) location and distance to lot lines 30 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 D pceal Ordinance. Signature of responsible person: Z� y i 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 �GU/►t O� �ueL'lri � l.�t�/'� BUILDING and ZONING DEPARTMENT Say and Haviland Road, R. D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' REPORT NAME .� LOCATION or ' Date/ Permit No . -,ji ✓ = APPROVED - NO Footing/Pier Forms Foundation Waterproofing Backfill Framing �Koofing ding Masonry ?ne erRough Plbing �,�i2elief Vves xt _ Porches -inished Floors / "Interior 'Prim 44�7-tairs & Railings Oka Cellar Drain Tile Concrete Floors L.Plbg , Fixtures Zug LF.rer . Fireproofi for Closers Zramoke Detector Chimney, 'LTN SU LAT I ON : t4r5undation Floors walls Ceiling ,e LAKgNAL ELE RICAL INSP CTION DRIV'EWA'Y A PROVAI,.,,,_ � J 4.�nal Buis g Survey Next scheduled inspection ( call when ready ) Remarks- /a(3 BuilWTng Inspector 6/86 and-vl � �t7l1fR !7� �+CIF�Pl73LSRlY`f� BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Queensbury. New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME LOCATION I DATE /_ 'PERMIT NCO. 41F� .f SOIL TYPE - Sand - Loam - Clay - 'Percolation Test Required? YES NO Percolation rate - Min/Inch E - TYPE of STk +i: Absorptio field , total e z Length of a ch trench Depth of tre ches Size of grave i SEEPAGE PITS{ er of -" Size- ft . _ — Gravel size PIPING : 5iz Type Bldg . to tank Tank to dirt . bo yL L r Dist . box to fi d Openings Seale E NO Partial LOCATXON/SEP TIONS Foundation t tank t, i Foundation o absorption _ . i Absorption o lot line ft. Separation pits LOCATION S TEM ON PROPERT (circle one ) Front ar Left side - Rig t side - CCHMEN J \ E E l SYSTEM USE APPROVE YES NO Bui 1ng Inspector i 01/86 and vl Cot, Ic� own 1 �'f BUILDING, and ZONING DEPARTMENT q; Bay and Haviiand Road, R- D. 1 Box 98 Queensbury, New York 12801 t BIJI LO I NG I NSPECTOR F S REPORT NAME , LOCATION (�/U Date A? /_� Permit No . ✓ = - YE Footing/Pier F,prrns APPROVED NO Foundation Waterproofing Backfill 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 ELECT AL INSPECTION r DRIVEWAY APPR AL Final Building Survey Next scheduled inspection (call when ready ) Remarks- Building Inspector 6/86 ind-vl BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ` S REPORT !NAME - tX2*C LOCATION ir„/M r Date f, Permit' No . �fr'- ✓ = - Footing/pier Forms APPROVED NO Foundation Waterproofing Backfill LF'raming Roofing siding Masonry veneer Rough Plumbing Relief Valves - Ext . Porchesy�� - ^' Finished Flo rt5 s Interior Trim Stairs & Railings Cellar Drain. Tile Concrete Floors Plbg . Fixtures Gar . Fireproofi g Door Closers Smoke Detector ey wa ION : oundation Floors walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled fnspection (call when ready ) Remarks- Build ng Iinee�i� 6/86 and-vl �lvurn o� �ueer� �6urt� BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Oueensbury, New York 12801 BUILDING INSPECTOR r S REPORT NAME LOCATION Date, 'Permit No _ t / L * . * * * * * * * * * * ✓ - 5 Footing/Pier Forms APPROVED YE No Foundation Waterproofing Backfill teaming Roofing siding Masonry Veneer ugh Plumbing Relief Valves Ext . Porches Finished Floors _...... „ Interior Trim Stairs & Railings i Cellar Drain Tile� _ concrete Floors Plbg . Fixtures Gar . Fireproofing Door closers Smoke Detectors 777777 Chimney INSULATION : Foundation Floors Wa11s Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL_ Final Building Survey Next scheduled inspection call when ready ) Remarks- �} L� Building Inspector 6f85 md-vl _lvtan o� �ueerr .7fiure�{ BUILDING and ZONING DEPARTMENT Bay and Haviland ,Road, R. CI. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME LOCATION DATEB 'PERMIT No . , SOIL YPE - Sand - Loam - Clay - Percolation Test Required? YES Percolation rate - NO - Min/Inch TYPE of STEM= Ahsor tiO field , total 1 gth Length f ah trench Depth o tr ches Size of g SEEPAGE PI # er o Size- f Gravel size ' PIPING : Size Type � yp "- Bldg . to tank Tank to dist. ba Dist. box to fi d Dpeni.ngs Seale X NO Partial LOCATION/SER TIONS : Foundation tank ft. Foundation o absorption ft . Absorptio to lot line ft. Separati of pits ft. LOCATI F SYSTEM ON PROPERTY ircle one ) Front ear - Left side - Right side - CCMMEN SYSTEM O fmm Building Inspector 01/8 & and vi _ 3-3 awn a/ BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Oueensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME 00e C4 LOCATION Date/ Permit NO . "✓'' / r * tir * 1r * * * ,► * w * * * * * r * yr k ✓ APPROVED - S NO (/Ooo�oting/Pier Forms Foundation Waterproofing Backfill Framing Roofing Siding .... Masonry Veneer JOOOF Rough Plumbing Relief Valves Ext . Porches Finished Floors Interior Trim Stairs & Railings. AfF Cellar Drain Tile Concrete Floors air It Plbg . Fixtures Gar . Fireproofing Door Closers Smoke Detector Chimney "— IN SU LAT I ON : Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION . DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection (call when ready ) Remarks- Building Inspector 6/86 and-vl .J©w►e v� �ueens6etr�t BUILDING and ZONING DEPARTMENT Bay and Maviland Road, R. D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME LOCATION/ �,.. Date f / i s� Permit No . y oe' = APPROVED — YESQ Ve6'oting/Pier Forms Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext . Porches _ Finished Floors Interior 'Prim Stairs & Railings Cellar Drain Tile Concrete Floors P1bg . Fixtures_ Gar . Fireproo€ing Door Closers Smoke Detectors Chimney INSULATION : Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL_ no - — ILL+= Final Building Survey Next scheduled inspection ( call when ready Remarks- _ Building Inspector 6/86 and-vl BUILDING DEPT. COPY OF APPLICATION FORM 464EL, NEW YORK BOARD OF FIRE UNDERWRITERS. FILE THIS COPY WITH BUILDING DEPT. WHEN REQUIRED* TEMP DATE C#TY OR VILLAGE TO^W"S�HI�Pf �r (J CWNTY tT J ,I! ND MO. 014 ROAD AND POLE Nb.. - tj J /;C V T 4 f' vk.1.� !t+� / t. �r POLE NO. BETWEEN WXHAT TWO a ''} 4REM SESRLOCATED? / ILI S Imo` 1'�{ '4/�� t j SECTION BLOCK LOT OCCUPANT'S BUILDING NAME OCCUPANCY ,r✓ r,_ - !' 04 wic OWNER'S NAME ,'} ,.1 _ I '� fI -;['+ .,..1;:rJ* JR;. ' _ TE L. # ( C� ytiq ANDADORESS �/��,nr sF tWMENT 1` {:_ � +"� ✓ SUPPLIED # � ' 'I ( f'..! FROM THEIR ^" Gi OFFICE _ E+b,�r 1—1 ��p,r� DEFECTS BUILDING I$ NEW IL'T� OLD I.�i IWORM4 N£W ye7y, ADDITIONAL ClREMOVED 0 LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED Ne. of Fixbins r& BRANCH OFFICE USE NUIYBER OF OUTLETS Lanai Reeeptadea MOTORS HEATERS CIRCUITS ONLY Leea ti�oom CrIIIIIO 'YM N 'Is H.P. No. Wets No, A.W.G. INSPECTION 8neileil iMrdM.I Blaet.f No. Type Each Each Oelloa owt- stile be" Beer nicer Ise FI, 2" F I. Srd Fl, REMARKS: LIST OTHER ELECTRICAL DEVICES POD SET FDR TH ABOVE: DO NOT USE THIS SPACE. N T h1a aPWicatkm is intended to ewer the above-INted equipment to be impacted hot if at time of inspection thfwe is found edditiord Wuipmmt not above Riled, you are authai:ed to make "m inepearion and adjawl the too to ewer the edditiORd aquWmeM, as pro ~ bV fhe applicant. TOTAL SIZE OF ELECTRIC SIGN WATTS FEEDERS LAMPS CHARACTER EXPOSED GAS TUBE SIGN OF YVORK CONCEALED TRANSFORMERS OF VA WORK TO BE INUMBERI (CAPACITYT STARTED COMPLETED SIZE OF SIGN SERVICE OVERHEAD UNDFROROUN13 MAKER ENTERS OF SIGN ILOI ON EGA$NEARS STEO J ,( / / / N"v OLDED AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION, ALL SPACES DATE OF MUST BE 'FILLED IN OR APPLICATION MAY BE RETLIRNEO. APPLICATI91m . PRINT NAME AND ADDRESS NAME OF { SIGNATURE s APPLICANT ' r �°}� l �' f `�� OF APPLICANT STREET ADDRESS f!4 '' Xi TELEPHONE # ,ZIP LICENSE NO. CP IOTSY ORT OFFICE i! CODE '�- WHEN APPLICABLE 46 EL (REV. 1/845) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING, I £f} i I r � j If! .� t� �� � + �� ��0 S �� ��� �� i ym1 � �� I ��( �R � ' Vl { � � � �� � � {\ �'S � � . � �� w �, h �� f_ . _. _.._ �- -- .. _.� ... _.�.r . .�:�_�.._ . . .. ... .__._. __...�..._.__�___..�._._.�. ti � � ��. � c � � ,axe �� � 1 � ( 1 J ' � + _