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1988-267 CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date August io 19 _2_8 1 This is to certify that work quested to be done as shown by Permit No. 88-267 has been completed. This structure may be occupied as a One Family Dwelling Location\\ b Mud Pond Road Owner Robert & Mary Moser By Order Town Board TOWN OF QUEENSBURY Building & Zoning Inspector BUILDING PERMIT TOWN OF QUEENSBURY No. 88-267 WARREN COUNTY, NEW YORK o PERMISSION is hereby granted to Robert & Mary Moser N N OWNER of property located at Mud Pond Road Street, Road or Ave. ,! N 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. OWNER'S Address is 9 Crestwood Dr. x' Glens Falls, N.Y. 12801 0 't 2. CONTRACTOR or BUILDER'S Name Same n 3. CONTRACTOR or BUILDER'S Address 0 Same 4. ARCHITECT'S Name a. ro 0 5. ARCHITECT'S Address a. 6. TYPE of Construction—(Please indicate by X) (x)Wood Frame ( ) Masonry ( 1 Steel ( ) 7. PLANS and Specifications No.24' x 40' as per plot plan, specifications and application including Septic system Enid o; 8. Proposed Use One Family Dwelling w $5.00 C/0 $ 70.00 PERMIT FEE PAID —THIS PERMIT EXPIRES December 1 , 19 88 (If a longerperiod is required an application for an extension must be made to the Buildingand Zoninginspector of the 9 q PP � P town of Queensbury before the expiration date.) 0 Cig Dated at the Town of Q bury this 23rd % Day of May 19 88 SIGNED BY for the Town of Queensbury Building and Zoning Inspector .r:,)'�.h/N OF QLiE .:,'e4:..,-. TO BE COMPLETED BY BLDG.-DEPT. � � IC� C � 1�1 [� �] Application No. �JJ � _ wn o/ Queenilury Permit Issued 19 (� BUILDING and ZONING DEPARTMENT Permit Expires 19 MAY 21°W$ Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation Queensbury, New York 12801 Variance No. 3'U1L.D1NG & CODE DE T. Site Plan Review ,o. /] �r a '' "$� ApPrr ed ID: : 1 !'/�l-f 17 ,,,p8APPLICATION FOR 1�( �(� �� 1,“1 I . 0, 4-4 //VC, • BUILDING AND ZONING PERMIT * * of * * * as * * * * * * * * * * * * •*• * * * * * * * * •a• * * * * *• * to * * ::•.* • 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: �i(.' , Aek/ /9015g,----- P.O. Address e %,ZO®Z ,4,9Z )/,�/J 4/// /, /-4. 77 Tel. /7f f ....- ,ram © Tax MapNo. y /Z //Z,Zi Property Location: ///Y.L �✓/ %�?�� ,of c�Ji� � Street number or bui _:Iing lot number . . Subdivision name (if applicable) �` THE SON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS: 110 Name P.O. Address Tel. No. Name of builder A /� Address Tel. Name of plumber Address Tel. Name of mason Address Tel. 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 // •- ft X 3/ ft. * Existing building(s) Size ft X - ft. . PROPOSED BUILDING AND USE: * • Existing building(s) Use • Size of new structure �� ft X Lb ft * Foundation-pier/slab/crawl/partial/( * Proposed building, distance from property line (circle one) * Front yard 5-0 ft Rear yard Z /7--- ft No. of stories (habitable space) * Side yards • 5 ft and 70-f- ft Height (grade to ridge) ft. * If on corner, setback from side street ft If residential, no. of families / No. of rooms(excluding baths) 5 * OCCUPANCY INFORMATION No. of bedrooms * * PRIMARY BUILDING - No. of bathrooms t X One family dwelling Primary heating system 1' L&-e-i * Two family dwelling Type of fuel ��—L��T r * Multiple dwelling / Number of units No. of fireplaces to be installed xPermanent occupancy Will a wood stove be installed? - — * * Transient occupancy Central Air conditioning? * Business BUILDING STYLE, PRIMARY STRUCTURE * Industrial * Other ' Contemporary Log cabin * If addition, what will use be? fp—e• ranch Mansion Duplex -Split level Old style Bungalow * Cape Cod Cottage Other * ACCESSORY BUILDING- Colonial Row Town House * ' Detached garage/one car/ two ca car ( CIRCLE ONE PLEASE ) * Attached garage/one car car/_ car * * * * * * * * * * * * * * * * * * _Private stora I ding ESTIMATED MARKET VALUE OF * Other CONSTRUCTION , CC 00-0 • INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED! Form BPA 4/86 and-vl BUILDING PERMIT APPLICATION CONTINUED - • BUILDING SPECIFICATIONS: • Type of construction, food fram) fire safe,etc. Will any second-hand or-ungrac1ed lumber be used?- If•.so, for what? f O i C/ -- Foundation wally material ••j��,)/>0 .- Thickness • Depth of-foundation below grade (to bottom of footing) *-2. --G' IA-•- Will there be a cellar? *-5 Heated or unheated? 14A56.0 Floor. sq. footage ?' O sq ft Will there be a basement? Alp Will any portion be used as living space? /(.C. (If so, what portion? - sq.ft. - - Type of use? Type of roof - gT6iT /flat/shed/other Material.-of roof Size, wood studs 7"X (;, " spacing / /""o.c. length ft. . Joists(floor beams) 1st. floor -Z "X /P " spacing / .("o.c. span —'-/ft. Joists (floor beams) 2nd. floor "X " spacing "o.c. span ft. Overlays(ceili-ng--beams) -- "X " spacing "o.c. span ft. Roof rafters "X "--spacing o.c. span ft. . Roof trusses (pre-engineered) spacing ( "o.c. span Z'/ft. c- Exterior wall finish y-- // / - Of what material? �G—'e/»mC2.-yj 479-4 .�-X Interior wall finish 2,, -y e;-.!:4;-�c- . If a garage -is to be attached-,__des r.ibe,_materialstobe used_forFIRESEPARATION: /U /i-- Is there to be an opening between garage and dwelling? 0- If so will a Fire-rated door, enclosure, and self-closing device be provided? / P-- Will a flue-lined chimney be installed? ,i(J Height abo�J e roof ft. Depth of chimney foundation below grade ft. Depth of fireplace hearth ft in- Water supply - Municipal o private wel SEPTIC SYSTEM _ Distance from ANY private well(including adjoining properties /d 0 -I- ft. (A separate application is necessary for any repair or new installation of septic system) Town of Queensbury AFFIDAVIT STATE OF NEW YORK County of 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 comolete statement if all proposed work to be done ,on the described premises and that all prov'sions 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 uch.- rk is • author zed by t - owner. ;e7l SWORN TO EFO' E ME THIS Signatur :,,, :l -� �__ Owner, owners agent,arcnitect,contractor . da .f 19 Notary •ublic, Warren County, N.Y. * * * * * * * * * *. .* * * * * * * * * * * * * * * * * * * * * * * * * * * •* * * * * * * * SPE IAL CONDITIONS OF THE PERMIT: • • • 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 following: 1 . Gross floor area �r A4 ,t(. 0--____ Li +. 2 . Type of heat 4 e__, i 3 . Is the building mechanically cooled? i" 4 . Percentage f area of windows and doors /5 6 Z- • A. Over 16% my • 1 . U valu of gross area of walls , roof/ceiling a-nd floors exposed t ambient conditions .,,f0'' 2 . Floor over heated paces YE5 NO a. Are foundation lls insulated? YES NO rl. If YES , what is the R value? . 3 . Slab on grade YE NO a. If YES , w4t-is the R value o., f insulation around perimeter"-of floor? 4 . Is base•me` nt 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 2 . R value of exterior walls /U q.) - R= - 3 . R ,value of glazed arear-itA\ ,J• 2- 24o 4 . R value of doors _ e?- 1 3 r .. 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) ;,J2-/ ✓,, 9 . R value of heated basement/cell r ,wails (below grade) 10 . Type of insulation (4 =,...1- - _ -.S' C. Controls P 1 . Thermostat maximum heat setting gal D. Duct Systems • 1 . Is duct system installed in unheated spaces? YES e('NO ,/ a. If YES , R value of duct installation ' B. R value of duct in other areas _• • E . Piping Insulation f( ,��� 1 . Size of hot water or cooling carrying agent pipe / 2 . R value of pipe insulation / f F. Service Water Heating O 1 . Performance efficiencylg.:7 2. Temperature control setting maximum /yoe, G. For Swimming Pool Only • 1 . Maximum heating a - • Telephone No. f i I�Y-31/ Z1 .--) "--y-16-2,0) applicant ' s signature) . r Y�% INTERIM BUILDING PERMIT PERMIT APPLICANT I�d G2�- Aos E 2_ CONSTRUCTION LOCATION Moo n" 12n . EFFECTIVE DATE A'4 2 ) q cRV APPROVED BY SPECIAL CONDITIONS : P,c,- cFAA•Ci LUI ISSUED hjC(oGvi & Padc6-557,(1 . CC) O 5 i u C_7- 1 d,`l /44H This will certify that all submittals for a Building Permit have been received and fee has been paid . During the processing of the Permit, the above named may begin construction per plans submitted . It is the responsibility of the applicant to obtain the Permit from the Building Department, following processing . POST THIS INTERIM PERMIT IN A CO PI UOUS 0 ATION ! ! Building & odes Department • . TOWN OF QUEENSBURY iI/1'I b- Of Qua i4A* APPLICATION FOR SEPTIC DISPOSAL PERMIT DATE - i / A LOCATION OF PROP R Y FOR IN , ALLATIO c9 iz/ p`¢ 52-2-12. Z Owner's Name: , , 0 ie p ���lJ ��� (� Tele hon///7 ' / Address: 2 e2,724 ---e:.9,fge, ' - -- C44,-/..J5 S !/� , /Zcivc°/ Installer's Name: Telephone: Number of bedrooms (residential only) _ Total daily flow (compute @ 150 gal per bedroom) Ll S-0 Topography: circle one: Flat ollin_ Steep Slope % of slope Soil Nature: circle ones Sand Loama Clay Other / Depth: feet / Ground Water: At what depth? ` 1 /Pr- feet Bedrock or Impervious Material: At what depth? /U /i"" feet Percolation test: circle one: of requirf required / rate min. inch. Domestic water supply: circle one: Municipal , Well Other IF domestic water supply is a, Well: / Separation: Watersupply from Septic absorption 6 o %-1--" feet PROPOSED SYSTEM: Septic Tank I 0 00 gal. (minimum size: 1,000 gal.) TILE FIELD: Each Trench ..S"'S feet / Total system length a 0 feet SEEPAGE PIT(S): Number of ize each eet Size of stone to be used it a / Depth or Thickness 1 feet - * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * IMPORTANT ... ...Please...LIST NEW EQUIPMENT TO BE INSTALLED * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * l 10 0 0 CA S- i 1 ,/1 :0 1 .1 cx) 4 p Fi„ rt ts_&,-- P‘ ,0:,..74.-C) (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 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 ide by these and all r quirements of the Town of Queensbury Sanitary Sewag e�ial Ordinance Signature of respons. e person: • Date .2 /Y Town of Queensbury Building and Code Department Bay at Haviland Road Queensbury, New York 12801 (518) 792-5832 . .. ..,.r .,. - n ni .rr . . • BUILDING DEPT.COPY OF APPLICATION FORM 46-EL,NEW YORK BOARD OF FIRE UNDERWRITERS. FILE THIS COPY WITH BUILDING DEPT.WHEN REQUIRED. • (TEMP.#(CITY OR `D �• ,t( f l� VILLAGE TOWNSHI 'j '� 4tG/t-- COUNTY lsC#(9 ." ` J�// STREET AND NO.OR // �/ ` /// ROAD AND POLE NO. /�/L� 6� srr' /f" POLE NO.BETWEEN WHAT t L CROSS STREETS ISWO �`� `� PREMISES LOCATED? SECTION 5Z-9 BLOCK LOT • - OCCUPANT'S - BUILDING NAME OCCUPANCY W L 1✓I v! n OWNER'S NAME '/�- /,� sis'/ C`�JJ`rYT /J/� �/ J%"J�}�J�'f AND ADDRESS 4,1, F 4,, ,G st',,e � ,L,�%l G'G l(!/+._ TEL.# iT �/ �/ CURRENT ���I ,,,ttt G/ SUPPLIED J�i {O C r FROM THEIR r , "1. ( .� OFFICE BY r` BUILDING WORK DEFECTS �IS NEW OLD •❑ IS NEW % ADDITIONAL❑ REMOVED ❑ LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED NUMBER OF OUTLETS LampfReceptacles MOTORS HEATERS CIRCUITS OFFICE USE Loca- ONLY tion Side Attaeh't H.P. Watts A.W.G. Ceiling Wall Recep'Is Switch Pendant Bracket No. Type Each No. Each No. Gauge INSPECTION Out- side Sub- base • Base- ment '1st Fl. ' 2nd Fl. 3rd Fl. • REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: DO NOT USE THIS SPACE. This application is intended to cover the above-listed equipment to be inspected but if at time of inspection 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 by the applicant. SIZE OF ELECTRIC SIGN TOTAL MAINS FEEDERS LAMPS WATTS CHARACTER EXPOSED GAS TUBE SIGN OF WORK CONCEALED TRANSFORMERS OF VA WORK TO BE . (NUMBER) (CAPACITY) STARTED - COMPLETED SIZE OF SIGN SERVICE OVERHEAD - UNDERGROUND MAKER ENTERS BUILDING - OF SIGN INSPECTION REQUESTED ON OR AS NEAR AS POSSIBLE NEW n OLD 111 AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES DA;fir /MUST BE FILLED IN OR APPLICATION MAY BE RETUR D. APP DPRINT NA E ONAMD ;D�„ r��� ` X SIGNATUREi �j � APPLICANT 6�' i`OF APPLICA // STREET ADORE IS /?61 `/G� /J// J�QTELE/PHONE# POSTOFFICEI. b4". ,Y f�J" i �F/ ' / ZIP CODE/sLU�/ LICENSE WHEN APPLICABLE 46 EL (REV. 1/86) A SEPARATE APPLICATION MUST BE FILED1 FOR EACH SEPARATE BUILDING MIDtIE DEPARTMENT INSPECTION AGENCY, INC. `Ft'ctrical-Building-Plumbing-Fire Inspections s Date • = 'so" lector Idlifhl* T constitutes certification that the above installation, but not the equip- ment itself, has been visually inspected as of this date pursuant to the applic- able codes. If additional equipment should be introduced or alterations made to the existing system or struc- ture, application for inspection should be submitted promptly to this Agency. Jown o/ Queeni4ar, BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING/11051; INSPECTOR ' S REPORT NAME LOCATION MUO PO,v0 p 8 Date , /3/ W Permit No. �b 67 * * * * * * * * * * * * * * * * * * * * * * * V = APPROVED - YES / NO Footing/Pier Forms Foundation Waterproofing Backfill AFraming Roofing Siding Masonry Veneer V ) ough Plumbing Relief Valves Ext. Porches . Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg. Fixtures Gar. Fireproof in• 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- ._ ( n _ , li Building Inspectol; ' 6/86 and-vl _town of QueQni1urj BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME X%y// LOCATION )e//�/ ,ALAe/46 DATE ,S yl / PERMIT NO. SOIL TYPE - Sand ' Loam Clay - Percolation Test Required? YES - 4 Percolation rate - Min/Inch TYPE of SYSTEM: Absorption field, total length -"— Length of each trench ep Q Depth of tr'nches Z.•-3 T- Size of gra -I ,3 SEEPAGE PITS Numbe o • Size- f _ ft Gravel - 'ze PIPING: Size Type Bldg. to tank q 5-ctI-140 pyr--, Tank to dist. tox Lit Dist. box to fi- d/pit 19UL _ Openings seale.. NO Partial LOCATION/SEPA4T •NS: Foundation too tank lJ ft. Foundation /to abso ption 715-ft. Absorption/to lot 1'ne Separatioyi of pits ----Tz. LOCATION /OF SYSTEM 0 PROPERTY(circle one) Front - - Left sLde - Right side - COMMENT.: • SYSTEM USE APPROVED YES 0 Bui ding Insp cto • 01/86 and vl bi /elfawn of Queenáury J BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME .#/f<.,,77. LOCATION f/ </%/ Dates /1/ Permit No. g---KWY * * * * * * * * * * * * * * * * * * * * * * * ✓ = APPROVED - YES / NO Footing/Pier Forms Foundation ta aterproofing ckfill Y/•.. 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 INSPECTION DRIVEWAY APPRIVAL Final Buildin; Survey Next scheduled inspection (call when ready) Remarks- icirA 6// Building Inspe for 6/86 and-vl ei/ J.' bUU ..own of Queeniur, � BUILDING and ZONING DEPARTMENT ri ay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR' S REPORT NAME LOCATION y32.4d /�7 .,ate- ze Date S= S` /ff Permit No �` � - * * * * * * * * * * * * * * * * * * * * * * * ✓ = APPROVED - 4 / NO ,oting/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 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- , fZINCL- Building Inspecto 6/86 and-vl Jown of Qur1 BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME rapn 1 AIDS(-re LOCATION /Pal }QQ,ij E Date /j / Permit No. 1 * * *, *///* * * * * * * * * * * * * * * * * * * ' ✓ = ' APPROVED - YES / NO Footing/Pier Forms / Foundation / Waterproofing Backfill Framing L / )<Roofing }cSiding Masonry Vene_r Rough Plumbing• )<1 elief Valves (Ext. Porches �. }CFinished Floors ' ` SU-MS XInterior Trim K Stairs & Railings Cellar Drain Tile Concrete Floors >Plbg. Fixtures Gar. Fireproofi g Door Closers YSmoke Detector- 1/ Chimney INSULATION: Foundation Floors Walls ! -7 Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey / Next scheduled inspection (call when ready) Remarks- kAa(A6-U eXIMC rto0 KS I-N1St4L1D • LaboAt S -- i Build n Inspec or 6/86 and-vl a_Tct- I4/(9,°1( /4°5 g".- e eic Gz 114V r ,z/c/ e)/ ev diTri SC/gie IN/ r t7j e s 7:/// aQ l yr I4._":...i Q 7" y..... __... 0 .9 ; .•I.C. k"z:l.._o. f / ;j x,;.,',, `• f • • • • O' - � f ate. -.. Oaf. 6 N d • 041c., • - ' ....''' _-_,',._-,.....: . t • _ • • -• 8