8766 -
CERTIFICATE OF OCCUPANCY ,
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date T"8.77 ' '' 19 .L
This is to certify that work requested to be done as shown by Permit No.
has been completed.
65177:1f- YANAq- -1---- )E.L.--e_MVL42\
This 7 tructure may be occupied as a
triu t Rd-d4e Rcsazk
Owner -1)6\ kat&CI-/VO•rif---
By Order Town Board
TOWN OF QUEENSBURY
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•
Building & Zoning Inspector
CREATIVE "1NSTA•• PRINTING. GLENS FALLS N Y 12801 15181793-5658 •
BUILDING PERMIT
•
TOWN OF QUEENSBURY No. 8766
WARREN COUNTY, NEW YORK •
PERMISSION is hereby granted to David Schryer
OWNER of property located at Chestnut Ridge Road Street, Road or Ave.
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
ti
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is Triphammer Road
Glens Falls, New York
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I-1
2. CONTRACTOR or BUILDER'S Name
Vaughn Verwold
3. CONTRACTOR or BUILDER'S Address
Coach Road
Hartford, New York
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address (i
CD
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R.i
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel (X POGt and Ream
7. PLANS and Specifications
40 'x28 ' dwelling, 24 'x28 ' two-car attached garage
No. per plot plan, specifications and application submitted o
including sewage system.
8. Proposed Use
One-Family Dwelling
1-1
N-
$5. 00 C/O Paid
_ d
$171. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 1 19 85
(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.)
Dated at the Town of Queensbury this 18th Day of SPpi-PmhPr 19 84
SIGNED BY iii a-fl ' r� for the Town of Queensbury
Building and Zoning Inspect r
TOWN OF QUEENSBURY •
(Space inside block to lx filled in by
WARREN COUNTY, NEW'YORK Building Inspector)
lication for Application No. .
PPPermit Issued 19.
BUILDING AND ZONING PERMIT Permit Expires. 19.
Y,()11!I1L District
THREE (3) Copies of a PLOT PLAN, Drawn to scale •\1'1'I•' (11 bV 0 /
showing the actual dimensions of the lot to be built Iternar)o
upon, The exact size, and location on the lot of the •
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION.
5 -5—_ R _ 6- 1 0 0,1 iOV�JNOr QiJEEPSBURY
1 DATE RECEIVE. 'A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK
ANSWER ALL OF THE FOLLOWING. ,� 41984 •
The undersigned hereby applies for a permit. to do .the following work
: /^ ,®° P.P.
done •46Q.
in accordance with the description, plans and s ecifi- 11 1 2 0� 4 5 6
which will be P P i �'�1fs
cations, and such special conditions as may be indicated on the permit. I �
The owner of thisyropert is: . _
��/9v/.� �.c/?i y6I\ (R/i1/2n//I'I C K A)D g E i 3 P4 C LS V,y.
(NA'.1E) (P.O.ADDRESS)
The person responsible for supervision of the wor insofar as the Building Code and the Zoning Ordinance apply is:
. . V./9.V. .C.HV. . .V. .:i?.rv.CS.L:, . CQot.Ider . . . . . . .0ffti/D SCHRY6 MN' 1(D Gcrltis
(NAME) vagi.4 (P 0 ADDRESS) AI te.S
Name of Builder. . . V L 1) .6."; 11 Pl.) 1/ t R)V 0 LjJ Address COACH 12 D , . J-I_H KTFoxi)) %1/.y•
Name Of Plumber /3 rtct h Th•2 v 1^S Address .60CM T`I. .4./1116 . . ....... . .('/Etvs F/IL6_5
Name of Mason.kC rx s /7` 'I Address /ftlt7 o K. .pp, R-13
Lot Number Unit Estimated value of proposed work 3 s/D D t `o
Name of Village cP LEIt/.-.3 F %}L-LS
Name of Street . . .CJ ,ES 7 /l/ t) 7 1 1 12 G C Side of street: north 0, east ®, south O. west ❑
Nearest Cross Street . . J.1.0 L C_. kip / J3 Distance from this cross street l,--5 a Ft.
Property is north ❑,south ®,east i i, west ❑from Cross Street
If on Corner,which corner, northeast ❑, northwest ❑, southeast D. southwest
. (Designate by marking with an "X" in the correct space.)
. NATURE OF PROPOSED WORK OCCUPANCY '
® Construction of a new building. Main Building
❑ Addition to a building. One-family dwelling 0
O Alteration to a building. Two-family dwelling 0
❑ Demolition of a building. -family apartment house ❑
Store building ❑
;.-car attached garage
Other:
• Accessory Building
One-car detached garage
0 Other work. Describe Two-car detached garage ❑
Private chicken house ❑
• Private storage building ❑
Other:
•
ZONING SPECIFICATIONS. Fill in for new building, or addition to existing building, or a change of occupancy.
' • Indicate on the plot plan street names, the location and
size of the property, the location, sire and setbacks of pro-
posed buildings, and the location of all existing buildings.
NORTH Show proposed building(s) in dotted line and existing
huilding(s) in solid line.
Size of property ft. x ft.
' Size and use of existing buildings, if any
in ul
/
la
i m Size of proposed building ft.x d ft.
Height (from grade to ridge) ft.
Front yard , ft.
Side wards ft. and ft.
• _ Rear yard ft.
SOUTH If on corner,setback from side street- ft.. .
Note: All distances are net, as measured from street side
line to nearest part of building. •
(OVER) -
7-73—M . .
(cont'd.)
BUILDING SPECIFICATIONS.,
Kind of construction: Wood frame, fire safe, etc.?. . .p.(� i. . . .
Will any second-hand lumber be used? /V() If so, for what7 "—
Material of foundation walls Thickness
Depth of foundation walls below grade Continuous foundation?
Will there be a cellar? (1!0 If so, material of cellar floor
Type of roof: Sloped or flat? . ... i.O.i I.J. . . . Material of roof f/6 E I? G i/9=S /}
Size,wood studs " x ", spacing "o.c., length ft.
Size, floor beams, 1st floor " x ", spacing "o.c., span ft.
Size, floor beams, 2nd floor " x ", spacing "o.c., span ft.
Size, ceiling beams " x ", spacing "o.c., span ft.
Site, roof rafters or beams "x ", spacing "o.c., span ft.
Exterior finish . . . . . .1 O../ .R. 1.) C / .rr 1_• /Y Co cfA what material? / /iV/-
Finish of interior walls. . . .,fl NP. .i. .7. Y. . . . ....JL'.r. . . . . .t-. . 0 C..
If garage is to be attached, of what material is wall between garage and main building to be constructed?
i�ii G G. %rX . . .f.RJ y.L,ii.%/. D.i!/. t(C2 . 0i;fr<.2e1. %`.O 1!I._c,V
Is there to be an opening between garage and building? TE S
Kind of heating system . B U D. . ) . . Oil-burner ut coal?
Will a flue-lined chimney be provided? . . /Y% Depth of chimney foundation below grade
Height of chimney above roof
Will there be a fireplace? iV 0 Depth of fireplace hearth
Will a toilet be installed? 2'•C S
Will a kitchen sink be installed and connected to water supply? :'E .
Water supply (public water supply or pump) L!J G'-
Distance of cesspool from any private well feet
Will drainage system be provided with required traps, cleanouts, and vents? / -
Town of Queensbury AFFIDAVIT
County of Warren
State of New York
I swear that to t l of my knowledge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, are a true and co.e.plete statement of all proposed work to be done on the described premises and that all provisions of the BUILD-
ING 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.
Sworn to before me this Signature /
� '•'�
OWNEFj.OWNER'S AGENT,ARCHITECT,CONTRACTOR
day of 19 �/
NOTARY PUBLIC. WARREN COUNTY. N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
•
By
•
TOWN OF QUEENSBURY
BUILDING & ZONING DEPARTMENT
SEWAGE DISPOSAL PERMIT APPLICATION
1. Owner' s Name 0/iv p S C H 12 `% �
Address I ///,,`f7//I/i9L 2 Ri) 6 D is 3 ,1e
6 L6i s v,*LL 1 l /I/- `f. Telephone No. 2 - 7y4/a.
2. Property location L y(=.;7/U ; RID 6 c,
3 . Name of person or firm responsible for installing system a---
r ci tA) a.-V- c�S . Telephone No. 79
Address F/9 R J i Io i is % R L ('/F1Yi F/ 3
4. Number of bedrooms (residential buildings only)
5. Daily flow 1,312.3 c7 gallons/day
6. Septic tank capacity 0 U gallons
7. Topography: flat, rolling, steep
% of slope
8 . Nature of soil and depth 5 g /y/ 0 J ,VEL,, RO UL06-1R
9. If ground water, bedrock or impervious material is apparent at what
depth does it begin? ft.
10. Percolation test: A is required
• B is not required
C If required what is the rate minutes/inch
11. Water supply: municipal, well, other
12. Type of system proposed: drywell, tile field, other
Any contractor,, corporation, individual, etc. engaged in the construction
of a sanitary sewage disposal system who covers the same before inspection,
does not have an approved permit, or varies from the approved application
will be subject to a penalty of $250 as provided for in Section 6 . 010 of the
Queensbury Sanitary Sewage Ordinance.
Date 9' /0
PP
signature f a li ant
g
On separate sheet of paper submit a diagram of the proposed septic system
with all dimensions, including distance from any structure, distance from
property line and domestic water supply, etc. Include all dimensions of
the system itself. -
Form 3-82
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 WOO n /3I C/t I/ e E(_6( T IC soLfi R
3 . Is the building mechanically cooled? I/Q
4 . Percentage of area of windows and doors ao7 CCS 1M/7- E/
A. Over 16% Only
1. U value of gross area of walls , roof/oeiling and fl -�s
exposed to ambient conditions R of 3 (o o� /-LL)
2 . Floor over heated spaces YES NO
a. Are foundation walls insulated? cce) NO
1. If. YES, what is the ,R value? -j(p
3 . Slab on grade 41230 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 (' & L O
v /vn6R SLRB Gu /T/f /2_0 - / g0 tom- oar ,5n/✓A FoR ii,/SS,
B. Under 16% Only
1. R value of roof and floors exposed to ambient conditions_
2 . R value of exterior walls
3 . R value of glazed area
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 baement/cellar walls (above grade)
9. R value of heated basement/cellar walls (below grade)
10. Type of insulation
C. Controls d
1. Thermostat maximum heat setting (c r F
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
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 / /S (1F
G. For Swimming Pool Only
1. Maximum heating
p 293- '2 j)
Telephone No. / ��d%I
applicant ' s signature)
BUILDING DEPT.COPY OF APPLICATION FORM 46-EL,NEW YORK BOARD OF FIRE UNDERWRITERS.
FILE THIS COPY WITH BUILDING DEPT.WHEN REQUIRED.
TEMP.# DATE
CITY OR __
VILLAGE f f- nU C . T�r i•IL( _5 TOWNSHIP 6.tI 6k1.S L�(JRf/ COUNTY WI/�`)
N6i✓
STREET AND NO.OR � �/
ROAD AND POLE NO. /`P ' (� 5 i i'f l K / !) 6 67 (/v64 L+ -RI'b Crt lZ lJOLE NO.
BETWEEN WHAT TWO n JJJJJ
CROSS STREETS IS R 6G l?D '.Al Fo J?_1 5 :K')DI TION - .+ BLOCK LOT
PREMISES LOCATED?
OCCUPANT'S BUILDING ]�
NAME JA {� 1 D. S c H f Y[-'g OCCUPANCY $J -� ����V�� -•
OWNER'S NAME �1 7 % /P//I/f7/'11 c /{ (LL V, 7 G� / /�
AND ADDRESS le)4 v/i S G. fH K �4. i (r rL i." iIf 1 .�^ /)L LS TEL.# `�� / / LJ 4�
CURRENT /
SUPPLIED , j ° FROM THEIR 5 /�`Z, OFFICE
BUILDING NEW ���UILDING WORK DEFECTS '
OLD❑ IS NEW $ ADDITIONAL❑ REMOVED ❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
o. •
NUMBER OF OUTLETS LampfReceptaFixturcles "MOTORS HEATERS BRANCH CIRCUITS OFFICE USE
Lam. ONLY
lion Side Attaeh't H.P. 'Watts A.W.G.
Ce(I(ng Wa11 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 I 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 n
POSSIBLE NEW I I OLD
AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
PRINT NAME AND ADDRESS
NAME OF —1 / i
APPLICANT l>�:l li 1l I �C- }l'I• �%� DATE'OF q 1 i 44 i,s'
APPLICATION 4
� '.2 ? l l• Y 0
STREET ADDRESS 11 V�=� I ?A x ) � � 1 �f , `r11l, }'1',N."Y,('-e' �'e TELEPHONE# 'll� � /
CITY OR ,/'+ Y ZIP. G LICENSE NO.
POST OFFICE ! f?nq ``% CODE 1 2 a-O l WHEN APPLICABLE
46 EL(REV.1/84) A S PAFATE APPLICATIO MUST BE FILED FOR EACH SEPARATE BUILDING
TOWN OF QUEEN BURY
Building Department
Inspectors Report Date /40--/ie--
Name .cc/-/R y
Location C ALZ 57 1(0-/i Der e 1 .C)
Permit Na. Weather
A/R[:, //5'P Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing /- �,¢/e • (0/K.
Sheathing
Roof Felt
Roofing \ i
Siding
Masonry Veneer
Rough Plbg. / "N
Relief Valves /
Wall Board
Ext. Porches
Finished Floor
Interior Trim �_
Stairs & Railings(.,,." (ZJi
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures L�
Gar. Fireproofing/
Door Closers (,/
Chimney
Water Meter Inst. _
Septic Approval
Floors _
Insulation Foundation
Walls
Ceilin
Building Inspector
REMARKS
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date / 9/475"
Name �'Gf°7';.2&7 c'Z G
Location i L-fir%
Permit No. 6'7 Vieather
Rerna rks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves
Wall Board
Ext. Porches
Finished Floor r.
Interior Trim
Stairs & Railings
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fire roofin
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floor
Insulation Fot2n atiDn
Walls
Ceiling
Building Inspector
REMARKS
•
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date /37
Name_ C rf t✓L. ,
Location
Permit No. 7 � Weather
Remarks
Exca tja ti on
Footing Forms
Footing & Piers •
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing
Sheathing
Roof Felt •
Roofing
Siding %/"ii
Masonry Veneer
Rough Plbg. �/ /,4;� 4-z l fif,//7 1 f-
Relief Valves /'
Wall Board -/7)
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railings /
Cellar Dr. Tile (// 7
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers /
Chimney
Water Meter Inst.
Septic Approval
FloOrs
Insulation FoundationL-7Jf 7�F4t -
s-
Walls
Ceiling • • •
• Building Inspector
REMARKS
CCU—{%���_el?
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