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1989 w .. . . ... NINE CERTIFICATE OF OCCUPANCY , TOWN OF QUEENSBURY 1 WARREN COUNTY, NEW YORK ad Late }- 19 �f This is to certify that work requested to be done as shown by Permit No, 1. 989 has been completed. This structuree_, may be cm=upied as a Dwelling Location Owner By Order Town Board WN OF QUEENSBUR'Y Builds & ZcMis$ 1napector . J BUILDING PERMIT TOWN OF QUEENSBURY No. 1989 WARREN COUNTY, NEW YORK + r PERMISSION is hereby granted to Elmer K. Evans OWNER of property located at Old Bay Road Street, Road or Ave. in the Town of Queensbury, To Construct or place a Dwelling & Saw"* System ExI at the above location in accordance to application together with plot plans and other information hereto filed and ACi approved and in compliance with the Town of Queensbury Building and Zoning Ordinance, v t. OWNER'S Address is R . Dv#1 Imo+ Lake George , Now York 12845 2. CONTRACTOR or BUILDERS Name • Re S . Bates 3. CONTRACTOR or BUILDER'S Address Fort Edward , N .Y . O r 4. ARCHITECT'S Name I.y ftlf flr " 5. ARCHITECT'S Address 6. TYPE of"yConstruction — (Please indicate by X) E*) Wood Frame I I Masonry i I Steel ( ) 7. PLANS arx! Specifications No. , 24 Eta by 5D fto as per plot plan & specifications sutintitted iucludin 8. Proposed Use One familjrydwelling Sewage System 6/0 -50 QD s 40. 00 PERMIT FEE PAID — THIS PERMIT EXPIRES (if a longer ge period is r squired an application for an extension must be made to the Building and Zoning inspector of the town of Oueansbury before the expiration date.) Dated at the Town of QueensbLuvthis 1j: Day of Am"at 13�� SIGNED BY for the Town of QueensWry Building and Zoning Inspecttor N OWN OF QUEENSBURY {Spare inside block trr Ix• fillr•rl in 1a% WARREN COUNTY, NEW YORK � Building Insrx•r tirrl Application forPo: mil , ;, ),w d- - BUILDING AND ZONING PERMIT , 't.I "I= l• Nl ,iI-v, . . . . . . . . . . . . . . I,{ tr-Iet . . . - . . . . - . THREE 131 Copies of a PLOT PLAN, Drawn to scale showingthe actual dimensions of the lot to be built < " " + " + L upon, Te exact size. and location on the lot of the !wilding to be erected or altered MUST BE SUB- MITTED WITH THIS APPLICATION. TOWN OF QUEENSBUr� Y A PERMIT MIDST BE OBTAINED BEFORE BEGINNING WORK ANSWER ALL OF THE FOLLOWING. A U to S The undersigned hereby applies for a permit to do the following work 7 $ 9 tI II I2 I 213141 b 6 which will be done in accordance with the description, plans and specifi- . ! , , ' , + a cations, and such special conditions as may be indicated on the permit. The owner of this prro�rt is: . x L. �. .1t . . 'J'r+4PNsf . . . . . . . . . . . . . . . . 11 1 - r I . !a Xi e e5P0A - Ne 'c} P C7 A0DRESSI The person responsible for supervision of the work insofar as the Building Code and the .Zoning Ordinance apply is: . . . . . . . . . . . {NAMyE-Y,"�r,�+ . . - �P0 ADDRESS �*,� - -q. Name of I3uiiderk4f1R �T .AG.-.? . .,t . . yy�� . . . . . . . . . . . . Address b Ror C- �s 44 !��, se,1 '� - yy . Name of Plumber . . . - . 7J .b' C - ff . rIG. . . . . . Address . �oJG' 7'" .zr ,�"GLJr7'I 'L1°%.,� Name of Mason - . t . . - do . . . . . . . . . Address :r . . y "�,r. . . . . . . . . . . . . . . . . . Lot Number . . . , - . . . . . . . Unit . , . . . . . . . . . . Estimated value of proposed work. S .-'1�44040 . . . . . . . . . . . . . . . . . . Name of Village . - . . . . . }.�, . . . . . . . . . . . . . . . . . . . . . . . . . Name of Street . . . [" .�..lf 4;� '4 ' . . . . . Side of street-. north east ❑ , south ❑ , w Nearest Cross Street . . .2246' • . . . . . . . . . . . . Distance freirn this cross stree . - Ft. Property is north M, south ❑ . east c i , west ❑ from Cross Street If on {Corner, .which corner, northeast 0 , northwest E3 , southeast ❑ . southwest (Designate by marking with an "X " in the correct space.) NATURE OF PROPOSED WORK OCCUPANCY N. Construction of a new building. Main Building Addition to a building. One-fart7ily dwelling Q Alteration to a building_ Two-family dwelling L� C7 Demolition of a building. fam'sly apartment house Store building . . . . -car attached garage Other: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Accessory Building One-car detached garage 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. Ytttsnes, the location and size of the property, the location, site and setbacks of pro- NORTH posed buildings, and the location of all existing buildings. ��..JJJ Show proposed building(s) in dotted line and existing tt,uilding(s) in solid line. 1 Size of property . . , 4;ZQ" G? . . . . . ft. x . vv�cnolo. . . . ft. Size and use of existing buildings, if any . . . . • . 0 "t Size of proposed building , . . - ..,;$.jai. • ft. x ft. Height (from grade to ridge) . . . . . . . .i .' A it. . . . . . . Front yard . . f . . . . . . . . . . . ft. Side yards . . . . . - . . . .,rr . . _ ft. and . . . s`+ . . . . . . . . ft. Rear yard . . . . . . . tP.T/f . . . . . . . . . . . . . . . . . . . . . . . ft. SOUTH If on corner, setback from side street . . . . . . . . . . . . . . . ft. Note: All distances are nek as ocsssrrad irons so, side fine to nearest part of building. IOVERI (cont'd.) BUILDING SPECIFICATIONS., Kind of construction: Wood frame, fire safe. etc.? . . . . . . . . '�'�. . . . f; . . . . . . . . . . . . . • • . . . . . . . . . . . . . . Will any second-hand lumber be used? . . . . .144? . . . . . If so for what? . . . . . . . . . . . . . . . . . . . . }�, . . . . .�. . . . . , . -�f.-� orw . . . . ?�'. , . 5. . . Thickness Material of foundation walls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Depth of foundation walls below grade . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . � . . . Continuous foundation? . . . . . . . . . . Will there be a cellar? V e.%:5 . . . . . . . If so, material of cellar floor . . . . . . . . . . . . . . . . Type of roof: Sloped or t? . , _ . .,$7 !4 . . . . . . . . Material of roof . , . ,� �Q .�k . . .- 4rvt . 44. . . �?"°' . . . . . . . . . . . . . . .. . . . . . . . , . . 114V. 1- 1 . . _ . ft. Size, wood studs . . . . . . . , �. . . . - . . . . . " x . '", spacing . ./. cw!.. . . ."o.c., length . . Size, floor beams, 1st floor . - . . " x . - - . . . . . . . . . . ", spacing span . . . . . . ft. Size, floor beams, 2nd floor a . . . . . - ", spacing "o.c., "n . . . . '. ft, Size. ceiling beams . . . - . - . . . . . . . . . " x . . t� . . . . _ _ . . . . ", spacing . . . - . 1. - , - - "o,c,, span . . . . . f ?r . . , , , . ft. Site, roof rafters or beams �,f- . - . .�.. .y.. . " x . - dc`s . . . ", spacing , . . . . . . ram . . . . , "n.c., span . . . . J.-4 I� . . . . . . ft, Exterior finish . . . , - AZfI{ 1. . . t lJ f . . . . . . . . . . With what. material? . . . . . . . . . . . . . Finish of interior walls . . . . . . . -5kc. ,4. �ke, ', . . . . . . - . . . • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . If garage is to be attached, of what material is wall between garage and main building to be constructed? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Is there to be an opening be weer garage and building? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . » . . , . » » . Kind of heating system . �Ve:)7.". c�Z_ i . Jr. . . . . . . Oil burner a:-eeo : . . . . . . . . . . . Will a flue-lined chimney be provided? . )qCVJ;L4015qAiepth of chimney foundation below grade . . . . . . . . . . . . . . . . Height of chimney above roof. . . . . .;L 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . I . . . . . . . . . . . . . . . . . . Will there be a fireplace? . . . . c' . . . . . . . . . . . . . . . . . Depth of fireplace hearth . . . , , . , . . , . . . . , . . . . _ . Will a toilet be installed? . . . . ' �. . . . . . . . . . . . . . . . . . . . . . Will a kitchen sink be installed and connected to water supply? . - �� .C'. - . . . - . . - . . - . . • . • . . • • . • • . . . . . . . . . . . . . . Water supply (pub a Wr- z1,pp4vyLc= pump) . . e> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Distance of cesspool from any private well . . . . . . . . . . 4 - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . feet Will drainage system be provided with required traps, cleanouts. and vents? . . .}=. ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Town of Queensbury AFFIDAVIT County of Warren State of New York: I &wear that to the best of my knowledge and belief the statements contained in dds application, wgwther with the and apurf6aatisra *ttb- arc a true and complete statement Of all proposed work to be done On the described premsem and that a�i*iatw of Illutll;D� � or eai, 1No CODE, THE ZONING ORDINANCE, and all Other La peruin' the proposed work *hall be core whe*Ler and that such work is autlwrised by the owner. Sworn to before me this Sitnsthl . . . . OWNER. Ow1+I t:R'S AGENT, ARC411TECT, CONTRACTdR _ ---- - --- day of. . .. . . ... . . . . . . . . . . . . ... . .... . .. . . . . . . . . . . 19_ . . . .... .... . . .. . . .. . . NOTARY PLRLIC. WARRaN COUNTY, N. Y. SPECIAL CONDITIONS OF THE PERMIT: 4 my ...... ...... ........ . ....... .... .. ...... .. . ...... . ...... ............ ...... . ................,.................. TOWN OF QUEENSBURY WARREN COUWrY, NEW 1( 0F; K Applicalion for A PERN.IT TO CONSTRUCT , ALTER OR ENLARGE F, `3EWAGE DISPOSAL SYSTEM. FOR A PRIVATE RE:ai l bENC:E WI T f it -N THE TOWN OF QUEENSBURY Mail or bring this application to : Building & Zoning Department Queensbury Town Office Building R. D . 1 Bay Road Glens Falls , New York 12801 This application for a Sewage Disposal Permit must. kre accompanied by a plot plan drawn reasonably to scale showing all dimensions , the size of the lot , the loc _; tiOn on the lot of the water supply and sewage system . 1 . Name and mailing address ofj applicant : 4 2 . Specific location of property : c` L Aggz RA STREET AD JN. LER 3 . Application is for : New construction of private dwelling . Alteration or enlargement of existing sewage isposal system . 4 . Description of building : a . number of bedrooms b . garbage grinder _ ». ;JC3 5 . Topography e ----- i-r-' gentle s ope , etc . 6 . a . Nature of soil . ( Describe to a derth of b feet if the field is to be used or 1U feet if leaching fits are proposed , giving thickness of various strata such as �� top soil , clay , loam , sand , grave ?- , rock , etc . ) b . How determined ? 7 . a . Soil percolation test made by -� ( Refer to Part III , Bulletin 1 , NoY . a . L7ep1'etment o � Health b . Percolation test notes submitted ? OA�O ) - — - -- Be Proposed sewage disposal system indicated on attached plan or sketch ? YES Ott 90 Date when construcjk ion will commence uo _.• .crc . It is hereby agreed that if thi = apv location anr3 att : ch ¢d { 1 :3ns dated or any amendment or revi inc: thereof , -�-- - are appFoved , inst�ajl'� -taon of sewage disposal facilities will be made in accordance with the details thereof as shown on such approved plans . Amo Inst. ed Bye Contractor m Sign re of ape icant Owner t L L r THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 41 STATE STREET, ALBANY, NEW YORK 12207 Date Feb it IA%ry g * j '�� Application No. on fide 242734 A 354639 THIS CERTIFIES THAT I only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of 61% r .l +►r�', 1l1d��p}�*� cw R" Nueo SbW- 1New ar in thefollowing location ; 8 men q,ll lst 1. 2nd h'd_ � r$t, �S,eetion Block Lot was examined on � { � 1 � �� JJJ""^""" a.nd found to be in c�o/l�lpltance with tole requirements of this ► oard. FIXTURE FIXTURES I RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES IINCANDESCIENTI FLUORESCENT I MY RAPORYr K. W. AMT. K. W. AMT, K.W. AMT. K. W. AMT. H. P. l3 27 1 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS I SPECIAL REC'PT TIME CLOCKS I BELL JUNIT HEATERS MULTI-OUTLET DIMMERS AMT. K. W- OIL H. P. GAS H. P. AMT, NO, A_ W_ G. AMT. AMP. AMT_ AMPS. TRANS. AMT. H. P. SYSTEMS AMT. WATTS NO. OF FEET Fr SERVICE DISCONNECT NO. OF S E R V I C E METER NO, OF CC. C4NP- A. W. � AMT. AMP_ TYPE Et]UlP. 2w 1 .R" 9W 3 .B' 3W 3 A' 4W PER AY OF CC- COND_ "0. OF HI-LEG OF HI-LEG NO, OF NEUTRALS OF NEUTRAL 3so cis wb OTHER APPARATUS: 1 -� i . Skra ►K a4 a rhos# C -■ ter' '+i 7' . - - ....�L�-.-._. 'dill htilm 23 f1CeclC * 'hux" 04 BRANCH iV NAGER S. G1 tt%s 17161 Ls , Ntub I'drK 1Z%Gj Per COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. Ce 00 ,S e fs*mc.. io h .k 3 spy. ,� o 4