6163 CP.) r:a-;c;
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date -1 19
?C)( iii,2
This is to certify that work requested to be done as shown byPermit No. `r -I'I
4F
has been completed. i
This structure may be occupied as a • `� `' ���'1'1�1 - '1 �,1"
Location � I� t �
Owner I (14,,6 S Kir
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoning Inspector
CREATIVE "INSTA• PRINTING. GLENS FALLS. N T 12801 1518)793-S858
•
BUILDING PERMIT
TOWN OF QUEENSBURY No 6163
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Martin C. Mosher
OWNER of property located at Lot 87 Helen Drive (St. #33) Street, Road or Ave.
in the Town of Queensbury,To Construct or place a One—Family Dwellingrt
ri
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.
n
1. OWNER'S Address is 4 Helen Drive
Glens Falls, New York
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2. CONTRACTOR or BUILDER'S Name
Same
3. CONTRACTOR or BUILDER'S Address
Same
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4. ARCHITECT'S Name rt. c'f'
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5. ARCHITECT'S Address ~
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6. TYPE of Construction—(Please indicate by X) C'
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(X)Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
26 'x56 ' per plot plan, specifications and
No. application submitted including sewage system
and two—car attached garage.
b
8. Proposed Use
fD
One—Family Dwelling F
$5. 00 C/O Paid
$ 80. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES May 1 19 80
(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.)
1-1
F-'
I•-+-
Dated at the Town of Queensbury this 29th Day of October 19 79
SIGNED BY . 10' for the Town of Queensbury
Building and Zoning Inspector
TOWN OF QUEENSBURY (Space inside block to lx tilled in bv
WARREN COUNTY, NEW YORK Building Inspector)
•
A lic�fioi #or Application No.
R� Permit Issued 19•
BUILDING AND ZONING PERMIT Permit Expires. ig
Zoning District ,
\ aloe o1 Work
il�ru� l by
cc
THREE (31 Copies of a PLOT PLAN, Drawn to scale I\l)! )1C'
showing fha actual dimensions of the lot to be built
upon, The exact sire, and location on the lot of the
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION.
o -- �y�{ . . �c — 9 / 979 TOWN OF QUEENSES.r:.
C! i DATE EslW E B
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK QC I G 'd .H/9
ANSWER ALL OF THE FOLLOWING. •
Thu undersigned hereby applies for a permit to do the following work A.M. P.M.
which will be done in accordance with the description, plans and specifi- 7I8I9I10111I12Ih12I3I4I5I6,
cations, and such special conditions as may be indicated on the permit. /6 `e
he wner of this pro -rty is: l
(NA''E) IP.O.ADDRESS)
The person responsibie for •supervision of the work insofar as the Building Code and the Zoning Ordinance apply is:
(NAME) (P.O.ADDRESS)
Name of Builder. . !1/4.--. tr'\--4' Address
Name of Plumber (\---- -4')'11-� Address
4� Nathe of Mason � � --'' - Address
✓A\'9 Lot Number , 7 Unit Estimated value of proposed work S O 64_,--c__ -
Name of Village ''//� - �Li-
Name of Street . /<L A, e A Side of street: north 0, east 'pi, south 0. west 0
Nearest Cross Street . -4-eei i/-i'c./J `hp' ' Distance from this cross street /Z e O Ft.
Property is north 0,south 0,east 1..-i, west ❑from Cross Street -
If on Corner,which corner, northeast ❑, northwest ❑, southeast Q, southwest
(Designate by marking with an "X" in the correct space.)
NATURE OF PROPOSED WORK OCCUPANCY
0- Construction off a new building. Main Builtling
0 Addition to a building. • One-family dwelling
❑ Alteration to a building. Two-family dwelling ❑
❑ Demolition of a building. -family apartment house ❑
Store building ❑
c -car attached garage 0
Other:
Accessory Building
- One-car detached garage El
❑ Other work. Descaibe: •
Two-car detached garage ❑
Private chicken house El
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, site and setbacks of pro-
posed buildings,and the location of all existing buildings.
NORTH Show proposed buildings) in dotted line and existing
• 4, Iluilding(s) in solid line.
1 F , Size of property / ' ' ft. x 7 ft.
rdt
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`'� � Size and use of existing buildings, if any
7C-tj-4
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w Size of proposed building G ft.x . '/ ft.
Height(from grade to ridge) . . . . • • • • • • •/•4.• • • • • ft.
. Front yard J—O ft.
Side yards O ft. and D 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.) p `
BUILDING SPECIFICATIONS.,
Kind of construction: Wood frame, fire safe, etc. - -/ -/2��'r c--,
Will any second-hand lumber be used `--7Z0 If so, for what
Material of foundation walls . . . . . . . . .ffe1,Vzi.,.pC--. Thickness
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Depth of foundation walls below grade 0 A Continuous foundation? . .
Will there be a cellar? . . l!f / If so, material of cellar floor f/ I' �...r_•.2 C1vj.�e_.2(.-.. . ?- !G
Type of roof: Sloped or flat? . .,off✓ ..12..C.-- Material of roof ./2 - nnC2
Size,wood studs x y ", spacing / "o.c., length v ft.
Size, floor beams, 1st floor . - "x / 0 ", spacing ,/ "o.c., span /� ft.
Size, floor beams, 2nd floes c. . "x /D ", spacing /�o "o.c., span .lam ft.
Size, ceiling beams . • ..a1 'x ", spacing 4 &" "o.c., span ft.
Size,roof rafters or beams "x ", spacing c7Z' y "o.c., span a ft.
Exterior finish L.. C .��� With what material?
Finish of interior walls <=•c ~ c-5/1-4,--c2.
If garage is to be attached, of what material is wall between garage and main building to be constructed?
- /� ` S h-,w//1 r-r �...)
Is there to be an opening between garage and building? LAB
Kind of heating system Oil burner or coal?
Will a flue-lined chimney be provided?,. . ra--/ . Depth of chimney foundation below grade \.5---
Height of chimney above roof. . . .
Will there be a fireplace? ` , Depth of fireplace hearth /.�
Will a toilet be installed J
Will a kitchen sink be installed and connected to water supply? � '
Water supply(public water supply or pump) . . . .,
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 tt;-hoof my knowledge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, are a true and complete statement of all proposed work to be done on the described premises and that an_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. L� y-
Sworn to before me this Signature "L-11--/4-- 71/ ‘77't -4 -, •
OWNER.OWNERS AGENT.ARCHITECT.CONTRACTOR
day of 19 -
NOTARY PUBLIC. WARREN COUNTY, N. Y.
SPECIAL 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 • • .
2. Type of heat ..
3. Is the building mechanically cooled? .
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
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 . U value of roof and floors exposed to ambient conditions
2. U value of exterior walls
3. U value of glazed area '
4. U value of doors .. ... .. . •. .. . ... .. •. •
5. U value of floors over heated spaces .. .. ... .. . .
6. R value of slab edge insulation - unheated slab ..
7. R value of slab insulation - heated slab
8. U value of heated basement/cellar walls (above grade) ..
9. Rvalue of heated basement/cellar walls (below grade)
10. Type of insulation . .. .. ... .... ..
C. Controls
Trmostat maximum heat setting... .
D. Duct Systems
1 . Is duct system installed in unheated spaces? YES NO
a. If YES, R value of duct insulation
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 .064060
G. For Swimming Pool Only
1 . Maximum Heating . .. ..
Telephone No. ..
Applicant s Signature
•
' TOWN OF QU Et SBUFW
BUILDING & ZONING DEPi ,
QUEENSBT.RY TOWN OFFICE BUILDING
BAY & HAVILAND ROADS, RD#1
GLENS FALLS, NEW YOU 12801
•
APPLICATION FOR A PERMIT TO CONSTRUCT, ALTER OR ENLARGE .
SEWAGE DISPOSAL SYSTEM WITHIN. ZHE TOWN OF QUEENSEURYO
CX CUPAN T a S NAME 47 ' 17: .. :°,;Dt ES,S :1 7 iA.
T ELEPHONE1 —r-/—.n-?•.s.—p[.C� Nf3v S NAME �...._.. . .
—._C:�Y..I..a.• :- >gm.� 4�a.�t' .-'m'b.:esi.Fa+i.a_LC-I6SM^• __'�.
ADDRESS 11 ' / . NUMBER OF tjEDRO( M y I
GARBAGE GRINDER? ! LO ' ( `ES CR NO) TOPOGRAPHY TOPOGRAPHY% i''LAT, ROLLING, STEEP
SLOPE, GENTLE SLOPE, OTAIEI 'f'— _ -
ae/JLLmLTW1WR'�n. !/�RsyvLam�'4 vanaz • •••at�UY.rcw.ra eKw+llYts+'.:af-ess.cifLvTsss+..••--.--•...:
UAT RE OF SOIL: CLAY, SANDY, LOAM, GRAVEL, ROCK, ETC. ___, . _y--
PERCOLATION TEST WATER SUPPLY: 1:INICIPAj WELL O ER
,..,.--:cs,as ,n„••,_.••A••- spas.. a asa-..a.-•••,..--•-nr -� r+ivaa�",..Eanr..t�.sari..-ae:�.�+..a.ia.oa..�s aca.. s.:
DIAGRAM 01 PROPOSED SEPTIC SYSTEM
OTHER PERTINENT INFORMATION
IT IS HEREBY AGREED THAT IP THIS APPLICATION AND PLANS ARE APPRO .: t •
INSTALLATION OF SEWAGE DISPOSAL FACILITIES Will BE MADE IN ACCORDANCE
WITH DETAILS SHOW
PERMIT FEE IS $5.0 0a
tt.. __..
DA.T E / 7/c 9/z9 SIGWkTURE OF APPLICANT
.J..9A'..,,,U9._L..,,,l'%:.Al..a.A.CJ_."1.CJ_.9?..)".CJ!cCa.9.lJ.....et.AVn.1.9.CJ...I.AC..?,A10..J....JJ.4‘1Ca9..J.". 1ACJ.t.J.1,1C,110._C..90cCa.9.-��.1.In.1,,I.J.".1,J.naN.An.7.1-InAt_1Ate,a%anJJ.IecUe..,..J.,1...+N.a7...11cl.1,.1aN.laltsla10tiJJ!.4.1
• THE NEW YORK BOARD OF FIRE UNDERWRITERSIN
BUREAU OF ELECTRICITY .
=Y it 41 STATE STREET,ALBANY,NEW YORK,1220,7_
> . ;;?f
P. Date - " Application No.on file F_- it /y ry
Lt. ,
h �0 THIS CERTIFIES THAT
ii only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
t'..+_.- :, Ll .,. `1 L'e=-.. Y ..; •..-i. s ,.IL-_.. .''[.. - .. J._ ... ; r - :•:, ... 9 b.i_.r; ,5,.. K3
ii
in the following location; El BasementEl 1st Fl. ❑ 2nd FL. Section Block Lot
-, "n f,-..r.
was examined on 1 ` -'; and found to be in compliance with the requirements of this Board. s
FIXTURE INCANDESCENT FLUORESCENT VA
FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS ECEPTACLES SWITCHES MERC AMT. K.W. AMT. K.W. AMT. K.W.. AMT. K.W. AMT. H.P.
tyPORURY
y DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
'AMT. K.W. OIL ' H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT: -AMPS: TRANS: MAT. H.P. NO.OF FEET .AMT. WATTS
51 SERVICE DISCONNECT NO.OF _s _.'.' ''rr : S L..'.'„,' E R V I C E
MAT. AMP. TYPE METER I�,2W ,B'3W 3.B'3W 3/B'.4W NO,OF C.COND. A W G NO.OF HI-LEG A.W G• NO.OF NEUTRALS A.W.G.
EQUIP.gi PER.B' OF CC.COND. OF HI-LEG OF NEUTRAL
e .
iOTHER APPARATUS:
} ._ :i,�" . .L _�L .•;_] ;, I
22 ..i ' ...11
; .
3.
* !:.:., .....__.:..L.,..-_-: 4._,;_ -:,-.)-.:.-7,111,--C" . ,'!5,'II-44...i./2. 1i1
S.7f•A _..,. .. ;fit ;L'. L L.0 v ,J ,..,...,i'....
BRANCH MANAGER o.
PO.
Per
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE. ALTERED IN ANY MANNER.
TOWN OF QUEENSBURY
Building Department
Inspectors report Date
Name /ia.5Ai • r-
Location Q (97 fie/i
Permit No. Cf,I ( 3 Weather
•
•
Remarks
Exca fia ti on
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Ba ckfi ll ,Q�C!
Final Survey
Framing ��
•
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves
Wall Board
Ext. Porches •
Finished Floor
Interior Trim
Stairs & Railings /'
Cellar Dr. Tile
Concrete Floors •
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval •
Floors
•
Insulation Foundation "
Walls
Ceiling
• Buil ing In ector
REMARKS
. � al �
_I.
TOWN OF QUEENS•BURY•
Building Department
Inspectors Report Date
Name /'ch.c-.
Location d.> ,L 8'7 Aj��-► 5-7. - 3
Permit No.6/6 3 Weather
Remarks
Excata ti on
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill •
Final Survey
Framing
Shea thi,ig
Roof Felt
Roofin
Siding
Masonry Veneer
Rough 'Plbg.
Relief Valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railings -\\
• Cellar _Dr. Tile
Concrete Floors •
Plbg. Fixtures / �•
Gar. Fireproofing
• Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors '•
Insulation Foundation '
Walls
Coiling
wilding Ins ctor
•
REMARKS
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date gD
Name HoLayr .
Location .10/4 87 teie x/ AA?. "33
Permit No. (p 1 le 3Weather
Remarks
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
Interior Trim
Stairs &
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors '
Insulation Foundation '
Walls "
Ceiling
•
Building In ector
•
REMARKS
�1�/ti'lvner (/1/Cv � �f�; S/``
•
• TOWN OF QUEENSBURY
Building Department
Inspectors Report Date /L!/b/ 2 9
Name
Location L.4
. �2
. Pew No. (e 9(o3 Weather
Remarks
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
Interior"Trim
Stairs& Railings
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
.Floors"
Insulation Foundation "
Walls " -
"Ceiling
Building nspector
ONREMARKS
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