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AO` TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20150190 Application Number: A20150190
Tax Ma No: -01-0 -015-0000
p 523400-308-0050077
Permission is hereby granted to: KEITH &JANA KILGALLON
For property located at: 116 LAUREL Ln
in the Town of Queensbury,to construct or place
at the above location in accordance with application together with plot plans and other information hereto filed
and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning
Ordinance. Type of Construction Value
Owner Address: KEITH &JANA KILGALLON
116 LAUREL Ln Residential Addition $10,000.00
QUEENSBURY NY 12804-0000 Total Value $10,000.00
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2015-190
Residential Addition 255 s.f.
$100.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,June 08, 2016
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the To o eens ; A 'Aiwa une 08, 2015
SIGNED BY 1 .• for the Town of Queensbury.
Director of Building&Code Enforcement
PRINCIPAL STRUCTURE APPLICATION Office Use Only
DATE -6 . . - 6 Received
Tax Map ID
.
TAX MAP ID 0Ap C I— 11015 P"v 2 2 2015 Permit No. 2,0 5- 1 Csf
in Permit Fee
ZONING Sn-LA- 4, Rec Fee
U v
�n Site Plan# //qq
HISTORIC SITE Yes No Subdivision # ( . 1.,briA) I-f t L
j�� I �•r116
SUBDIVISION NAME GI rwint_ -1'OOk Lot# 15
Ont. Pa-1-16/4_,
TOWN Ba RESOLUTION 86-2013: $850 RECREATION FEE FOR NEW DWELLING UNITS,INCLUDING SINGLE FAMILY DWELLINGS,DUPLEXES
OR TWO FAMILY DWELLINGS, MULTIPLE FAMILY DWELLINGS, APARTMENTS, CONDOMINIUMS, TOWNHOUSES, AND/OR MANUFACTURED &
MODULAR HOMES, BUT NOT MOBILE HOMES. THIS IS IN ADDITION TO THE PERMIT FEE.
APPLICANT \ e,,i44 '< 1CJ!/(Yf? OWNERK e I �'' i4 - o//o•
ADDRESS 116 /uRiL 1-11. ADDRESS Ke____,?Ueen5,i uirr 4/f
PHONE/E-MAIL I40 /1'/5Gf/o de 6rbtaii .Can PHONE/E-MAIL
Ce/I f°, ; I -2, q .g-0510 1
CONTRACTOR COST OF CONSTRUCTION(ESTIMATED): $ 0,C2C74
ADDRESS: BUILDING ADDRESS:
PHONE/E-MAIL
CONTACT PERSON FOR BUILDING& CODES COMPLIANCE: PHONE
TYPE OF CONSTRUCTION
Check all that apply Please indicate measurements as required below
New Addition Alterations`floor sq.f 2nd floor sq.ft. Total sq.ft. Height
Single Family 5 5 i \ 1
Two-Family6° (N-70 7
Multi-Family
(# of units ) S6D il"t*
Townhouse
Business Office
Retail - Mercantile
Factory- Industrial
Attached Garage
(# of )
Other
1.
Town of Queensbury Building&Codes Principal Structure Application July 2014 1
1
If commercial or industrial indicate name of business
Proposed use of building or addition
Source of heat (circle one) Gas Oil Propane Solar Other
Fireplace: complete a separate application for Fuel Burning Appliances &
Chimneys
Are there structures not shown on plot plan?
Are there easements on the property?
Site Information
a. Dimensions or acreage of lot
b. Is this a corner lot?
c. Will the grade be changed as a result of construction Yes /No
d. Public water or Private well
e. Sewer or Private Septic System
Value of all work to be performed (labor or materials) $
DECLARATION:
1. I acknowledge no construction shall be commenced prior to issuance of a valid permit and will be completed
within a 12 month period.
2. If work is not complete by the 1 year expiration date the permit may be renewed, subject to fees and department
approval.
3. I certify that the application, plans and supporting materials are a true and complete statement/description of
the work proposed,that all work will be performed in accordance with the NY State Building Codes, local building
laws and ordinances, and in conformance with local zoning regulations.
4. I acknowledge that prior to occupying the facilities proposed, I or my agents will obtain a certificate of occupancy.
5. I also understand that I /we are required to provide an as-built survey by a licensed land surveyor of all newly
constructed facilities prior to issuance of a certificate of occupancy.
i 44 14-,l lion
I have read and agree to the above: PRINT NAME: DATE
SIGNATURE: ✓ � DATE
FOR OFFICE USE ONLY
Operating Permit Issued: Yes No
Occupancy Type
Construction Classification
Assembly Occupancy Limit
Special Conditions
2
Town of Queensbury Building&Codes Principal Structure Application July 2014
Town of Queensbury Building&Code Enforcement \(\(E�
Office No. (518)761-8256 a^
Rough Plumbing I Insulation Inspection Report
Inspection request received: '\-24 tS 1
Name: 1c 1�a.+� Inspected on: 1622)(tQ,1S
Location: I' lou VL,ILcutui Arrive: ' IAN/ i' I ' .
Permit No.: 15— 1`'jD Inspector's Initials: '„
Type of Structure: 2Q. .466.
COMMENTS
Y N NA
Plumbing under slab Kv_A N-1 . o c o
Rough Plumbing/Nail Plates
Plumbing Vent/Vents in Place ;dQ)7 ‘S e it
1 1/2 inch minimum Drain Size
WO 9Xkj \S V14NY(>
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet/change of direction
Pressure Test
Drain/Vent
Air/Head
5 P.S.I. or 10 ft. above highest connection for 15 minutes
Pressure Test
Water Supply Piping
Air/Head ��
50 P.S.I for 1 ••' . -
Insulatio” '-- .- is eco ommercial Check
Window Sealing
Tyvek or Similar Exterior Sealant
Proper Vent, Attic Vent
Door/Window Sealed (No Insulation)
Duct/Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly/No duct tape
Blower Door Test
Air Sealing
Rough Plumbing/Insulation Inspection Report
Town of Queensbury Building & Code Enforcement `RA
Office No. (518) 761-8256 a-ip
Framing 1 Firestopping Inspection Report
Inspection request received: 1\2�t5
Name: Lt l Inspected on: " 11-
fair S/
Location: 1��p L `�Y Arrive: Aa. ap.�
Permit No.: ° Inspector's Initials: rV.
TYPE OF STRUCTURE: QS,
Y N NIA COMMENTS:
Framing
Attic Access 22"x 30"minimum
Jack Studs/Headers K� 216-0 690
Truss Specification Provided
Bracing/Bridging
Joist hangers
Jack Posts I Main Beams
Exterior sheeting nailed properly
12"O.C.
Headroom 6 ft.8 in.
Stairwells 36 in.or more
Exterior Deck Bracing
Headroom 6 ft.8 in.
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 1/2(w) 16 gauge(8)16D nails each side
Draft stopping 1,000 sq.ft.floor trusses
Anchor Bolts 6 ft.or less on center
Ice and water shield 24 inches from wall
Fire separation 1,2,3 hour
Fire wall 2,3,4 hour
Firestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side 1/2 inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space/Bedrooms
24 in.(H)
20 in.(W)
5.7 sf above/below grade
5.0 sf grade
Design Professional Sign-off,if required
Framing/ Firestopping Inspection Report
Town of Queensbury Building & Code Enforcement M®rJ
Office No. (518) 761-8256 e''1')
Framing I Firestopping Inspection Report
Inspection request received: to 125\15
Name: A 61\av1 Inspected on: (oI21 12015
Location: jly Arrive: a.m.l p.m.
Permit No.: 15- Inspector's Initials:
TYPE OF STRUCTURE:
()Y N NIA COMMENTS:
itFraming
(` Attic Access 22"x 30"minimum
Jack Studs/Headers / 6'1 '2.Ij 60C10Truss Specification Provided I
Bracing/Bridging
Joist hangers
Jack Posts/Main Beams
Exterior sheeting nailed properly
12"0.C.
Headroom 6 ft.8 in.
Stairwells 36 in.or more
Exterior Deck Bracing
Headroom 6 ft.8 in.
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 1/2(w)16 gauge(8) 16D nails each side
Draft stopping 1,000 sq.ft.floor trusses
Anchor Bolts 6 ft.or less on center
Ice and water shield 24 inches from wall
Fire separation 1,2,3 hour
Fire wall 2,3,4 hour /f
�►\ Firestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side 1/2 inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space/Bedrooms
24 in.(H)
20 in.(W)
5.7 sf above/below grade
5.0 sf grade
Design Professional Sign-off,if required
Framing /Firestopping Inspection Report ��,
Foundation Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pmDepart: `, pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: ! 4I"
NAME: PERMIT#: I
LOCATION: Gka INSPECT ON: C C
TYPE OF STRUCTURE:
s
Comments
N N/A
Footings
Piers
Monolithic Slab
Reinforcement in Place `i�
The contractor is responsible for J `)
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on site.
Foundation/Wallpour
Reinforcement in Place
Footing Dowels or Keyway in place
Foundation Dampproofing
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/18/2013 2:44:00 PM