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,n TO'R'N OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
,
Community Development - Building Codes (518) 761-8256
BUILDING PERMIT
Permit Nutt-ber: RC-0IOOC�220-2016
Tax Map No: 296.19-1-25
Permission is hereby granted to: KL Crist Holdings,
For property located at: 90 GLEN'WOODAVT?
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
Owner Name: KL Crist Holdings Single family-addition $0,00
Owner Address: 90 Glenwood AVE Total Value $0.,00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans& Specifications
80 sq. ft. residential addtion to be used as a shed; storage of property maintenance equipment. Residential and Commercial
property.
$ 100.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Monday, Apri1 17, 2017
(If a longer period is required,ars application for an extension must be made to the code Enforcement Officer
of the Towyn of Queensbury before the xpiration dat .)
Crated at the Town o Queen. ry; 4-
SIGNED
rid , 016
BY: for the Town of Queensbury.
Director of Building&Code Enforcement
PRINCIPAL STRUCTURE APPLICATION Office Ilse Qnly
Received
Date: Tax Map ID Zc cam»l 9_�,
Tax Map ID � r _� Permit No. /(
Permit Fee � � �— � � � �7
Zone Rec Fee
Historic Site Yes No Site Ilan#
Subdivision Name LotSubdivision
. .. � as
Project Location � � � � �� � � 1i VY 19
TOWN 131 . RESOLUTION 86-20,13: $850 recreation fee for ne4hngs- �g ui ual` xosJtwa-family,
multiple family,apartments,condominiums,townhouses,andy or rn nufactured & modular ome but not mobile
homes. This is in addition to the permit fee(s). 1'�aniM �ISC �
i°"o.iN@,MV id G i i i l r
Applicant _Owner �
3r i P,oa
Address Address
,��'�"' to,,;�., �,r d �F° :�k � �...�E :. ,ram%;✓ �2
Phone/E-mail Phone/E-mail )` y Cy
,�, � �f7 � .f f. p,✓"�F p 4:.
Contact Person for Building&Codes Compliance: i. , Phone 3 Z y l�
TYPE OF CONSTRUCTION
,/Check all that apply New Addition Alteration I" floor sf 2nd floor sf Total sf Height.
Ingle Fa�uctil
Two-Family 296.19-1 -25 RC 220-2016
Multi-Family Keith Crist / KL Crist Moldings
90 Glenwood Avenue -Residential Addition
( of units_} shed attached to rental SFD & corn"l bldg
Townhouse
Business Office
Retail-Mercantile
Factory- Industrial
04
y
Other t)
(✓ I"
If commercial or i ustrial please indicate of business
Town of Queensbury Building&Codes Principal Structure Application Revised September 2015
Proposed use of building or addition
Source of Heat(circle one) Oil Propane Solar Other
Fireplace: Complete a separate application for Fuel Burning
Appliances&Chimneys
Are there structures not shown on plot plan? 1yo
Are there easements on the property? N a
Site Information
a. Dimensions or acreage of lot ��- Pcs-e-r
b. Is this a corner lot? Na
c. Will the grade be changed as a result of construction Yes Y, No
d. Public water or Private well Pub tic
e. Sewer or Private Septic System Sc e- -
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 I description of
the work proposed,that all work will be performed in accordance with the NYS 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 1 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 have read and agree to the above:
PRINT NAME: K e 171-t , Gu-;,�t DATE: "/// g//(
SIGNATURE: '? . '_-- DATE: VjfY/t6
For office use only
Operating Permit Issued: Yes No
Occupancy Type
Construction Classification
Assembly Occupancy Limit
Special Conditions
Town of Queensbury Building&Codes Principal Structure Application Revised September 2015