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7028 r Cv"n FICA"A" QF { OCC�t.JPA.NCY OWN OF QUEENSBURY Y WA�REN COUNTY, NEW YORK E II Dace "tctz 24 19 r I, k Tlde is to f► thu work , bodone as dmYwn hy Permit Na.—7_0 has been compleft& 1 Mdf stfucture may be occupied las a Pdd jtj on to C)nn-Fam i Ronald Dc mad B9 Order Town Board TOWN OF QUEENSBURY ' ,s ram. Building ® Zoning Inspector . i CWCATIV[ "INfTA" PRINTING. OLE" FALLS. N T 12{ol Il1�17f f-f{S• BOILDING PERMIT TO� ffl OF QUEENSBURY No.7 02 8 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Ronald aermadv tj OWNER of property Located at '� 15 Kiley Lane Street,Road or Ave. i Cy in the Town of Queensbury,To Construt or place a Addition to dwel line (1 iving rea at•the above location in accordance t application w� i °� pot plans and other information hereto filed and Ib approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. I. OWNER'S Address is 15 Kiley Lane Glens Falls, New York 2. CONTRACTOR or BUI LDER'S Name William ' rombley Ln r 3. CONTRACTOR or BUILDER'S Address (D sD West Mountain Road "C Glens Falls, New York r p, 4. ARCHITECT'S Name M I 6. ARCHITECT'S Address 6. TYPE of Construction—(Plow indicate bye XI p, 06 Wood Frame ( ►Masonry 1 1 Steel rh O 7. PLANS and Specifications. 221*22' per plot plan, specifications and & No. application submitted. a E S. Proposed Use m One-Family Dwelling (additional living area) w , $ g0S0C/0 Paid $ PERMIT FEE PA16—THIS PERMIT EXPIRES February 1 19 82 � (If a long 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 31 st Day of July 1981 SIGNED BY for the Town of Queensbury Balling and Zoning I nspellor TOWN OF QUEENSBURY (Space inside block to Ix filled in by WARREN COUNTY. NEW •YORK - Building inspector)_ . Application, for .kmilication No. . . F--,,:,,Permit ls.tied 19. v z �l''•i nut'l�:xhircr ' - I ". CJ:: BUILDING: AND `ZONING PERMIT �- a= /onint-l)istrict . AA Ale01 \V irk`i . THREE (3) Copies of a PLOT PLAN, Drawn to scale; \1)1)r,,`tt1 h}•_ ' showing the- actual dimensions of the lot to.be built Rciii:rrit ' upon,'-The exact size, and location on:the lot: of the: _ building`to. be erected or altered MUST BE SUB- MITTED WITH, THIS APPLICATION.. _ TOWN.Cif' QUEENSBURY YtJ • tT s 3c DATE ' . a p t {9 A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK J ii ' ( 1flO'I ANSWER ALL OF THE FOLLOWING:. A.M h!"- Z3 P.�rl. The undersigned, hereby applies for a. permit. to, do: the following .wotccj , 7ig1��1.e'1i112111213141516 .!, which will. be done.in accordance.with the description; plans and.-spec+fi , .A A 1, : r : i ' ' ° ill cations, end such special conditions:as may`.be indicated on the,,permit. Th owner of this property is:p -s.--AK.7. : . . . ... . ...:. . ®/.4,7, ,- r . ,, . (NA'EI (P OO.,ADDRESS) PBX i . The person responsible for supervision of the-•work'insofar as the Butidii g Code and the Zoning Ordinance apply is: j/t l'/i l?/r-% a'/,/,4j`,L.E k1E•5./. . . i�,:7"a P))i . (NAME) (P'O ADORE 1' Name.of Builder. .li✓t~/./!/fo--i.. . . /.. .!?-. .""P7! '.G . . Address:,. v=-s r . ! e/ t �"r � 'r tr r J �. Name,cif Plumber- Address Narite of Mason Address,' ,g r Q 0 C) Lot Numb_ er Unit Estimated value of proposed work S /'ice Name of. Village . .-. i , �_ 1 Name of°Street• : . : .I ( `-may 419-*E Side of:street; north. Q, east: ,,south ❑. west Nearest Cross Street Distance from this cross street . . . . . ..... . . . . . . Ft. Property is north. 0 south 0',east r t i,west- 0 from Cross Street If•on Corner; which corner, northeast D, northwest 0, southeast 0, southwest. (Designate by.marking with-an "X" in the='correct space.), NATURE OF PROPOSED._WORK OCCUPANCY - 171 Main Building Construction,of a new building. One family.dwelling - X Addition to a building' .• ' Two-family dwelling,. 0 Ki g` 0 El Alteration toa,buitding:. family apartment house . 0: Demolitton,of:a building: • Store building, 0 -car attached.garage. . 0 - Other: Accessory Building . - One-car.detached.garage . Li []_ Other work: 'Describe: Two-car detached garage.. El Private chicken house 'l Private storage building C '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,.size and setbacks of pro- posed buildings,and the location of all existing buildings. NoRTa' , -_ Show. s r sed buildings)=in_dotted' line and', existing iluilding(s):in solid line: _ Size of;:property :ft. x ft. Size and,use of�ejx'isting buildingy if any • w S• ize.of proposed building . . . . .�t•�;f -!L .ft. Height (from grade to ridge) . ./. ' /.� ft. , Front yard ft. _ Side yards ft. and, ft. Rear:yard ft. sour►+.. If on corner,setback from.side street ft . .. NOW All distances are net; as measured from street side line to nearest part of building.: (OV.ERI . 7-73-.M (cont'd.) BUILDING SPECIFICATIONS., Kind of construction: Wood frame, fire safe, etc.' 1/7,,,,....:„.._12._ _., Will any second-hand lumber be use ? . . . . . . r�.I. , for what , sr Material of foundation walls he• • • •N Thickness Depth of foundation walls 1 w grade 9g Continuous foundation? Will there be a cellar? . . If material of cellar floor . . . . . . .A . . . . . . . . . .,�.�. Type of roof: Sloped or flat? Material of roof . . . :`. . , „x s cing . • . . ."o.c., len ft. Size,wood studs t,� ft. Size, floor beams, 1st floor "x CIO ", spacing... ,. .` .r, "o.c.,span . . Size, floor beams, 2nd floor x ", spacing "o.c., span ft. Size, ceiling beams "x 6 ", spacing "o.c., span �� ft. V--- . ", spacing "o.c.,span . ft. • Site, roof rafters or beams . : . • • •" • • • �� ' ',' ' `y' '" ' ' ' Exterior finish (><10. • • With hat material? . . . . , .C� c� Finish of interior walls 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 betwee garag and uildin ? . . . .-'71 Kind of heating system . . , Oil burner or coal? Will a flue-lined chimney be provided) . . . 1 Depth of chiliiney foundation below grade Height of chimney above roof Will there be a fireplace? - ! Depth of fireplace hearth Will a toilet be installed) - Will a kitchen sink be installed and connected to water supply? 4'; Water supply (public water supply or pump) ����' fig Distance of cesspool from any private well feet Will drainage system be provided with required traps,cleanouts, and ve ts? AFFIDAVIT Town of Queensbury County of Warren State of New York I swear that to tr, ve,i of my know,ledge and belief the statements contained in this application,together with the plans and spi mfications sub- mitted, are a true and coa.pp lete 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 pro work shall be complied with,whether specified or not, and that such work is authorized by the owner. Sworn to before me this Signature l' OWNER.OWNER' AGENT,ARCHITECT•COJtT CTOR 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? 'Z7-2 4 . Percentage of area of windows and doors 0(4`, J A. Over 16% Only d 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. R val a of roof and floors _exposed to ambient conditions Xv2Y7 byte- 2 . R value of exterior walls Q "" 2( 3 . R value of glazed area rQ � 4 . R value of doors 5. R value of floors over heated spaces 6. R value of slab edge insulation - unheated slab 7. R value of slab insulation - heated slab 8. R value of heated basement/cellar walls (above grade) 9. R value of heated basement/cellar walls (below grade) 10. Type of insulationk70-4/17t2g1-4/177<0er C. Controls a y o 1. Thermostat maximum heat setting 5 `� D. Duct Systems .. 1. Is duct systtm 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 3� 1. Size of hot water or cooling carrying agent pipe 2. R value of pipe insulation _ j9 F. Service Water Heating 1. Performance efficiency 2. Temperature control setting maximum G. For Swimming Pool Only 1. Maximum heating Telephone No. G ! :4? `oC��3 '7717 ./'-� (applicant ' s signatur ) TOWN OF QUEENSBURY Building Department Inspectors Report Date ;? ti(9 f Name f Location /3' Kt LE8 G.A- Perrait No. -. o '� 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 & Railing, Cellar Dr. Tile Concrete Floors Plbg. Fixtures Gar. Fireproofing Door Closers �. Chimney Water Meter Inst. Septic Approval Floors ' FOundatiOn Insulation Walls Ceiling 1Wf a Building Inspector • REMARKS TOWN OF QUEENSBURY Building Department Inspectors Report Date C5" — 37 Name .4>orge7004 Location Permit No. '10_ B W;to • Remarks Excavation Footing Forms � Footing & Piers (J.j/ Foundation "`���t, Cement Coat Waterproofing Backfill Final Survey Framing Sheathing Roof Felt Roofing Siding Masonry Veneer 1\, Rough Plbg. J Relief Valves 1 Wall Board Ext. Porches Il 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 Ceilin Building Inspector REMARKS • TOWN OF QU-EENSBURY Building Department Inspectors Report Date r �-C Name Location / Permit No. 7 0 8 ✓ Weather i� r Remarks Exca f7a ti on Footing Forms Footing & Piers Foundation Cement Coat Waterproofing Backfill Final Survey Framing Sheathing ////K::-J; Roof Felt Roofing t/ --0,R_, Siding i [t),r , Masonry Veneer Rough Plbg. Relief Valves Wall Board Ext. Porches f i/, 64 j I Finished Floor i,/ �n Interior Trim /f }, Stairs & Railings / OIr Cellar Dr. Tile Concrete Floors Plbg. Fixtures Gar. Fireproofing Door Closers Chimney Water Meter Inst. Septic Approval Floors Insulation Foundation Walls Ceiling Building Inspector REMARKS "j7"LL - 0, �'2iL'l/G� �C'kaif�. 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