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86-353 CERTIFICATE" ;OF OCCUPANCY' -TOWN OF QUEENSBURY WARREN COUNTY,, NEW YORK Date 19 This is to certify that work requested to be done'as shown by Permit No. 86-353 has been completed. This structure may be occupied as a 'Ad'dition to"one family dwelling — family room - Location Luzerne Road Owner Ralph-. and Helen Knickerbocker By Order Town Board TOWN OF QUEENSBURY Building &-Zoning Inspector Aw. BUILDING PERMIT TOWN OF QUEENSBURY No. 86-353 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Ralph and Helen Knickerbocker w F, OWNER of property located at Luzerne Road Street, Road or Ave. w in the Town of Queensbury,To Construct or place a Addition to dwelling (living area) a at the above location in accordance to application together with plot plans and other information hereto filed and x n approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. n 0 1. OWNER'S Address is Box 262 Luzerne Road n Glens Falls, New York CY 2. CONTRACTOR or BUI LDER'S Name 0 n Cifone Construction x n 3. CONTRACTOR or BUILDER'S Address 11-15 Katherine St. Glens Falls, New York r 4. ARCHITECT'S Name r_ N (D r•I 5. ARCHITECT'S Address C w a. 6. TYPE of Construction— (Please indicate by X) ( 7 Wood Frame ( ) Masonry ( ) Steel ( ) 7. PLANS and Specifications 26'x26' per plot plan, specifications and application submitted. No. B. Proposed Use ^ p' � a d rt One-Family Dwelling (family room added) H• o• 00 � $5.00 C/O Paidrt H O 40.00 $ PERMIT FEE PAID -THIS PERMIT EXPIRES January 1 19 87 (D £ (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the (D town of Queensbury before the expiration date.) N F'• Dated at the Town of Queensbury this 26`th Day of June 19 86 UQ SIGNED BY / ' 9.` "' for the Town of Queensbury Building and Zoning Inspector TO BE COMPLETED BY BLDG. DEPT. a // Application No. ,ca n 01 QueenJGury Permit Issued 19 aU S.NG and ZONING DEPARTMENT Permit Expires 19 'n, Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation Queensbury, New York 12801 Variance No. all /a Uj r Site P an Review No. ,Ih�!v I_ ` :,g:,4; J APpr p e - bIlk APPLICATION FOR BUILDING AND ZONING PERMIT A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. ANSWER ALL OF THE FOLLOWING. The undersigned hereby applies for a Building Permit to do the following work which will be done in accordance with the description, plans and specifications submitted, and such special conditions as may be indicated on the Permit. ---------------------------------------------------------------------------------------------- The owner of this property is.Ralph & llel;!�n Knickerbocker P.O. Address B o x 262 Tel. Property Locationll u z e r n e Road , Glens Falls , 14 Y Tax Map No. / / Street number or building lot number Subdivision name (if applicable) THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS: Cif.one Construction 11 -15 Kgt-I 'inc, St . , G .F . 7a�-n7Li7 Name P.O. Address Tel. No. Name of builder C i f 0 n e C 0 n s t . Address Tel. Name of plumber C i f.o n e C o n s t . Address Tel. Name of mason Saracco Aiasonry Address - T,a.mnl i-Q f Pr, S .�­F _ Tel. NATURE OF PROPOSED WORK: * ZONING INFORMATION: Construction of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED, x Addition to a building * drawn reasonably to scale and attached hereto, Alteration to a building * showing clearly and distinctly all buildings, (no change to exterior dimensions) * whether existing or proposed and indicate all Other work (describe) * set-back dimensions from property lines. Give * street and number or lot number and indicate FOR DEMOLITION PERMIT, STATE SIZE AND whether interior or corner lot. Show location LOCATION OF STRUCTURES AFFECTED. of water supply and location and configuration* of septic disposal area. * * COMPLETE INFORMATION REQUIRED BELOW. * Size of property 300 ft X znn ft. * Existing building(s) Size28 ft X 4 n ft. PROPOSED BUILDING AND USE: * Existing (s) Use building(s)g reSidPnt'_i_al Size of new structure 26 ft X 26 ft Foundation-pier/slab/crawl/partial/full * Proposed building, distance from property line (circle one) * Front yard g 0 ft Rear yard 276 ft No. of stories (habitable space) 1 * Side yards 5 0 ft and ]_S& ft Height (grade to ridge) 1 ! ft. * If on corner, setback from side street ft If residential, no. of families 1 No. of rooms(excluding baths) 1 * OCCUPANCY INFORMATION No. of bedrooms 0 * PRIMARY BUILDING - No. of bathrooms 0 _ Primary heating system e1e c t r i c * x One family dwelling Type of fuel * Two family dwelling No. of fireplaces to be installed` * Multiple dwelling / Number of units Will a wood stove be installed? no * Permanent occupancy Central Air conditioning? No * Transient occupancy * Business BUILDING STYLE, PRIMARY STRUCTURE * Industrial Ranch x Contemporary Log cabin * Other ' Raised ranch Mansion Duplex * If addition, what will use be. f am i 1 v r n nm Split level Old style Bungalow Cape Cod Cottage Other * ACCESSORY BUILDING- Colonial Row Town House * x Detached garage/one car/ two car/ car ( CIRCLE ONE PLEASE ) * Attached garage/one car/ two car/ car * * * * * * * * * * * * * * * * * * _Private storage building ESTIMATED MARKET VALUE OF * _Other CONSTRUCTION $20 , 000 INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED! Form BPA 4/86 and-vl BUILDING PERMIT APPLICATION CONTINUED BUILDING SPECIFICATIONS: Type of construction, wood frame, fire safe,etc. wood frame Will any second-hand oY'"Wtgf"�umber be used? If so, for what? no Foundation wall material poured concrete or b'lrhd:drkness 6" poured or 8x8x16 block Depth of foundation below grade (to bottom of footing) [, 1 Will there be a cellar? noHeated or unheated? Floor sq. footage sq ft Will there be a basement? no Will any portion be used as living space? (If so, what portion? sq.ft. - - Type of use? Type of roof - sloped/flat/shed/other Material -of roof s h i n,41 e s Size, wood stud9_1lX I, spacing "o.c. length ft. Joists(floor beams) lst. floor 2 "X 10 " spacing 16 "o.c. span ft. Joists (floor beams) 2nd, floor "X spacing "o.c. span ft. Overlays(ceiling beams) "X ifspacing "o.c. span ft. Roof rafters lox spacing O.C. span ft. Roof trusses(pre-engineered) spacing 24 "o.c. span ft. Exterior wall finish vinyl siding Of what material? Interior wall finish 2" gypsum If a garage is to be attached, describe materials to be used for FIRE SEPARATION: Is there to be an opening between garage and dwelling? If so will a Fire-rated door, enclosure, and self-closing device be provided? Will a flue-lined chimney be installed? Height above roof ft. Depth of chimney foundation below grade ft. Depth of fireplace hearth ft.. in. Water supply - Municipal or private well SEPTIC SYSTEM _ Distance from ANY private well(including adjoining properties ft. (A separate application is necessary for any repair or new installation of septic system) Town of f Warre A F F I D A V I T STATE OF NEW YORK County of Warre I swear hat o he best of my knowledge and belief the statements contained in this applic tion, og ther with the plans and specifications submitted, are a true and complete state ent of 1 proposed work to be done on the described premises and that all provisions of t e BUI ING CODE, THE ZONING ORDINANCE, and all other laws pertaining to the proposed wo k s 1 be complied with, whether specified or not, and that such work is authorized by t o er. -- - SWORN TO BE RE T IS Signature _ _ _ ____ _ -------------- O�ie , owner's agent, rcnirect,contractor day of 19 Notary Public, War g County N.Y. SPECIAL CO DITIONS OF THE PERMIT: By--------------------------------------- i 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 �l0Qtr1c I 3 . Is the building mechanically cooled? no 1 4 . Percentage of area of windows and doors f A. Over 16% Only 1 . Uo value of gross area of walls , roof/ceiling and floors exposed to ambient conditions 1 2 . Floor over heated spaces YES NO a. Are foundation walls -insulated? YES NO f 1 . If YES, what is the R value? i 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 i B. Under 16%. Only 1. R value. of roof and floors exposed to ambient conditions_ Roof R- 19 Floors R- 19 j 2 . R value of exterior walls R- 19 - 3 . R value of glazed area 2 .0 4 . R value of doors R15 .15. 5. R value of floors over unheated.--spaces- R-19 6. R value of slab edge insulation - unheated slab u n.heated 7 . R value of slab insulation - heated slab N/A 8. R value of heated basement/cellar walls (above grade) W/A 9. R value of heated basement/cellar walls (below grade) N/A 10. Type of insulation- C. Controls 1 . Thermostat maximum heat setting qn D. Duct Systems 1. Is duct system 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 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 G. For Swimming' Pool' Only 1. Maximum heating Telephone No. applicant s ignature) CIFONE CONSTRUCTION COMPANY JOB 11-15 Catherine Street SHEET No. OF P. 0. Box 684 GLENS FALLS, NEW YORK 12801 CALCULATED BY DATE Phone 792-9242 CHECKED BY DATE_ SCALE i ...........................5.............:.............d.............j.............>............;..............I............. ..... ..... ..... ..... ..... ..... ..... ...... .... ..... ...... ...... .... ..... ..... ...... .... ... .... ..... ..... ..... .........................i:,............ ...._........i..........................d................................... ...... ...... .... ..... ...... ...... .......................... ..... ... ..... .... .................. ..... ..... i ..........._!..........................:..........................:............ .... ..... ..... ...... ..... ...... ..... .. ...... .... .. ...... ..... ..... ... .... ...... ...... ...... .... ..... .....i.. ! I I i I 1 : i V ! 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' b FTI L rT7 Lu i ! j j .. .... ..... ...... ..... ...... ...... ..... .... ..... ...... ...... ...... ..... ..... ....................................................................-..............:..........................I........... ..._.. ..... - ...... ...... c c� Jown of QueenjLry BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME LOCATION LU a Date Permit No. * * * * * * * * * * * * * * * * * * * * * * * V� = APPROVED - YES NO Footing/Pier Forms Foundation Waterproofing Backfill }I Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext. Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg. Fixtures Gar. Fireproofing Door Closers Smoke Detectors Chimney INSULATION: \ Foundation Floors Walls 1 Ceiling FINAL ELECTRICAL INSPECTION Final Building Survey Next scheduled Inspection(call when ready) Remarks- - Building Inspector 6/86 and-vl r*4 Z-V'f' 4`0 1">- Ll 1 k,,r�ti Jown of QueenjLry BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME • til f l c c tea✓ � LOCATION 124 Date b / p Permit No. 353 * * * * * * * * * * * * * * * * * * * * * * * APPROVED - YE. NO Ix-ooting/Pier Forms C91 Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext. Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors / Plbg. Fixtures Gar.. Fireproofing % Door Closers Smoke Detectors Chimney INSULATION: Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION Final Building Survey Next scheduled Inspection(call when ready) Remarks- - 1 Building Inspector 6/86 and-vl