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87-737 -t` CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date May 13, 19 92 This is to certify that work requested to be done as shown by Permit No. 87-737 has been completed. One Family Dwelling - Addition This structure may be occupied as a Cleverdale Rd. Location Owner William & Lorraine Keis By Order Town Board TOWN OF QUEENSBURY f,. J,' Building & Zoning Inspector t ' BUILDING PERMIT - y TOWN OF QUEENSBURY No. 87-737 WARREN COUNTY, NEW YORK 0 PERMISSION is hereby granted to William & Lorraine Keis OWNER of property located at Lot 29 & of 28 Cleverdale Rd. I .)-.3cC.4. Street, Road or Ave. in the Town of Queensbury,To Construct or place a Addition to one family 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. 1. OWNER'S Address is 3 Northeast Lane Ballston Lake, N. Y. r• 2. CONTRACTOR or BUILDERS Name R. John McBain r' n Iv r• 3. CONTRACTOR or BUILDERS Address rD 1007 24th Watervliet, N. Y. 12189 r• w 4. ARCHITECTS Name 0 5. ARCHITECT'S Address �* N R'+ naF+ 6. TYPE of Construction—(Please indicate by X) 1 /Wood Frame ( 1 Masonry ( )Steel ( ) oo 7. PLANS and Specifications No. 16'x 24' taaxax addition to one family ( tearing off existing n 8'9" x 16'9" one story addition on north side of building. as per plot plan 8. Proposed Use and applica.liuii. Addition of den & dining area, and 2 additional bedrooms a, $5.00 C/0 IA 74.00 May 1 88 $ PERMIT FEE PAID —THIS PERMIT EXPIRES 19 (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the ~' rt town of Queensbury before the expiration date.) N• 0 29th October 87 Dated at the Town of Queensbury this.,s�r� Day of 19 0 SIGNED BY / ' /G� �� /�'-� '=� for the Town of Queensbury Building and Zoning Inspector 7/C . 0 r• TO BE COMPLETED BY BLDG. DEPT. a t,.,tV °'` .i Application No. ' 0 L ;=j ; .7own of Queen.stury permit Issued 19 , BUILDING and ZONING DEPARTMENT Permit Expires 19 OCT 23 1987 Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation Queensbury, New York 12801 Variance N -„ BO, I oy Site Pla Review No D - 3 - � �� ASprov' `1 q i' 0 A t o 1 APPLICATION FOR I. 1 G n ()JCL, 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: : //1/t%(l71 di X.oI ra /rile /1(-'L S 3 VDt' e6 i- �a 'j P_. - gaol.a r) , /c Ai•'-/ . Tel. �77 ",5(//P P.O. Address /,/ Property Location: ,4D/-. aZ9 30,d�a/ 'a� ,L..1174 o?� *e�/er/ /e.,ax Map No. /,3 / "--/ 5 Street number or building lot number ei Subdivision name (if applicable) THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS: f-P .S011(1 1(4C-8u1n 06-7 - ,21./ -r'445-74-74-- Uiel. er-✓itej" `R. /,;I/I?/ (617)�73 --id7? Name P.O. Address Tel. No. ti- Name of builder 9a y'n a Address - Tel. Name of plumber . Address Tel. Name of mason Address Tel. NATURE OF PROPOSED WORK: * ZONING INFORMATION: Construction of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED, )'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 grin * -f� Se,,,0_,ii gI9`/X/ ( ,/ Oe3e Steyr of septic disposal area. arlr`',A,6,) 017 ,(fey,-Ili s, /e 012 t( * COMPLETE INFORMATION REQUIRED BELOW. but /d/r7 * Size of property 90 ft X 20.5.- ft. * Existing building(s) Size 3:)._ ft X 3,5' ft. PROPOSED BUILDING AND USE: * Existing building(s) Use S'u nrner hvm e_. Size of new structure //o ft X c47/ft * ' Foundation-pier/slab/crawl/partial uI11 * Proposed building, distance from property line (circle one) * Front yard 2/, ..L ft Rear yard /5 ft No. of stories (habitable space) 02- * Side yards :45'3 " ft and ft Height (grade to ridge) aoZ ft. * If on corner, setback from side street ---- ft If residential, no. of families / No. of rooms(excluding baths) � * OCCUPANCY INFORMATION No. of bedrooms * * PRIMARY BUILDING - No. of bathrooms ® y, One family dwelling Primaryheatingsystem * . Y 1�rv,3ArL 2 * Two family dwelling Type of fuel p11_ * Multiple dwelling / Number of units No. of fireplaces to be installed p * Permanent occupancy Will a wood stove be installed? A/v * , Transient occupancy Central Air conditioning? 4/0 * Business BUILDING STYLE, PRIMARY STRUCTURE * Industrial * Other Ranch Contemporary Log cabin * If addition, what will use be? ,32/1 4 /71,0/06, Raised ranch Mansion Duplex Split level Old style Bungalow * Area. 4- 0 addl i6h a/ ,becfroo rn�s (cape Cod__) Cottage Other * ACCESSORY BUILDING- Colonial Row Town House * 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 * $ /5DO o 0 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, od frame fire safe,etc. Will any second-hand or ungra ed lumber be used? If so, for what? ide) Foundation wall material (_dne ire to // (nr ,e Thickness /6 Depth of foundation below grade (to bottom of footing) '/O Will there be a cellar? Ve Heated or unheated? 1/AJhPe Floor sq. footage ,-y'jt/ sq ft Will there be a basement'' Will any portion be used as living space? /Uo (If so, what port' ? sq.ft. - - Type of use? Type of roof - lope flat/shed/other Material of roof 47,ber7/i SS chip f.01- Size, wood stuff "X $4 " spacing /6. "o.c. length 3/ ft. Joists(floor beams) 1st. floor 9 "X / " spacing /(o "o.c. span/3 7 ft. Joists(floor beams) 2nd. floor .- "X lb " spacing /(o "o.c. span/S/y"(ft. Ove an ft. Roc- rafts "X __spacing-- ©.c. -spare---fit. Roof trusses(pre-engineered) spacing /6 "o.c. spar044 ft. Exterior wall finish Id . Of what material? 1/1/1f(1 Interior wall finish S{(iParrve(� l If a garage is to be attached, describe materials to be used for FIRE SEPARATION: Is there to be an opening between garaged 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/7 ow grade t. Depth of fireplace hearth in. Water supply - Municipal or ivate well onq SEPTIC SYSTEM _ Distance from ANY private well(inbluding adjoining properties ,j//A ft. (A separate application is necessary for any repair or new installation of sep is system) Town of Queensbury AFFIDAVIT County of Warren STATE OF NEW YORK I swear that to the best of my knowledge and belief the statements contained in this application, together with the plans and specifications submitted, are a true and complete statement of all proposed work to be done 'on the described premises and that all provisions of the BUILDING 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. SWORN TO BEFORE ME THIS Signature,_ F-�-- ♦ --� Owner, 4 eras agerft,arcnitect,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 1/p i- sl 4, 2 . Type of heat G7 1,33'-ker"_ f,,,mee raLlid /Or1 3 . Is the building mechanically cooled? ,tic 4 . Percentage of area of windows and doors /S 6 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. R value of roof and floors exposed to ambient conditions_ /9 2 . R value of exterior walls Le 3 . R value of glazed area , .J 5 4 . R value of doors U` 5 . R value of floors over unheated spaces 6. R value of slab edge insulation - unheated slab / 7 . R value of slab insulation - heated slab / A 8. R value of heated basement/cellar walls (above grade) /I/)4 9. R value of heated basement/cellar walls (below grade) /1/A 10 . Type of insulation (161r /�i55 - f3a C. Controls l 1 . Thermostat maximum heat setting 7Da D. Duct Systems 1 . Is duct system installed in unheated spaces? YES NO a. If YES , R value of duct installation ►v b. R value of duct in other areas i E . Piping Insulation 1 . Size of hot water or cooling carrying ent pipe 2 . R value of pipe insulation Y�`-J F . Service Water Heating 1 . Performance efficiency f}/if 2 . Temperature control setting maximum G. For Swimming Pool Only 1. Maximum heating Al/,4 Telephone No. ,273 -o 77 1, kc/A- 1 (a 1ic ant ' s signature) TOWN IF QUEENSBURY ( BUILDI AND CODES DEPARTMEN BAY & H!VILAND ROADS QUEENSBi 'Y, NEW YORK 12801- TELEPHO (518) 792-5832 BUILDING INSPECTI ' 'S REPORT REQUEST Fs' INSPECTION REC IVED I � r(� NAME 1 r {{ LOCATIRI(�-, 2(1 — �/, 4 ' ClLe.t`;d(:tjj ,u� DATE ?1 q PE' IT # APPROVED YES NO FOOTING/PIERS MONOLITHIC POU' FORMS FOUNDATION/DAMP PROOFIN BACKFILL APPROV'' ROUGH PLUMBING FRAMING ELECTRICAL ROUGH— N INSULATION: FOUNDATION FLOORS • WALLS p CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES T.PS STAIRS—CLEARANCE & v•ILS PLUMBING FIXTURA./RE IEF VALVE INTERIOR TRIM/P' VAC DOORS FINISHED FLOORS GARAGE FIREPROO ING DOOR CLOSER(S) SMOKE DETECTOR' FINAL ELECTRICAL INSPECT ,N FINAL APPROVAL • CONSTRUt TION OK TO ISSUE C/O •R C/C A SIGNED CERTIF CATE OF OC PANCY MUST BE OBTAINED FROM E BUILDING 'EPARTMENT BEFORE THESE PREMISES 'RE OCCUPIED. REMARKS: 6711- ' C/ 1 ARRIVE���� !'" DEPAR INSPECTOR 1 1 TOWN OF QUEENSBURY Pm BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS (I - 2.) QUEENSBURY, NEW YORK 12804- TELEPHONE (518) 792-5832 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED 5110 i qG NAME W)Lii)120'? * ( Aviadi Ir1�t LOCATION f71 t,u" A q DATE 5 Iv J el f) tip z PERMIT # ,�'7-(1 `8 -J3 • APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING r BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN INSULATION: FOUNDATION FLOORS WALLS C/ 1 /9 CEILING !I / 3g" FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING ✓� EXTERNAL PORCHES/STEPS ✓ STAIRS-CLEARANCE & RAILS PLUMBING FIXTURES/RELIEF VALVE INTERIOR TRIM/PRIVACY DOORS FINISHED FLOORS GARAGE FIREPROOFING DOOR CLOSER(S) ✓� SMOKE DETECTORS FINAL ELECTRICAL INSPECTION FINAL APPROVAL OF CONSTRUCTION OK TO ISSUE C/O OR C/C A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS e 4 1/GeGe ; ,7-d • /fro k 0 - ; 4‘41 ARRIVE /% l° DEPART - -S61 INSPECTOR avA-8ss id pq Queeniur t. BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME /ram LOCATION „( q Dates- /if /dr Permit Noll 7g 7' * * * * * * * * * * * * * * * * * * * * * * * ✓ = APPROVED - YES / NO Footing/Pier Forms Foundation Waterproofing Backfill Framing Roofing Siding Masonr . Veneer R 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 ELECTRIC ,L INSPECTION DRIVEWAY APPRS. AL Final Building Survey Next scheduled inspection (call when ready) Remarks- / A Od/1/4 " Building Inspector 6/86 and-vl rl I '� awn o1 Queena ur j % IPIBUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.O. 1 Box 98 Queens bury, New York 12801 BUILDING INSPECTOR' S REPORT NAME id a/72 /(:06et iv. . LOCATION Date ,7//6?p- Permit No. O /x9 i * * * * * * * * * * * * * * * * * * * * * * * ✓ = APPROVED - YES / NO Footing/Pier Forms Foundation Waterproofing _ ,�Bacckfill / 1pming a�,e6., �-O� !/ 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 ELECT••ICAL INSPECTIO DRIVEWAY APP'OVAL Final Building Survey Next scheduled inspection (call when ready) Remarks- •� AL Building Inspector 6/86 and-vl Jotun o/ ?ueeniurj BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME t' LOCATION CZ 6-`��1) tqc. Date/Z/ / 7 Permit No. 67-- 7_73 ✓ = APPROVED - YES / NO Footing/Pier Forms Koundation A-bv t r-ront Waterproofing Backfill Framing Roofing Siding Masonry Vene= Rough Plumbin• 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 EIECTRIIAL INSPECTION DRIVEWAY APPR6VAL Final Buildin: Survey Next scheduled inspection (call when ready) Remarks- /„. L a ,: _ 57i / 95 /421') Buil 'ng nspector 6/86 and-vl fir 4 A awn ol) Queensbury a1 UILDING and ZONING DEPARTMENT Be and Haviland Road, R.D. 1 Box 98 4 ✓I Queensbury, New York 12801 I ILDING INSPECTOR ' S REPORT AME /f� > 1 �� LOCATION y//,x'-2� ae „let e,6 Date I(// Permit No.1' ?' * * * * * * * * * * * * * Sr = A�PPR V.ED - ,/ NO Footing/Pier Forms a � AYf7 Foundation Waterproofing t 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 ELECTR CAL INSPECTION DRIVEWAY APPFOVAL Final Builds g Survey Next scheduled inspection (call when ready) Remarks- --.) 772 77 //f(: , 04// 1 fry Building Inspector 6/86 and-vl