4575 TOWN OF QUEENSBURY (Space inside block to be filled in by
WARREN COUNTY, NEW YORK Building Inspector)
Application No. "• APPlication for
I crmit Issued 19. .
BUILDING AND ZONING PERMIT 1''''-"'ii Expires. lg. .
i.,,iiinu District '
. \ alai ()I Work%
THREE (3) Copies of a PLOT PLAN, Drawn to scale • Aiil "%t•(I I'`
showing the actual dimensions of the lot to be built Rt'ni:i(.Kfr
upon, The exact size, and location on the lot of the
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION.
,>i / TOt:'i OF QUEENS `R t
. DATE ' .4 k Virli I] VE
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK X D�t�)� � � 1977
ANSWER ALL OF THE FOLLOWING.
A.M;
The undersigned hereby applies for a permit. to. do the following work `1I$I9 i10�I1112�1 2 J 3I�� ��P.M"
which will be done in accordance with the description, plans and specifi- �� _e__a__a_-a-_e, a_,_+ ,_ , R 4_,
cations, end such special conditions as maybe indicated on the permit.
t �.. .
The owner of this ra rt is: �7
�P Pe Y
L A'S. Q. P.441.a N.k�s� . `GLJ�S. ? ?� �r:c�af s' fi•r•. e.p---�i�c � � , ��./
"� �� �. (P.O.ADDR S)
G' /�� + Yo' tfie wdr ins r as the Building Code and the Zonin Ordinance apply is:
eron res'ponsiff �u� is n t K g 1'P
J/ ���
�. !• / (NAME) - (P.O ADDRESS),
Name of Builder. . .. Uf��e • Cd c''j'c � •`l'Address
Name Of Plumber "r. Address
s r . :ar
Name of Mason • Address d d
Lot Number • Unit Estimated value of proposed work 5 /./. .®C: .0.. C>'C-%r. . �• . • . . • .
Name of Village , I /ii L `•
Name of Street . / .f/f l - ��� �-f�` s'• / `.3 Side of street: north ❑, east 0, south O. west 0
Nearest Cross Street . . ._ 2 rel-Ae.. 0, e- Distance from this ri-oss street • Ft.
Property is north fcuth ❑,east i 1, west ❑from Cross Street
If on Corner, which corner, northeast 0, northwest ❑, southeast ❑. southwest
(Designate by marking With.an "X" in the correct space.) .
NATURE OF PROPOSED WORK OCCUPANCY
14 Construction of a new building. Main Building
❑ Addition to a building. One family. dwelling ❑
ElAlteration to a building. Two-family dwelling • []
family apartment house ❑
❑ Demolition of a building. Store building ❑
. ca Cached garage
D � �'Q -0/6 Other:�G '✓ f.cz-,e acrrl i Fl '�. . . .;,
t`/�� Accessory Building
• - One-car detached garage Li
❑ Other work. Describe• Two-car detached garage ❑
Private chicken house . E.
- �� Private storage building. ❑
)11: � _ .�.
`t/ .�� �1TrAIWAr� 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.
. NORTH Show proposed building(s) in:dotted line and existing
huilding(s) in solid line. -
Size of property 0 ft. x . . . S'7gO. . ft.
Size and use of existing buildings, if any
F f r
s w Size of proposed building ./ Z- ft.x„• . :7 • . ft.
Height (from grade to ridge) . . . •./f ft.
Front yard . . ft.
Side yards .• ft. and ft.
Rear yard ft.
SOUTH If on corner, setback from side street ft.. ..
' • Note: All distances are net, as measured from street side
line to nearest part of building.:
(OVER) .
7-73-M
(cont'd.)
BUILDING SPECIFICATIONS.,
Kind of construction: Wood frame, fire safe, etc.' t�-9:-/-7�C' "�/zr—
Will any second-hand lumber be used? IS so, fqr what
Material of foundation walls . . . .(,e-ec.w.. C g ia-cw Thickness /fie"
Depth of foundation walls below grade Continuous foundation?
Will there be a cellar? . I o,jaterial of cellar floor
Type of roof: Sloped or flat? . -6. . . Material of roof . . . . � �✓�/1' . .
Size,wood studs " x ", spacing "o.c., length • ft.
Size, floor beams, 1st floor "x ", spacing "o.c., span ft.
Size, floor beams, 2nd floor " x ", spacing "o.c., span ft.
Size, ceiling beams it " x -z spacing "o.c., span ft.
Size, roof rafters or beams • • .R,C, C� , spacing "o.c., span ft.
Exterior finish . With what material?
Finish of interior walls
If garage is to be attached, of what material is wall between garage and main buUding to be constructed?
Is there to be an opening between. aragee and building?
Kind of heating system AVr /T Oil burner or coal? L' .
Will a flue-lined chimney be provided? - Depth of chimney 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 suppy?,.
Water supply (public water supply or pump)
Distance of cesspool from any private well feet
Will drainage system be provided with required traps, cleanouts, and vents?
Town of Queensbury AFFIDAVIT
County of Warren
State of New York
I swear that to a bard my knowledge and belief the statements contained in this application,together with the plane and specifications sub-
mitted, are a true and co.,.plete 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 proposed work sh 1 complied with,whether specified or not,
and that such work is authorized by the owner.
Sworn to before me this Signature .r:rpm CTOR
,0 HEWS AGENT.ARCHITEC . ONT CTOR
day of 19
NOTARY PUBLIC, WARREN COUNTY. N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
•
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BAY 4 $aj�5rr,;.LAND ROADS,,,, a q id c. I
GLENS FAILS, NEW YORK 1280
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Stb IS HE.R.ri345 AGREED D THAT-AT x HIS APPLICATION AND PLANS ARE APPROVED,
INSTALLATION OF SEWAGE DISMAL FACILITIES WILL BE MADE X.?'4 ACCOT WANC d
• WITH DET AU:S S O+WN, MATURE OF APPLICANT '✓ .
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TOWN OF QUEENSBURY
• Building Department
Inspectors Repo.Tt Date /2 -Jlr'
Name IC,I�C.�'(�
Location
Permit No.---- � f Weather L,.11-11-W
Per Cent
Complete Remarks
Excavation
Footing Forms
, Footing & Piers k,
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey ✓ ,
Framing
Sheathing ✓ 67-1
Roof Felt
Roofing
Siding ✓/ ' •
Masonry Veneer
Rough Plbg.
Rough Htg.
Relief Valves r�
Wall Board i / /n
Ext.Porches /
Finished Floor Y �'
Interior Trim
Stairs&Railings
Cellar Dr.Tile
Concrete Floors
Plhg.Fixtures
Gar.Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
17Za4
Building Inspector
REMARKS
/2
TOWN OF QUEENSBURY. •
Building- Department
Inspectors Report Date 1 7
Name �i✓//I�/G tf It in-7
Location . j3 / T 6 4
Permit No. 474.3-7.5- Weather
Per Cent
Complete . Remarks
Excavation
Footing Forms D /->
Footing & Piers
Foundation
• Cement Coat /
Waterproofing
Backfill C� j/mot/
• _Final Survey
Framing t/
Sheathing /.:194)r/
Roof Felt l��
Roofing T/2IJS.5 r�
Siding
Masonry Veneer
Rough Plbg.
Rough Htg.
Relief Valves •
Wall Board
Ext.Porches
Finished Floor
Interior Trim
Stairs&Railings
Cellar Dr.Tile
Concrete Floors
Plhg.Fixtures
•
Gar.Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval rzi,/
Building Inspector
REMARKS
TOWN OF t•U ENSB RY
Building Department
Inspectors Rort Date_ ? /
Name .",, � t Ce
Location �%L'' l 4 Permit No. Weather
Per Cent
Complete Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Rough Htg.
Relief Valves
Wall Board
Ext. Porches
Finished Floor /
Interior Trim
Stairs&Railings
Cellar Dr.Tile
Concrete Floors
Plhg.Fixtures
Gar.Fireproofing
Door Closers �r
Chimney
Water Meter Inst. e/ 4
Septic Approval
Building Inspector
REMARK
•
TOWN OF QUEENSBURY
Building Department
Inspectors Repor, Date � 302
Name /k? i 8/2 / G ,
Location /' z2- / //'ti
Permit No. Lf 5-7 5— Weather
Per Cent
Complete Remarks
Excavation L..-^ .11
Footing Forms
Footing & Piers l/
Foundation
Cement Coat
Waterproofing
d4(
Backfill e
Final Survey
Framing rll
Sheathing V/ /7/&;/eiLit.,/
Roof Felt
Roofing L ,.
Siding
Masonry Veneer IJ
Rough Plbg.
Rough Htg.
•
Relief Valves
Wall Board
Ext.Porches
Finished Floor
Interior Trim .�
Stairs&Railings
Cellar Dr.Tile
Concrete Floors
Plhg.Fixtures
./1>
Gar.Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
/ alf/yel‘
Building Inspector
REMARKS
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VACATION LAND. BROADCASTING Co.
PROPOSED
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JECKEL, INC.
SEARS, ROE CK CO. (warehouse)
north-
11
F90ft" :hVWAWN MAP ON THIS, �Hlrf-r NAtp TFAaV
"OtA A lC7UKVt-Y PRMWV Cl'( 60ULTt?, Q Mc, CZ:'FA A61V,
LZM:7tV LAND to0AqryoF4ep, 6rLM-b MALLev ; Nt'W `(OfNh, -
i' TITLE V I kw OF LAN T'UAT
IN 4 ITT :-r & lb. Erg C2 hk�L I DrTOZ 14K &e7fT-0 a'Nue"t-N KI
WAK" COUNT'(, htY4 YORK, BATED OcTOb0N 11 1D75
I TOV-,�j OF QUEENSBURY
. D
APR 26-1977
AN
P.M.
516 j
TJTLE
DUKE CON-CRIETE PROOLIC I