5124 BUILDING PERMIT
TOWN OF QUEENSBURY No. 5124
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Arthur Byers
OWNER of property located at Sullivan Road Street,Road or Ave.
in the Town of Queensbury,To Construct or place a Demolition mobile home
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 R. D. #1
Lake George, N. Y.
2. CONTRACTOR or BUILDER'S Name (I)
(p
3. CONTRACTOR or BUILDER'S Address
C')
C
4. ARCHITECT'S Name
N
lv
5. ARCHITECT'S Address P7
0
A
Cl.
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( )Masonry ( )Steel ( )
7. PLANS and Specifications
Demolition mobile home 8' x36' and 9t6"x20' d
No. per application submitted. o
8. Proposed Use Fes•
Demolition dwelling w
0
$ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES Aug. 1 1978
(If a longer 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 17th Day of April 19 78
SIGNED BY ,p e for the Town of Queensbury
Building and Zoning Inspector
TOWN OF QUEENSBURY
(Space inside block to Ix. filled in by
WARREN COUNTY, NEW YORK Building Inspector)
Application for kl►I►Ilration No. •
I'crmit Is,ued.
19
BUILDING AND ZONING PERMIT I'1'I alit Expires Ici
i:1,n R1 Uistrirt
l lll' 4)1 Work,
THREE (3) Copies of a PLOT PLAN, Drawn to scale 'i T'°'c'cl Itv
showing the actual dimensions of the lot to be built I' 11,.11
upon, The exact size, and location on the lot of the
building to be erected or altered MUST BE SUB •
-
MITTED WITH THIS APPLICATION.
1L , TO. F QUEENSBURY
n4TE D j _ V E _�
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK
a`il? d t "-. .
ANSWER ALL OF THE FOLLOWING. �a u✓ ' v t
The undersigned hereby applies for a permit to do the following work A,M. I i P.M.
which will be done in accordance with the description, plans and specifi- 7 1 8 1 9 1101111121 1I213141516
cations, and such special conditions as may be indicated on the permit. A
The own of this proRer is:
(NA 'E) IP O ADDRESS)
The person responsible for supervision of the work insofar as the Building Code and the Zoning Ordinance apply is:
. . . . . . . . . . . . . .
(NAME) IP 0 AGDRESSI
Name of Builder Address
Name of Plumber . Address
Name of Mason Address
Lot Number. / ?./%. . . Unit Estimated value of proposed work S
Name of Village
•
Name of Street .,&?///U►3 N Ro P+j Side of street: tvrth 0, east 0, south O. west Er-
Nearest Cross Street
•f /f.F1.. . Aee 1'60 Distance frc,rl this Cross street Z(7.c. . . It.
Property is north I i,south 0,east ri,west ❑from Cross Street
If on Corner, which corner, northeast 0, northwest 0, southeast 0 southwest
(Designate by marking with an "X" in the correct space.)
NATURE OF PROPOSED WORK OCCUPANCY
❑ Construction of a new building. Main Building
❑ Addition to a building. One-family dwelling ❑
❑ Alteration to a building. Two-family dwelling ❑
74 Demolition of a building. family apartment house ❑
Store building ❑
. -ear attached garage ❑
other:
Accessory Building
One-car detached garage ❑
❑ Other work. Describe Two-car detached garage
ti
. . ._:"C:/,r e'/A .7`i.4?). . _. . .�°'?. .a.,.C = Private chicken house
Private storage building ❑
illu �' 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-
NORTH posed buildings,and the location of all existing buildings.
Show proposed building(s) in dotted line and existing
building(s) in solid line.
Size of property . . . .1. . . . . . . ft. x . .,l 0. . . . ft
Size and use of existing buildings, if any
Size of proposed building . . .a . . ft.x 3 ft' ft.Gr
Height (from grade to ridge) ►�1 t '` Ga'" it.
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.?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . .
Will any second-hand lumber be used? If so, for what?
Material of foundation walls Thickness
Depth of foundation walls below grade Continuous foundation?
Will there be a cellar? If so, material of cellar floor
Type of roof: Sloped or flat? Material of roof
Size, wood studs "x ", spacing "o.c., length • ft.
Size, floor beams, 1st floor "x ", spacing "o.c., span Pa ft.
Size, floor beams, 2nd floor " x ", spacing "o.c., span
ft.
Size, ceiling beams "x ', spacing "o.c., span ft.
Size, roof rafters or beams "x ", 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 building to be constructed?
Is there to be an opening between garage and building?
Kind of heating system Oil burner or coal?
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 supply?
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 bead my know,iedge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, are a true and co.,.plete statement of all proposed work to be done on the described premises and that ail provisions of the BUILD-
ING CODE,THE ZONING ORDINANCE,and all other laws pertaining to the roposed work shall be complied with,whether specified or not,
and that such work is authorized by the owner.
Sworn to before me this Signature .... .. C ?YZ'
OWNER,OWNERS A N ARCHITECT,CONTRACTOR
day of. 19
--- _ _ NOTARY PUBLIC. WARREN COUNTY. N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
•
•
•
By