1476 BUILDING PERMIT
TOWN OF QUEENSBURY No. 1476 0
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Didio Florist cn
OWNER of property located at 17 Luzerne Road Street,Road or Ave.
in the Town of Queensbury,To Construct or place a Dpmolition
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
17 Luzerne Road
Glens Falls, New York
2. CONTRACTOR or BUILDER'S Name
Stanley Walezak
3. CONTRACTOR or BUILDER'S Address
Montray Road
Glens Falls, New York
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( 1 Wood Frame ( 1 Masonry ( 1 Steel ( )
7. PLANS and Specifications ..1
No. C
N
8. Proposed Use
Demolition of a 2 family dwelling fD
v
a.
$ 10.00 PERMIT FEE PAID—THIS PERMIT EXPIRES 12-1- 19 71
(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 Queensbur this 13 Day of OCtohcpr 19 71
SIGNED BY for the Town of Queensbury
Building and Zoni nspector
TOWN OF QUEENSBURY
(Space inside block to Ix. filled in by
WARREN COUNTY, NEW YORK Building Inspector)
Application for \►'Plicatio„
Permit Issued 1(1
BUILDING AND ZONING PERMIT h.,mil Expires
histri(
\ ;ilia• oil \Work 's
THREE (3) Copies of a PLOT PLAN, Drawn to scale \11) '"ed by • "
showin the actual dimensions of the lot to be built k r.n nrk.
upon, The exact size, and location on the lot of the
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION.
DATE
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK
ANSWER ALL OF THE FOLLOWING.
The undersigned hereby applies for a permit to do the following work
which will be done in accordance with the description, plans and specifi-
cations, and such special conditions as may be indicated on the permit.
The owner of this property is:
n /Jr a F/Gri f/
INA`IE1 IP 0 ADDRESS)
The person responsible for supervision of the work insofar as the Building Code and the Zoning Ordinance apply is:
(? NAME) /,/ IP 0 ADDRESS)
Name of Brtriil iet'. . ,J.J ' G'� Z Address e2 dYY,/i��i la
Name of Plumber Address
Name of Mason Address
Lot Number Unit Estimated value of proposed work S
Name of Village
Name of Street Side of street: north 0, east 0, south 0. west ❑
Nearest Cross Street Distance from this cross street Ft.
Property is north 0,south ❑,east ri, west 0 from Cross Street
-If on Corner, which corner, northeast ❑, northwest ❑, 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 L
❑ Alteration to a building. (Two-family dwelling [Er
❑ Demolition of a building. -family apartment house ❑
Store building ❑
-car attached garage ❑
Other:
Accessory Building
One-car detached garage ❑
Other work. Describe. Two-car detached garage ❑
� pl i Qh e ,C Private chicken house El
�,/ private storage building ❑
. . . . . . . . . /-d- �. i!? GG/ /7 /e4rr--rie 4TOther:
y
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, site and setbacks of pro-
NORTH posed buildings,and the location of all existing buildings.
Show proposed building(s) in dotted line and existing
iwilding(s) in solid line.
Size of property C/2e3 ft. x ft.
Size and use of existing buildings, if any
t- I-
u, N
W W
Size of proposed building ft. x ft.
Height (from grade to ridge) 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)
(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 ft.
Size, floor beams, 2nd floor "x ", spacing "o.c., span ft.
Size, ceiling beams "x ", spacing "o.c., span ft.
Site, 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 ss.
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 sub-
mitted, are a true and complete statement of all proposed work to be done on the described prewaes and that all provisions of the BUILD-
ING CODE,THE ZONING ORDINANCE,and all other laws pertaining a 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 ... .....
OWNER,OWNER'S AGENT CHITEC CONTRACTOR
day of 19
NOTARY PUBLIC, WARREN COUNTY. N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
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By