86-611 BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-611
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Freda LaBargeimJ
OWNER of property located at Upper Ridge Road (Route 9L) Street,Road or Ave. is)
in the Town of Queensbury,To 13Dintiliitt or place a Demolition (part of dwelling)
at the above location in accordance to application together with plot plans and other information hereto filed andCrQ
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. CD
1. OWNER'S Address is Star Route Box 151
Glens Falls, New York
2. CONTRACTOR or BUILDER'S Name
same
3. CONTRACTOR or BUILDER'S Address m
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same
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address 0
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6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( 1 Steel ( )
7. PLANS and Specifications
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No. demolition 12'x12' end of dwelling per application submitted.
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8. Proposed Use
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Demolition part of dwelling D
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April 1 19 87
$ 10.00 PERMIT FEE PAID—THIS PERMIT EXPIRES
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the 0-
town of Queensbury before the expiration date.)
F-'
Dated at the Town of Queensbury this 22nd Day of September 19 86
SIGNED BYa C7• 4
for the Town of Queensbury
Building and Zoning Inspector
TO BE COMPLETED BY BLDG. DEPT.
rr Application No.
own 61 QUeOn3burt�
Permit issued 19 tolfinu
V OF
BUILDING and ZONING DEPARTMENT Permit Expires 19 QUEENSBu1
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation NEOEIVE
Queensbury, New York 12801 Variance No.
Site Plan Review No. SET 2 2 t , :
22 02-/ _? ed Approv b : /4-C.. AO >.
APPLICATION FORPAL
A/- ---- �1��•`i " ��el`ti;I4�6
FUILDING 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: - 'Z2 � :� lci , J c A--� --t.-
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P.O. Address _.}, `L A.,,,,eke, 4 /J�1r L ,,,,,, ...c64. v+ Tel. � /�Property Location: 36, ;1t-c-c -� � Tax Map No.• : / f / Q
Street dumber or building lot number
Subdivision name (if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
Name P.O. Address Tel. No.
Name of builder 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
of water supply and location and configuration
LOCATION OF STRUCTURES AFFECTED. *
1 Y / of septic disposal area.
/, '1 /i f cf.`1\ .-t-e2rt... *
/ * COMPLETE INFORMATION REQUIRED BELOW.
* Size of property/,4C/W. ft X ft.
* Existing building(s) Size ft X ft.
*
PROPOSED BUILDING AND USE: * Existing building(s) Use
Size of new structure ft Xft
Foundation-pier/slab/crawl/partial/full * Proposed building, distance from property line
*
(circle one)
No. of stories (habitable space) * Front yard ft Rear yard ft
* Side yards ft and ft
Height (grade to ridge) 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
* One family dwelling
Primary heating system
Type of fuel * Two family dwelling
Multiple dwelling / Number of units
No. of fireplaces to be installed *
Will a wood stove be installed? * Permanent occupancy
Central Air conditioning? _ * Transient occupancy
* Business
BUILDING STYLE, PRIMARY STRUCTURE * Industrial
Ranch Contemporary Log cabin * Other
Raised ranch Mansion Duplex * If addition, what will use be?
Split level dstyle. Bungalow *
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 $ *
•
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. d
Type of construction, wood frame, fire safe,etc.
Will any second-hand or ungraded lumber be used? If so, for what?
Foundation wall material Thickness
Depth of foundation below grade (to bottom of footing)
Will there be a cellar? Heated or unheated? Floor sq. footage sq ft
Will there be a basement? 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
Size, wood studs "X " spacing "o.c. length ft.
Joists(floor beams) 1st. floor "X " spacing "o.c. span ft.
Joists (floor beams) 2nd. floor "X " spacing "o.c. span ft.
Overlays(ceiling beams) "X spacing "o.c. span ft.
Roof rafters "X " spacing o.c. span ft.
Roof trusses(pre-engineered) spacing "o.c. span ft.
Exterior wall finish Of what material?
Interior wall finish
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 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 Queensbury t1 g F F I D Afi V I T STATE or NEW YORK
County of Warren
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 hot,',and that such work is
authorized by the owner.
SWORN TO BEFORE ME THIS Signature
er, ownerc5 a ent arcnit� tractor
g . r
day of 19
Notary Public, Warren County, N.Y.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
SPECIAL CONDITIONS OF THE PERMIT:
By
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