87-781 • BUILDING PERMIT
re>/\°— \ TOWN OF QUEENSBURY 87-781
No. ,b
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Bob Murtha a,
OWNER of property located at Fitzgeaald Rd. Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Alteration to interior
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 Same
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2. CONTRACTOR or BUILDER'S Name
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Same
a. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name ro
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a.
5. ARCHITECT'S Address id
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6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ► Masonry ( )Steel ( )
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7. PLANS and Specifications rD
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No. Replace broken windows, upgrade bathroom as per specifications
and application. p
8. Proposed Use
Atiditimt Alterations to one family
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$ 20.00 PERMIT FEE PAID kTHIS PERMIT EXPIRES June 1, 19 88
(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.) 0
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Dated at the Town of Queensbury this 23rd Day of November 19 87
SIGNED BY V/Z for the Town of Queensbury �c
Building and Zoning Inspector -
TO BE COMPLETED BY BLDG. DEPT.
.acc�77�� Application No. -k r .
wn of ?ueenJ4ury I1.` Permit Issued 19 y i_ , _t z
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BUILDING and ZONING DEPARTMENT Permit Expires 19 I_ ,_.
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation NOV 15 81
Qu e,�sbury, New York 12801 Variance No.
t ,\ Site Plan Review No. eLII!_!`A G dr CODE OEpy.
\,. N\ ' Approved by: 6 r
APPLICATION FOR /( f r/C- 01, ,:,/
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: &G /71 O/Tf/A
P.O. Address F / T ZC s//1lLD eqD. , GLe.NS 1-,6LL-.T Tel. 79. /ciJ
Property Location: F l TZgEWf1/-D ,eri/q, Tax Map No. / / '
Street number or building lot number
Subdivision name (if applicable) —
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK ASS REGARDS BUILDINGt/ CODES IS: /
G( 06F2T m(//eTHf! Ql mf1/vlVJ ? , G,LrvJ. /cFLLs, Ai. Y. <7 Q,i'/9/.i
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,
X Alteration to a building * showing clearly and distinctly all buildings,
(no change to exterior dimensions) * whether existing or proposed and indicate all
X Other work (describe) 'f oo.racE &poKFN * set-back dimensions from property lines. Give
ithioOoa)s, UPr�e,7,9£ �tTyeoom * 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. *
of septic disposal area.
*
* COMPLETE INFORMATION REQUIRED BELOW.
* Size of property ft X ft.
* Existing building(s) Size ft X ft.
*
PROPOSED BUILDING AND USE: * Existing building(s) Use
Size of new structure ft X ft *
Foundation-pier/slab/crawl/partial/full * Proposed building, distance from property line
*
(circle one)
* Front yard ft Rear yard ft
No. of stories (habitable space)
* 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 * Two family dwelling
Type of fuel * Multiple dwelling / Number of units
No. of fireplaces to be installedPermanent occupancy
Will a wood stove be installed? *
* Transient occupancy
Central Air conditioning? * Business
BUILDING STYLE, PRIMARY STRUCTURE * Industrial
* Other
Ranch Contemporary Log cabin * If addition, what will use be?
Raised ranch Mansion Duplex
Split level Old style Bungalow *
Cape Cod Cottage gano2-STOeY * 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 $ /p) COO *
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, 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 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 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 AFFIDAVIT STATE OF 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 not, and that such work is
authorized by the owner.
SWORN TO BEFORE ME THIS Signature cs € - -
Owner, owner's agent,arcnitect,contract r
day of 19
Notary Public, Warren County, N.Y.
* * * * * * * * *_ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
SPECIAL CONDITIONS OF THE PERMIT:
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