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1857 BUILDING PERMIT t., TOWN OF QUEENSBURY rxi r No. 1857 WARREN COUNTY, NEW YORK 0 PERMISSION is hereby granted to John Ambler OWNER of property located at Mayflower Lane Street,Road or Ave. in the Town of Queensbury,To Construct or place a Addition Sewage System 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 Kattskill Bay New York 2. CONTRACTOR or BUILDER'S Name A.C. Mason 3. CONTRACTOR or BUILDER'S Address Cleverdale, New York 4. ARCHITECT'S Name 5. ARCHITECT'S Address 6. TYPE of Construction—(Please indicate by X) X )Wood Frame I )Masonry ( )Steel ( ) 7. PLANS and Specifications No. 12'X22' as per application Sewage System as per plans. r' 8. Proposed Use Living Area 1000 gal. conc. tank $ 11.00 PERMIT FEE PAID—THIS PERMIT EXPIRES 9-1- 19 72 (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 19 Day of June 19 72 SIGNED BY w ! 4"), for the Town of Queensbury ding and Zoning Inspector ® TOWN OF QUEENSBUR'� i Splice inside block to Ixc lillecl in b1 `.VAF'.•REN COUNTY, NEW YOFK Building lnspe(tort Application for ' .';'t.iti• rt No Pornnt 1-.ored. BUILDING AND ZONING P..l.' Pr•Imit 1.-.Mires . . . . . . . . r! /tt,un•., 1r,tri,t . hill„ n! \1 .,L , THREE (31 Copies of a PLOT PLAN, Drawn to scale \i'!""" '! IR. showing the actual dimensions of the lot to be built It. w.,, . • upon, The exact size, and location on the lot of the TOWN G: QEJ�Ef�lSl3l3E2Y building to be erected or altered MUST BE SUB- MITTED WITH THIS APPLICATION. D = 3 P [I l . 1 •o © rr ,� 4 " U N 1 9 19 Q DAT,' g P.M. A PERfr11T MUST BE OBTAINED BEFORE BEGINNING WORK I 7iglg1101111121 1 1 2 1 3 1 4 1W ANSWER ALL OF THE FOLLOWING. A. 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 this property is: [7 o (NA 'E) P0 A,,CiESS) The person rrye�sponsihie ffiy supervision of the work insofar a/ .1),e uil`diing Code /and the Zoning rdinance pply is: (NAME) (PO. A( DRESS) Name of Builder �,r _ Address Name of Plumber /�'�' '" e Address ram" "�` '`'� �' 4-s—"- * 9 Name of Mason . . Address . . Lot Number Unit Estimated value of proposed work$ . e.r. cs, — . Name of Village Name of Street Side of street: north 0, east 0, south 0. west 0 Nearest Cross Street . . . . . Distance from .}:,a cross street Ft. Property is north 0,south 0,east i i, 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 teis.„ Addition to a building. One-family dwelling 0 Alteration to a building. Two-family e`linf; El 0 Demolition of a building. . -family apartment house ❑ Store building ❑ . -car attached garage ❑ Other: Accessory Building One-car detached garage ❑ ❑ Other work. Describe �1 / Two-car detached garage ❑ /.��/di // / Lc v,/A'z S Private chicken house Private storage building ❑ 4".',a.-1 , 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- C.-7 NORTH posed buildings,and the location of all existing buildings. Show proposed buildingis) in dotted line and existing /4..44- l;uilding(s) in solid line. Size of property ft. x ft. li Size and use of existing buildings, if any ~la ` in < d�'�1ab s usSize of proposed btri•lditf ri` ft.x Z ft. Height (from grade to ridge) ft. 1 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, es measured from street side line to nearest part of building. (OVER) (cont'd.) BUILDING SPECIFICATIONS. Kind of construction: Wood frame, fire safr, etc.?. . . , . . . .'Ai. e...." -. . , .°:- Will any second-hand lumber be used? u o If so, for what) Material of foundation walls 0 , thickness . . . .3.". . i cd.4, . . , , Depth of foundation walls below grade `3 !(�-' 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 a • ft. Size,floor beams, 1st floor �,_.. . . " x ",spacing , . , , , , . 117. , . ,"o.c., span l?-� ft. Size,floor beams, 2nd floor 2,, . . ." x /° ", spacing , , . , , , .!.G. , , ."o.c.,span . , , .i.'?-— ft. Size,ceiling beams 2. " x c, ", spacing "G "o.c., span , , , ./.2 - ft. Size,roof rafters or beams . . . .2. " x G ", spacing l,. . ."o.c., span 1 44_ ft. Exterior finish 5 4i'f,e- e 5 ^ With what material? Finish of interior walls. . . . . . . . . . . . . . . . . . . . . . If garage is to be attached, of what material is wall between garage and main buij.8ing 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? AFFIDAVIT Town of Queensbury 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 premises and that all of the BUILD- ING 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. a D1' . „�d'�y__ Sworn to before me this Signature .... . .. . .. l t- C C� ._�, OWNER,OWNERS AGENT,ARCHITECT,CONTRACTOR day of 19. NOTARY PUBLIC, WARREN COUNTY. N. Y. SPECIAL CONDITIONS OF THE PERMIT: By • TOWN OF QUEENSBURY WARREN COUNTY, NEW Y0RK Application for A PERMIT TO CONSTRUCT, ALTER OR ENLARGE A SEWAGE DISPOSAL SYSTEM FOR A PRIVATE RESIDENCE WITH WIND F QUEENSBURY TOWN OF QUEENSBURY p i l Mail or bring this application to : 6-.0JUN 1 9 19Q Building 8 Zoning Department Queensbury Town Office Building A.M. P.M. R.D. 1 Bay Road 71M10Ni12P1PM4lM Glens Falls, New York 12801 A This application for a Sewage Disposal Permit must be accompanied by a plot plan drawn reasonably to scale showing all dimensions, the size of the lot, the location on the lot of the water supply and sewage system. 1. Name and mailing address of applicant: .7:04 /bs-,4 I 7 g J. 0,4 2.44ri,e 2. Specific location of property: (STREET AND NUMBER) 3. Application is for: New construction of private dwelling . Alteration or enlargement of existing sewage disposal system. 4. Description of building: a. number of bedrooms b. garbage grinder (YES OR NO) 5. Topography: daft rolling, steep slope, gentle slope, etc. ) 6. a. Nature of soil. (Describe to a depth of 5 feet if tile field is to be used or 10 feet if leaching pits are proposed, giving thickness of various strata such as top soil, clay, loam, sand, gravel, rock, etc. ) b. How determined? 1=-2e 7. a. Soil percolation test made by (Refer to Part III , Bulletin 1 , N.Y.S. Department of Health) b. Percolation test notes submitted? (YES OR NO) 8. Proposed sewage disposal system indicated on attached plan or sketch? (YES OR NO) COAte 7Lif/Of/` 9. Date when construc4 n will commence It is hereby agreed that if this application and attached plans dated or any amendment or revision thereof , are approved,insulation of sewage disposal facilities will be made in accordance with the details thereof as shown on such approved plans. Installed By: Contractor - (Signature of applicant) Owner Cottage Rentals Contracting TAKUNDEWIDE, INC. A. C. Mason CLEVERDALE, N. Y. 12820 Tel. Kaffskill Bay NL 6-9573 !Area Code 518) - - <, l - c Y % I ' ,,.\\.\\ • , .s., , dc.,, , .4„.s,,, ., \ \,_ , , ..L. ,..,...._. -, „„ ,,,, vi 'N'l '71, d T \ k SI 4.4 J