5255 BUILDING PERMIT
TOWN OF QUEENSBURY No. 5255
WARREN COUNTY, NEW YORK (D
CL
• ft
PERMISSION is hereby granted to Frederick R. Jr. - and Shirley B. Shenk 0:
e
OWNER of property located at Lot 19 Northwest Road Street, Road or Ave.
in the Town of Queensbury,To Construct or place a One-Family Dwelling e�
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
9 Pershing Road cn
Glens Falls, New York 12801
y
N
2. CONTRACTOR or BUILDER'S Name fD
Robert W. Weaver Jr.
3. CONTRACTOR or BUILDER'S Address :'
fD
6E Manor Drive
Glens Falls, New- York 12801 x
4. ARCHITECT'S Name
. r
5. ARCHITECT'S Address
L
O
H
6. TYPE of Construction—(Please indicate by X) C+
()d Wood Frame ( ) Masonry 1 )Steel ( ) (D
N
C+
7. PLANS and Specifications ;Cl
No 341 x 48' per plot plan, specifications and application 0
submitted including sewage system and two-car attached
garage
8. Proposed Use
One-Family Dwelling o
D
(D
$5.00 C/O Paid
$ 70>00 PERMIT FEE PAID —THIS PERMIT EXPIRES JanLlary 1 19 EI
(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 9th Day of June 19 78_
m
SIGNED BY for the Town of Queensbury
BuilAng and Zoning Ins ectorLa
TOWN OF QUEENSBUIZY
(Space inside block to be filled in b%-
W/ARREN COUNTY, NEW YORK Building Inspector)
Application for Application No.
Per,l,it Ismied Iq.
BUILDING AND ZONING PERMIT Expires.
isums,, Distri(t
;,luc• nl \Vork
THREE (3) Copies of a PLOT PLAN, Drawn to scale h\.
showing the actual dimensions of the lot to be built
upon, The exact size, and location on the lot of the
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION.
TOY�'N OF(QUEE(NSBURY
2 DoA PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK
ANSWER ALL OF THE FOLLOWING.
A.M. `75d° �&
The undersigned hereby applies for a permit. to. do the following work M.
7�8J9i1Oj11�12�1 2 3 4 5 6 which will be. done in accordance with the description, plans and spacifi- + -+ + + I +1+ I+ I+ I
cations, and such special conditions as may be indicated on the permit. Lz�'
The owner of this propert is:. �—/-e c%j-;C/C /P 7Y. h i r/e V �` o lac
. . . . . . )7 -tiE'NK. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(NAVE) (P.O.ADDRESS)
T n responsible for supervision of the work insof C.as the Building Code and the Zoning Ordinance apply is:
._.V1� (�.v.i y?. .AFC. . . . . . . . . . . . . . . . . . . . . . �E. . ..V1+1:�d� •�'_ C
(NAME) (P.0 AQRESS). . . .
Name of Builder. . . . . . `. . . . . . . . . . . . . . . . . ...:. . . . . . . . . . . . . .Address . . . . . . . . . . . . . . . . . ... . . . . . . ... . . . . . . . . . . . . . . .
Name of Plumbers 1 . .�' t? �6' 7-`. . . :. . .-.'. . :. . : '. :. . .Address ti�
._ .
Name of Mason. . . . . L. .2.i . . . . . . . . . . . . . . . . . . . . I . .Address . . . . . . `
Lot Number. . . .1.CA. . . . . Unit : . . . . . . . . . . . Estimated value of proposed work i
. . . . . .
Nameof Village . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Name of Street .� .. . . . .V. Side of street: north ❑, east ❑, south ❑. west ❑
Nearest Cross Street . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Distance from this cross street . . . . . . . . . . . . . . . . . . . . Ft.
Property is north ❑,south ❑,east i J,west ❑from Cross Street
If on Corner, which corner, northeast ❑, n(irthwest ❑, southeast E,'souoi"est
(Designate by marking'with.an "X" in the correct space.)
NATURE OF PROPOSED WORK OCCUPANCY
❑ Construction of a new building. Main Budding
❑ Addition to a building. One-family. dwelling
❑ Alteration to a building. Two-ramify dwelling ❑
❑ Demolition of a building. . • • • . -family apartment house ❑
Store building ❑
. . .7�.-car attached garage ❑
Other: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . ... . . . . . . . . . . Accessory Building
One-car detached garage ❑
Other work. Describe:. . . . . . . . . . . . . . . . . . . . . '. . . . . . . . Two-car detached garage
Private chicken house
... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
❑
Private storage building ❑
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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, site and setbacks of pro-
`
NORTH posed buildings,and the location of all existing buildings.
Show proposed building(s) in dotted line and existing
ttuilding(s) in solid line.
Size of property ft. x . . . ft.
Size and use of existing buildings, if any . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . .
to W Size of proposed building . . . 3.�. ft.xO . . ft.
Height (from grade to ridge) . . . ..... . . . . . . . . . . . . . . . ft.
Front yard . . 0140. . 1
Side vards . . .70. --. . . . . ft. and . . d . . • • . . ft.
Rear yard . . 6 ^�. .,r . . . . . . . . . . . . . . . . . . . . . . . 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. ood frame, f' a safe, etc.?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... .. . . . . . . . . . . . . . .
Will any second-hand lumber be used? . . . . ... 9' .CD. . . . . If so, for what?. . . . . . . . .
Material of foundation walls . . . .VVV\7:&u;v• . N. . Thickness .
. . . . . . . . . . . . . . . . . . . . . . . . .Depth of foundation walls below grade . . . . . . . . . . . . . . . . . . .
Continuous foundation?
Will there be ar? . . . A)V. . . . . . . . If so, material of cellar floor . . . . . . . . . , , , . . . .
Type of roc Sloped flat? . . . . . . . . . . . . . . . . . . Material of roof . . . . �'��� �- ,�• ,
Size, wood studs . . . . . . . . . . . . . ..`? . "x . . �. . . . . . . . . .", spacing . . . . . , �. "o.c., length. . .
Size, floor beams, 1st floor . . . . . . . . . . . . ..x . . " spacing ."o.
ft.
c., span . . . . . . . . . . . . . . ft.
Size floor beams 2nd floor . . . . . :Z . " x . . . . . . . '
", spacing . . . . . .(. .� . . .'o.c., span . . . . . .T. . ft.
Size, ceiling beams . . . . . . . . . . . x, . . . . . . ", spacing "o.c. s an . . . . . .p . . . . . . . . ft.
Siie, roof rafters or beams . . . . . . .. x . . . . .t .� .", spacing . . . . /. I. . . . . ."o.c., span . . . . ./. 6. . . . . , ft.
Exterior finish . . . . . .�--". .! . �. Sy I"?. . . . . . With what material? . . . . . . . . . . . . . . . . . .
Finish of interior walls. . . . . . . . . . . .' . - '. . . . . .
F attached,
, fit. . . in t�. `�.. between . . . . . . . . . . . . be constructed?
o . tructe . . . . . . . . . . . . . . .
If garage is to be attached, of what material ' wall between n garage and main bui<1Qing to be constructed?
g g v� �--
Is there to be an opening between gara e a d building? . . . . . , • "
Kind of heating systeml. . . .�. . . =-1�!� "Z. . ?
- - - - - - - - - - Oil burner or coal. . . . . . . . . . . . . . . . . . . . . . . . . . . .
Will a flue-lined chimney be provided? . .�. . . . . . . . . . . . . Depth of chimney foundation below grade . . . . . . . . . . . . . . . .
Height of chimney above r f. � . . . .{. . . : . . . . . . . . .
Will,there be a fireplace? .�. � . . . . . . . . . . . . Depth of fireplace hearth �-< Y'��. . . . .�-L=
Will a toilet be installed?. . . . . . . . . . . . . . . . . . ... .
Will a kitchen sink be installed and to water supply? . . . . . . . . . . . . . . • " .
Water supply.(public water supply um . . . . . . . . . . .
Distance of cesspool from any private well . . ... . . . . . . . ...�.�' . . feet
Will drainage system'be provided with required traps, cleanouts, and vents? . . . . . s'. . , , , _ , _ . • • . _ . . . .
Town of Queensbury AFFIDAVIT
County of Warren
State of New York
I swear that to it;"bar of my knowledge and belief the statements contained:112-du' ther with the plane and a ,cations sub-
mitted, are a true and co.c.plete statement of all proposed work to e-o the described p see and that a[I provuione the BUILD-
ING CODE,THE ZONING ORDINANCE,and all other laws ming to the proposed work e 1 be complied with,whether ified or not,
and that such work is authorized by the owner.
Sworn.to before me this. Signature ........... ...I. ... .......ER, ..E..ENT...................... . .
OWN R'S AG ,ARCHITECT,CON A Op
............................. ........day of......,..................................:.........19........
..... .. ...................................
NOTARY-PUBLIC,WARREN COUNTY.,N.-Y.
SPECIAL CONDITIONS OF THE PERMIT:
By ...............................................................................................................
T01,TH OF ("USENSN-TRY
BUILDTNCZ & 2(MI-TM4
BAY ex IL61vil-AiM, ROADS T L'r', I
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DIAGRAM OF Pr-,'OPOSED "ErTic ISYKILI'll
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THE NEW YORK BOARD. OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
41 STATE STREET,ALBANY,NEW YORK 12207-
Date Application No.on file A
THIS CERTIFIES THAT /1
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
in the following location; ❑ Basement ❑ 1st Ft. ❑ 2nd Fl. Section Block Lot
was examined on and found to be in compliance with the requirements of this Board.
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS RECEPTACLES SWITCHES INCANDESCENT1 FLUORESCENT MERCURY
VAPOR AMT. I K.W. AMT. K.W. AMT. K.W.. I AMT. I K.W. AMT. H.P.
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS DELL UNIT HEATERS MULTI-OUTLET DIMMERS
OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. SYSTEMS .AMT.' WATTS
NO.OF FEET
SERVICE DISCONNECT NO.OF S E R V I C E
AMT. AMP. TYPE METER EQUIP.
.0 2W 10 3W 3 0 3W 3,6"4W NO,OF CC.COND. A.W.G. NO.OF HI-LEG A•W.G. NO.OF NEUTRALS A.W.G.
EQUIP. PER B• OF CC.COND. OF HI•LEG OF NEUTRAL
OTHER APPARATUS:
BRANCH MANAGER
Per
rnoY rew RnII nINN nroAOTAAFfJT_ rues rnoY nr. rERTIEICATE MAST NnT RE ILLTERE13 IN ANY MANNER_
TOWN OF QUEENSBURY
Building Department
Inspectors Repori Date :Z` _
Name w_ ,
Location r
Permit No. Weather
Per Cent
Complete Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Rough Ht .
Relief Valves
Wall Board
Ext.Porches
Finished Floor
Interior Trim
Stairs&Railings
Cellar Dr.Tile
Concrete Floors
Plb .Fixtures
Gar.Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic A proval
Bui 'ng lnapector
REMARKS
• N �
TOWN 'OF QUEENSBUR
Building- Department
)inspectors Report Date_ / ® oc " 7j
Name ��<-1 ,
Location_ ,►��.r 1_ �o"cs
Permit No. 53r2.h ri (-*Weather
Per Cent
Complete Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
,Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough PIb .
Rough Ht .
Relief Valves
Wall Board
Ext.Porches
Finished Floor
Interior Trim
Stairs&Railings /
Cellar Dr.Tile
Concrete Floors
Plb .Fixtures
Gar.Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
B ilding Inspector
REMARKS
L�i/'cic� .� f��Ct6tS� •etf'17c,:�
9
LL7 pj
1� I
TOWN OF QU"EENSBURY
Building- Department
Inspectors Report Date /O- /o-7N--
Name
Location wj-t 1� k 0 r W U"r 12
Permit No. S la_°; Weather
Per Cent
Complete Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
.Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer Z
Rough Plbg.
Rough Ht .
Relief Valves �.
Wall Board
Ext.Porches
Finished Floor
Interior Trim
Stairs&Railings
Cellar Dr.Tile
Concrete Floors
Plb .Fixtures
Gar.Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval /
Building Inspector
EMARKS
�pao�'R � S�e�
�)iS! .
do /���
TOWN OF QUEENSBURY-
Building Department
Inspectors Report Date_ 9 L� 917 d'
Name_
Location
Permit No. 52 5s Weather
Per Cent
Complete Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
_Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plb . ✓
Rough Ht .
Relief Valves
Wall Board
Ext.Porches
Finished Floor
Interior Trim
Stairs&Railings
Cellar Dr.Tile
Concrete Floors
Plb .Fixtures
Gar.Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Building Inspector
REMARKS
� '� v, /
TOWN OF QUEENSBURY
Building Deparrtment
Inspectors Report Date
Namnc /
Location
Permit No. .5c2 S SWeather__.
Per Cent Remarks
Complete
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofin
Backfill
Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Rough Ht .
Relief Valves
Wall Board
Ext.Porches
Finished F
Interior Trim 1-1
Stairs&Railings
Cellar Dr.Tile
Concrete Floors
Plh .Fixtures
Gar.Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
—� Building Inspector
REMARKS
TOWN OF gUEENSBU Y-
Building- Department
Inspectors Report Date /7
Name -9
Location Z-i 7' IL"7/Z S� "77
Permit No. 2 y Weather
Per Cent
Complete Remarks
_ Excavation ;
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
_Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plb .
Rough Ht . 5
Relief Valves All �
Wall Board
Ext.Porches
Finished Floor
Interior Trim
Stairs&Railings ,
Cellar Dr.Tile `
Concrete Floors p`
Plb .Fixtures
Gar.Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Building Inspector
REMARKS