1986-275 BUILDING PERMIT
TOWN OF QUEENSBURY No 86-275
�/1 WARREN COUNTY, NEW YORK
36) . a w—. 0 Brian 0.Blackburn
PE R��HHRIIMMMN00��ISSION is hereby granted to
OWNER of property located at 261 Bay Road Street.Road or Ave. m
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in the Town of Queensbury.To Construct or place a
Alterations to dwg. a
at the above location in accordance to application together with plot plans and other information hereto filed and o
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. cv
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1. OWNER'S Address is 261 Bay Road o
Glens Falls, New York Cc
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2. CONTRACTOR or BUILDER'S Name
same
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3. CONTRACTOR or BUILDER'S Address to
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4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
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( I Wood Frame ( 1 Masonry 1 1 Steei ( 1 q (4
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1. PLANS and Specificationsm r
No. alterations to dwelling for apartment and gallery per n o
specifications and application submitted. o• of
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8. Proposed Use N• E
Apartment and Gallery Y N
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$ 10.00 PERMIT FEE PAID -THIS PERMIT EXPIRES Jan. 1 19 67
Of 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 4th Day of June 19 86-y
SIGNED BY 2V '4/ a-A3.c.are for the Town of Queensbury
Building and Zoning Inspector
TO BE COMPLETED BY BLDG. DEPT.
�] Application No.
✓own of Qna¢ndiury Permit Issued 19
BUILDING and ZONING DEPARTMENT Permit Expires 19 TOWN OF QUEENSFIU^"
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation REDEEM
(ail �� pp fl
Queensbury, New York 12801 Variance No. V( LS UU I V J
Site Plan Review No. u
6N141. :� !3 148E g7
7 _ 1 - 2 Approved by. /�� �J
Y A.M#C, rd9 / P.M.
APPLICATION FOR 7IBI9P 12III?I3I4I5I6
BUILDING AND ZONING PERMIT
• * * * * * * * * * * * * * * * * * * * • * * * * * * N N • • • • • * • • •.(•
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: 32/0N O . /3(..ACdc/' Ui2liJ P.O. Address t C,/ /3499 R0.90 Tel. 798-3V7
Property Location: a-G/ '3S99 ?ZOW Tax Map No. /07/ //2y
Street number or building lot number
Subdivision name (if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS RFFARDS BUILDING CODES IS:
SELF
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
* whether interior or corner lot. Show location
FOR DEMOLITION PERMIT, STATE SIZE AND * of water supply and location and configuration
LOCATION OF STRUCTURES AFFECTED. * of septic disposal area.
*
* COMPLETE INFORMATION REQUIRED BELOW.
* Size of property * 0 ft X /XJ ft.
* Existing building(s) size(o ft X 3C, ft.
*
PROPOSED BUILDING AND USE: * Existing building(s) Use R6szoS-447749-C-
Size of new structure yo ft x24. ft *
Foundation-pier/slab/crawl/partial ul " Proposed building, distance from property line
(circle one) "
* Front yard ft Rear yard ft
No. of stories (habitable space) a * Side yards ft and ft
Height (grade to ridge) ft. * If on corner, setback from side street ft
If residential, no. of families I
No. of rooms(excluding baths) 3 * OCCUPANCY INFORMATION
No. of bedrooms I *
No. of bathrooms * PRIMARY BUILDING -
a-- * One family dwelling
Primary heating system Hol'•ai2 * Two family dwelling
Type of fuel G/J'J * Multiple dwelling / Number of units
No. of fireplaces to be installed Permanent occupancy
Will a wood stove be installed? No ▪ —
• Transient occupancy
Central Air conditioning? A/0 * 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 *
ape Co. Cottage Other * ACCESSORY BUILDING-
Colonial Row Town House * 17 Detached garag: one cal two car/ car
( CIRCLE ONE PLEASE ) * _Attached garage one car/ two car/ car
* * * * * * * * * * * * * * * * * * _Private storage building
ESTIMATED MARKET VALUE OF * Other
CONSTRUCTION *
s_2Goa,
INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS:
Type of construction, Wood fiZA fire safe,etc.
Will any second-hand or ungraded lumber be used? If so, for what? /./j
Foundation wall material BLOCK_ Thickness
Depth of foundation below grade (to bottom of footing)
Will there be a cellar? Heated or unheated? Floor sq. footage s ft
Will there be a basement? Will any i.ortion be used as living space? q
(If so, what portion? sq.ft. - - pe :le?
Type of roof - sloped/flat/shed oth r rial of roof
Size, wood studs "X " ac'ng 'o -ngth ft.
Joists(floor beams) 1st. floor "X ' sp. ing "o.c. span ft.
Joists (floor beams) 2nd. floo " spacing "o.c. span ft.
Overlays(ceiling beams) " -pacing "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 // 71 PE )( .4Mz ��=may P Qp R eb
if a garage is to be at ached, describe materials to be used for FIRE SEPARATION:
Is there to be an opening between garage and dw ling? 4/0 door, enclosure, and self-closing device be/pro ided7 If so will a Fire-rated
Will a flue-lined chimney be installed? e'' ht above roof ft.
Depth of chimney foundation below grade f .,LJ
Depth of fireplace hearth ft. in. j
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
County of warren AFFIDAVIT 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 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 Signatures.... 0 • Y //�G C
1-8 r/' � lg� Owner, owner's agent,arcmcect,contractor
day of /*
N tary P ic, W en C ty .Y.
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* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * • * * * * •
IAL CONDITIONS OF THE PERMIT:
By
Jown of Queenelury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road. R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR'S REPORT
NAME f3.4
1-
e7
LOCATION a . , / al Date �(/ / 4 y Permit No. 34- a-i
x ♦ * • • * * ♦ * • * * * • * *
= APPROVED - YES / NO
Footing/Pier Forms i
Foundation
Waterproofing
packfill
Li-Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs 6 Railings
Cellar Drain Tile
Concrete Floors Plbg. Fixtures
Gar. Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION:
Foundation /
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
K\
Final Building Survey
Next scheduled Inspection(call when ready)
Remarks- -
Building Inspector
6/86 and-vl
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