1986-337 BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-337
(30\
WARREN COUNTY, NEW YORK
Kathleen Chesney N
PERMISSION is hereby granted to co
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Peggy Ann Road
OWNER of property located at Street, Road or Ave.
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in the Town of Queensbury,To Construct or place a Addition to dwelling (screened porch)
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 RD #2
Glens Falls, New York
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2. CONTRACTOR or BUILDER'S Name 04
Gerald Gasper
3. CONTRACTOR or BUILDER'S Address o
Applehouse Lane
Glens Falls, New York
4. ARCHITECT'S Name
5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
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( ) Wood Frame ( ) Masonry ( ) Steel ( )
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7. PLANS and Specifications
No. 12'x18' per plot plan, specifications and application submitted.
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8. Proposed Use OQ
One-Family Dwelling (porch added)
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$ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES January 1 19 87 b
(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.)
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Dated at the Town of Queensbury this 23rd Day of June 19 86
SIGNED BY Wi 4t for the Town of Queensbury
Building and Zoning Inspe r
TO BE COMPLETED BY BLDG. DEPT. 1 •
a� / Application No.
wn wn of Queeniur y Permit Issued 19 1,O N CF QUEENBEIU nY
BUILDING and ZONING DEPARTMENT Permit Expires 19 t '; E (( Ell
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Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation ! `(
Queensbury, New York 12801 Variance No. � �, a
Site Plan Review No. - ` " •- WO 3 98
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�- ;, J Approved by:
APPLICATION FOR t I/7 ._.. ,e c o r c e a e .
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BUILDING AND ZONING PERMIT
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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: KA7-171LE25,Xf (7.1-i -SwE7'
P.O. Address PE66y im RD RED #02 Tel. 7��3y0,7
Property Location: �4E/y5 /z -L.LS my i zee/ Tax Map No. / /
Street number or building lot number
Subdivision name (if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
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Name P.O. Address Tel. No.
Name of builder .cW1r4q) -/a.5/0eg Address f OOSc' 2f>' '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,
x 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
*
LOCATION.OF STRUCTURES AFFECTED, of water supply and location and configuration
• * of septic disposal area.. •
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* COMPLETE INFORMATION REQUIRED BELOW.
,i----7 4 * Size of property /a 3. ft X /s3 ft.
* Existing building(s) Size ;#� ft "X A ft.
* . . . . .yo . 2 1-
PROPOSED BUILDING AND USE: * Existing building(s) Use
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Size of new struc e /2_ ft X /8 ft *
Foundation-pier slab crawl/partial/full * Proposed, building, distance from property line
circle one)
*• Front yard ,3 e. ft Rear yard ,75- ft
No. of stories (habitable space) * Side yards . . . ..p ft and • ,3 p ft
Height (grade to ridge) ft. * If on corner, setback from side street 3 e3 ft
If residential, no. of families
No. of rooms(excluding baths) . . . * OCCUPANCY INFORMATION •
No. of bedrooms *
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No. of bathrooms * PRIMARY BUILDING -
Primary heating system ** /One family dwelling
Type of fuel * Two family dwelling
No. of fireplaces to be installed * Multiple dwelling / Number of units
Will a wood stove be installed? --- * it-Permanent 'occupancy
Central Air conditioning? _ Transient occupancy
* Business
BUILDING STYLE, PRIMARY STRUCTURE ** *. Industrial
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*' Other.
Contemporary Log cabin * If addition, what will use be? Poft2.c/{ SceEEiyED
•.ised ranch Mansion Duplex . . .• . . . . . . . . . . . .
Split level Old style 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 A ,eh * Other ' .56..eE E.0 Poe /-1
CONSTRUCTION $_dikkKHOt/✓NINOO
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 r
Depth of foundation below grade (to bottom of footing) 51_4(,), oii &Yrs.<
Will there be a cellar? /yp Heated or heated 1>- Floor sq. footage sq ft
Will there be a basement? Wp Will any portion be used as living space?
(If so, what port' ? sq.ft. - - Type of use?
Type of roof - sloped flat/shed/other Material. of roof Aj,1
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Size, wood stu 2. "X y " spacing /` "o.c. length g 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) 4•, "X $ " spacing . "o.c. span aft.
Roof rafters - Z. "X (, " spacing /(v"o.c. span lg, ft.
Roof trusses (pre-engineered) spacing "o.c. span ft.
Exterior wall finish CLAP C50/1/242,5 Of what material? I,��o p
Interior wall finish l>g r-j,4/ .sj f p
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? Nil, 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)
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Town of Queeiisen A F F 'I D A V I T 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- lupii.0 u-4'r.lthj" uu it:'tiii-t Sp Ci:ll:ted" not,--and- that SliCli 'v7o rii -iS
authorized by the owner.
SWORN TO BEFORE ME THIS Signature}
�� Owner, owner's agent,arc contractor
day of 19
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SPECIAL CONDITIONS OF THE PERMIT:
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