1986-389 BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-389
WARREN COUNTY, NEW YORK
j° 04
PERMISSION is hereby granted to Ronald Havens
OWNER of property located at 010 . Mountain View Lane Street,Road or Ave.
in the Town of Queensbury,To Construct or place a Addition to dwelling (carport)
at the above location in accordance to application together with plot plans and other information hereto filed and
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approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. a �'
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1. OWNER'S Address is 50 Mountain View Lane w
Glens Falls, New York
2. CONTRACTOR or BUI LDER'S Name
Bill McCoy
3. CONTRACTOR or BUILDER'S Address O
Tee Hill Road
Glens Falls, New York
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4. ARCHITECT'S Name H.
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
(x)Wood Frame ( 1 Masonry ( 1 Steel (
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7. PLANS and Specifications rt
22'x16' per plot and application submitted. o
No. p
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8. Proposed Use
One—Family Dwelling (carport added)
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$ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES Feb. 1 19 87
(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.) p •
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Dated at the Town of Queensbury this 10th Day of July 19 86
Re
SIGNED BY A1La''�"' for the Town of Queensbury
Building and Zoning Inspector
TO BE COMPLETED BY BLDG. DEPT.
�] Application No.
✓olvrl Di QUeeHS1UrIJ Permit Issued 19 •
BUILDING and ZONING DEPARTMENT Permit Expires 19
CiWN OF QUEENSBU `
. Bay and Haviland Road, R.D. 1 Box Zoning Designation l�
Queensbury, New York 12801 Variance No. Ej
Site Plan Review N e __,
. 62 -, ,j Z Approved by: A.M. IJUL
U Or�271986� I�A0.
APPLICATION' FOR I 71 E I9 p1 1J�12)1I 213 41516
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: 0710'
P.O. Address s ® f ,.tr< 4t�„, Tel.,n7 7 /d e
Property Location: :3 ® rei' 4, , Tax Map No. / /
. Street nun
u er or buildinllot number .
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Subdivision name (if applicable) .
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS: -
f �' �2� /�rr! 7 Y.� v�
Name 4P.O. Address Tel. No./r --a
Name of builders jJ '" Address , 7�-4' GPr.�. � 6 Tel. Z- ,� (�'
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
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.
*
' * COMPLETE INFORMATION REQUIRED BELOW.
* Size of property s„ yj 0o ft X" ",,�',& ft.
* Existing building(s) Size ,a ft X ,z, v ft.
*
PROPOSED BUILDING AND USE: * Existing building(s) 'Use _ ice, .
Size of new structure ,2., ft X /G ft *�/q, / . . • . . . v''
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 residential, no. of families * If on corner, setback from. sice street �ft
No. of rooms(excluding baths) • * OCCUPANCY INFORMATION
No. of bedrooms .*
No, of bathrooms * PRIMARY BUILDING -
* �ne family dwelling
Primary heating system Type of fuel * Two family dwelling
No, of fireplaces to be installed * Multiple dwelling / Number of units
* Permanent occupancy
Will a wood stove be installed? Transient occupancy
Central Air conditioning? * Business
*
BUILDING STYLE, PRIMARY STRUCTURE * Industrial •
Ranch Contemporary Log cabin
* ' Other '
Raised ranch Mansion Duplex * If addition, what will use be? 604, '
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' Split level Old style . Bungalow *
Cape Cod Cottage Other * ACCESSORY BUILDING-
Colonial Row Town House * 1,4etached garage/gap / two car/ car
( CIRCLE ONE PLEASE ) * Attached garage/one car/ two car/ car
* * * * * * * * * * • * * * * * * * * Private storage building .
ESTIMATED MARKET VALUE OF * Other • •C,Atz .C/ s. •
CONSTRUCTION $� Y� 6, 6
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INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
Form BP1 ,/nr, m.i-vl
BUILDING PERMIT APPLICATION CONTINUED -
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BUILDING .SPECIFICATIONS:
Type of construction, wood frame, fire safe etc. itiYy44 =
Will: any second-hand or ungraded lumber be used? If so, for what? 2/
• �f.
Foundation wall 'material ��� _-- Thickness , /d. '4 /6
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,0 ►e ,/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 Z_. "X IC) " spacing /(A o.c. span_/( ft..
Roof trusses(pre-engineered) spae-ing -"o.c. span tt.
Exterior wall finish Of what material? •
Interior wall finish •
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
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Is there to .be an opening between ,
P g 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.
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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, to.ether with the plans and specifications submitted, are. a. .true and
completR statement of .. 1 proposed work to be done on the described premises and that all
provisions of the BU . DING CODE, -THE ZONING ORDINANCE, and all other laws pertaining to
the pro••sed work s'all be complied with, whether specified or not, and that such work is
authorize,' by the "caner.
SWORN TO BEF•RE 4 THIS Signature LC
Owner, owner's agent, -icnitect,contractor _
day of 19
Notary P .lic, Warren County, N.Y.
* * * * * * * * * * * * * * * * * ,* * * * * * * * * * * * * * * * * * * * * * * * * * * *
SPECIAL CONDITIONS OF TIE PERMIT:
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By
flown of Queenibur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
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BUILDIN
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INSPECTOR ' S REPORT
NAME
Alkt1> 14-411,uS
LOCATION 5 d Mr Vr r 1-A
Date )/z5—/ Ow Permit No.��p^`
APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing CA3( Co t i
Roofing '--
Siding _
Masonry Veneer
Rough Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim,
Stairs & RailinNgs
Cellar Drain Tile
Concrete Floors 'N
Plbg. Fixtures
Gar.. Fireproofing
Door Closers / }'
Smoke Detectors s� \
Chimney / N
INSULATION:
Foundation
Floors '
J
Walls
Ceiling i
FINAL ELECTRICAL INSPECTION
Final Building Survey .
Next scheduled Inspection(call when ready)
Remarks- -
Q G� 't'n C/Vg-
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F,ZAA4tt
Bui ding Inspec or
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F2AJ7 ELEVATOM -5, * q 144,
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BILL Mc -Coy
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QLe-jr-sm-T- k4omEs
TE I APPROVED BY r *A*tk NUMBER
ALBA14ENE CB) 10 5455
ARCHITECTS' STANDARD FORM
MADE IN U.S.^.