1986-392 BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-392
2Z1C1 ca1WARRENCOUNTY, NEWYORK
PERMISSION is hereby granted to Thomas and Gail Hazelton
OWNER of property located at /3 Tee Hill Road Street, Road or Ave.
dwel
ling
Addition to we n
in the Town of Queensbury,To Construct or place a g (deck) En
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 P. 0. Box 1128 N
South Glens Falls, New York
N
N
2. CONTRACTOR or BUILDER'S Name
0
same
3. CONTRACTOR or BUILDER'S Address
same
H
4. ARCHITECT'S Name m
5. ARCHITECT'S Address 0
w
6. TYPE of Construction—(Please indicate by X1
( )Wood Frame ( 1 Masonry ( )Steel (
7. PLANS and Specifications
No. 12'x16' and 12'x12' deck per plot plan, specifications and
application submitted.
8. Proposed Use r*
0
One—Family Dwelling (deck added)
r•
Feb. 1 1987 °Q
$ 10.00 PERMIT FEE PAID—THIS PERMIT EXPIRES ...
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the a
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 10th Day of July 1g 86
SIGNED BY 211 a /JQ for the Town of Queensbury
Building and Zoning I nspector&
TO BE COMPLETED BY BLDG. DEPT.
�] Application No.
Jown of Queenitursj Permit .Issued 19
BUI�L,DING and ZONING DEPARTMENT Permit Expires 19
Bay •and Haviland Road, R.D. 1 Box •r.; : OWN OF QUEr.�' r:F-Zoning Designation
Queensbury, New York 12801 • Variance No. i ti�1-
Site Plan Review No. I n!.:11
Ear
• J_' 3 ' a 5 Approved by: 'JUL O 9?. t'
APPLICATION FOR - ':.M. -e -\� '.` 0`A,
BUILDING AND ZONING PERMIT ,t a all �'. ,,g -,
EMIT
* * * * * * * * * * * * * * * *. * * * * * * * * * * * * * * * * * * * * * *::*
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: --7;;, • Agt./,v /7 .-K�iv ,
P.O. Address Ag_f--
s 4-C ,-,f,r 1 eAr A/ y' Tel. 793-3�2JP
Property Location: /// /L4 /apj.4 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:
• DM /�sr" �G dic/ gr .,/30U�
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) 0 ..tt * 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 ' d.. �C ft X 2- 03 ft.
*- Existing building(s) Size ft X ft.
*. . . . . . . . . . . . . . .
PROPOSED BUILDING AND USE:
a-/ /b * Existing building(s) 'Use
Size of new structure /,1- ft X /2.�ft * .. . . . . . . . . . . . . _ .
Foundation-pier/slab/crawl/partial/full * Proposed building, distance from property line
(circle one)
No. of stories (habitable space) * Front yard " ft Rear yard ft
Height (grade to ridge) ft. * Side yards ft and ft
If residential * If on corner, setback from side street ft
, .no. of families
No. of rooms(excluding baths) ' ' * OCCUPANCY INFORMATION
No. ' of bedrooms *
No. of bathrooms * PRIMARY BUILDING -
* 2' One family dwelling '
Primary heating system * Two family dwelling
Type of fuel
No. of fireplaces to be installed * Multiple dwelling / Number of units
Will a wood stove be installed? * Permanent occupancy
Central Air conditioning? * Transient occupancy
* Business
BUILDING STYLE, PRIMARY STRUCTURE ,. Industrial
' Ranch Contemporary Log cabin * Other '
If addition, what will use be?
*
Raised ranch Mansion Duplex . .
Split level Old style . Bungalow * '
Cape Cod Cottage Other * ACCESSORY BUILDING-
(Eoloni� Row Town House * ' Detached garage/one car/ two car/ car
( CIRCLE ONE PLEASE ) * Attached; garage/one car/ two car/ 'car
* * * * * * * * * * • * * * * * * * * -7-Private storage building.
ESTIMATED MARKET VALUE OF * Other ' ' '
CONSTRUCTION $.KJfr do
INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
Form BPI\ /! T and-vl
BUILDING PERMIT APPLICATION CONTINUED -
' f
BUILDING SPECIFICATIONS:
Type of construction, wood frame, . fire safe,etc. . 2 ri &G', 7_ ,
Will any second-hand or ungraded lumber be used? If so, for what? /Q
' Foundation wall,material 44)^( - -o 5 V '" Thickness •
Depth of foundation below grade (to bottom of footing
Will there be a cellar? gArN 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/shed/other Material. of roof
Size, wood studs "X " spacing "o.c. length ft. •
II
Joists(floor beams) 1st. floor a "X 5( " spacing "o.c. span ft. D K
Joists (floor beams) 2nd. floor "X " spacing "O.c. span ' ft.y -- �� I4l3
Overlays(ceiling beams) "X " spacing "o.c. span ft. S f' �
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
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? 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)
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, 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 a.11 .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 Signature__- =-- - _
Owned ownei's gent,arcnitect,contractor _
day of 19
•
Notary Public, Warren County, N.Y. •
SPECIAL CONDITIONS OF THE PERMIT:
•
By
I 1
..7,,,,JA.
:
, . 1 ., , 1
_ ,
, __
_ . �; - ;Fii�-/ /�[{L9 (3-�/ y i'
I I
� I I I � � 1 : � I
i- - }
- -- -- -i
• I
-- - - I I -- --- ' -'--- '
I
i
I
I
I 1�
i ; I ;I I + I
I I ,
j
I 1 i I Q0- - .-
! I
- II
I
I 1
j
am
� iemsr.
f
'r d-
_. ._. __ /``, G�i_Q�-. .-�Oo(« 13'6__ `gip (/ v �.I -- -- ; - -I- ---I- - .i ---1- - ---i-- - ! - !
1
! ,
1
i ,
! !
I '
Lj "- '
li _ II (,I/ i '
I
:
' -- - i-
/�ri.�2l - 1 - - -
I
'
�; - I
,E c i,. i
- -
- i I - ,-
I �I I I i
1 I
V
1
1
I I
i
• i I 1 . L i , ,
I
I I i 1 , I
I ! _
i
,
I '
i I
f
11 I '`.e."
- + j i i R
• 1 I I I I 1 1�, 1 I I
1
-- '\- --- -- ----! - j - 1 _ - i _ J�I� - -- - ----- /%'l/(/!/.mil/- - - - -- -
•
' - , . 1 - f
I I I I
--- - -1- - C - '- ' - - i - --'
1
•
JI
Ij1 ; ..' jij
-i ' I
I ! 1 !
, i- r j-
- - _.- 1- - - -I . 1 _ _..
1
I Ijjj ' I ' I I •
I 1 I j 1 I I I I I 1 I I ,
. . .. 1. I kA, ' I 1 1
- -_ I ! I I I -1 1 - - I - - •
-_ _-
\ 1
1l r
li 1 I II J _
1
•
jli
' 1 i 1 1 l I