1986-507 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 86-507
\� 1 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Albert and Eleanor Oudekerk
OWNER of property located at Gt30 Bay Road Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Addition to dwelling (deck and ramp)
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.
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1. OWNER'S Address is RD #1 Box231 4
Glens Falls, New York
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2. CONTRACTOR or BUI LDER'S Name N
same
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3. CONTRACTOR or BUILDER'S Address
Same
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
( I Wood Frame ( I Masonry ( ) Steel ( )
7. PLANS and Specifications
No. ll'x20' per plot and application submitted. a
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8. Proposed Use
One—Family Dwelling
) (deck and ramp added)
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$ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES March 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.)
19th August 86
Dated at the Town of Queensbury this Day of g 19
�+
SIGNED BY ®60' `i for the Town of Queensbury
310
Building and Zoning Inspecto 0
TO BE COMPLETED BY BLDG. DEPT. I
c� Application No.
Jotun ol Quee,iiur, Permit Issued 19 1OWN OF Q€UE=N BURY
BUILDING and ZONING DEPARTMENT Permit Expires 19 (� (� LE 1
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation \IA- E lJ U U
Queensbury, New York 12801 Variance No. a .,
6
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Site Plan�Review No. A�//f�7 6 �0
> !,l Approv d by. �ga�1S�����2�1a sl�:��'
1
APPLICATION FOR ftX/ v _'
BUILDING AND ZONING PERMIT 1
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.
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The owner of this property is: r� De G'_ L,/1, � (7)(A prel�72fr
P.O. Address Ems, ;50,x- -3/ Tel. -DS y/
Property Location: Tax Map No. / /
Street number or building lot number
Subdivision name (if applicable)
THE P�.,�N RESPO LE D / � /U�`/R(VISION Ol�RK 7/S//�R,EGARDS BUILDING CODES �:9�_ J J/
Jf� / , - F' ( D J
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
c/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
\ * of water supply and location and configuration
LOCAT ON OF STR CTURES #EFECTED.
* of septic disposal area.
*
* COMPLETE INFORMATION REQUIRED BELOW.
\ \ * Size of property ft X ft.
�\ �\ �\ * Existing building(s) Size ft X ft.
*
PROPOSED BUILDING AND USE: * Existing building(s) Use
Size of new structure /t ft X /O ft * '
Foundation• -'i'+'slab/crawl/partial/full * Proposed building, distance from property line
(circle one) *
* Front. yard ft Rear yard /v'U '4- ft
No. of stories (habitable space) / * Side yards /j '- ft and /0-r, '..4- ft
Height (grade to ridge) ft. * If on corner, setback from side street ft
If residential, no. of families
No. of rooms(excluding baths) * OCCUPANCY INFORMATION
No. of bedrooms *
No. of bathrooms * PRRY BUILDING -
Primary heating system * Ore 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? * rmanent occupancy
Central Air conditioning? • Transient occupancy
* Business
BUILDING STYLE, PRIMARY STRUCTURE Industrial
Ranch Contemporary Log cabin *
Other
Raised ranch Mansion Duplex * If addition, what will/nfuse be?
Split level ( Old style Bungalow * c 1 W 1�—
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
* * * * * * * * * * * * * * * * * * +4rivate storage building
ESTIMATED MARKET VALUE OF * Other
CONSTRUCTION
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? -7 L 472 d - e `la
Foundation wall material yX 7 -1W-TIED Thickness
Depth of foundation below grade (to bottom of footing) , '
Will there be a cellar? ///o- Heated or ea a Floor sq. footage „PVC, sq ft
Will there be a basement? AA' Will an ion be used as living space? s'ee R, ,>,�
cif
(If so, what portion? • D sq.ft. - - Type of use?
Type of roof - sloped/flat/shed/other Material, of roof
Size, wood studs "X " spacing "o.c. length ft.
Joists(floor beams) 1st. floor A "X C, " 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 "X " spacing o.c. span ft.
Roof trusses(pre-engineered) spacing "o.c. span ft.
Exterior wall finish Of what material?
Interior wall finish ' '
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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 aTl 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 propos d work .shalAl be complied with, whether specified or not __and- that such work is
authorized y the ower.
SWORN TO BEFORE MET HIS Signature __
day o / 19 Owner, owner's agent,arcnitect,contractor
Notary Public rren County, N.Y.
* * * * * * * *' * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
SPECIAL CO DITIONS OF THE PERMIT:
i/
By
TOWN OF QUEENSBURY •
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 1280k
TELEPHONE (518) 792-5832 )/k
BUILDI G INSPECTOR' REPORT
r REQUEST FOR INSPE;:TION RECEIV:D g�/�9U
NAME /, / fI A .14 , i . '
LOCATION ,c?5 41 /QS�
DATE , 0 PERMI +
O # hc -A-0 7
APPROVED
f�p,ptA . ! YES NO
FOOTING/PIERS
MONOLITHIC POUR 1`FORS
FOUNDATION/DAMP-PROOFING t
BACKFILL APPROVAL l
ROUGH PLUMBING - 1
X FRAMING 1
ELECTRICAL ROUGH-IN ‘ 1 '
INSULATION: 1
FOUNDATION '
FLOORS ' 1\11 . .
WALLS
CEILING
)(FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING 1
SIDING / k /,
EXTERNAL PORCHES/S EPS\
STAIRS-CLEARANCE & RAI49
PLUMBING FIXTURES/ ELIE ' VALVE
INTERIOR TRIM/PRIVACY DgQRS
FINISHED FLOORS I
GARAGE FIREPROOFI'G
DOOR CLOSER(S)
SMOKE DETECTORS
FINAL ELECTRICAL I SPECTIONt
_FINAL APPROVAL OF ONSTRUCT ON "
OK TO ISSUE C/O Ok .C/C l/
A SIGNED CERTIFICATE OF OCCUkI
ANCY MUST BE
OBTAINED FROM THE' BUILDING D ARTMENT BEFORE .
THESE PREMISES A'E OCCUPIED! c
REMARKS:
i
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. ARRIVE 3 (jc`,l
DEPART' i .�(7
INSPECTOR
Jocun of Queenitur1
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR` S REPORT
NAME ,r� ,�/ 1�
LOCATION v`u' �rl t4
)13""../ 12-0
HeeqDate 15-/ / 21.0 Permit No. y(,_5"
* * * * * * * * * * * * * * * * * * * * * * *
= APPROVED - Ipsf 5b
ooti •/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
_ Stairs & Railings__— ____t_____ _ _-
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing U
Door Closers 1 w
Smoke Detectors
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
Final Building Survey
fay /, -
Next scheduled Inspection(call when ready)
Remarks- -
1"'1
Bui ding Inspect r
6/86 and-vl
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