1986-538 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 19
This is to certify that work requested to be done as shown by Permit No. 86-538
has been completed.
This structure may be occupied as a Alterations to office/light mgr. plant
Location Quaker Road V
Mallinckrodt, ,Inc.
Owner
• By Order Town Board
TOWN OF QUEENSBURY
Building & Zoning Inspector
fi BUILDING PERMIT
TOWN OF QUEENSBURY
No. 86-538_
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Mallinckrodt, Inc.
OWNER of property located at Quaker Road Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Alterations office/light mfg.
at the above location in accordance to application together with plot plans and other information hereto filed and H.
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
0
1. OWNER'S Address is Quaker Road
rt
Glens Falls, New York
n
2. CONTRACTOR or BUI LDER'S Name
F. T. Collins
3. CONTRACTOR or BUILDER'S Address
Dix Ave.
Glens Falls, New York
4. ARCHITECT'S Name
ti
0
a.
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( )
o H
H rt
7. PLANS and Specifications rt, CD
H. rt
W
No. alterations per specifications and application submitted. m rt
H.
H 0
H. U
aq cn
8. Proposed Use
(1- rt
Office/Light Mgr.
0
$5.00 C/O
H•
$ 100.00 PERMIT FEE PAID—THIS PERMIT EXPIRES April 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 0
town of Queensbury before the expiration date.) oa
Dated at the Town of Queensbury this 5th Day of September 19 86
SIGNED BY /r/ �. ,aze„t for the Town of Queensbury
Building and Zoning Inspector
TO BE COMPLETED BY BLDG. DEPT.
•
] */ Application No.
_lown 01 Queen ibur, Permit Issued 19
BUILDING and ZONING DEPARTMENT TOWN OF QUEENsRus
Permit Expires 19
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation R ' 0 IY1 E
Queensbury, New York•12801 Variance No. �
Site Plan dView No. JUL 2 2 1986
D / — /- If- 3 2_ Approve y: A.M. r.M.
,?I8Ig1� �1x12J3J J`J
APPLICATION FOR . e r ► e , A v A
BUILDING AND ZONING PERMIT 4 to' - /c,,, , h Gio
* * # * # * * * * # * * 8, * # # # * * * # * # # # # # .. . # # � # # # # # * :,#
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.
t_
The owner of this property is: /41,/t./A/(�/ RO 0 1 `�/V Ci .
P.O. Address Q v A )e, E.4e. ep . - qN0 fu.)-ety2AE'. Z/ �, Tel. '793.44 i✓
Property Location: . U�j .E.2 UC1 p . ax Map No. / /
Street number r building lot number
Subdivision name (if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
e t-, L'r n,c( OVA 4,6X R,e), �ve.KAis R/ 99. - C7/
Name P.O. Address Tel. No.
Name of builders Address t n,t0J/`jq r+-f-3 Tel. '7! J.. 771C
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 andtindicate all
_Other work (describe) * set-back dimensions from property lines. Give
5to;� PL,I S pritq-46-6 * 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 ft X ft.
* Existing building(s) Size ft X ft.
* .
PROPOSED BUILDING AND USE:
* Existing building(s) Use
Size of new structure ft X ft *
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 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 * PRIMARY BUILDING -
Primary heating system x 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? * Permanent occupancy
Central Air conditioning? * Transient occupancy
* X Business
BUILDING STYLE, PRIMARY STRUCTURE ,. KIndustrial
Ranch Contemporary Log cabin * Other
Raised ranch Mansion Duplex * If addition, what will use be?
Split level Old style Bun•alow *
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 * Other
CONSTRUCTION *
s'._0--ge®d oa
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. // 6.--7-41ta "=f- a .", or-/x
Will any second-hand or ungraded lumber be used? If so, for what?
Foundation wall material Thickness
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/shed/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 "X " spacing o.c. span ft.
Roof trusses(pre-engineered) spacing "o.c. span ft.
Exterior wall finish Of what material?
Interior wall finish PA;,1 `7- 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? 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 Warr„pn
I wear that to the best of my knowledge and belief the statements contained
in this .i•plication together with the plans and specifications submitted, are a true and
complete '.tatement .f all proposed work to be done on the described premises and that all
provisions of the 4UILDING CODE, THE ZONING ORDINANCE, and all other laws Iiertaining to
the proposen wor shall be complied with, whether specified r not, and that such work is
authorized b th- owner.
SWORN TO BEFO• " THIS Signature
Owner, o ner's agent,arcnirect,contractor
day of 19 r
Notary Public, Warren County, N.Y.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *. * * * * * * * *
SPECIAL CONDITIONS OF THE PERMIT:
By