1987-061 BUILDING PERMIT
TOWN 4F QUEENSBURY No. $7_51 ro
WARREN COUNTY, NEW YOR K r,
PERMISSION is hereby granted to Frederick Hathaway ( Southwest Traders ) px,
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OWNER of property located at —ems Route 9 south of ake George Town Street, Road or Ave.
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in the Town of Queensbury, To Construct or place a
at the above location in accordance to application together with plot plans and other information hereto filed and o
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. 'Y
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1 . OWNER'S Address is Lake George Road
Lake George , New York 12845 r-3
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2. CONTRACTOR or BUILDER'S Name ' I
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John Parker
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3. CONTRACTOR or BUILDER'S Address �
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RD # 2 Box 2530 t , rn
Lake George , New York 12845 x
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d. ARCHITECT'S Name G m
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5. ARCHITECT'S Address
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6. TYPE of Construction — iPlea4se indicate by X? to
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( y wood Frame I ! Masonry C 1 Steel l Y o
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7. PLANS and Specifications
new roof structure per specifications and application submitted .
No.
B. Proposed Use
Retail Store (new roof )
$ 46 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES QCtober 1 1987 oa
p O r�irt
(if a longer period is required an application for an extension must be made to the Building and Zoning inspector of the ro H ro
town of Oueensbury before the expiration date.) N W
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llth March 87 o c r
Hated at the Town of Queensbury this -�.y� Day of 19
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SIGNED BY !/7 C.l. for the Town of Queensbury o rt
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Building and Zoning Inspecto ro r
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TO BE COMPLETED BY BLDG . DEPT . TOWN OF QLIEENS`,Ak� W
�JApplication No . MMNUTkkk?
�lotun o/ Q"eenjg"ry Permit Issued 19 !!AA pp
BUILDING and ZONING DEPARTMENT permit Expires 19 {fla R 9 1987
Bay and Haviland Road, R. D. 1 Box 98 zoning Designation '
Queensbury, New York 12801 variance BUILDING & CQDE DEPT.
Site Pl Re iew No . Lt4f / `7L, ' C
Appr c� �,� Cil
APPLICATION FOR
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
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P . O. Address -¢ - � - ` t �. iy r `Z GY C# r Tea . �e
Property Location : C3ciyv . R. _ Tax Map Pao . S15/,L/ 3.3
Street number or building lot number
Subdivision name ( if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS :
7? c-y `) a :510 ]L G r a` [ t'z $ �[ 5 fn 2M -y' -- Q. 1 1
Name lt� P . O . Address Tel . No .
Name of builder 4yo./� 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 ,
t./ 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
* whether interior or corner lot . Show location
* of water supply and location and configuration
of septic disposal area .
jlw _n r ��y � ri f lZ * COMPLETE INFORMATION REQUIRED BELOW . � � ,4
-•ty% K) L -1 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 )
No . of stories (habitable space) * Front yard ft Rear yard ft
Height ( grade to ridge ) ft . * Side Yards ft and ft
* If on corner , setback from side street ft
If residential , no . of families
No . of rooms ( excluding ba s ) * OCCUPANCY INFORMATION
No . of bedrooms
PRIMARY BUILDING
No . of bathrooms �. -
* One family dwelling
Primary heating sys
Type of fuel * Two family dwelling
Number of units
No . of fireplaces to be installed * Multiple dwelling /
Will a wood stove be installed? * vo�Vermanent occupancy
Central Air conditioning? Transient occupancy
we'Susiness
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-
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
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 . 7J13 \ T cr r
Will any second-hand or ungraded lumber be used.? If so , for what ? DSO
Foundation wall material e p( ;,5T ...r 4z. 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 u Material of roof
Size , wood studs " X ,f spacing "o . c . length ft . p / '
Joists ( floor beams ) lst . floor "X It
spacing "o . c . span ft . Pea F d�
Joists ( floor beams) 2nd . floor "X " spacing "o . c . span ft .
Overlays ( celling beams ) "X spacing "o . c . span ft.
Roof rafters ..__"X ( Q spaci.ng !to . C . spank 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
County of Warren. A F F I D A V I T STATE OF NEW YORK
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 complied with, whether specified or not , and that such work is
authorized by the owner .
SWORN TO BEFORE ME THIS Signature __ _ ou
Signature....
day of 19 owner ' s agent , archxrect , contractor
Notary Public , Warren County , N . Y .
SPECIAL CONDITIONS OF THE PERMIT :
By
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12804-
TELEPHONE (518) 792-5832
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTION R EIVZD �,II,2� Qf�
NAME
LOCATION
DATE P XT #
APPROVED
YES I NO
FOOTING/PIE
MONOLITHIC UR FORMS
FOUNDATION/D P—PROOF G
BACKFILL APP VAL
ROUGH PLUMBIN
FRAMING
ELECTRICAL ROU IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFSNG
SIDING
EXTERNAL PORCHES . TEPS
STAIRS—CLEARANCEk RAILS
PLUMBING p-rxTvRSAPELXEF VALVE
INTERIOR TRIM/PRVkCY DOORS
FINISHED FLOORS
GARAGE FIREPROO N
DOOR CLOSERS)
SMOKE DETECTORS
FINAL ELECTRICAL NSPE " 'ION
- FINAL APPROVAL OF `CONS UC 0
_ OX TO ISSUE C/O O C/C
A SIGNED CERTIF�TE O CUPANCY MUST BE
OBTAINED FROM TH BUILDI DEPARTMENT BEFORE
THESE PREMISES RE UPI D!
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REMARKS:
i
ARRIVE
DEPART
INS TOR '~
TOWN OF QUEENSBURY
BUILDING AND CODES .DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY,, NEW YORK I280&
TELEPHONE (518) 792-5832
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTION RECEIVED. ,r��q
NAME S�,di LUPt CMli7�k 4f1 pe!! P+ W� s
LOCATION
DATE f
PERMIT #
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATIONfDAMP-P OOFING
23ACKFXLL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-I
INSULATION:
FOUNDATION
WALLS
CEILING
j�FINA L INSPECTION:
II CHIMNEY HEIGHT
>OZGOFI NG
SIDING
EXTERNAL PORCHE /STEP
,STASRS-CLEARAN E S RAI
PLUMBING FIXT RES/BELIE VALVE
INTERIOR TRI /PRIVACY RS
FINISHED F RS
GARAGE FIRE ROOFING
DOOR CLOSE (SJ
SMOKE DET TORS
FINAL ELEC ICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION
Al
o s L cD E3 yi c 01 AlCn
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIEDI
REMARKS:
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BUILDING DEPT. COPYCIE THIS
COPY
WIFORM Ul PING DEPT WREN REO.UIRED�RE UNDERWRITERS,
TEMP. !F PATE
CITY OR r' M y 5 TOWNSHIP COUNTY
VILLAGE }
STREET AND NO. OR C t ` POLE NO.
ROAD AND POLE NO. ,.,....yj
BETWEEN WHAT TWO
CROSS PREMISES LOCATED? BLOCK
STIR E ETS ISOCCt,, LOT
p t s! BUILDING
NAMUPANT'S �- t i... '!'S Ki ti..F./ I�i T OCCUPANCY
OWNER'S NAME 4'� TEL. #
AND ADDRESS 'r u
UR@NY� FROM THEIR OFFICE
By l� DEFECTS
BUILDING SORK NEW REMOVED
par
OLD
IS NEW ❑ 19s ❑ 0.DA4Y14NAL
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
No- at Fixtures m BRANCH OFFICE USE
NUMBER OF OUTLETS Lamp Receptacles MOTORS HEATERS CIRCUITS ONLY
Lacar
ech•t H.P. Wach Na. A.W.G.
tion side Att INSPECTION
Cellists W4II Recepwis Switch pendent Btecket No. Type £ecIs rio. Each
Out-
side
Sub
base
Base
meet
tst Fl.
2nd FL
3rd FI,
REMARKS- LIST OTHER ELECTRICAL 6EYlCEB NOT SET FORTH ABOVE :
00 NOT USE THIS SPACE.
This aPPlicaliaa is intended to cover the above-listed equipment to be inspected but if at time of inspection thew is found additional equipment not above listed.
the inspection and adjust. the tee to cower the additional equipment, as can
provided by the applit.
you are authorized to make TOTAL
SIZE OF ELECTRI SIGN WATTS
MAINS FEEDERS LTUBE SIGN
AMPS
CONCEALED EXPOSEDGAS TRANSFORMERS OF VA
OF WORK CONC
(NUMBER) ICAPACITYI
WORK TO BE COMPLETED SIZE OF SIGN
STARTED
SERVICE OVERHEAD UNDERGROUND MAKER
ENTERS OF SIGN
UILDING
INSPECTION REQUESTED OLD
ON OR AS NEAR AS NE-W 1J
POSSIBLE
AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
PRINT MAW rANCh ADDRSS {I ' DATE OF
NAME OF
"�,L 'kU C.l.. -. Y �. ,+'R APPLICATION
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APPLICANT .—
.) 4C de t (' {} .J �-. �. { + J 2 - C., TELEPHONE
STREET ADDRESS
LICENSE NO.
CITY OR CODE WHEN APPLJICABLE
POST OFFICE
na EL InEV. s/e5I A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDINGS ----M
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