1986-806 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 86-806
0)fi . \/.\ 4wARRENCOUNTYINEWYORK
PERMISSION is hereby granted to Richard Bailey
OWNER of property located at \ Lot 2 Tina Lane Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Alterations to dwelling (porch)
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 ##2 a'
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Queensbury, NY 12801 1-1
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2. CONTRACTOR or BUILDER'S Name N
Harvey s Specialty Const. m
3. CONTRACTOR or BUILDER'S Address
RD #1 Box 1432
Lake George, New York 12845
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4. ARCHITECT'S Name 0
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5. ARCHITECT'S Address G
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6. TYPE of Construction—(Please indicate by X) Z
(xI Wood Frame ( I Masonry ( I Steel ( )
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7. PLANS and Specifications Q'
PL.
12'xl8' deck converted into screened porch - will use H.
No. combination windows - per specifications and application.
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8. Proposed Use see building permit 86-215 for dwelling 0
One-Family dwelling (deck converted to porch)
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$ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES June 1 19 87 a' w
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the `-' t
town of Queensbury before the expiration date.) p
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Dated at the Town of Queensbury this 14th Day of November 19 86 0
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SIGNED BY Vile ' r .t. , for the Town of Queensburyro
/lCIy-to j Building and Zoning In'.i'ctor # I~-.
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' TO BE COMPLETED BY BLDG. DEPT.
Application No. ,OWN Orr^Q EN/513
Jown of Queenitury Permit Issued 19 ; Ri 0 Ri 11
W Fo B
BUILDING and ZONING DEPARTMENT Permit Expires 19
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation LI l' OV 1 31986
Queensbury, New York 12801 Variance No. oU p c�,
! Site P n. R view N ''` j 6 P— F- - t:ii��PPii�
1"2 Appr ed a . ® e`d e o o a
I APPLICATION FOR
BUILDING AND ZONING PERMIT -.-N--..---•----- __
* 3,, * * * * * * * * * * * * * * * * * * * * * .* * * * * * * * * .* it- * * * *;:.-11-
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: Mc' , R+c--kd,,�k ,ja i e l
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P.O. Address 4\�D, 1 ;n,` l--,<--\e G7le.,-v5(ei 1)5 N•y Tel. 70?'5-.3 / o
Property Location: L a _I_ -Y4- I i cv---, G �,, e Tax Map No./'")52 lJ/ z-
Street number or building lot number
Subdivision name (if applicable). (Pr) An A, 0-'1. �"v6c11'``J' sion
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
—0,,�; � , ( 1 -,,-✓D RO) - Sox i,-/3a i, +-e Georj e `773 -7/ Sc
Name P.O. Address Tel. No.
ffar✓e,S 5�e�<'u-l�� Cv e Tel. ?�—�/Sc�
Name of builder Cam.,) �c± c, , Address t?i i- B x/ye a Aahc
Name of plumber iv/A Address Tel.
Name of mason i\i%A. Address • Tel.
NATURE OF PROPOSED WORK: * ZONING INFORMATION:
Construction of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED,
Addition to a buildin * drawn reasonably to scale and attached hereto,
Alteration to a building * showing clearly and distinctly all buildings,
(no change t_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
,�r +f �W72 ° �' * of water supply and location and configuration
et. !\3;0 �YLT1 LA:, '0�C-1L /).J ra A * of septic disposal area.
S Ci2.6r&AJ L X) FN PO yr.C-(--t. * COMPLETE INFORMATION REQUIRED BELOW.
W1C.L vSk= Co.4-4/3 lv t.UY3ouJS
t Size of property ft X ft.
(5-Mit °'t) * Existing building(s) Size, ft X ft.
*
PROPOSED BUILDING AND USE:
Existing building(s) Use
Size of new ructure ft X ft *
Foundatio -pier slab/crawl/partial/full * Proposed building, distance from property line
(circle one) * Front yard ft Rear yard ft
No. of stories (habitable space)
Height (grade to ridge) /'S ft. * Side yards ft and _ ft
If residential, no. of families * If on corner, setback from side street ft
No. of rooms(excluding baths) _ * OCCUPANCY INFORMATION
No. of bedrooms " — *
No. of bathrooms — * PRIMARY BUILDING -
Primary heating system — * 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
* , Business
BUILDING STYLE, PRIMARY STRUCTURE ,. Industrial
'
Ranch Other
Contemporary Log cabin * , "
If addition, what will use be? S'Gre e� (Doc-G�
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 co *
$ /-/0 0 0. —
INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
Form BPA 4/86 and-vl
1 I p14 G-es )'‘-a/J- -5 U+- A(Ail
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BUILDING PERMIT APPLICATION CONTINUED -
i3LJILDING SPECIFICATIONS:
Type of construction, wood frame., fire saf e,etc. vv o Q
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 -Cilopej/flat/shed/other Material. of roof Asp ha
Size, wood, 'studs 2 "X 4( " spacing "o.c. length ft.
Joists(floor beams) 1st. floor A "X ' " spacing /6 "o.c. span /-CR ft.
Joists (floor beams) 2nd. floor "X ',' spacing "o.c. span ft.
Overlays(ceiling beams) Z "X 6 " spacing /6 "o.c. span /off ft.
Roof rafters a "X 6 " spacing / o.c. span Q ft.
Roof trusses(pre-engineeed) spacing "o.c. span ft.
Exterior wall finishl�' u/'ooc_ IJccme 1 Of what material? C-e Q ± G.
Interior wall finish 1r/'o o 0.
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 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. ^ In
SWORN TO BEFORE ME THIS Signature c l )U/`A• v14 .
Owner, owner's agent,archit c ,contractor
day of 19
Notary Public, Warren County, N.Y.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
SPECIAL CONDITIONS OF THE PERMIT:
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By
BUILDING DEPT.COPY OF APPLICATION FORM 46-EL,NEW YORK BOARD OF FIRE UNDERWRITERS.
FILE THIS COPY WITH BUILDING DEPT.WHEN REQUIRED.
(TEMP.# 'DATE
CITY CITY OR j� I /
VILLAGE - r) ." --4 TOWNSHIP COUNTY \; ` r c ,-1
STREET AND NO.OR ;
ROAD AND POLE NO. = ( �'" . . ' f - POLE NO.
BETWEEN WHAT TWO
CROSS STREETS IS -' i 1 I -I ( 1=i
PREMISES LOCATED? i " --- • ' 1 ' r '_I ' 'SECTION BLOCK LOT
OCCUPANT'Si �' BUILDING _
NAME y ill( l 1 1 C,,. 1 r /;;�• 1 J.,.�. L. OCCUPANCY —. •, A C.!..`.` I„
OWNER'S NAME -- -- —
AND ADDRESS i I/ TEL.# _
CURRENT
SUPPLIED BY FROM THEIR OFFICE
BW
• DEFECTS
SUILDING NEW,Q OLD❑ IS
NEW ❑ ADDITIONAL J REMOVED ❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETS No:of Fixtures MOTORS HEATERS BRANCH OFFICE USE
Lamp Receptacles CIRCUITS
Loco- ONLY
lion Side Attach't H.P. Watts A.W.G.
Ceiling Wall Recap% Switch Pendant Bracket No. Type Each No. Each No. Gauge INSPECTION
Out-
side
Sub-
base
Base-
ment
1st Fl.
s.
2nd Fl.
3rd Fl. .
REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: DO NOT USE THIS SPACE.
This application is intended to cover the above-listed equipment to be inspected but if at time of inspection there is found additional equipment not above listed,
you are authorized to make the inspection and adjust the fee to cover the additional equipment,as provided by the applicant.
SIZE OF ELECTRIC SIGN TOTAL
MAINS FEEDERS LAMPS WATTS
CHARACTER EXPOSED GAS TUBE SIGN
OF WORK CONCEALED TRANSFORMERS OF VA
WORK TO BE (NUMBER) (CAPACITY)
STARTED COMPLETED SIZE OF SIGN
SERVICE OVERHEAD UNDERGROUND MAKER •
ENTERS
BUILDING OF SIGN
INSPECTION REQUESTED
ON OR AS NEAR AS
POSSIBLE NEW OLD 1-1
AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION.•ALL SPACES DATE OF J/ r
MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. APPLICATION 'j/ / ' /1,--
PRINT NAME AND ADDRESS /
NAME OF 1 ) V SIGNATURE / ;"-:
APPLICANT / 1 F; ' - .: J ' %t 1 is_.,..\ .-:--.)'t' X OF APPLICANT _:�',I ., - ' f f 1.�j"< < --
STREET ADDRESS •.--1/ ' /-' y r '/ �- TELEPHONE#
CITY OR _ `��. - �_ �, ,'',. _- ZIP ,� _1 c�.,r .i LICENSE NO,
POST OFFICE f_-- CODE' •-..-- •- WHEN APPLICABLE
/
46 EL (REV. 1/86) •A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING ---- ._-
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