1987-212 BUILDING PERMIT
TOWN OF +QUEENSBURY No. 87- 212
WARREN COUNTY, NEW YQRK
PERMISSION is hereby granted to Raymond Adams o
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OWNER of property located at 7 Cottage Hill Road Street, Road or Ave.
in the Town of Oueensbury, To Construct or place a Demolition of garage
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.
t . OWNER'S Address is 7 Cottage Hill Road
Queensbury , NY 12801
2_ CONTRACTOR or BUILDERS Name
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3. CONTRACTOR or SUiLDER'S Address
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4. ARCHITECT"S Name ¢
5. ARCHITECT'S Address
S. TYPE of Construction — (Please indicate by X1
( ) Wood Frame ( ) Masonry ( ) Steel I l
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7. PLANS and Specifications F3
15 ' x3O ' garage per application
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8. Proposed Use
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Demolition of garage
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$ 10 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES
Dec . 1 19 87
(if a longer period is required an appiication for an extension must be made to the Building and Zoning inspector of the
town of O.ueensbury before the expiration date.)
Dated at the Town of Queensbury this 5th Day of May 19 87
SIGNED BY `"� '� for the Town of 4ueensbury
Building and Zoning Inspector
TO BE COMPLETED BY BLDG . DEPT .
Application No .
,Jv[tlre oCeeer� �6tt►�t�t Permit Issued 19
BUILDING and ZONING DEPARTMENT Permit Expires 19
Bay and Haviland Road, R.D- 1 Box 98 Zoning Designation
Queensbury, New York 12801 Variance No . i
f q ,tom Site Plan Review APR 9 1987
��'� / f 4 f " Approved by : BU[L.DI 7+G Bc CODE DEPT.
APPLICATION FOR
FU I LD I NG 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 is ; �� Y+►S� e'L - �I ( ' 3 q �r /
P . O. Address 7 � [jTc _ } �i €� +�/ SZf+�S FUG. Tel .
Property Location : � { r10 11 Tax Map No . ref /
Street number or building lot number
Subdivision name ( if applicable)
TH PERSON RESPONSIBLE FOR SUPERVISION OF WORK. AS REGARDS BUILDING CODES IS :
Name P . O . Addre s 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) set-back dimensions from property lines . Give
street and number or lot number and indicate
� jL^ IkI r whether interior or corner lot . show location
w+ D * of water supply and location and configuration
n 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 )
No . of stories (habitable space ) Front yard ft Rear yard ft
side yards ft and ft
Height ( grade to ridge ) ft
If an corner , setback from side street ft
If residential , no . of families
Now of rooms ( excluding baths ) * OCCUPANCY INFORMATION
No . of bedrooms PRIMARY BUILDING
No . of bathrooms
Primary heating system K One family dwelling
Type of fuel Two family dwelling
* Multiple dwelling / Number of units
No . of fireplaces to be installed
Will a wood stove be installed? x Permanent occupancy
Central Air conditioning? Transient occupancy
* Business
BUILDING STYLE,, PRIMARY STRUCTURE x Industrial
Ranch Contemporary Log cabin Other
Raised ranch Mansion Duplex If addition , what will use be?
Split level Old style Bungalow
Cape Cod Cottage Other ACCESSORY BC7ILDING-
Colonial Row Town House , . Detached garage/one Car/ t ca / 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 sa€e , etc .
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 ) lst . floor "X It spacing "o . c . span ft .
JO ists ( floor beams ) 2nd . floor "X Of spacing "o . c . span ft .
Overlays ( ceiling beams ) "X spacing '"o . c . span ft .
Roof rafters "X No 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-71 if so will a Fire-rated
door , enclosure , and self-closing device he 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 A F F I D A V I T STATE OF NEW YORK
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Warren County off War 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
provisiorl„s of the BUILDING CODE , THE ZONING ORDINANCE , and all other laws pertaining to
the prop sed work shall be complied with, whether specified or not , and that such work is
authorize by the owner . + / �
SWORN TO B ORE ME HIS Signatur �] '� _
Owner , owner ' s agent , arcnrtect , contractor
day 19
Notary lic , W rren County , N. Y .
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
SPECIAL CONDITIONS OF THE PERMIT :
By-- --------------- --------------------
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12804-
TELEPHONE (528) 792-5832
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTION ,RECEIVED
NAME "-
LOCATION
DATE S- I ' �{�_ PERMIT #
APPROVED
Q� �c YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/ AM -PROOFING
BACKFILL APX;A PAL -
ROUGH PLUMBI
FRAMING
ELECTRICAL ROU -IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/STEP -
STAIRS-CLEARANCE & RA S
PLUMBING FIXTURES/REL-t VALVE
INTERIOR TRIM/PRIVACY" D RS
FINISHED FLOORS
GARAGE FIREPROOFING
DOOR CLOSER (S)
SMOKE DETECTORS
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL OF CO STRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY T BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS :
INSPECTOR