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1987-288 BUILDING PERMIT TOWN OF +QUEENSBURY No. 87_28 } WARREN COUNTY, NEW YORK . 1 �7 ' - CD CD James Rozell rn PE R M I SSI O N is hereby granted to 0 N OWNER of property located at In Harris Street Street, Road or Ave, CD in the Town of Queensbury, To Construct or place a _ Addition 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. 1 . OWNE R'S Address is RD #3 Box 1.3 Queensbury , New York 12801 x w H 2. CONTRACTOR or BUILDER'S Name same m rt 3. CONTRACTOR or BUILDER"SAddress d. ARCHITECT'S Name ly 5. ARCHITECT'S Address h• rr r• 0 rr 5. TYPE of Construction — (Please indicate by X) o G. E I X Wood Frame I } Masonry 11 Steel I I ro k-• r• 7. PLANS and Specifications aqq No 12 ' x12 ' per plot plan , specifications and application 0 �s = S. Proposed Use One—Family Dwelling. (porch added) $ 10 , 00 PERMIT FEE PAID -- THIS PERMIT EXPIRES December 1 1g 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.) Dated at the Town of Queensbury this 28th -Day of May 19 87 SIGNED BY _ a , ��for the Town of Queensbury Building and Zoning Inspector TO BE COMPLETED BY BLDG . DEPT . 7 Application Nov _locum o Queen3fiurt Permit Issued 19 Ei ..y BUILDING and ZONING DEPARTMENT Permit Exp fires I9 _ Bay and Haviland Road, R.D. 1 Box 98 Zoning DesignationI ID l01:9 Ed QueensCury. New York 12801 Variance No . Site Plan Review No . MAY 2 0 19c]p7 Approved r 1►f APPLICATION FOR ,� �/ BUILDING AND Z©NING PERMIT 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 he 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 : P . O. Address - Tel . - c Property Location ; - rsr�► Tax Map Nod!_ Street number or building 1 number Subdivision name (if applicable) ' THE PERSON RESPONSIBLE FOR SUPERVISION OF AS REGARDS BUILDING CODES IS : Name P . O. ddress Tel . No . vc Name of builder Address_ "tyE � 3 Tel . i . y�- Name of plumber Address 91A Tel . Name of mason Address Tel . NATURE OF PROPOSED WORK : ZONING INFORMATION : Cnnstruction of a new building A PLOT PLAN MUST BE PREPARED AND SUBMITTED , ddi.tion 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 York (describe) * set-back dimensions from property lines . Give :::pOne, � r� fir/ � � street and number or lot number and indicate i'" * whether interior or corner lot . Show location FOR DEMOLITION PERMIT , STATE SIZE AND * of water supply and location and configuration LOCATION OF STRUCTURES AFFECTED. * of septic disposal area . * * COMPLETE INFORMATION REQUIRED BELOW . * Size of property ft X�ft . Existing building ( s) Size _£t X ft . PROPOSED BUILDING AND USE : * Existing buildings ) Use Size of new structure IX ft X 0 Et * ~ 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 j ft and los� Ift Height ( grade to ridge ) t ' If on corner , s tback .from side street ft If residential , no . of families No . of rooms { excluding baths } OCCUPANt:Y INFORMATION No . of bedrooms * PRIMARY BUILDING - No . of bathrooms one family dwelling Primary heating system Two family dwelling Type of fuel ,� Multiple dwelling / Number of units No . of fireplaces to be installed Permanent occupancy Will a wood stove be installed? * Transient occupancy Central Air conditioning? Business BUILDING STYLE, PRIMARY STRUCTURE Industrial �, Other Ranch Contemporary Log cabin If addition, what will use be? Raised ranch Mansion Duplex * �'d JZZ Split level Old style Bungalow Cape Cod Cottage Other ACCESSORY BUILDING- Colonial Row Town House * �Detach+ed 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 , ]Eire safe , etc . Will any second-hand or ungraded lumber be used? If so , for what ? [^� Foundation wall material � �} Thickness �r7ff Depth of foundation below grade (to bottom of footing ) a Will there be a cellar? I .o Heated or unheated? Floor sq. footage sq ft Will there be a basement? -Will any portion be used as living space? -r— ( If so , what port '. Type of use? Type a£ roof - sl ped 1 shed/other Material of roof OO, Site , wood stu "X spacing "o . c . length ft . Joists ( floor beams ) 1st . loor " „ spacing`"o . c . span ft . . Joists ( floor beams ) 2nd . floor ",X . •-"" spacing 1_ - 4O . c . span ft . Overlays (ceiling beams ) "X ' s acinglf4 "o . c . span�_ft . Roof rafters _�T "X "' spaci �o . c . span�ft . Roof trusses (pre-engineered) //spacing."o . ca Sp n ft. Exterior wall finish CY 94 L Of what material? Interior wall finish ,� _ �, If a garage is to be attachpa , descrAbo materials to be used for FIRE SEPARATION : Is there to be an openifigibetween garage and dwelling? NO If so will a Fire-rated door , enclosure , and self-closing device be provided? 0000 Will a flue-lined chimney be installed?)� Height above .roof_ 1G? ft . Depth of chimney foundation below grade ft . Depth of fireplace hearth r— ft . mOmO Sn . 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 _ day of 19 er , owner s ent , architect , contractor - Notary Public , Warren County , N . Y . SPECIAL CONDITIONS OF THE PERMIT : By- ------__ ............ ------------- __ ev" of Queen3l " ry BUILDING and ZC7NING DEPARTMENT Bay and Haviland Road, R.D. i Sox 96 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME -� LOCATIO f Llate �/ r� + Permit No '� * * * * * * * * y✓ * * APPROVED YES NO Footing/Pier Forms Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief 'Valves Ext . Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg . Fixtures Gar . Fireproofin Door Closers Smoke Detector Chimney INSULATION Foundation Floors Walls Ceiling FINAL E CTRICAL INSPECTION DR EWA APPROVAL inal ilding, Survey Next scheduled inection (call when ready sp Remarka- c //�" Buil g Inspector 6/86 and-vl flown of Q94ee" 44"ry BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. i Box 98 QueenSbury, New York 12601 BUILDING INSPECTOR ' S REPORT NAME L.00ATIfL�c a Date C / Permit Nov 0 f a /✓ APPROVED - YES NO Footing/Pier Forms Foundation Waterproofing Sackfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext , Porches Finished Floors Interior Trim Stairs & Railings Cellar 'Drain Tile Concrete Floors Plbg , Fixtures Gar . Fireproofing Door Closers Smoke Detectors Chimney y&CNSULATION ! Foundation Floors Walls e it ing FINAL ELECTRICAL INSPECTION !„ DRIVEWAY APPROVAL_ Final Building Survey Next scheduled inspection (call when ready Remarks- Building Inspector 6/86 and-vl flown o/ Queen3l "ry BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT ! NAME L©CATION i I O v- r Date.W,.a./12( Permit Nc3 o APPROVED - YES NO Footing/Pier Forms Foundation Waterproofing Backfill Framing Roofing S id:.ng Masonry Veneer Rough Plumbing Relief valves Ext . Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg . Fixtures Gar . Fireproofing Door closers Smoke Detectors Chimney INSULATION : Foundation Floors Walls ceiling FINAL ELECTRICAL INSPE TION _...., DRIVEWAY APPROVAs_ -�_ Final Building Survey Next scheduled inspection (call when ready Remarks-- Building Inspector 6/86 and-vl awn v/ Queens6ury BUILDING and ZONING DEPARTMENT Bay and Waviland Road, R. 0- 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR " S REPORT NAME �T4 +v, .,Q f, I& I LOCATION s -r-. 0,7 +_ $ A6 - Date �/ �-7 Permit No . ✓ = APPROVED - YES NO Footing/Pier Forms Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext , Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg . Fixtures Gar , Fireproofing Door Closers Smoke Detectors Chimney INSULATION Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection ( call when ready Remarks- I If �lt;7 _L'- 1(m a�ing Bnspector 6/86 and-vl