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1987-623 BUILDING PERMIT yr � TOWN OF QUEENSBVR►. l NO. 87-&23 Fv WARREN COUNTY, NEW YORK o Richard Rozell to PERMISSION is hereby grant ad Street, Road or Ave. �t IL0 West Mountain Rd . r � OWNER of property located at Pole Barg in the Town of Queensbury. To Construct or place a at the above location in accordance to application tog Bu other B with plot plans and uilding and Zoning O dinancern�ration hereto filed an approved and in compliance with the Town of Ctueenshury t . OWNER'S Address is West Niountain Rd . Queensbury > Na Y . 12$01 n m +-t a 12. CONTRACTOR or BUILDER'S Name a cv Same 3. CONTRACTOR or SUI'LDER'S Address 4, ARCHITECT'S Name Z4 m m rr f3 5. ARCHITECT'S Address r+ VId r.. 6_ TYPE of Construction — (Please indicate by X} y { ]j Wood Frame l } Masonry I ) Steel { T 7. PLANS and SPecillostions licatl0n . > No. 151 x 28 ' per Plot plan specifications and apP It a. Prose Use Pole Barn < April 1 , 19 88 1Q . fla PERMIT FEE PAID — THIS PERMIT EXPIRES in eon of the i1f a longer period is required an application for an extension must be made to the Build ing a rid Zoning 'sP town of Gueensbury Dore the expiration dare.) 87 17ttt Septa 19 this Day of Dated at the Town of Queensbury � � �- y/f For the Town of Clueensbury SIGNED BY Bu1ld1ng and Zoning Inspector TO BE COMPLETED By BLI7G . DEPT . (' 10 {P2 � . c Application No . 19 ; I, ✓QWI! © tteeli3l7ttl'1 Permit issued S �f p f +I,�Q!7 BUILDING and ZONING DEPARTMENT Permit Expires 19 Say and Hauifand Road, R.D. i Box 98 Zoning Designata.on Queenshury. New York 12801 Variance No . BUILL>INC3 t 'C7l 0EP, % Site Plan Review No . Approved by : APPLICATION FOR 10 r BUILDING AND ZONING PERMIT L OF THE FOLLC4JING . A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION . ANSWER AL 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 be indicated on the Permit . -------------- special conditions as may The owner-of-this property is : -,} � l cam/ / / / Tel . P . O. Address Tax Map Now ./ Property Location :-- street number or building lot number Subdivision name ( if applicable) THF,ssVM­R1>N ESPONSIBLE FOR,v SUPERVISION orrJ WORK AS REGARDS BUILDING CODES IS ! Tel . N o . P . O . Address Name Do ' �'�_ ,�' _ r/ IJ o Tel Isds /dam• Name of builder f�o2c-{ � Address 2._ ✓-�+� r� �1f Tel . lumber Address Tel . Name of p Address Name of mason NATURE OF PROPOSED WORK : * ZONING INFORMATION : A PLOT PLAN MUST BE PREPARED AND SUBMITTED , K Construction of a new building * drawn reasonably to scale and attached hereto , Addition to a building * showing clearly and distinctly all buildings , Alteration to a building * whether existing or proposed and indicate all (no change to exterior dimensions} * set-back dimensions from property lines . Give Other work (describe) * street and number or lot number and indicate * 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 . * REQUIRED BELOW . * COMPLETEIN'k"ORMATION �� f t X � �� f t - Size of property ft . Existing building ( s) Size-. C_Lft X. .—b-' r"-- - * PROPOSED BUILDING AND USE : * Existing buildings ) Usle J * line c� ft X eN ft distance from property Size of new structure artial/full * Proposed building , Foundation ier slab/crawl/P * and ft {circle one} * Front yard 9% ft Rear y ft Side yards ft and No . of stories (habitable space} _ - Height (grade to ridge} G'` ft ' * If on cornerr setback from side street , '•. / � If residential , now of families * OCCUPANcY INFORMATION /U///" No . of roams ( excluding baths ) / 1 No. of bedrooms PRIMARY BUILDING - No . of bathrooms tine family dwelling stem Two family dwelling Number of unit:s �__�.�I/�,1 primary heating s * Multiple. dwelling / Type of fuelIII * - Now of fireplaces to be installed * Permanent occupancy - Will a woad stove be installed? * Transient occupancy Business Central Air conditioning * * Industrial BUILDING STYLE, PRIMARY STRUCTURE " Other Ranch Contemporary Log cabin * If additicn , what will use be? Raised ranch Mansion Duplex Bungalow Split level Old style * ACCESSORY BUILDING- car Cape Cod Cottage her * e one car/ two car/ Town House Detached garag / two car/ Row car Colonial * Attached garage/one car/ __.----•-- { CIRCLE ONE PLEASE } building * * * * * * * * * * « * * * * * 'Private sK�`3�� Other ESTIMATED MARKET` VALUE F * CONSTRUCTION Ii+1FdRMA`iIC3N ON BUILDING SPECIFICATIONSr ON REVERSE SIDE OF THIS SHEET , TO BE COMPLETED ! Form EPA 4/86 and-vl BUILDING PERMIT APPLICATION CONTINUED - ~ ; BUILDING SPECIFICATIONS : Type of construction , wood frame fire safe , etc . Will any second-hand or grade ].umber be used? If so , for what . Foundation wall material Depth of foundation below grade Thickness �J (to bottom of footing ) +P461� + Will there be a cellar ? LA"lL) Heated or unheated? i Will there be a basement? ^-,40 Floor sq. footage sq ft Will any portion be used as livin( If so , what portion? _sq. ft . - - Type of use? g space? Type of roof u slopes flat/shed/other Material of roof Sizes , wood stud - "X iff _" spacings . length „ft . Joists ( floor beams ) lst . floor six is Joists ( floor beams) 2nd . floor Spacing "o . c . span ft . Overlays (ceiling beams ) ",X „ y,X �" spacing "o . c . span ft , spacing o . c . span ft . Roof rafters _ .�_-.rx CF "' spacing._ c. O . c . span-_..` ft . Roof trusses (Pre-engi r� s g ,"o . c , span ft Exterior wall finish p 0? Interior wall finish Of what material ? 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? Depth of chimney foundation below grade ft , ft . above roof 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 D Ty ,V r I County of Warren A F F I A 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 per rning to the proposed work shall be complied with, whet spec ' f ' d or not , d tha authorized. by the owner . uh work is SWORN TO BEFORE ME THIS Signature day of Owner . Owner ' s agent , ar Itect , contractor - 19 Notary Public , Warren County , N. Y . SPECIAL CONDITIONS OF THE PERMIT : By TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT SAY & HAVILAND ROADS QUEENSBURY, NEW YORK 12801 TELEPHONE (518) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED r[ ` NAME2 ZoOCATION DATE !� 7 PERMIT #_ APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDA TTON/DAMP—PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING RLECTRT L ROUGH—IN SNSULATIO FOUNDATI FLOORS WALLS CEILING j,,PtNAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES STE STAIRS—CLEARr1NC & RAI _ PLUMBING FIXTUR S/RELIEF VALVE INTERIOR TRIM/ RIVACY DOO FINISHED FLOOR GARAGE FIREPR FIND DOOR CLOSERS SMOKE DETE_C RS FINAL ELECTR CAL INSPECTION F�``NAL APPROVAL OF CONSTRUCTION A .SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: r r INSPECTOR 5 � I I t .7l OL G ��p �pr �4� g� q"f✓M:.. Z P7 }yj7k}.!}.. P4r bMy S f 123f f I i t LS G`►` C} Pr i