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8905 { TOWN OF QUEENSfBUR i (, ;pace inside block to 1x• filled it, b% WARREN C„+pi{,o NOry, NEWT YORK Building l"%jXActcor) ppl is at ic>'r, No. Application for iI" oi, i, l .nttc d =9 BUILDING AND ZONING PERMIT hI -t r,tit Expire. . � { l.. 3rrrr,41 Ili%trrc t tJ l �C " 1 y ✓ 1 ;rliri r l \ 1'r,r'1 l ..� ---- 4i ,Irru+ e•cl h.• THREE ( 3 ) Copies of a PLOT PLAN. Drawn to state ltt•t,,:,rkS showingg the actual dimensions of the lot to be built upon. The exact size. and location on the lot of the building to be erected or altered MUST BE SUB- MITTED WITH THIS APPLICATION. . . . . - $ . . . . . TOWN OF QUEENSOURY A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK DATE [DR JE a '.S 0 1'! F ANSWER ALL OF THE FOLLOWING.. �W 6�LUj Then undersigned hereby applies for a permit to do the following work �r�r which will be done in accordance with the description, plans and specifi- }l.iN. cations, and such special conditions as may be indicated on the permit. 'T� $ 0 i :�'�� q 2 3141516 The owner of this property is; V .,1. �iP 0. ►.vo)Rhs�4'"V� %v lNA :c1 'Ube person responsibic for supervision of the work insofar as the Building Code and the Zoning Ordinance apply i.: _ . - - . - . Ib O 4bbi;E5S1 - . . . - - - - . Name of Builder . . . .C>%XIOUSk . Address - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Plumber . - . . . . Address . - . . . . . . . . . . . . . . Name of Mason . - . . . . . . . . Address d d d . . . . . . . . . . . . . . . . . . . . . . Lot Number . . . l Estimated value of proposed work S . - . -eo,�,C? . . . . . . . . s3.ws.r�lot ge . . Name of Street . . , . i" �' c Side of street: north ❑, east l�s�►rath Q . west Q Nearest Cross Street RJAI -S" - ^ . . . Distance irc,m this ^rosy street . . . TO..O.. 'F Ft . Property is north ❑ , south Q , east Wwest ❑ from Cross Street If on Corner, which corner, northeast 0 , northwest 0 . southeast Cl . southwest ( Designate by marking with an "X" in the correct space.) NATURE OF PROPOSED WORK OCCUPANCY Or Main Bu"ding �. Construction of a new building. One-family dwelling El Addition to a building. "rwo-famiiy dwelling M Alteration to a building. - . , . -family apartment house I] Demolition of a building. Store building t . - - -car attached garage s Other: d . . . . . . . . . . . . . . . . . . . . . . . . Accessory Building . . . . . . . . . . . . . . [� One-car detached garage El Other work. Describe: . . . . . . . . . . . . . . . . . . . . . . . . . . Two-car detached garage Private chicken house 0 . . . . . , , . . , . . . . , , . . . . Private storage building I] Other: . . . . . . . . . . . . . . . . . . . . . ZONING SPECIFICATIONS. Fill in for new building, or addition to existing building, or a change of occupancy. Indicate on the plot plan street names* the location and size of the property, the location, size and setbacks of pro- posed buildings, and the location of all existing buildings. NORTH Show proposed buildings) in dotted line and existing z %k building(s) in solid line. Size of property ft. x . .� - � . . . . it_ dr At Size and use of existing buildings, if any . . . . . . . . . . . . . . Size of proposed building . . . . '� . . ft. x . . �' '. . . . ft. t Height ( from grade to ridge) . . _ . . . . . . ft. Front yard . L.� . . . . . . . . . . . . ft. Side yards . . . . . ft, and , . . , s�'.r�y'r ^'# . . . . . ft. Rear yard . . . - . . . .�. �!`_ +.^�. " . . . . . . . . . . . . . . ft. SOUTH No on corner, setback from side street . . . . . . . . . . . . . . . ft" Note : A11 distances are neg. as measured from street side f line to nearess }tart of building. r� ;oVt:Rl f � l.7 3 �M BUILDING SPECIFICAXIONS., { Kind of construction : Wood frame, fire safe, c.? . . �i .� '. .-.."�`. . . . . . . . . . . . . . . " . Will any second-hand lumber be used? . . . t>- - - - - - - If so, for what? . . . . . . . . . . . 1 . . . . . . . . _ . . .� . . . . _ i . . . , Material of foundation walls . . .45d.A e ;-. -�' . . . . , . Thickness . . r . . .E . . . . . .Depth of of foundation walls below grade . . . . , .� �. . Et. . .+ . . . . . . . . . . . . . Continuous foundation? . sylrer.5, Will there be a cellar? . . . \.� gg S . . . . . If sa, material of cellar f]oor . . . . GG57�C:. • . , _ , , - - Type of roof: Sloped or flat. . . . ��'- 1 ;4? . . . Material of roof V_Zrr40 � Le.. �r� ' A Size, woad studs . . . . . . . . . . . . . . Z . . . - x . - . - � - - . , . . . . ", spacing . . , . . 24 . . . . . ..o.c., length t gt �.� . . . . r ft. Size, floor beams, 1st floor . . . . . . . Z - - - " x . . . . VC). . . . . . . . ", spacing . . . . . .L 1:p . . . . "o.c., span . . _ . . ( ,1 � . ft, Size, floor beams, 2nd floor . . . . . , .4- . . " x . . , . .ems . . . . . ", spacing . . . . . . . ..o.c., span Size, ceiling beams . . . . . - . . . - . spacing "o.c., span _ ft-2 : Site, roof rafters or beams x . . . . . . . ", spacing . . . . . . . ` o.c.�r pan . . 2 . . . �`��" . ft. Exterior finish - t4c � . . . . . . . . . . . . . . . . . . . . . . With what material ? - - . �! , . `{13�.�"t+ 7C't� , . Finish of interior walls . . . .t}" . . . Soif4. .Z> L-�. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . If gars e is to be attached, of _wyhat material is wail between. garage and main buOding to be constructed? / t :,LV%O*. . ., , ,7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Is there to be an ripening between garage and building? . . V lr J . . . . . . . . . . . . . . . . . . . . . . . . . Kind of heating system aL45_A* _ . ,P. . . . . . . . . . . . . . . . . . Oil burner or coal? . , . . . . . . . . . . . . . . . . . . . . . _ . . . . . Will a flue-lined chimney be provided? . . . . . . . . . . . . . . Depth of chimney foundation below grade . . . . . . . . . . . . . . . Height of chimney above roof . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . - _ _ - - - Will there be a fireplace? . . . . . . . . . . . . . . . . . . . . . Depth of fireplace hearth . . . . . . . . . . . . . . . . . . . . . Will a toilet be installed? . . )�'.e9iaJ. . . . . . . . . . . . . . . . . . . . . . . . . . Will a kitchen sink be installed and connected to water q supply? , . `-/�� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - . . Water supply (public water supply or pump) . . t�L:,.t l4::;. 4 - - !. , . . . . . . . . . Distance of cesspool from any private well . . . . . . . . . . . .'} Jj A.. . . . . , . . . . . . . . . . . . - . . . . . . . . . . . . . . feet Will drainage system be provided with required traps, clew outs, and vents? . . N/ PFE5S . . . . . . . . . . . . . . . . . . . . . . . . . . . Town of Queenshury AFFIDAVIT G County of Warren State of New York I swear that to tr. �s tt of my knowledge and belief the statements contained in this application, to4ether with the plans and rpeaifications still. mitred, are a true and om fete statement of all proposed work to be done an the described premises and that an �x�v' " of the $UILD- Ind CODE, THE ZONING ORDINANCE, and all other laws permaintn proposed work ilt be/y/gnnnti�sd with'whether specified or not, and that such work is authorised by the owner. _C_ Sworn to before me this Signatom . . . . . _ OWNER- OWNER'S. AGENT, ARCHITECT. CONTRACTOR dayof. . .. ... . . . .. . . . . . . . ... . . ... . .. . . 19, . . . N0TARY PUBLIC, WARREN COUNTY. N. Y. SPECIAL CONDITIONS OF THE PERMIT: t By _.. . . ... .. . ....__ ._ .... ... . . . . .. . . . . . . . .... . . . . .. .. . ...-.. . .... .. .... . .. .. .... . ..... .... _ . .-. ...---.. .-- TOWN OF OUFFNSBURY BUILDING & ZONING DEPARTMENT SEWAGE DISPOSAL PERMIT APPLICATION 1 . Owner ' s Name�'�, y�p, ,.I Add r e s s :;�' G��7 �" '. ;� �—T— '�. # . _ s- _7 l E. _ Telephone No . 2 . Property location Lem: t 1 ZIUA&rt= "�% 3 . Name of person or firm responsible for installing system Telephone No . Address µ 4 . Number of bedrooms ( residential buildings only ) i 5 . Daily flow. 451!f> gallons/day 6 _ Septic tank capacity 1-== gallons ? . Topography . flat ro ing , steep % of slope 8 . Nature of soil and depth 9 . If ground water , bedrock or impervious material is apparent at what depth does it begin? " ft . 10 . Percolation test : A , is required B �,.�' is not required C If required what is the rate m±nutesfinch ll . Water supply : unicipal well , other 12 . Type of system proposed : dryweil , file field , ther Any contractor , corporation , individual , etc * engaged in the construction of a sanitary sewage disposal system who covers the same before .inspection , does not have an approved permit , or varies from the approved application will be subject to a penalty of $ 250 as provided for in Section 6 . 010 of the Queensbury Sanitary Sewage Ordinance . ,ryy Date t ~ . =� ` -``- signature of applicant On separate sheet of paper submit a diagram of the proposed septic system with all dimensions , including distance from any structure , distance from property line and domestic water supply , etc . Include all dimensions of the system itselflad Form 3 - 82 TOWN OF C EENSSURY Building Department ink R""W t . Date Nama 91r) •., ..sx Permit Weather Rema rks Footin Forms pootin G Piers Foundation Cement Coat _ Water roofin Backfill Final Survey Fraxr+s n sheathing, - Roof Fell Roo fin Sidin Masonr Veneer Rou h PI Relief Valves _ WaS S Board Lxt . Forches Finished Floor Interior Trim Stairs & Railin s CeSlar Dr . Tile Concrete Floors �---' pS Fixtures Gar . Fire ,Door Closers Chimne Water Meter Inst . se tic A royal - Floors Foundation �� � ---- Insulation Walls Ceilin -- Buildings Inspector REMARKS TOWN OF QUEENSSURY Building Department rn.poebwo Repot Date - azoS Name C>t4 Aq y A.Ac 42d Perr.oit Ma wemther I Remark's Exca0at on Footing Forams rooting & Piers Foundation Cement Coat waterproofing Backfiil Final survey Pxamingr sheathing Roof Felt Roofin Siding Masonry Veneer Rough PlLffo Relief Valves Wall Board Ext , Porches Finished Floor interior Trim Stairs & Railings Cellar Dr . Tile Concrete Floors PJbg . Fixtures Gar . Fireprooff-insr- Door Closers Chimney Water Meter Inst . Jf Se tic A royal _ Fl rs 2nsulation Foundation Walls Ceilin W BuildinggTnspector REMARKS TOWN OF CUEEMSBU RY Building Department r la s Report y ame Pearreitelfig Weather Remarks Exca�at on Footing Forms Pooting & Piers Foundation Cement Coat Water .roof3n BacJcf33l Final Surve Frsm3n Shea thin Roof Felt Roc fln Siding Masonry Veneer Rough PI Relief Valves Wall Board Est . Porches Finished Floor Interior rr3m Stairs & Rallin s Cellar Dr . rile Cancrete Floors Plbg . Fixtures Gar. Fire roofin Door Closers Chimney Water Meter 2nst . Se tic AppXoVal Floors Insulation Foundation Walls --..__.....,..............................._. _ Ce3l3n �:?2165L bl7l lding Inspector REMARKS BUILDING DEPT. COPY OF APPLICATION FORM 46-EL. NEW YORK BOARD OFFIRE UNDERWRITERS. FILE THIS COPY WITH BUILDING DEPT. WHEN REQUIRED. CITY OR VILLAGE TOWNSHIP �,.-'�yi ]V:� (= ?j ,ApCOUNTY \f„� ' �� Iw �... STREET AND NO. OR POLE NO- ROAD AND POLE NO_ CROSS STREETS IS O ►REMISES L ATEOT SECTION BLOCK LOT OCCUPANT'S BUILDING NAME OCCUPANCY OWNEWS NAME 0.N0 ADDRESS E-UWA ENT # SUPPLIED FROM THEIR OFFICE BY 1-�is NEW WORK OEFECTS NEW LG OLD C� LL• REMODELED © 1S NEW F;e ADDITIONAL ❑ REMOVED LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED No. of Fixtures A MOTORS HEATERS BRANCH LAMPS NUMBER OF OUTLETS Lamp Receptaeks CIRCUITS Loca- tion Side Attach't H. P, Each A.W.G. WATTS Ceiling WalI Raceptots Switch Pendent Bracket No. Type EaoI1 No• EMIs No- O,w,M NO, EACH Out. side Sub- base Base- ment 1st FI. 2nd F4 I. Srd FL REMARKS; LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE; DO NOT USE 7'H IS SPACE_ r ation is intended to corer the above-listed equipment to be inspected but if at time of inspection ttlare is found additional equipment not above listed. horized to make the inspection and adlwt the fee to corer the additional equipment, as prorided by the applicant, ELECTRIC SIGN TOTAL FEEDERS LAMPS WATTS ER EXPOSED GAS TUBE SIGN CONCEALED TRANSFORMERS OF VA BE INUMBER} ICAPACITYI COMPLETED SIZE OF SIGN SERVICE MAKER ENTERS OF SIGN BUILDING INSPECTION REQUESTED ON OR AS NEAR AS NEW El OLD POSSIBLE AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED, NAME OFA �j DATE OF APPLICANT._,.. C'i-- '�"` + s t e� � - APPLICATION STREET ADDRESS '��+ u:�k-� �— I NO CITY OR 5 _ ,\ �-^ ! "-. ZIP LICENSE PLI POST OFFICE f�,1�� I""- ..i CODE WHEN APPLICABLE A SEPARATE APPLICATION MUST BE FILED FOR EA H SEPARATE. BUILDING TOWN OF +Q►UEENSBURY Building Departmnont Inspectwe Repro t D.te g •9 Nam PAGE G1 r4 * . Pw=ait No. 1Neat�enr ,�I Tf.• G. Remarks ExcatYa ton Footing Forms Footing & Piers Foundation Cement Cast waterproofing Backfill Vdoor Final Sur Framin ------- Sheathing ,Roof Felt Roofin ,SidIn Masonry Veneer Rough -p2bgo Relief Valves Wall Board sxt . Porches ? , Finished Floor Interior Trim �- Stairs & Railin s Cellar Dr . Tile Lill Concrete Floors PI . Fixture re s Gar . Fi roofin Door Closers Chimne Water Meter Xnst . Septic ApProval Floors Insulation Foundation Walls Ceiling ..-__. Building Inspector REMARKS