8493 BUILDING PERMIT
TOWN OF QUEENSBURY Na 8493
O\ WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to John and Hulda Ellingsworth
OWNER of property located at 4 Montray Road Street, Road or Ave.
in the Town of Queensbury,To Construct or-place a
One—Car Detached Garage 0
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. OWNER'S Address is 34 Montray Road
Glens Falls, New York
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2. CONTRACTOR or BUILDER'S Name
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David Myers N-
Mustard Seed Services
3. CONTRACTOR or BUILDER'S Address
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Regency Park
Glens Falls, New York 12801
4. ARCHITECT'S Name
5. ARCHITECT'S Address t')
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6. TYPE of Construction—(Please indicate by X) 1i
(x)Wood Frame ( ) Masonry ( ) Steel ( )
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7. PLANS and Specifications ly
12 'x22' per plot plan, specifications and (:)-1
No. application submitted.
8. Proposed Use
One—Car Detached Garage
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$10. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES December 1 19 84
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the Fi
town of Queensbury before the expiration date.) - CJ
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Dated at the Town of Queensbury this 14th Day of May 19 84
SIGNED BY 04 for the Town of Queensbury
Building and Zoning Inspector g
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:,, p, TOWN OF QUEENSBURY •
-,f • (Space inside block to he filled in by-
1..... WARREN COUNTY, NEW YORK • Building Inspector)
�.- Application for Application No. :
Permit I5,ue(l 19.
�� BUILDING AND ZONING PERMIT Permit Expire,. 'g
%(sling District s--,
\ AR. of Work,$ I I•
THREE (3) Copies of a PLOT PLAN, Drawn to scale e v / �-,
showing the actual dimensions of the lot to be built 1zi'mat'Ki
upon, The exact size, and location on the lot of the
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION. l
J✓ TOWN OF QUEENSBURY
6 — J-- a� off/ - D A E H .E n V E [ 47 E '
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK
ANSWER ALL OF THE FOLLOWING. ,,?'br' 114 191 C)
The undersigned hereby applies for a permit:to do the following work A.M.`�"'/Cir `f > �� ��M.
which will be done in accordance with the description, plans and specifi- 71819110}472)112131.4I5i6
cations, and such special conditions as may be a indicated on the permit.
The owner of this roperty is:
Invx& -���c� E(ill\c 5,0 0,--k-k ,3,-/- M o�-6 ay Rd- 6'(ev.5 R (s, N y t Z go /
(NA.4E) I IP.O.ADDRESS)
The person responsible for supervision of the work insofar as the Building Code and the Zoning Ordinance apply is:
JQLV t cl 4\Jc V s /(NAR. 61 e c/ P IC, G I e s F 1 I S, N ' P 0.AOOR'S)
Name of Builder PA\? S-61-`"d ec1 Se-4-u 1 c eS Address
Name of Plumber Address
Name of Mason Address
Lot Number R•%' Unit Estimated value of proposed work S `%- =' "`'• a
Name of Village ( ✓`a
Name of Street -a.'i .'`.i.�' Y:v:+: r.I: .t���)• Side of street: north 0, east 0, south 0. west
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Nearest Cross Street `,C;°`-.r;,b- I c 1. Y=r '~ Distance from this cross street Ft.
Property is north ❑,south ,Q,east Ili, west ❑from Cross Street
If on Corner, which corner, northeast [:_1, northwest ❑, southeast ❑. southwest
(Designate by marking with an "X" in the correct space.)
NATURE OF PROPOSED WORK . OCCUPANCY
`^ Construction of a new building. Main Building
❑ Addition to a building. . One-family dwelling . ❑❑
O Alteration to a building. Two-family dwelling •
❑ Demolition of a building. -family apartment house ❑
Store building ❑
-car attached garage El
Other:
Accessory Building
• One-car detached garage
Other work. Describe Two-car detached garage ❑
Private chicken house ❑
• Private storage building ❑
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.
1 NORTH Show proposed building(s) in-dotted line and-existing
. huilding(s) in solid line.
J _ fdi ON / � `f ft.
N .�..>r= /4,t. k Size of property ft. x
r r �'' t}�� • Size and use of existing buildings, if any •
i W Size of proposed building l ?`' ft.x '' , ft.
,. "' ('� Height (from grade to ridge) IL• • ft. —
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Front yard a�' ft.
L.f� Side yards . . . .'z L ft. and . . . .2 . . . . . . . ft.
Rear yard ?2 ft. —
SOUTH If on corner,setback from side street ft. —
Note: All distances are net, as measured from street side
line to nearest part of building.
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(OVER)
7-73—M
(cont'd.)
BUILDING SPECIFICATIONS.,
Kind of construction: Wood frame, fire safe, etc.?. ...n' .
Will any second-hand lumber be used? VI c If so, for what2
Material of foundation walls C-vv-t" ' r�I ' ' ; ��"" C f` Thickness
Depth of foundation walls below grade . . .0)91e
. . /Z /9 Continuous foundation? . Yc5
Will there be a cellar? Y ), ` l � J` `If so, material of cellar floor ,I s,-�I
Type of roof: Sloped or flat. �. Material of roof spacing $ ft.
Size,wood studs . . � 2 " x •F p g /•6• •.• • • • •"o.c., length
-" x ", spacing . . .- "o.c., span
Size, floor beams, 1st floor . . . . ft.
Size, floor beams, 2nd floor " x ", spacing "o.c., span ft.
�' /2
Size, ceiling beams 2 . x 6 ' ', spacing ,��f� "o.c., span ft.
Size, roof rafters ct m a 2 x ' ", spacing l6 "o.c., span 8 ft.
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Exterior finish ii' i t 1 5 i i)i:1 t J% With what material? . .(ec A1!./
Finish of interior walls. . . . �� tY
If garage is to be attached, of what material is wall between garage and main bui.ding to be constructed?
Is there to be an opening between garage and building? .
Kind of heating system 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
Willa toilet be installed?
Will a kitchen sink be installed and connected to water supply?
Water supply (public water supply or pump)
Distance of cesspool from any private well feet
Will drainage system be provided with required traps, cleanouts, and vents?
Town of Queensbury AFFIDAVIT
County of Warren
State of New York
I swear that to th b, of my know/edge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, area true and co.a.�lete statement of all proposed work to be done on the described premises and that all provisions of the BUILD-
ING CODE,THE ZONING ORDINANCE,and all other laws pertaining the pro po shall be complied with,whether specified or not,
and that such work is authorized by the owner. C /
Sworn to before me this Signature ... .... ... exec)
OWNER. NER'S AG .AR HITECT,CONTRACTOR
day of 19
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NOTARY PUBLIC, WARREN COUNTY, N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
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BUILDING DEPT.COPY OF APPLICATION FORM 46-EL.NEW YORK BOARD OF FIRE UNDERWRITERS.
FILE THIS COPY WITH BUILDING DEPT.WHEN REQUIRED.
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V t�� /14L�_G / 1 [ TOWNSHIP COUNTY
STREET AND NO.OR ROAD AND POLE NO. Ai 4/,1 7/r1r G , /fir/ POLE NO.
BETWEEN WHAT TWO I f /i
CROSS STREETS IS !> 7�- if
PREMISES LOCATED? �J rD 1')fil/ G• �j- (s1 CI /.Y LGf i f U /�CSECTION BLOCK LOT
OCCUPANT'S J /_ BUILDING /J
NAME ! F /-1��. /J../i•/ra /..r r., 7/
C r.ub! OCCUPANCY
OWNER'S NAME
AND ADDRESS r ill
CURRENT _ f 4 F �/ OFFICE
SUPPLIED FROM THEIR f/�'
BY ^/
BUILDING DEFECTS
NEW OLD❑ REMODELED ❑ IS
NEW ❑ ADDITIONAL❑ REMOVED ❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
No.of Fixtures& BRANCH
NUMBER OF OUTLETS Lamp Receptacles MOTORS HEATERS CIRCUITS LAMPS
Loca-
tion Side Attach't H.P. Watts A.W.G. WATTS
Ceiling Wall Recept'Is Switch Pendent Bracket No. Type Each No. Each No. Gauge NO. EACH
Out-
side
Sub-
base
Base-
ment
1st Fl.
2nd Fl.
3rd Fl.
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REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: . DO NOT USE THIS SPACE.
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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 MAKER
ENTERS OF SIGN
BUILDING
INSPECTION REQUESTED
ON OR AS POSSIBLE NEAR AS /./'� NEW OLD Ell
AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
NAME OF nx /JJ - DATE OF /L
APPLICANT • !/!(^ /�- //.r 1^li.- 1��•_• D1. APPLICATION���r !� f / �;4' ��
STREET ADDRESS
CITY OR .J / (// /
POST OFFICE ( > -c�� r `° I1r/ 7 ,' CODE / / WHEN APPLICABLE •
• A SEPARATE APPLICATION MUST BEFILED FOR EACH SEPARATE BUILDING
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