8784 4 .
BUILDING PERMIT -
TOWN OF QUEENSBURY No. 8784
WARREN COUNTY, NEW YORK
30 t
PERMISSION is hereby granted to Clyde and Ann Hess P
OWNER of property located at 9 Helen Drive Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Addition to dwelling (living area)
at the above location in accordance to application together with plot plans and other information hereto filed and
N
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. N
1. OWNER'S Address is 9 Helen Drive
Glens Falls, New York
2. CONTRACTOR or BUILDER'S Name
Richard DeForest
0
H
3. CONTRACTOR or BUILDER'S Address - (D
RD #1 Box 99A d
Greenfield Center N•
4. ARCHITECT'S Name
tD
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X) -
(x)Wood Frame ( ) Masonry ( ) Steel ( )
7. PLANS and Specifications
10'x14 ' per plot plan, specifications and
• No. application submitted.
o
8. Proposed Use
rt
One-Family Dwelling (additional living area) o
cL
H
$ 12. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 1 19 85
fJ•
(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 24th Day of September 19 84
SIGNED BY In a d. ��=�G/V for the Town of Queensbury
Building and Zoning Inspector
TOWN OF QUEENSBURY (Space inside block to he tilled in by
WARREN COUNTY, NEW YORK Building Inspector)
Application for • Application No. .
pp Permit Issued 19.
BUILDING AND ZONING PERMIT Permit Expires. lfl.
7•nning District
aloe n1 Work A �
THREE (3) Copies of a PLOT PLAN, Drawn to scale Ai'1 u c'c1 b G'�` �
showing the actual dimensions of the lot to be built Rcn,;()'ks
upon, The exact size, and location on the lot of the
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION.
�0 /f_ j /� //� ' TO
WN OF QUEENSBURY
l DATE D
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK SEP 2 1 19
ANSWER ALL OF THE FOLLOWING. ' (Slj •
The undersigned hereby applies for a permit to do the following work 7''�'j P.M.
�1• ' 2�3�4�b1
which will be done in accordance with the description, plans and specifi- 71MI 8I9110 • i lis ea
cations, and such special conditions as may be indicated on the permit.
The owner,of this property is: '
C: 1/ 6-e.. . .•. '''4- 71.Y011. . .H= . . .` t's:s . .`U, r. `) Eeiv ). . G�.' .Ks. . . .s. . . ,. .•. . .
(NA`•(E) (P.O.ADDRESS)
The per n responsible-for supervision of the work insofar as the Building Code and the Zoning Ordinance apply is:
bQ---t-c-, 2.70-1/4 (i).>,.,c c\c/A C-t---e_o_AZO4 Cc--,_('-, IQ y
(NAME) (P 0.ADDRESS)
Name of Builder .h''��c% s'. Address
-rE� (, '-Q-`2" •C1 Cam'L' \e
Name of Plumber ----��—� Address •
Name of Mason. . . i c v, . .. .�v. . eQ-o..-s. Address V-)z-d-( ,-- N- -
cp o..
Lot Number 7 / Unit I Estimated value of proposed work S . .6 c-10.
Name of Village 7 1.(. �'. 1'1S.Id Gfl'•y
r l
Name of Street . . e. .e 4s \l1, Side of street: north aeast 0, south 0. west El
Nearest Cross Street .` �e 1.11 NC t)• • . r."0
Distance from this cross street . . . . Ft.
Property is north .,south ❑,east i i, west ❑from Cross Street
- If on Corner, which corner, northeast 0, northwest ❑, southeast 0, 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
Si
❑ Alteration to a building. Two-family dwelling ❑
❑ Demolition of a building. -family apartment house • ❑
Store building ❑
-car attached garage ❑
. 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.
NORTH Show proposed buildings) in dotted line and existing
'-16A''-`-\1 C-1-• building(s) in solid line.
Size of property /0 ° ft. x / 7 d ft.
C ++Size and use of existing buildings, if any . .n
U in
w NQ w b ft.x . . . ./... . . ft.
s Size of proposed building /
Height (from grade to ridge) ft.
Front yard • 0.o ft.
Side yards . . . .�,-6 ft. and ft.
Rear'yard (C.S~ 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.
(OVER)
7-73-m
(cont'd.)
BUILDING SPECIFICATIONS.,
Kind of construction600d frame fire safe, etc.?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Will any second-hand lumber be used? J'1 J If so, for what?
Material of foundation walls . . . .O I' , . .'6. a.c Thickness ( r�
Depth of foundation walls below grade Al' Continuous foundation? . ,, ,. . . . .
Will there be a cellar? . . . . M.. . . . . . . . If so, material of cellar floor 0
. . �� < Material of roof C F fit-A S (2-%
.
Type of roof: Sloped or flat? �. . .r-?` •
Sue,wood studs ;, io-i x ", spacing M "o.c.,'lngth g ft.
Size, floor beams, 1st floor . . . . . . .D. . . . " x ", spacing (C "o.c., span . . . . JO ' ft.
Size, floor beams, 2nd floor " x ", spacing "o.c., span ft.
Size, ceiling beams 9_. . . " x . . 6 ', spacing ( "o.c., span le' ft.
- - Size, roof rafters or-beams ._....._ _. I"x . G_ _ ",,spacing_ - - (6 _ "o.c., span (4/' _ _ft.
Exterior finish U-K?cQ S•'AL.-A.-SA With what material? p~t,;----1
Finish of interior walls S• �i-c
If garage is to be attached, of what material is wall between garage and main building to be constructed?
Is there to be an opening between garage and building? ---
Kind of heating system . . . ....Q.-c._;,-, ' Oil burner or coal?
Will a flue-lined chimney be provided? . . . . NJ. . . . . . . . Depth of chimney foundation below grade
Height of chimney above roof q/
Will there be a fireplace? I'fo I Depth of fireplace hearth
Iv
Will a toilet be installed? - 4'
Will a kitchen sink be installed and connected to water supply? IUc
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 tr. j of my know,ledge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, are a true and co.z.p•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 pertainingto 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 .•-� ? sc ..'.` , ..Jvc
` /J OWNER.OWNER'S AGENT,ARCHITECT.CONTRACTOR
_ . _ dayof _p•,`' i9.O/ -- — - - -- -- ______
NOTARY PUBLIC. WARREN COUNTY, N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
•
By . .
BUILDING DEPT.COPY OF APPLICATION FORM 46-EL,NEW YORK BOARD OF FIRE UNDERWRITERS.
FILE THIS COPY WITH BUILDING DEPT.WHEN REQUIRED.
•
° - TEMP.# DATE ,
CITY OR
' VILLAGE ( 1)(j (:-=.P.4.C(Oki)/s • .TOWNSHIP COUNTY
STREET AND NO.OR / /]
. . ROAD AND POLE NO. -t-o_-e--" cp POLE NO.
BETWEEN WHAT TWO - .
CROSS STREETS IS
PREMISES LOCATED? SECTION BLOCK LOT
': OCCUPANT'S /- • - - - BUILDING �^ /�/} ? l J j_ (>!f
k NAME •
C / , r�G •r,`r+ F(J OCCUPANCY >-+ -" - of /`7 rY - ! ! /
OWNER'S NAME 1
AND ADDRESS t_ •(
(� (`
n 4- ,t 4 fr tin a `'.* TEL.# 79) K?(7
CURRENT
SUPPLIED I
BY / f. JI 1 FROM THEIR ,_'t, , .-7,) /- '% //), OFFICE
fy ..
`''''' BUILDING r ) WORK R ' ' DEFECTS
IS NEW❑ OLD IS NEW ❑ ADDITIONAL L ' REMOVED ❑
_ __.LIST_BELOW AL-L EQUIPMENT WHICH YOU INSTALLED ` -
NUMBER;OF OUTLETS LampfReceptacles MOTORS HEATERS CIRCUITS OFFICE USE
L 's�P�':. . -__-._ ,—:; ,. v _ ONLY
LIDn i
Side AtLeh't�' *iv t• H.P. Watts A.W.G.
. Ceiling Wall Recep'Is Switch Pendent Bracket No. Type Each No. Each No. Gauge INSPECTION
Out-
side
Sub- -
base .
Base
ment -
Y, 1st Fl. /
(/: I 1 frAl,.. • . .
e 2nd Fl.
3rd Fl. -- •
•REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: DO NOT USE THIS SPACE. .
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 I. / (NUMBER) (CAPACITY)
STARTED /& i)7 COMPLETED 7/� /-1 SIZE OF SIGN
SERVICE OVERHEAD ! UNDERGROUND ! MAKER
ENTERS OF SIGN
BUILDING
INSPECTION REQUESTED
ON OR AS NEAR AS �� / �j
POSSIBLE / NEW I I OLD -
• r
• AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
PRINT NAME AND///ADDRESS
NAME OF ��--}-- .. •
- DATE OF j
APPLICANT �• t• "4Y'1 -4' - - APPLICATION ��� 11 ;W`r •_
.- STREET ADDRESS y 1 �U� i CITY OR (5_Y C( r t4 TELEPHONE# • .i 6 1( 1�,�`'/
POST OFFICE C . r� .• `I CI—Y r ( CODE `' s'' P a WHEN APPZIP LICENSE LICABLE
C `. 111
46 EL(REV.1/84) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING
i
tr•cx•.4"..a•.A, ,�•i.�.•..".A.A.xti..•,I.•,te,!..I ie,i,..I ta•�1na•.t •t •� •.te. •.te4 I to na•.c n •.Ana•. •.e n)•tiAn�t�Ane �t��•�au TT, na• �.•ti. ati�•ti4•i.anti n
THE NEW PORK BOARD. OF FIRE UNDERWRITERS ,.
4046161
� T
,__ -r, BUREAU OF ELECTRICITY Y
171.arj 41 STATE STREET,ALBANY,NEW YORK 12207 'T
r r rp a ,Yi
Date , _ Application No.on file Y
-- THIS CERTIFIES THAT ,r
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of ,y,
..-- d�.L,ele Hess, 9 Helen St7fe t, �.� ean_sbu`ry, New York
._ T
_ in the following location; i❑.Basement El1st FL 2nd FLSection Block Lot
.‹, was examined on and found to be in compliance with the requirements of this Board. ,r -
-4, y
1 FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS ,k2
OUTLETS RECEPTACLES SWITCHES INCANDESCENT FLUORESCENT MERCURY
VAPOR AMT. K.W. AMT. K.W. AMT. K.W.. AMT. K.W. AMT. H.P: ,Y
- --<, 1 <x 1 '
n� -( DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET - DIMMERS r
'AMT. K.W. OIL ' H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET 'AMT.. WATTS
SERVICE DISCONNECT NO.OF S E R V I C E • '
ME
AMT. AMP. TYPE EQUIP 1,B'2W 1 if 3W 3,B'3W 3..8 4W NO,OF CC.COND. OF CC.COND. NO.OF HI-LEG OF.HI-.G. NO.OF NEUTRALS OF NEUTRAL
• •
Y •
OTHER APPARATUS: Oi
A.
'r
Electric,} } �} _ . y
.C.F'.:PL...1.�:. Heater.! j_•-A .L u'ii ise6:a ,..T
AT
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—
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z. o fi
R.D. F1, Box 99A r,,> ,Y
f it 1 r . 126`� ;ram
l:�G' i1I:Ii _._. Center, 1c.z6 ,- L..3 • ►
5 •
' BRANCH MANAGER
Per - .-
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-- ('TVT'TYT'r¶717 T 7 TTaIT7TTT 7 1.7<'re<7 Y'jt'/ ]fLl*i ,/1litLV/lfllingli lei lu Ail tlL NWi'
- COPY FOR BUILDING DEPARTMENT.THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
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