6003 BUILDING" PERMIT
TOWN OF.. QUEENSBURY. No 6003
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Fredy A. Ca.rvin
OWNER of property located at lY l Luzezne._Road Street, Road or Ave?
in the Town of Queensbury,To Construct or place a Swimming Pool
at the above location in accordance to application together with plot plans and other information hereto filed and. k
approved and in compliance with the Town of Queensbury Building,and Zoning Ordinance.. �y
1. OWNER'S Address is (j
R. D. #3
Glens Falls, -N.Y.
2. CONTRACTOR or BUI LDER'S Name
Splash Pools` Inc.
3. CONTRACTOR or BUILDER'S Address
Main Street
Glens Falls," N. Y. ti
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4. ARCHITECT'S Name
5..ARCHITECT'S-Address ¢,
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( )` -
7. PLANS and Specifications
16 'x32 ' inground swimming' pool"..per :plot plan and
No application submitted
8. Proposed Use. .
Swimming Pool:
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0
$ 10. 00` November 1 PERMIT FEE PAID—THIS PERMIT EXPIRES 19 79
(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 3 otl-bay of July. 19 7 9
• SIGNED BY /" ' for the Town of Queensbury.
Building and Zoning Inspe or
TOWN OF QUEENSBURY (Space inside block to be filled in by
WARREN COUNTY, NEW YORK • Building Inspector)
Application for Application
''''l" ition
1+� Permit Issued 19.
BUILDING AND ZONING PERMIT 1',,,-,,,it Expires. 1g.
/.c'i ins 1)strict
\ pl,te of Work
THREE (3) Copies of a PLOT PLAN, Drawn to scale \i'I ru" i c1 l)V
showing the actual dimensions of the lot to be built Re'>>oI Kf
upon, The exact size, and location on the lot of the
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building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION, ...OWN a�1`s :, _ ;p Pp `'u F,
DATE t 11,a
Fr-,
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK Jiit r6 'W 1::: e.,! ('-
ANSWER ALL OF THE FOLLOWING. , E )4.(�z, ,
IIg9111�21n ,, 1; ; , s
The undersigned hereby applies for a permit. to do the following work 4, •
i s � ► a . 1. '
which will be, done in accordance with the description, plans and specifi-
cations, and such special conditions as may be indicated on the permit. .
ThAdy
wner 9if this roper���sjjj is:.
/cy• /C. .D. g . //A'4E) (P.0 ADORES 1
The person respons'hie'for 'su ision of the work-insofar as the Building Code and the Zoning Ordinance pply isr
/ JJ (NAME) , (P.0 ADDRESS),
Name of Builder. . . /a.S�. . ��O iS• . '-L C'. . . . . .Address
Name of Plumber
�. . . Address
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Name of Mason ' Address
Lot Number Unit Estimated value of proposed work S
Name of Village J �/
Name of Street LA Z--e-(fe- Co.a Side of street: north .(4,•east 0, south O. west 0
Nearest Cross Street . . LG.t ur1?.l. .4a4e. Distance front this cross street /QO Ft.
'Property is north 0,south 0,east K, west ❑from Cross Street
If on Corner, which corner, northeast ❑-, northwest ❑, southeast E. southwest
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• (Designate by marking with an "X"in the correct space.)
NATURE OF PROPOSED WORK OCCUPANCY
❑ Main Buii-lding
Construction of a new building. One-family dwelling ❑
❑ Addition to a building. • ❑
• Two-family dwelling
❑ Alteration to a building.
❑ Demolition of a building. .-family apartment house ❑
Store building ❑
-car attached garage • ❑
Other:
• Accessory Building
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One-car,detached garage . ❑
lil Other work. Describe• I/ 9Iaa•2C. ./2C2O/• Two r_ar detached garage ❑
// . s / Private chicken house • • ❑
C99 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 building(s) in dotted line and existing
Iuilding(s) in solid line.•
Size of property // 0 ft. x . . . I Y. . . ft
Size and use of existing buildings, if any
I- I-
la 4 s la Size of proposeda :ng . . . . • •/6. ft.x . . . •..9 ft.
Height (from grade to ridge) . ft.
Front yard ft.
Side yards ft. and • ft.
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Rear yard - 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) •
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7-73-M -
(cont'd.)
BUILDING SPECIFICATIONS.,
Kind of construction: Wood frame, fire safe, etc.?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Will any second-hand lumber be used? If so, for what2
Material of foundation walls Thickness
Depth of foundation walls below grade Continuous foundation?
Will there be a cellar? If so, material of cellar floor
Type of roof: Sloped or flat? Material of roof
Size,wood studs "x ", spacing "o.c., length •
ft.
Size, floor beams, 1st floor " x ", spacing "o.c., span ft.
Size, floor beams, 2nd floor " x ", spacing "o.c., span ft.
Size, ceiling beams " x ", spacing "o.c., span ft.
Size, roof rafters or beams . . " x ", spacing "o.c., span ft.
Exterior finish With what material?
Finish of interior walls
If garage is to be attached, of what material is wall between garage and main bui,leting 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
Will a 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 in bear 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.l.�lete statement of all proposed work to be done penal
described premises and that all provisions of the BUILD-
ING CODE,THE ZONING ORDINANCE, and all other laws peai posed work be complied 'th,whether specified o,not,
and that such work is authorized by the owner. R� > f G"v"/w . . G^ 0� C )
Sworn to before me this Signature ` ?�-�..
OWNER,OWNS ENT,ARCHITECT,C NTRACTOR
day of 19
NOTARY PUBLIC. WARREN COUNTY. N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
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