4139 BUILDING PERMIT
TOWN OF QUEENSBURY No. 4139
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Ri hard A and Karla Hill
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OWNER of property located at 'a A UtUR D-r" vo Street, Road or Ave. =r
in the Town of Queensbury, To Construct or place a .AAbove q rntllncl SNd mmf ncl 91 el
at the above location in accordance to application together with plot plans and other information hereto filed and A
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance_
1. OWNER'S Address is 34 Arbutus Drive
R . D , #3
Glens Falls , New York *i
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2. CONTRACTOR or SU1 LDE WS Name
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same
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3_ CONTRACTOR or BUILDER 'S Address. 1•-�
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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S. TYPE of Construction — (Please indicate by X) (b
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( ) Wood Frame I ) Masonry I l Steel I I
7. PLANS and Specifications
241 dia . above ground pool per plot plan and application 0
No_ submitted .
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S. Proposed Use
Private Swimming Fool
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$ 10 00 PERMIT FEE PAID — THIS PERMIT EXPIRES October 1 1976
(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_l
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Dated at the Town of Queensbury this 91 stt' Day of .Tune 19_76 �
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SIGNED BY J./ > for the Town of Queensbury ~
Building and ZoniAg I nspecto" ram'
TOWN OF e, UEENSBURY r { tigrace inside block to lxk filled in by
WARREM COUNTY, r4E:W YORK Building; Insrirtttrrl
%pplit .,tioti No-
Application for C'e r,rrlt l„twd
BUILD106 AND ZONING PERMIT i , t ,,, �t Expire% IC7
THREE ( 3 ) Copies of a PLOT PLAN, Drawn to scale
showin the actual dimensions of the lo+ to be built
upon. The exact size. and location on the lo+ of the
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION* 'rOwi r O,F QUEr=Ng8URY
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A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK JUN 2+ } 19769
ANSWER ALL OF THE FOLLOWING- A.M. 1 1 24 $y �The undersigned hereby applies for a permit to do the following work 41a1�a 11
which will be done in accordance with the descrip+ion, plans and speci€i- �+
cations, end such special conditions as may be indicated on the permit`.
The owner of this property is:
- K , f% 1
Z:4 .ce . . `Id�r . .$4-. _ 1�-'-fit- I - . . . . r - . t.'S
INA AC) IP n A;3pRrc$Sl
ision of the work inserter as the (large? t:tg C .+Kle and the Zoning, Ordinance apply is-
The person responsibit-, for supery
�NAME1a 1 / IP O A❑60tESS!
Name of Builder . - -
Address
Address
Marne of Plumber . . . . - . . . .
Name of Mason Address
.
Lot Number . - Unit . . . . - - Estimated value of ,proposed work S
Name of Village . . t'QlA aami-kt . . . . . . . . - -
Name of Street . . .A%*�b+s. �
vptr+z�, Side of street no-b-th �. east 0 , south ❑ • west Q
Nearest Cross Street . . . . Distance- s!ri>. -russ street
Property is north 0 south east i i west ❑ from Cross Strew
If on Corner,11 which corner, northeast L1 , northwest l3 . southeast cut',wt :t
(Designate by marking with an "X" in the correct space.)
NATURE OF PROPOSED WORK OCCUPANCY
Construction of a new building. Main B±uii Ing G
Cane-{arnily dwelling
CD Addition to a building. Two-tamiiv dwelling
0 Alteration to a building, family apartment house
{� Demolition of a building. Store heralding 0
-rar attached garage
Other,
Accessory Building
!!. __. .ii. . . . . . . . . . . . . . . . !Dne-car detached garage
Tit d^ . ° "f w o-car detached garage 0
Other work. Describe: . . �` . .
+ { _ Private t-Iiicken house
J?a , , , 2+ Grn'V a qYes . . . . , . . . - . .
`GJ ' Private storage building
. . . . . . . . . . . . . . . . . . . . . . Other
ZONING SPECIFICATIONS. Fill in for new building, or addition to heisting building, or a change of occupancy.
Indicate on the plot plan street names, the location and
size of she property, the location, size and setbacks of pro
posed buildings, and the location of all existing buildings-
A RTH Show proposed building (s) in dotted line and existing
(j huiiding(s) in solid line. yr ,ry
i Size of property . . . . . . . • . ft.
' Size and use of existing buildings, if any .070 X
r dd . .
t ft.
w Size of proposed building . . . . , . . - . . ft. x - .
Height (from grade to ridge) . . , ft.
Front vard . . . . . . . . . . . . . . . . . . . . it,
Side wards ft. and , . . . , ft_
Rear yard ft.
souTl+ � If on corner, setback from side street
ft,
Note: All distances are net, as measured from street side
line to nearest part of building.
-7
(OVER)
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(cont'd.)
BUILDING SFEGIFICA,'TIONS4
Kind of construction : Wood frame, fire safe, etc.? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Will any second-hand lumber be used? . . . . . . . . � . . . . . . . . . . I . . . . . . . . . . . . . . .
. . . _ . . . Ifso, far what. . . . . . . . . . . . . . . . � . . . . . . . _ . . . . . . . _ .
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 . . . . . . . . . . . . . . . . . . . . u , . . . . . . . . . . . . . . . . .
Size, wood studs . , , , . . - . . . . , . . , . . . . . " x . . . . . . ... spacing , . . _ . . . . . . . . . . 'o.c., length . , . . _ .
Size, floor beams, 1st Floor . . . . . . x. . . . - . " ft.
. . . . . . . . . . . , spacing . � , , . . . . . - , . . . o.c., span . . . . . . . . . . . . . Ft.
Size, floor beams, 2nd floor . . . . . . . . _ . . " x . . . . . . . . . . . . . . . ". spacing . . . . . . . . . . . . . . '"o.c , span . . . , . . . . . . . . . . ft.
Size, ceiling beams . . . . . . . . . . . . . . . . . . " z - - - . . - . . . . . . . . . ", spacing . . . . . . . . . . . _ . . ..o.c., span . . . . . . .
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 budding 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 he 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 Queenshury AFFIDAVIT
County of Warren
State of New York
I swear that to ttl lva of my knowledge and belief the statements contained in this application, together with the plans and speciiieations sttls-
Mined, are a true and co.k plete statement of all proposed work to he done on the described prenuors and that a lone of Cite BUILD-
ING CODE, THE ZONING ORDINANCE, and all other laws pertaining to the proposed work shall be complied with, whether knagified or not, .
and that such work is authorised by the owner. . e r
Sworn to before me this Signature .. .. . .. i T, O .. r . . .... . . ... . .
OWNE , OWNEH's AGENT, IT t, CONTRAC [3R
dayof.. . . . ... . ... . . .... .. .. . .. .. . .... . .... . ... . . ... . . . 19. .. .
NOTARY PUBLIC. WARREN CQUT/'rY'. N. y,
SPECIAL CONDITIONS OF THE PERMIT:
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