6563 BUILDING PERMIT
TOWN OF QUEENSBURY No 6563
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Robert S S. Jordan 17'
Lot 66 Helen Dr. (St. No. 58)
OWNER of property located at Street, Road or Ave. rt
cn
in the Town of Queensbury,To Construct or place a Add i -Finn to .r1 wP 1 1 i ng (en c l ()spa pnrrh)
at the above location in accordance to application together with plot plans and other information hereto filed and o
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. ri
sv
1. OWNER'S Address is
58 Helen Drive
Glens Falls, New York
2. CONTRACTOR or BUILDER'S Name
same
3. CONTRACTOR or BUILDER'S Address
same
4. ARCHITECT'S Name
it o
• rt
cs,
5. ARCHITECT'S Address- O cm
(D
ODl✓
(D
6. TYPE of Construction—(Please indicate by X)
Fi
k ) Wood Frame ;( ) Masonry ( )Steel ( ) C'
(D
7. PLANS and Specifications
12 'x16 ' enclosed porch per plot plan,
No. specifications and application submitted.
•
8. Proposed Use
(D
One—Family. Dwelling ~ H-
O H-
U] o
(D
$ 10. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 1 ._ 1981 t-o¢ 0
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the p
town of Queensbury before the expiration date.) K Pi
n
Dated at the Town of Queensbury this 5th Day of September 19 80 N
SIGNED BY .1 SZ 6, p for the Town of Queensbury H.
Building a Zoning Inspector
e✓'►yea a t e)c i .
TOWN OF QUEENSBURY `- . (Space inside block to lie filled in by
WARREN COUNTY, NEW YORK - . Building Inspector)
Application -for .application No.
Permit issued 19.
BUILDING AND ZONING PERMIT ►'vrn,it Expires. '
7.oriin;: District
\aInt•dtl Work,$ •
THREE (3) Copies of a PLOT PLAN, Drawn to scale ..'PI "v(i l'!'
showing the actual dimensions of the lot to be built ltem,rgr •
upon, The exact size, and location on the lot of the- •
building: to be erected or altered' MUST BE SUB-
MITTED WITH THIS APPLICATION. . • .
/ , . . _
41° (/ s6p7-,,,,BE,. 5 /Fs° TOWN OF QUEENS r � `i
1 �" Jam''J g� ATE R , J. ,(114:
v� BEFORE BEGINNING WORK _, --3
A PERMIT MUST BE•OBTAINED SEP J 198ANSWER ALL OF THE FOLLOWING.The undersigned hereby applies for a permit. to do the following work A.) .) I I ICI I IIPIM.
which will be done in accordance with the description, plans and-specifi '] $ 91011 1 2 5 6
cations, and such special conditions as may .be indicated' on the permit.Theo er of this pro rtyy ,\,,
Nl� $�l
85,E-7 ..S3., 53 11s�•�' Niel.vE�Aoo ss•tt-s `Q l /1
(NA'%E)
The person responsible for •supervision of the work insofar as the Buildi.i g Code and the Zoning Ordinance apply is:
. (NAME) • 1P.0 ADDRESS,'
Name of Builder Address..
Name of Plumber Address
Name of Mason Address
•
Lot Number Unit Estimated value of proposed work s r2 d' l )
Name Of Village c6 -- '
p/ l �^ Side of:•street: north 0, east.
.0, h 0. west ❑
Name of Street . s '
Nearest Cross Street ei 0 PY z 4 Distance fro this ross street Ft.
Property is north 0,south 0,east 5,west 0 from Cross Street.
If on Corner,which corner,northeast ❑, 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 ❑
0 Addition to a building. One-family dwelling Two-family dwelling 0
❑ Alteration to a building. , _ . , , . .-family apartment house CI❑ Demolition of a building. Store building ❑
-car attached garage ❑
Other:
• • Accessory Building
One-car detached garage ❑
❑ Other work. Describe. • Two car detached garage .❑
L'Xle Per'G6Pe." Private chicken house 0
Private storage building CI
2-,e' 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, site and setbacks of.pro-
posed buildings,and the location of all existing buildings.
NORTH Show proposed buildings) in dotted line and existing
tMilding(s) in solid line.
• Size of property . / ft. x ./- . . . . ft.
Size and use of existing buildings, if any
w - /�.. Pet
si m Size of proposed building I.l-r-ft.x/ ft. •
Height(from grade to ridge) . ft.
Front,yard - ft.
Side yards . . ._ ft.
Rear yard
SOUTH If oft 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 construction: Wood frame, fire safe, etc.?. . . • • • • • 0. . . ' • . ' ' ' ' ' ' ' ' . . . • • • • . • • • • •
Will any second-hand lumber be used? If so, for what?
Material of foundation walls Thickness
Depth of foundation walls below grade
r 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 4 "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.
Side, 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 building 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 chi/inlay 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?
AFFIDAVIT
Town of Queenshury
County of Warren -
State of New York
I swear that to tt oea i of my knowledge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, are a true and coa. lets statement of all proposed work to be done on the deecrtbed premises and that all_provisions of the BUILD-
ING CODE,THE ZONING ORDINANCE,and all other laws pertaining to pro work shill complied with,whether specified or not,
and that such work is authorized by the owner. ''z � GAG-�s'�
Sworn to before me this Signature '
OWNER.OWNER'S A • .ARCHITECT.CONTRACTOR
day of 19 .
NOTARY PUBLIC.WARREN COUNTY, N. Y. .
SPECIAL CONDITIONS OF THE PERMIT:
•
•
By
•
•
•
TOWN OF QUEENSBURY. .
Building Department
Inspectors Rep Date ,,ej -.,3_8v
Name
Location(/ :��r9 ✓%lam-/¢.v J)�'
Permit No. /„ ( 3 Weather
Remarks
Exca t)a ti on
Footing. Forms • ,2)iV
Footing & Piers PO4,4Jr�� one 'ivt t-tf
Foundation
Cement Coat.
Waterproofing
Backfill •
Final Survey •
Framing
' Sheathing
' Roof Felt
Roofing
Siding
' Masonry Veneer
. Rough Plbg.
Relief Valves •
Wall Board \I
Ext. Porches
Finished Floor •
Interior Trim
Stairs &Railings /(\\\\\,.
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures /fI
Gar. Fireproofing
Door Closers •
Chimney
Water Meter Inst.
Septic Approval .
F1Oors '
•
Insulation Foundation ' •
Walls
• Ceiling
Building In ector
•
REMARKS •
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