1139 BUILDING PERMIT
TOWN OF QUEENSBURY No. 1139
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Joseph Robillard
17 Richardson Street
OWNER of property located at Street, Road or Ave.
in the Town of Queensbury,To Construct or place a roof over mobile home
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at the above location in accordance to application together with plot plans and other information hereto filed and Cr1
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
17 Richardson Street
West Glens Falls , N.Y.
2. CONTRACTOR or BUILDER'S Name
James Fisher
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3. CONTRACTOR or BUILDER'S Address t'l
2 Gardner Street-Glens Falls , N.Y.
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
PC)Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications Roof 55 Ft . long - overall width 11 ' -41" with
No overhang - Truss rafters to be used - 3/8" Plyscore
exterior finish-according to submitted plans and spec-
ifications .
8. Proposed Use
New roof over mobile home
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$ 6.00 PERMIT FEE PAID—THIS PERMIT EXPIRES 8-1-19 71
(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.) 0
Dated at the Town of Queensbury this 23rd Day of April 19 71 Cn
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SIGNED BY _J for the Town of Queensbury H
Building and ing Inspector
TOWN OF QUEENSBURY
(Space inside block to be filled in by
WARREN COUNTY, NEW YORK Building Inspector)
Application for .'pplication No.
Permit Issued I(r.
BUILDING AND ZONING PERMIT Permit Expires lu.
Zoning District
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Value ol \Vor•k S
THREE (3) Copies of a PLOT PLAN, Drawn to scale ''I'l'r•o) ('d by . .
showing the actual dimensions of the lot to be built Remarks
upon, The exact size, and location on the lot of the
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION. •
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TOWN OF QUEENSBURY
4 -2 7) D f 0 g., D W E
DATE
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK APR 23 19/1
ANSWER ALL OF THE FOLLOWING. A.M. P.M.
The undersigned hereby applies for a permit to do the following work 71 81 9t10l11112111213141516
which will be done in accordance with the description, plans and specifi- " ` `I ` ` `J
cations, and such special conditions as may be indicated on the permit. A.
The owner of this property is:
(NAME) (P.O.•ADDRESS)
The person responsible for •supervision of the work insofar as the Building Code and the Zoning Ordinance apply is:
•
(NAME) . (P.O.ADDRESS /)�
Name of Builder. . . . Ge.:Yj--e-ea-. .�—e--- ,e..., Address . . . . . . .i!✓. : . ,. . . . . . . . . . . .
Name of Plumber Address
Name of Mason Address
Lot Number Unit Estimated value of proposed work$ 7
e v:
Name of Village -
Name of Street /7 ar p Lu_e-7, Side of street: north 0, east ❑, south ❑. west 0
Nearest Cross Street Distance from this cross street Ft.
Property is north ❑,south ❑,east iii, west 0 from Cross Street
If on Corner, which corner, northeast Phi., northwest ❑, southeast ❑, southwest
(Designate by marking with an "X" in the correct space.)
NATURE F PROPOSED WORK OCCUPANCY
❑ Construct. n of new building. Main Building
❑ Addition to - uilding. teOne-family dwelling Cal
❑ Alteraf to building. .. � 'v V Two-family dwelling ❑
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❑ Demolition of a uilding. family apartment house CI
• 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, site and setbacks of pro-
NORTH - posed buildings,and the location of all existing buildings.
- �-- Show proposed building(s) in dotted line and existing
huilding(s) in solid line.
Size of property . . . . .1.a 7 .-4krft. x . . . ...5-O ft
Size and use of existing buildings, if any
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to N
3� W
Size of proposed building /2 ft.x . . . s . . . ft.
Height(from grade to ridge) ft.
Front yard ft.
Side yards ft. and ft.
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)
(cont'd.)
•_t;J a LDING SPECIFICATIONS., - •
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Kind of construction: Wood frame, fire safe, etc.7
Will any second-hand lumber be used? •`•' If so, for what
Material of foundation walls Thickness .
Depth of foundation walls below grade Continuous foundation?
Will there be a cellar? If,so,f. aterial of cellar floor ,
Type of roof: Sloped or flat? .4. . Z:%:'%.{:.fir.. . Material of roof 3 /4/ �0'l� , !r'C /c-'S' i
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.
Siie, roof rafters or beams o�-. . "x ", spacing �6 "o.c., span . . . ..:�) ft.
f'it-),i r') 7,j�i ,,• 4., ,c:.. ,
Exterior finish ;! -r 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 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 ss.
State of New York
I swear that to the best of my know,ledge and belief the statements contained in this application,together with the plans and specficatiussa sub-
mitted, are a true and complete statement of all proposed work to be done on the described premises and that all provisions of the BUILD-
ING CODE,THE BONING ORDINANCE,and all other laws pertaining to the proposed work shall be complied with,whether specified or not,
and that such work is authorized by the owner. i
Sworn to before me this Signature t/.....- ✓4k .v
OWNER.OWNER' AGENT,ARCHITECT,CONTRACTOR
day of 19 , /
NOTARY PUBLIC, WARREN COUNTY, N. Y.
SPECIAL CONDITIONS OF THE PERMIT: ., . ' ./._ /'
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