1191 BUILDING PERMIT
TOWN OF QUEENSBURY No. 1191
WARREN COUNTY, NEW YORK
(-30 . i, ,2_ , 7,_.-1
th.lean
PERMISSION is hereby granted to Sta S L. L gworth y r'
a
OWNER of property located at � Hil1cres t Avenue Street,Road or Ave.
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in the Town of Queensbury,To Construct or place a Bedroom addition 7c
at the above location in accordance to application together with plot plans and other information hereto filed and ,C
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is '--3
9 Hillcrest Avenue t-i
rii
Glens Fa.11s ,New York
2. CONTRACTOR or BUILDER'S Name r
Same as owner
3. CONTRACTOR or BUILDER'S Address
Same as owner
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4. ARCHITECT'S Name F-'
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CD I—,
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5. ARCHITECT'S Address I—' (D
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6. TYPE of Construction—(Please indicate by X)
(x}Wood Frame ( 1 Masonry ( ) Steel ( )
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7. PLANS and Specifications
Bedroom addition 10'x12 '
No.
8. Proposed Use
Dwelling
$ 6 .00 PERMIT FEE PAID —THIS PERMIT EXPIRES 11-1-71 19
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the cap
town of Queensbury before the expiration date.) p-'
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Dated at the Town of Queensbury this 18th Day of May 19 71 H.
SIGNED BY 7":`? - for the Town of Queensbury
Building nd Zoning Inspector
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TOWN OF QUEENSBURY
(Space inside block to be filled in by
WARREN COUNTY, NEW YORK Building Inspector)
Application for Application No.
Permit Issued I'i
BUILDING AND ZONING PERMIT Permit Expires
%A ning District
• \ altie of Work S
THREE (3) Copies of a PLOT PLAN, Drawn to scale :\l'I)1.('`ed by
showing the actual dimensions of the lot to be built Ilc m irkti
upon, The exact size, and location on the lot of the
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION. •
.51/ / 7/ TOWN OF QUEENSBUR'i
DATE jl (n1 Ell III
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK n1JJ G�l�l�/
ANSWER ALL OF THE FOLLOWING. .1 U vMAY 18 1971 •
The undersigned hereby applies for a permit to do the following work A.M. P.M.
which will be done in accordance with the description, plans and specifi- 71819110111112111213141516 LAI ,
cations, and such special conditions as may be indicated on the permit.
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The owner of this property is:
Sf IA b• �et.o5wd1rfA� j 9 //%/t✓r :e. . y /.1(fc-�
(r.O.A RESS)
The person responsible for supervision of the work insofar as the Building Code and the Zoning Ordinance apply is:
5t4 Psi`
(NAME) (P.O.ADDRESS)
Name of Builder. . . AA'h`Z. Address
Name of Plumber A/c' — Address
Name of Mason Address
Lot Number Unit, Estimated value of proposed work$ 7, U O, d d
Name'of Village to `e rz b u -
Name of Street . :.' /.�. l G. -.e 5.7� A c 0-e r Side of street: north
®; east ❑, south 0, west ❑
Nearest Cross Street . . . : ,/. Q.Sva S t. Distance from this cross street /5 0 Ft.
Property is north 0,south 0,east 1. west 0 from Cross Street
If on Corner, which corner, northeast ❑, northwest ❑, southeast ❑, 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 ❑
❑ Alteration to a building. Two-family dwelling ❑
❑ Demolition of abuilding. -family apartment house ❑
. Store building ❑
-car attached garage ❑.
Other:
Accessory Building
• One-car detached garage ❑
l] Other work. Describe• 014. . . 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-
NORTH posed buildings,and the location of all existing buildings.
Show proposed building(s) in dotted line and existing
IDuilding(s) in solid line.
57".4/� �' Size of property /0 0 ft. x 7 d ft
F�b� ,
Size and use of existing buildings, if any
Size of proposed / G ft.x . . . .l —ft.
BUI..OIN & ZONUE�SgURYrOR Height(from grade to ridge) ft.
TOWN OF OE 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.)
BUILDING SPECIFICATIONS.,
Kind of construction: Wood frame, fire safe, etc. (rt/ eN^el F '`.-4<-4,-- f
Will any second-hand lumber be used? //O If so, fpr what?
Material of foundation walls G.9-24 c/a.4 4 -e-c.&2`- ' Thickness
Depth of foundation walls below grade .74Continuous foundation?
Will there be a cellar? /(/0 If so, material of cellar floor
Type of roof: Sloped or flat? . . ..(f/• d. . . . . . Material of roof �� ��
Size, wood studs "x LI ", spacing 6` "o.c., length ft.
Size, floor beams, 1st floor 1__- "x /° ", spacing / "o.c., span /G ft.
Size, floor beams, 2nd floor "x j1 ", spacing t. �� "o.c., span ft.
Size, ceiling beams "x l ", spacing / i f/ "o.c., span G ft.
Size, roof rafters or beams 1 x Gl ", spacing 6 "o.c., span .<
— Ifft.
Exterior finish . . . . . . . . ./.(Y. . .R- /. . CC1.d. �:. . . . . . . . . With what material?
Finish of interior walls /at yt Q.L1 ei.5.
If garage is to be attached, of what material is wall between garage and main bui;,lding 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 knowledge and belief the statements contained in this application,together with the plans and specifications 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 ZONING ORDINANCE,and all other laws pertaining to th 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 ' . ......
OWNER,0 NER'S AGENT,ARCHI T,CO TOR
day of 19
NOTARY PUBLIC. WARREN COUNTY, N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
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By
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2-5
ArE.1:7- 7. 1ov D
BU1LCiW:, .0 J?DING INSPECTOR
TOWN OF •UEENSBURY