1040 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
• (
Date311 19
.
1046 This is to certify that work requested to be done as shown by Permit No.
has been completed.
olite
This structure may be occupied as a 1 154A, )k,"lf-:714/4 11(R.5
Location
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119 Lit
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Owner j I CkartiSOVICiZY:'
By Order Town Board
TOWN OF QUEENSBURY
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L'--7 Building fg/,Zoning Inspector
BUILDING PERMIT
TOWN OF QUEENSBURY 1040 •
No.
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to William Richardson
OWNER of property located at Arbutus Drive Street, Road or Ave.
in the Town of Queensbury,To Construct or place a One family dwelling
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
16 Greenway Drive-Glens Falls , New York
2. CONTRACTOR or BUILDER'S Name
Same as above F�
3. CONTRACTOR or BUILDER'S Address
n
Same as above
4. ARCHITECT'S Name 0
5. ARCHITECT'S Address
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N,
6. TYPE of Construction—(Please indicate by X)
(X)Wood Frame ( )Masonry ( )Steel ( ) _ _
• 7. PLANS and Specifications
No.
24x38 - One family dwelling
8. Proposed Use
Dwelling
$ 10. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES June 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.)
Dated at the Town of Queensbury this 2 5 th Day of November 19 7 0
SIGNED BY ],Qi �, for the Town of Queensbury
// ilding and Zoning Inspector
•
• - " ' TOWN OF QUEENSBURY
(Space inside block to be filled in by
WARREN COUNTY, NEW YORK Building Inspector)
No.
Application for Application , �: .r �� ,�.
Permit Issued. A A.P. J. ;, . 'h"9 ;
Pcrniit P:zp reti `•`,''.. ` ,#, '1( t''
BUILDING AND ZONING PERMIT � , � NOV 2.
zoning l)i. 5 197Q. . . . .
•
. value of Work S
THREE (3) Copies of a PLOT PLAN, Drawn to scale `\I'l"•"V`'(l l). • . v✓ . • . . .
showin the actual dimensions of the lot to be built lt<n..... s. . . BULL PING.
'20F i d, I`d:�t�(_CT
upon, The exact size, and location on the lot of the TOWN.OF. QUE�f�s ij
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION. .
f/—,�j_2O TOWN OFQU .ENSBURY
•
DATE 17) ? V E p �I E -�
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK ' s_I A =J
ANSWER ALL OF THE FOLLOWING. 1`!U if 23 i9 u
The undersigned hereby applies for a permit to do the following work A.M. 2 P.M.
which will be done in accordance with the description, plans and specifi- 71?I9I1,111t1211I21314a51G
cations, and such special conditions as may be indicated on the.permit.
A
The owner of this property is:
. . . . . . . . . . . .'.^—:-.-:� .. - ..-.. . . . . . . . . . . . Y. '%. ., : . : .�. .'. . . . . .•. ' ,.L- . . .''.,. . . . ..
... ..... . . . . . . . . . . . . �s�
. . 4..
(NA'%)E) (P.O.ADDRESS)
The person responsible for supervision of the work insofar as the Building Code and the Zoning Ordinance apply is:
'r' • : � .•' ,,,r,
(NAME) (P.O.ADDRESS)
Name of Builder " �' `1 J ` '' `' Address
t9 (t ES
Name of Plumber t, ,a t; Address .
Name of Mason Address _
Lot Number 4 Unit,. . . . . . . . . . . Estimated value of,proposed work$_,. `,:.,'-i.
Name of Village ., f ; t. _..lu '.
Name of Street Side of street: north ❑, east. ❑, south ❑, west
Nearest Cross Street - ' ; '.' , Distance from this cross street Ft.
Property is north ❑,south ❑,east El,-,west ❑from Cross Street
If on Corner, which corner, northeast ❑, northwest ❑, southeast CI, southwest
(Designate by marking with an "X" in the correct space.)
NATURE OF PROPOSED WORK OCCUPANCY
0 Construction of a new building. Main Building
❑ Addition to a building. One family dwelling
❑ Alteration to a building. Two-family dwelling ❑
❑ Demolition of a building. -family apartment house ❑
. Store building El
-car attached garage n.
• 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, size and setbacks of pro-
NORTH posed buildings,and the location of all existing buildings.
Show proposed building(s) in dotted line and existing
luilding(s) in solid line.
;' Size of property ft. x ft.
Size and use of existing buildings, if any
,Q . .
3 I Size of proposed building ft.x ,`., `'` ft.
Height (from grade to ridge) .,. ft.
j'J
Front yard '1 r 1•� ft.
`,f
Side yards ft. and ft.
Svt yL�^-e Rear yard ( ft.
• " SOUTH If on corner,setback from side street ft.. ..
Note: All distances are net, as measured from street side
T.- line to nearest part of building.
•
(OVER)
(cont'd.)
BUILDING SPECIFICATIONS., ..
Kind of construction: Wood frame, fire safe, etc.7 Wood Frame
Will any second-hand lumber be used? No If so, for what7
Material of foundation walls Concrete Thickness $tl
Depth of foundation walls below grade 7' Continuous foundation? Yes
Will there be a cellar? Yes If so, material of cellar floor li t1 Concrete Slab
Type of roof: Sloped or flat? Zh on. .12 Material of roof As.pbalt. .Shinglas. - .210. 1ba. . .
Size, wood studs 2 "x L ", spacing 16. . ."o.c., length 8• ft.
Size, floor beams, 1st floor 2 "x 8 ", spacing 16.. . ."o.c., span 12. . . . ft.
Size, floor beams, 2nd floor "x ", spacing "o.c., span ft.
Size, ceiling beams 2 "x 2 ", spacing 21t-. . ."o.c., span 12. . . . fttruss
Size, roof rafters or beams 2- "x LE ", spacing 21+. . ."o.c., span 12. . . . fttrUs s
Exterior finish Panel Siding With what material? Masonite
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 Forced Hot Air Oil burner or coal? Gas
Will a flue-lined chimney be provided? 1?1etal-4).17e.fth of chimney foundation below grade
Height of chimney above roof 21+u
Will there be a fireplace? No Depth of fireplace hearth
Will a toilet be installed? - Yes — one '
Will a kitchen sink be installed and connected to water supply? Yes — private. water. .supply
Water supply (public water supply or pump) . . . . Pulp
Distance of cesspool from any private well 1001 feet
Will drainage system be provided with required traps, cleanouts, and vents? yes
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 pertainin to t�posed work shal complL th,whether specified or not,
and that such work is authorized by the owner. . /
Sworn to before me this J Signature o NE/R AGENT,ARCHITECT,CONTRACTOR
f day of /� 192 C) OWNER,
NOTARY PUBLIC, WARREN COUNTY, N.Y.
SPECIAL CONDITIONS OF THE PERMIT:
•
By
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JOB
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