8659 BUILDING PERMIT •
TOWN OF QUEENSBURY No. 8659
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Beatrice E. Weber
OWNER of property located at Shore Colony Road, Assembly Point Street, Road or Ave. n
in the Town of Queensbury,To Construct or place a Dock improvement n
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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 R. D. #1 Box 1342
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Lake George, New York n
2. CONTRACTOR or BUILDER'S Name
Donald .G. Pensel
3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name C)
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5. ARCHITECT'S Address
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6. TYPE of Construction— (Please indicate by X)
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( )Wood Frame ( ) Masonry ( )Steel ( )
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7. PLANS and Specifications dock improvement (3 'x16 ' and 4 'x24 ' ) per
No plot plan and application submitted.
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8. Proposed Use
Dock
$ 15. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES - Feb. 1 1985
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the C7
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town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 26th Day of July 19 84
SIGNED BY i"iU4 for the Town of Queensbury
Building and Zoning Inspect
TOWN OF QUEENSBURY (Space inside block to lx filled in by
WARREN COUNTY, NEW. YORK Building Inspector)
pplication for Application No. : lg.
1 crmit Issued
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BUILDING AND ZONING PERMIT ►', rmit Expires. 19
/.caning District�.� • \ alit• id Work
THREE (3) Copies of a PLOT PLAN, Drawn to scale •\)')'mike I by / - 1
showing the actual dimensions of the lot to be built ltrnaarks"
upon, The exact size, and location on the lot of the
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION.
TOWN OR QUEENSBURY
—742 01�ATE IR Ig 0 C l VE 0
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK JUL 2 19
ANSWER ALL OF THE FOLLOWING: - j, "
which willsbened doneen accorrreby dancefor a with the description,ermit plans do the lla dnspec fk .71819110)1412)11, a Brie I�)a.
cations, and such special conditions as maybe indicated on the ermit. 1.
P P t
Th f,owner of this property*A" �' his:: �j
/ 6. . . '�� :'ili-C/j� , ` �I e° (3 Li 2i 14 ce_ t .CA\Q /i �/.
" 2 INA'••:F1 (P.O.ADDRESS) () )
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Th person responsible fo supervi ion of the work insofar as the Building Code and the Zoning Ordinance apply is:
. . . . . . . . l-vl�. .27- . a q-. . C�- �s FA-Ls /c>E�.
(NAME) IP O.ADDRESS) a ZI
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Name of Builder:-- ° �� Address
Name of Plumber -----` - Address •
Name of Mason -- ____-- Address
Lot Number Unit Estimated value of proposed work S ./0 C�vp ciLJ
Name of Village . G am?4 -,``"i"r ��
/ 4°� Side of street: north .
Name of Street ;(r�si,!? �j i a , east , south • ❑. west j
Nearest Cross Street Distance from this cross street Ft.
Property is north ' ❑,south ❑,east i i, 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 - v'04 ,-(474,n�: 7 ) 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 ❑
-car attached garage ❑
• Other:
• • Accessory Building
j One-car detached garage ❑
Other work. Describe• Di) 1' 1= e 4.4 "2'fr 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
1 size of the property, the location, site and setbacks of pro-
i. posed buildings, and the location of all existing buildings.
NORTH
Show proposed buildings) in dotted line and existing
}�l Iuilding(s) in solid line.
I I Size of property . . . . ft. x 3 S ft.
. Size and use of existing buildings, if any
(Q— Pol-itt (Y 'P.G-6ti #2/-`?
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i w Size of proposed building ¢ ft.x . . .2, . . . ft.
Height (from grade to ridge) ft.
Front yard • ft.
Side yards ft. and ft.
lirRear yard ft.
SOUTH I 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) . _
7-73-M
(cont'd.)
BUILDING SPECIFICATIONS.,
Kind of construction: Wood frame, fire safe, etc.?. . . . .O. (. . . . . • • • • . • • • • • • • • • • . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Will any second-hand lumber be used? "2l- If so, for 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
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.
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 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
State of New York
I swear that to tr be,r of my knowledge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, are a true and co.i.plete 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 the proposed work shall be complied with,whether specified or not,
and that such work is authorized by the owner. /�,� �/jj�� ✓
Sttsr� efore me this Signatur
OWNE OWNER'S AGENT,ARCHITECT.CONTRACTOR
e— 19
_NOTARY PUBLIC, WARREN COUNTY, N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
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By
14-12-2 (7/82) NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION TOWN OF QUEENsauR'
T1F') a NOTIFICATION OF AVAILABILITY FOR REVIE ', E C E I ' I
INITIATING UNIT: Re ulalor h irS Contact: Jar is Thema UL 2 01984
4Q P.M.
OTHER# DATE ISSUED 7/i'Zc* 1g11 11�1 ) � j1405�6
OTHER# DATE DUE 7/96/R4 ti
OTHER# DEC# 50.- _O 33/
PURPOSE FOR NOTIFICATION/REVIEW AUTHORITY: Ar'Hoe. 5' EC L_
APPLICANT: g cut-r'l'C e lr• We.h,er } R� / Bel x I 3411. itab evrncv
PROJECT NAME/DESCRIPTION: COnS'trVCt- a >&'x a4' ,& shaped sike cifr i /n
Cid %frot? *9 an a/react e,Yishi9 clock
PROJECT LOCATION: Ass bll/ Pc') )*-
City/Village (� Town: C.3 ueen5burc/
County: Warren USGS Quad: i/
(Attach a location map)
REMARKS:
DISTRIBUTION: Toumsupervisorl FrancisJi IAJa!iei Adjoceif 640i7dacl�Prc
F)re 51" Range rt Spec - -
C-C•0 '7'. Ca ll cthan
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no comments ❑ comments attached ❑
RESPONDING UNIT:.
BY:
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tJ{{U iL pp- 2 1984 .-
`14-19-5R5(9/81' NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATIagOULA 7 ION UNIT'
WARRENSBURG, NEW YORK 12885 REGION '5 -
APPLICATION FOR PERMIT ViArtr.5: S 54: °V. Y.
Construction or Installation of Wharfs in Lake George Recreation:Zone
Read instructions on back before completing this appllcation.Please type or print clearly in Ink.Uso separate addenda and exhibits to provide all roquirad
data and explanations for which space on the form is inadequate.
-❑Article 9,Title 1 (Lake George Recreation Zone Regulations)(Construction of wharf pursuant to 6 NYCRR'Part 646) -
- ❑Article 15,Title 5(Protection of Waters)-see note below(Construction of wharf pursuant to 6 NYCRR Part 608) _
1'_ NAME OF APPLICANT: ...„,:e
e4 f - e:try Eaio c E . : , . , ,
. -.:,
. ..., , : ..
- ::. :_2. APPLICANT ISA/AN.• -- _ =: .
^Individual ❑.Partnership- ❑ Association _❑ Corporation ❑ Municipality •❑ Governmental Agency •
3._ NAME OFAPPLICANT SIGNIN G APPLIC N: - PHONE- ?
-. Street or P . Box: .
l
- Post Office State Zip C e
� � y = i "
4. NAME AND ADDRESS OF OWNER(if not applicant): _ _ - PHONE -'
Street,or P.O. Box: , •
Post Office - - Stated- - Zip Code - .
5. PROJECT LOCATION: -
City or Village/7 a NOTE: ':`: `
JC- / � .. - ..
Town ,��---�' Y . Article-15 box must be checked and appropriate applica
"J t�,C L,)�.. 1 (..i1 V tion fee must be included if: -
County a) Wharf involves the excavation of material or the
2 , placement of fill such as= stone, sand, gravel,
6. PROPOSED USE: Slml r material below the mean
concrete •or la
Private•. El Public ❑Commercialabove- high water level (elevation- 320.2 feet._
_ 7. PROPOSED STARTING DATE: 8. APPROXIMATE COMPLETION DATE mean sea level) or,' -
t;C L iQt E Q (R-j � * c_co �S ,. _ b) -Wharf is built on floats,-' columns,':' open- : -
._,:_ . timber,- piles or:: similar .:open-work supports - _
9 FEE ENCLOSED
and`=is- larger than.,-200 Square feet and ,is not
_ _ �' _ _c-removed.in trte.fall (by.September 21)
(Required only for Article 15 Ttle 5 applications) - - .
r
'10. NAME AND ADDRESS OF OFFICAL NEWSPAPER OF LOCALITY WHERE PROPOSED WORKS ARE LOCATED:
a�i � : •
11_ IS ANY PORTION OF THIS ACTIVITY FOR WHICH PERMIT IS SOUGHT NOW BEGUN OR COMPLETED '
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❑ Yes".- '_� No -
If"yes",explain in addenda,giving reasons and dates,and show existing work on drawings or map- - - _
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12= CERTIFICATION: - - -
hereby affirm that.the information provided on this--form and all attachments submitted herewith is true to the best of,
my knowledge and belief.:
As a condition to the-issuance of a permit, the applicant_accepts full legal responsibility for all damage, direct or indirect, of whatever nature, and by -
whomever suffered, arising out-of the project described herein and agrees to"indemnify and save harmless the State from suits, actions, damages and costs of.
every name and description resulting from the said project. ",
l 1y
Da e- Signature :.
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