8686 BUILDING PERMIT
TOWN OF QUEENSBURY 8686
No.
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Susan and Kenneth Dott
OWNER of property located at Assembly Point Road and .on Lake Geotreet, Road or Ave.
in the Town of Queensbury,To Construct or place a Dock
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in with the Town of Queensbury Building and Zoning Ordinance.
U]
1. OWNE R'S Address is Village Wharf
Lake Geoge, New York
2. CONTRACTOR or BUILDER'S Name
Michael Crayford ID
3. CONTRACTOR or BUILDER'S Address
rt'
P. O. Box 105
Diamond Point, New York 12824 d
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4. ARCHITECT'S Name
5. ARCHITECT'S Address
to
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6. TYPE of Construction— (Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( ) pt
;pro
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7. PLANS and Specifications 6")
5'x30' stake dock per plot plan and
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No. application submitted. 0
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8. Proposed Use R�
Dock
$ 15. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES March 1 19 85
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the 0
town of Queensbury before the expiration date.) 0
Dated at the Town of Queensbury this 9th Day of August 19 84
SIGNED BY /m1,4 ,4, C , for the Town of Queensbury
Building and Zoning Inspector
TOWN OF QUEENSBURY (Space inside block to be filled in by
WARREN COUNTY, NEW YORK Building inspector)
Application for Application No.
pP Permit Issued - 19. .
BUILDING AND ZONING PERMIT Permit ENpires. 19.
7.(nuing District /
•
\ alum of Work i f �7 R
THREE (3) Copies of a PLOT PLAN, Drawn to scale .\I'I"'' 'c•c1 b ,( 7 ,./ _a
showing the actual dimensions of the lot to be built Itcm:il•Ks-
upon, The exact size, and location on the lot of the •
building to be erected or altered MUST BE SUB-
MITTED WITH 'THIS .APPLICATION� IiI
7 — t✓ — / . • ) 0 .Q/ --t TOWN OF QUEENSBURY
( i� ATE D E B E V Et
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK �,
ANSWER ALL OF THE FOLLOWING. AUG_ 9 984
The undersigned hereby applies for a- permit,to do the following work A.M. /5.)a P.M.
which will be done in accordance with the description, plans and specifi- 71g1g1101 .1112'1121�3141516
cations, and such special conditions as may be indicated on the permit. . e a e t a „ , , e
The owner of this property is: Ea`
Svsem, -e_ •nt!F Niv.-c / a oTT' V 1[.C.F}G E 11/0,092, L m-i4e. .lo(e< N'/ t Z z 4-7
(NA'.1E) IP.O.ADDRESSI
The person responsible for supervision of the work insofar as the Building Code and the Zoning Ordinance apply is:
f4i c.k4•t- . UetgW31et.D Po Ii (0 S - /A•'+-caAv4 ,o., r A/., /Z$Z —
(NAME) (P.O.ADDRESS)
Name of Builder 04/CH M �/e/9Y/442/0) . Address . . . .S.✓4!'1 *
Name of Plumber Address .
Name of Mason Address
eta
Lot Number Unit Estimated value of proposed work I .G G C
Name of Village .
Name of Street Side of street: north 0, east 0, south O. west ❑
Nearest Cross Street Distance from this cross street Ft.
Property is north - ❑,south ❑,east i 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 a building. -family apartment house ❑
Store building ❑
-car attached garage ❑
Other:
Accessory Building
One-car detached garage ❑
❑ Other work. Describe �QA.t ��r/1'C •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
• V . building(s) in solid line.
`t Size• of property ft. x ft.
G./9--frb6
.D n rrc • r Size and use of existing buildings, if any
f I I • C.f—o2 t. lf- N
s C Size of proposed building ft.x ft.
IP
Height(from grade to ridge) ft.
i 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)
7-73—M
(cont'd.)
BUILDING SPECIFICATIONS.,
Kind of construction: Wood frame, fire safe, etc.?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Will any second-hand lumber be used? If so, for what7
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?
Finishof 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 tt bea r of my know,ledge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, are a true and co.z.p lete statement of_all proposed work to be done on the descri premi and th t all prov' ions of the BUILD-
ING'6ODE,THE ZONING ORDINANCE;'and all other laws pertaining to the sed w sha rl a corn • ed with, ther specified or not,
and that euelkwvOrk is authorized by the owner.
Sworn to before i1 his '` Signature
OWNER.OWNER'S AGENT,ARC C TOR
n-y of 19
am.
TARP PUBLIC. WARREN COUNTY. N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
•
•
•
By
114-12-2 (7/82) NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
NOTIFICATION OF AVAILABILITY FOR REVIEW
INITIATING UNIT/`-'� 4A2 l�` ��� Contact:
OTHER# DATE ISSUED
OTHER# DATE DUE. � —A�
OTHER# DEC# C — 1/
PURPOSE FOR NOTIFICATION/.REVIEW AUTHORITY: � XS 7 ^�l _
APPLICANT: � //�
PROJECT NAME/DESCRIPTION: 7G�'/'=7 // / X.
4i/i9-,�`' ���`' �' � /7/1 �-c' - / I - 45/
PROJECT LOCATION: 5����,
City/Village Town: `'C tJ� �/ �1�
County: /-'�''//A/P- Z'` USGS Quad:
(Attach a location map)
REMARKS:
DISTRIBUTION: /-ieX%`'-lG.� _ ,Zl_�-i..�-e-1d/- 6L_J-2Pf7rs4;l
��.
no comments ❑ comments attached ❑
RESPONDING UNIT:
BY:
(name/unit/date)
s
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION APPLICATION FOR PERMIT-. .
ALBANY, NEV YORK 12233 APPLICATION_NO-
Read instructions on back before completing this application. Please type or print clearly in ink. Use separate -
addenda and exhibits to provide all required data and explanations for which space on the form is inadequate. -
❑ARTICLE 15, TITLE 3(CONTROL OF AQUATIC INSECTS, WEEDS, OR UNDESIRABLE FISH)
❑ARTICLE 15, TITLE 5(PROTECTION OF WATERS)
❑ Eor the construction, reconstruction, or repair of a DAM or other impoundment structure.
For the construction, reconstruction, or repair of any permanent DOCK, pier, or wharf;and any dock, pier, or
wharf, built on openwork supports, which has a top surface area of more than 200 square feet.
For the disturbance of a STREAM BED or excavation in- or fill of navigable waters..
❑ARTICLE 15, TITLE 1= Y—D,LONG ISLAND WELL
0 ARTICLE 24(FRESHWATER WETLANDS) ❑ Permit ❑ Letter of Permission
❑ARTICLE 25(TIDAL WETLANDS)
1. NAME OF APPLICANT: t n -
2. APPLICANT IS A/AN 1Individual .❑ Partnership D Association ❑ Corporation .❑Municipality ❑Governmental Agency
3. NAME&TITLE OF ��� r /�F?`f , � G�r'-
q
OFFICIAL SIGNING APPLICATION fCH4 - �'rr4 PHONE R- 3? --
STREET ADDRESS
OR P. O. BOX PG• I -' POST OFFICE 1/(40- o,v') rc=/iv/ STATE t/- ZIP CODE 2 2-Z<----
4. NAM &ADDRESS OF OWNER / j�C� "-5 z� '
•
(If not applicant) /Z-4--61 -dE
Vie/V/1 5 W -9 SdSii-r✓ L�c� i r PHONE bSTREET ADDRESS k,- �-- ,rt /^ �i5e-V - STATE YZIP CODE 1 Z 6���OR P.O. BOX POST OFFICE N �� r v' " `
6. WILL PROJECT UTILIZE
5. PROJECT LOCATION: STATE OWNED LAND?
a) City or Village of.
Q�r"' ���" l NAME OF STREAM OR OTHER WATER BODY:
(If appropriate; if un-named, show on ❑.Yes pS i�io,
Town of D(J -/Jsv2y map-See Item 5b)
County of W114-(2r5/ 1-,9vr/- 4l. s2G-� -
b) Specific project site or area is marked on U.S.G.S.or equivalent map, attached as Exhibit No: t
7. PROPOSED USE: Jrivate 8. PROPOSED STARTING DATE: 9. APPROXIMATE COMPLETION DATE 10. FEE OF S ENCLOSED
❑ Public ❑ Commercial i,'ln Ste%
11. PROJECT DESCRIPTION: (Feet of rip-rap new channel; cubic yards of material to be removed;draining,dredging,
filling, and location of disposal sites; type of structure to be installed; height of dam;size of impoundment; • -
capacities of proposed water sources; extent of distribution system;etc.) - '-
.
I/7j� �Ci G / "�'7s%G^ iio c .�r!V -1.fi.c -< i/'1/rL c'J�.c` "'c:"�;'•\ .�r, �:>a'�.T
1 .. ... .
12• This project will require the following additional permits, applications for which are the responsibility:cf-others: -
❑ DAM ❑ DOCK ❑ STREAM DISTURBANCE ❑ SPDES/NPDES ❑WATER SUPPLY ❑ L.I.WELLS 0 FRESHWATER WETLANDS 0 TIDAL WETLANDS
i
13. NAME AND ADDRESS OF OFFICIAL NEWSPAPER OF LOCALITY WHERE PROPOSED WORKS ARE LOCATED:
/'os 5;,9-/2 �4w2 ,ti-c./-' -e c„...,..F .57-"E• lCrr'S ,' 4u--s" ivy. r2�-o.,
14. IS ANY PORTION OF THE ACTIVITY FOR WHICH A PERMIT IS SOUGHT NOW BEGUN OR COMPLETE? ❑,`es 'No
If "YES", explain in addenda, giving reasons and dates, and show existing work on drawings or map.
- 15. CERTIFICATION:
I hereby affirm under penalty of perjury that information provided on this form and all attachments submitted here- 1
with is true to the best of my knowledge and belief. False statements made herein are punishable as a Class A
misdemeanor pursuant to Section 210.45 of the Penal Law. 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.
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1 ; 11.42 BAY-STREET.GLENS FALLS. N.Y. t2so
Tei.:.St 3-792-5145
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SCALE : 1" 6 / 1TAX
MAP SECTION X BLOCK / PAR,.1" Li .°1 D. /11, / 4, /..98,
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LAKE GEORGE QUADRANG'.
` " NEW YORK
NEW YORK 7.5 MINUTE SERIES (TOPOGRAPE
F TRANSPORTATION • NW/4 GLENS FALLS IS' QUADRANGLE
71 11 SW HAGUE (N.Y. 81 20 MI. 610
N LANDING) �BOLTGN LANDING 4.5 M! 4O' 680000 FEETI - -.- _ -r
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