86-288 BUILDING PERMIT
TOWN OF QUEENSBURY No 86-288
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Michael LeBlanc
H.
H.
OWNER of property located at Warren Lane Street, Road or Ave. w
in the Town of Queensbury,To Construct or place a Alteration to garage
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
RD #3 Box 231
Glens Falls, New York
2. CONTRACTOR or BUILDER'S Name
same
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m
3. CONTRACTOR or BUILDER'S Address
same 0
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4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction— (Please indicate by X) rt
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ri
( )Wood Frame ( I Masonry ( )Steel ( )
rt
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7. PLANS and Specifications ccn
No. moved 14'x20' one—car garage on site — will add foundation and o
roof per plot plan, specifications and application submitted.
8. Proposed Use >v
eQ
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One—Car Garage
$ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES January 1 19 87
(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 5th Day of June 1g 86
SIGNED BY for the Town of Queensbury
Building and Zoning lnspecto �T��
4.00.1 TO BE COMPLETED BY BLDG. DEPT.
/ Application No. _
_quirt o f QueeflJur, Permit Issued 19
BUILDING and ZONING DEPARTMENT Permit Expires 19 � � i�i 1l` '
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designaci.on (iU i3 !; „IMF
Queensbury, New York 12801 Variance No. v t U u !
Site Plan Review No. . .f€
100 Approved by: C�f
l
F`
APPLICATION FOR ' „2Y2e �`t't�� ` +` �: ..
BUILDING AND ZONING PERMIT
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. ANSWER ALL OF THE FOLLOWING.
The undersigned hereby applies for a Building Permit to do the following work which will
be done in accordance with the description, plans and specifications submitted, and such
special conditions as may be indicated on the Permit.
The owner of this property is: ; °}( ; C{mil o,_P 1 LLB 0 IQ ne.
P.O. Address prJd1/4-3 8c)x ;=i,;_ j tei i(�r, . (1 L. 012 Tel. 991- f'= i7
Property Location: i),_';;(`Fe rj 1,_c._i") . Tax Map No./Z f/ 4/ Z.
Street number or building lot number
Subdivision name (if applicable) ?u' �
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
Name P.O. Address Tel. No.
Name of builder OttJ1\f<; i" Address Tel.
Name of plumber ?,j/'; Address Tel.
Name of mason Address Tel.
NATURE OF PROPOSED WORK: * ZONING INFORMATION:
Construction of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED,
Addition to a building * drawn reasonably to scale and attached heleto,
Alteration to a building * showing clearly and distinctly all buildings,
(no change to exterior dimensions) * whether existing or proposed and indicate all
Other work (describe) * set-back dimensions from property lines. Give
* street and number or lot number and indicate
*
FOR DEMOLITION PERMIT, STATE SIZE AND * whether interior or corner lot. Show location
LOCATION OF STRUCTURES AFFECTED. of water supply and location and configuration
* of septic disposal area.
* COMPLETE INFORMATION REQUIRED BEIOW.
- * Size of property <. c3 '-.j ft X \CA ft.
* Existing building(s) Size Iil9 ft X 6 N ft.
*
PROPOSED BUILDING AND USE: t * g G1 ���
�`� Existingg building(s) Use y.e.
Size of new structure --1427 ft X-t‘lli ft *
Foundation-pier/slab/crawl/partial/full * Proposed building, distance from property line
*
(circle one) j * Front yard - j�. ft Rear yard ft
No. of stories (habitable space) \ * Side yards -7-; ft and /f ft
(Height (grade to ridge) I ft. * If on corner, setback from side street ft
If residential, no. of families I
No. of rooms(excluding baths) I * OCCUPANCY INFORMATION
No. of bedrooms WV *• PRIMARY BUILDING -
No. of bathrooms ' I
Primary heating system hi! * One family dwelling
Type of fuel � , * Two family dwellingI.. * Multiple dwelling / Number of units
No. of fireplaces to be installed K:t1 * Permanent occupancy
Will a wood stove be installed? t
Central Air conditioning? t)0 * Transient occupancy
* Business
BUILDING STYLE, PRIMARY STRUCTURE * Industrial � •
Ranch Cont:..nporary Log cabin * ./Other h'nrA(,1 e - I e Ct r.
Raised ranch Mansion Duplex * If addition, what will se be?
Split level Old style B .ng. low * —
Cape Cod Cottage Ether * ACCESSORY BUILDING- r
Colonial Row 'r6wn House * X Detached garage/one car/ two car/ /� car.
( CIRCLE ONE PLEASE ) * __Attached garage/one car/ two car/ car
* * * * * * * * * * * * * * * * * * Private storage building
r ESTIMATED MARKET VALUE OF * Other
CONSTRUCTION $ ' C'U *
INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
Form BPA 4/86 and-vl
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS:
Type of construction, wood frame, fire safe,etc. k6604 +_ -----------
Will any second-hand or ungraded lumber be used? If so, for what? l3ll
LotroD
Foundation wall material WL°D Thickness ...,.,4.4.r-&rfI 1
Depth of foundation below grade (to bottom of footing)
Will there be a cellar? KI,A Heated or unheated? U/J - Floor sq. footage ` - sq ft)(
Will there be a basement? 0 Will any portion be used as living space? NL+
(If so, what por ' ••? sq.ft. - - Type of use?_ alc}(ckcs,p _
Type of roof slope./flat/shed/other Material of roof `I kry A. tj, ZeA
Size, wood studs "Xe.Trn acing "o.c. length ft.
Joists(floor beams) 1st. floor(- "X " spacing "o.c. span ft.
Joists (floor beams) 2nd. floor tJ4 "X " spacing "o.c. span ft.
,y(Overlays(ceiling beams) B45. 17'f) " spacing "o.c. span ft.
►'Roof rafters ? "X Lit " spacing I o.c. span ' ft.
XRoof trusses(pre-engineered) spacing ag4 "o.c. span ft.
Exterior wall finish `e l ,s4--inask. Of what material? 7'X 1 S 1
4)9
Interior wall finish .ex} 5�--',
If a garage is to be attached, desdr.ibe materials to be used for FIRE SEPARATION: PJA
Is there to be an opening between garage and dwelling? KS A- If so will a Fire-rated
door, enclosure, and self-closing device be provided?
Will a flue-lined chimney be installed? N Jt Height above roof ft.
Depth of chimney foundation below grade ft.
Depth of fireplace hearth ft. in.
Water supply - Municipal or private well
SEPTIC SYSTEM _ Distance from ANY private well(including adjoining properties ' ft.
(A separate application is necessary for any repair or new installation of septic system)
Town of Queensbury AFFIDAVIT STATE OF NEW YORK
County of Warren
I swear that to the best of my knowledge and belief the statements contained
in this application, together with the plans and specifications submitted, are a tract and
complete statement of all proposed work to be done on the described premises and that all
provisions of the BUILDING 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. �y�
SWORN TO BEFORE ME THIS Signature.,�� 2/ / �`" !--
fi n p Owner, owner's agent,arcnitect,contractor
day of ll/,�.t-,i 19 o(o
Notary Public, Warren County, N.Y.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * k * * * * * * * * * * * * * *
SPECIAL CONDITIONS OF THE PERMIT:
By ---