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applicationsTOWN OF QUEENSBURY WARREN COUNTY,NEW YORK Application for BUILDING AND ZONING PERMIT One copy of @ PLOT PLAN,Drawn to scale showing the actual dimensionsofthelottobebuilt upon, The exact size,and location on the lot of the building to be erected or altered MUST BE SUB- MITTED WITH THIS APPLICATION. “gn.2-aQ.l HUBS ‘A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK ANSWER ALL OF THE FOLLOWING. ‘The undersigned hereby applies for «permit to do the following work .which will be done in accordance with the description,plans and specifi.‘7|8}2)2)3)4|5|6cations,and such special conditions as may be indicated on the permit.usDBRSOP‘The pyner of this iy <ina Vary vo RD.Roy (2ThefetuperviaionoftheworkinsofarastheBuildingCodeandthe Zonin rineSy iss"Seka ey WEEE TF CEA ny (Space inside block to he filled in by Building Inspecuor) 19 Poot Rapines 19 1:Distr Work & al by Remunks aNameofBuilder.Baha.Address Name of Plumber..Address Narne of Mason :Address Lot Number...2 Unit.....2...y Estimated value of proposed work 5 wh 008. Name of Village...StigtgNameofStreetCressscSorsatoes1Charwesciord,Sie of sect:north Gi,east O,south O.west O Nearest Cross Street :Distance from this cross street .Ht Property ismorth EJ,south Cleat R.west O from Cross Street Ion Corner,which corner,northeast LF,northwest (1,southeast C2,southwest (Designate by marking with an “XK”in the correct space.) NATURE OF PROPOSED WORK OCCUPANCY ©Construction of a new building.Main Building ,(Addition to «building.One-family dwelling a Alteratign to a building.‘Two-lamily dwelling.a C1 Demolition of a building.family apartment house Oo Store building Q car attached garage Q Oomnér vetteAccessory Bui ;One-car detached garage Qa C1 Other work.Describe:‘Two-car detached garage Qa Private chicken house Qa Private storage building oa 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- nontn posed buildings,and the location of all existing buildings. Show proposed building(s)in dotted line and existingGree lore SL huilding(s)in solid line. hm Size of property...£7.00.tex 08 a Size and use of existing buildings,if any ..°?-2°°S; :“Size of proposed building 32...fex . Height (from grade to ridge).oh4Frontyard...202...38 ak’“eC ft Side yards :fu.and oft. Rear yard 92.2 BS -ft sourn Ion corner,setback from side street f Note:All distances are net,as measured from street side line 10 nearest part of building. foven) 2-73 2M {cont'd.) BUILDING SPECIFICATIONS, Kind of construtions Woerm safe,e162.00.0 ::_ Will any second-hand Tumber be used?.2-2).Thao,for what?bose eaeMaterialoffoundationwalls.......grove,,Qoaire®,Thickness...9... Depth of foundation walls below grade ae.Continuous foundation?. Will there be a cellar?...“Ya If 40,material of cellar floor tue Type of rook(Slopedor flat?.......5.2....-25 Material of roof Size,wood studs bee Reh 6.an Size,floor beams,Ist floor .dete Ae.fe Size,floor beams,3nd floor Bina ee,ttSize,ceiling beams vx :fe. Sie,rool rafters or beams...On."oe 7 spacing f. Exterior finish page SREB.With what material?7Finishofinteriorwalls. Lf garage is to be attached,of what oe is wall bt 0 wr and main builA.C ipomy Nee Is there to be an opening between ceo hieKindofheatingsystem Foi burner or coal?........Will a flue-tined chimney be provided?..;.,.........+Depth of chimney foundation below grade Height of chimney above roof...2 :ernWilltherebeafireplace?2.0.6.9...- Depth of teplace hearth... Will a toilet be installed?::: +supply?.-goWillakitcheninstalledandconnected(0 ws Water suppl water supply or pump)...-60.000060000Ceecegeeeeeeeeetenntentteenies Distance of cesspool from any private well...AN.eel..feet Will drainage system be provided with required traps,cleanouts,and vents?oe... ‘Town:of Queensbury AFFIDAVIT County of Warren State of New York . "over that ou bgt my knows and ble th tataman contained in ht apelin hee with and specificained,aren,festit octane tl propa we tbe dona onthe etribedpms cod that af proves tthe BUILDRapedteEINSuRakSeeagedNaeeti‘and that such work is authorised by uhe owner.ettlniog Proposed ‘complied with,whether specifiedornot, ‘Sworn wo before me this Signature day of w ‘OWNER,oWnen's AGENT.ARCHITECT:CONTRACTOR MOTARY PUBLIC,WARREN COUNTY,W.¥. SPECIAL CONDITIONS OF THE PERMIT: By TOWN OF QUEENSBURY WARREN COUNTY,NEW YORK Application for:BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK STATE ENERGY CONSERVATION CODE A permit must be obtained before beginning work. ANSWER ALL of the following: 1. > Gross floor area QZoo appre type of heat.gas AJA Is the building mechanically cooled? Percentage of area of windows and doors \Z.4 “o A.Over 16%Only1.US value of gross area of walls,roof/ceiling and floorseXposedtoambientconditions. 2,Floor over heated spaces YES NO a.Are foundation walls insulated?YES No 1.If YES,what is the R value?. Slab on grade YES NO a.If YES,what is the R value of insulation aroundperimeteroffloor?, Is basement heated?YES No a.R value of insulation Type of insulation B.Under 16%onlyI.R value of roof and floors exposed to ambient conditions__ -}R value of exterior walls y-\V"\ R value of glazed area 2. —R value of doors \S+\ R value of floors over unheated spaces. R value of slab edge insulation -unheated slab___Y\\\ R value of slab insulation -heated slab,W\A R value of heated basement/cellar walls (above grade)a 9.R value of heated basement/cellar walls (below grade)x 10.Type of insulation CoS tfrea c.Controls ‘ ;‘Thermostat maximum heat setting 20 I,Is duct system installed in unheated spaces?a.If YES,R value of duct installation,b.R value of duct in other areas. No E,Piping InsulationI,Size of hot water or cooling carrying agent pipe2.R value of pipe insulation. F.Service Water Heating €I.Performance efficiency SS “Lo 2.Temperature control setting maximum iS= G.For Swimming Pool OnlyT.Maximum heating telephone no.27 E-AS*S Doky Moy(applicant's signature) Daun of Queensbury BUILDING and ZONING DEPARTMENT Bay and Haviland Road,R.D.1 Box 98 Queensbury,New York 12801 SEPTIC DISPOSAL PERMIT APPLICATION owner “s Name.Seku Edbjuy rel.29SISOS Address Apr fey 729 CGna Fey ALY, Person/Firm installing syster Uxiur Neh Number of bedrooms (residential only)JoeTotaldailyflow:(compute @ 150 cal.per bedroom per day)G00 Topography?flat)-rolling -steep -(circle one)Degree of slope _¢Gflate_— Nature of soils .<(Sand=loam-clay-other-Depth.ft. at what depth?ft.Ground water: Bedrock or impervious material--at what depth?ft. Percolation Test -Not required /Required -Rate min/inch, Domestic Water Supply zMunicipal -Well -Other IMPORTANT! On a separate piece of paper,submit a diagram of the proposed septicsystemwithalldimensions;including distance from any structure,distance from property lines and distances from any domestic watersupplyorshore-line of lake,stream,pondor wetlands.Include alldimensionsofthesystemitself. Description of proposed system: Septic tank size (000 gal.Tile field-Length of each trench SO ft.Total field©ft.elben HS —Size of stone # Seepage Pit(s)Number /Size__ftX _ft.Size of stone#_ Any contractor,corporation,individual,Etc.,engaged in theconstructionofaSanitarySewageDisposalSystem,who covers thesamebeforeinspection,does not have an approved Permit,or variesfromtheapprovedapplication,will be subject to a Penalty of $250asprovidedforinSection6.010 of the Town of Queensbury SanitarySewageOrdinance. x LUCignatureofApplidant 01/86 md/v1