applications TOWN OF QUEENSBURY ) /}- --74 7 - 2 zZP
(Space inside block to Ix. filled in by
WARREN COUNTY. NEW YORK • Building Inspector)
Application for Application
N '
pPPermit ',Num., _ 19. .
BUILDING AND ZONING PERMIT -mit Expires. 1g.
i:ot,tint District
. Volta. nl Work
•
THREE (3) Copies of a PLOT PLAN, Drawn to scale \i'I"""c1 by
showing the actual dimensions of the lot to be built Retnat Kf
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 OF QUEENSBURY
/02. -- 6 `i 4 -70 �'/3oJ33 DATE EU
•
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK AUb 3 01983
ANSWER ALL OF THE FOLLOWING. A.M. o°
The undersigned hereby applies for a permit to do the following work 7181911g11)12)11213)4I516
which will be done in accordance with the description, plans and specifi- 'a a . ' ' ' ' ' ' '
cations, and such special conditions as may be indicated on the permit. . h c, (, `G
The ow er of this property is:
/,-'
R •. . .f"i.r.N t`t.). M�:. .0 /Jo a 6-6 / AkeS St- Hie PS61v F4//_s,n!7 /2<S>
(P.O.ADDRESS)
The person responsible•for su rvision of the work-insofar as the Building Code and the Zoning Ordinance apply is:
. . . . . . . ., ' .>.v . . CO. i :le— ('.o //�, /de- R� /76.s'v.ivi=)1-4,' A// 1210
l (NAME) • • (P.O AODR SS)
Name of Builder /�fie, /� /p/e Address
Name of Plumber (9 2+-� �'VA , Address
Name of Mason Ell J✓ $L5 R. 413 Ill- Address . £!tl 13,-e e-. . /.D . ..hiap diJ F, 1I1
ULot Number. . 7'7 . Unit 13.4P!'a&?v • Estimated value of proposed work 5 0 6i 0 va- ecl
Name of Village . .0.1-1' I�1 NJ 13 a 0 '1
Name of Street .-- &1 h'P in 1" t Side of street: north ❑, east ❑, south ❑, west ®--
Nearest Cross Street fl e Ye R ieD Distance front this -.ross street . . .2: Ft.
Property is north ®;south 0,east ii, west 0 from Cross Street .
If on Corner, which corner, northeast ❑, northwest ❑, southeast E. southwest
(Designate by marking with•an'"X' in the correct space.)
b
NATURE OF PROPOSED WORK OCCUPANCY
0 Construction of a new building. Main Buitding
❑ Addition to a building. One-family dwelling
❑ Alteration to a building. Two-family dwelling El
❑ Demolition of a building. .-family apartment house ❑
Store building ❑
'Z- -car attached garage ❑
Other:
Accessory Building
One-car detached garage ❑
Q 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-
posed buildings, and the location of all existing buildings.
NORTH Show proposed building(s) in dotted line and existing
Iuilding(s) in solid line.
• Size of property ft. x ft.
J Size and use of existing buildings, if any
s f/e—/- i 1'1 4 W Size of proposed building ft.x ft.
Height (from grade to ridge) .
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.,
fire1�r,.f , r2. ./-. . . . . . . .
Kind of construction: Wood frame, safe, etc.?. . . J7��� ��• • • • • • • • • • • . • . • • �. . . . . . . . . . . . . . .
Will any second-hand lumber be used? //V ` If so, for what?
Material of foundation walls . . . . . . . . .JP). .. . /``���`�-/C Thickness . /!1 r
Depth of foundation walls below grade T -C5 Continuous foundation?
Will there be a cellar? . . . . ("�//� �-- . . . If so, material of cellar floor 9 '/ Nc R �f
Type of roof: Sloped or flat? -5/0 P-e 1� Material of roof . 2/ 1)1'&a-./-6...r .
Size, wood studs "x ", spacing le) "o.c., length • , ft.. . "x / ", spacing . . . ./63 "o.c., span .
Size, floor beams, 1st floor / l� . ii. . ft.
Size, floor beams; 2nd floor �. " x �v ", spacing 6 "o.c., span . . , -..l . ft.
Size, ceiling beams 2. . " x ., ", spacing . . /. "o.c., span . . f Z2. — ft.
Size, roof rafters or beams . . . . . . .c . . . " x ", spacing / 6 "o.c., span J ft.
Exterior finish With what material? ,.. . ./.a L 1'
Finish of interior walls `(-• 1 1 f-' " mil/
If garage is to be attached, of what m,t rial is wall between garage and main building to be constructed?
%/ I /2 D 1 Lt}.4//
Is there to be an opening between garage and buildin ? ,p ` � Si
� .'f- ding?Oil burner or coal? . .
Kind of heating system . . . . . . . . . . . P
Will a flue-lined chimney be provided . . .: .:� —• • • Depth of chimney foundation below grade 4` /
Height of chimney above roof j
Will there be a fireplace? Depth of fireplace hearth /ti
Will a toilet be installed? '
Will a kitchen sink be installed and connected to wate upply?
Water supply (public water supply or pump) a/7/''C-
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 ihr.aof my know,ledge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, are a true and co.i.p•lete 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 works 11 be mplied with,whether specified or not,
and that such work is authorized by the owner. 9 t
Sworn to before me this Signature ... (((�1C�/f��'""///}�
OWNER.OWNERS AG .ARCHITECT.CONTRACTOR
�p da of. .... U. 9' T . 19 4 .
NOTARY PU LI . ARE CO NTH,:N. Y.ROBERT V. LYNCL_NTCH
Notary 'UUue. 562.1c12 aa'... .7t1-g'iorii
Residing in Saratoga OOnntlounty a tit.,
SPECIAL.CONDITIONS OF THE PERMIT: My Commission Expires Marcht,lt4rj,ZI
•
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 2zk®®
2 . Type of heat 'A - � (I
OLA, \-\
3 . Is the building mechanically cooled? \AO
4 . Percentage of area of windows and doors V.% L
A. Over. 16% Only
1 . Uo value of gross area of walls , roof/ceiling and floors
exposed to ambient conditions
2 . Floor over heated spaces YES NO
a. Are foundation walls insulated? YES NO
1 . If YES , what is the R value?
3 . Slab on grade YES NO
a . If YES , what is the R value of insulation around
perimeter of floor?
4 . Is basement heated? YES NO
a. R value of insulation
5. Type of insulation
B. Under 16% Only
1 . R value of roof and floors exposed to ambient conditions
2 . R value of exterior walls m
3 . R value of glazed area ‘i ,CV
4 . R value of doors 'to
5. R value of floors over heated spaces \ck
6. R value of slab edge insulation - unheated slab *NITS
7 . R value of slab insulation - heated slab
8 . R value of heated basement/cellar walls (above grade) 'R S
9 . R value of heated basement/cellar walls (below grade) R g
10 . Type of insulation NrAh_ch,qp„o,, 90Nre c„
C. Controls
1 . Thermostat maximum heat setting �S
D. Duct Systems
1 . Is duct system installed in unheated spaces? YES NO..
a. If YES , R value of duct installation
b . R value of duct in other areas
E . Piping Insulation
1 . Size of hot water or cooling carrying agent pipe
2 . R value of pipe insulation
F . Service Water Heating
1 . Performance efficiency
2 . Temperature control setting maximum
G. For Swimming Pool Only
1 . Maximum heating
Telephone No . aU-10714 c6d'a )
(applicant ' s s nature)
. TOWN OF QUEFNSBURY
BUILDING & ZONING DEPARTMENT
SEWAGF DISPOSAL PERMIT APPLICATION
1. Owner ' s Name �I 1 C,K • MSC (0).LC)06 1-1
Address 1 U 5 ,
i r 1)cd,k1 C.�S ,( )(9, 9 Telephone No. riC/'7- 2rQo2ff
2. Property "iodation / R/P1--/M7 17 d erg (.u6Cn)S,(B(J F
3. Name of person .or firm responsible for installing system `
LC/O . i'1102�4-/0 Telephone No. 6s6 93( fl
Address 06 A- 0/C y c'Eldq-/C_,
4. Number of bedrooms (residential buildings only)
5. Daily flow 61'V gallons/day
6. Septic tank capacity If ( ) . gallons
- 7 . Topography: .rolling, steep
% of slope 0"
8 . Nature of soil and depth ��ftdtij�
9. If ground water, bedrock or impervious material is apparent at what
depth does it begin? ft.
10. Percolation test: A is required
B.1.) is not required
C If required what is the rate minutes/inch
11. Water supply: municipal , well; other h1( 1101C1 CA-(r
12. ' Type of system proposed: drywell, tile "field, other • "b 'L(JLLL
Any contractor," corporation, individual, etc". engaged in' the construction
of a sanitary sewage disposal system who covers the same before inspection,
does not have an approved permit, or varies from the approved application
will be subject to a penalty of $250 as provided for in Section 6 . 010 of the
• Queensbury Sanitary Sewage Ordinanceq
Date O, 6L7) ,{ rV
signature of al0/ icant
On separate sheet of paper submit a diagram of the .proposed septic system
with all dimensions, including distance from any structure, distance from
property line and domestic water supply, etc. Include all dimensions of
the system itself.
Form 3-82