86-513 BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-513
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Thomas L. Clary
OWNER of property located at Reardon Road, Glen Lake Street, Road or Ave.
H
in the Town of Queensbury,To Construct or place a Deck and dock
at the above location in accordance to application together with plot plans and other information hereto filed and
to
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
•
1. OWNER'S Address is RD #1 Vaughn Road
Hudson Falls, New York
2. CONTRACTOR or BUILDER'S Name
same
3. CONTRACTOR or BUILDER'S Address
H
a.
0
4. ARCHITECT'S Name 0
a
I✓
m
5. ARCHITECT'S Address
(D
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( 1 Masonry ( )Steel ( )
7. PLANS and Specifications
No.
8'x20' deck added to dwelling and 4'x26' dock per plot, specifications t7
and application submitted.
8. Proposed Use
One-Family Dwelling (deck added and dock) a,
a.
0
C)
$ 10.00 PERMIT FEE PAID—THIS PERMIT EXPIRES March 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 26th Day of August 19 86
SIGNED BY 7n U /6for the Town of Queensbury
Building and Zoning Inspe�ectdr,
TU BE COMPLETED BY BLDG. DEPT.
Application No.
Ouin Ot Queenaur5, Permit Issued 19 :OWN O x Y � •_` `
BUILDING and ZONING DEPARTMENT Permit Expires 19 iI": ,
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation } ` `
C)ueensbury, New York 12801 Variance No. A 11 Site Plan Review No. " :
A.M. /0 ,1P,R'Pry.
APProv �by� p>�� to 1' ``4 s ),2!,:, 1516
APPLICATION FOR Iw""` ' i l $
t1D `C�d
BUILDING AND ZONING PERMIT 4-= nt� G•+c-r- 14in,-tIr
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. ANSWER ALL OF THE FOLLOWING. ''yy7
The undersigned hereby applies for a Building Permit to do the following work which will ,ri 0/
be done in accordance with the description, plans and specifications submitted, and such 0�0
special conditions as may be indicated on the Permit.
-20--)1---to -
The owner of this prop rty is: c, 1.,,a , (lb? p y 4 g---
41 ' a ��� G
P.O. Address/) / led. e Tel. rLO
Property Location: Rpia�jn ��c - ) ''JS - )g , N1 ,\ �Tax Map No. tf Ste/3 //ir"
Street number or building lot number
Subdivision name (if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
Name P.O. Address Tel. No.
Name of builder Address Tel.
Name of plumber 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 hereto,
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
Cteck Inc,. street 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 BELOW.
e
* Size of property ci ft X 32-2. ft.
* Existing building(s) Size a,p ft X 3O ft.
*
PROPOSED BUILDING AND USE: *
Existing building (s) Use .
Size of new structure ft X _L'l-t
Foundation7pier/slab/crawl/partial/full * Proposed building, distance from property line
*
(circle one) * Front yard " ft Rear yard ft
No. of stories (habitable space)
Height (grade to ridge) ft. * Side yards ft and ft
If residential, no, of families * If on corner, setback from side street ft
No. of rooms(excluding baths) * OCCUPANCY INFORMATION
*
No. of bedrooms * PRIMARY BUILDING -
No. of bathrooms
Primary heating system * ✓One family dwelling
Type of fuel * Two family dwelling
No. of fireplaces to be installed * Multiple dwelling / Number of units
Will a wood stove be installed? * Permanent occupancy
Central Air conditioning? * Transient occupancy
* Business
BUILDING STYLE, PRIMARY STRUCTURE * _Industrial
. anch Contemporary Log cabin * Other
'R
If addition, what will use be?
Raised ranch Mansion Duplex * ��C � " -
Split level Old style Bungalow
Cape Cod Cottage Other * ACCESSORY BUILDING-
Colonial Row Town House * Detached garage/one car/ two car/ car
( CIRCLE ONE PLEASE ) * Attached garage/one car/ two car/ car
* * * * * * * * * * * * * * * * * * x./crivate storage building
ESTIMATED MARKET VALUE OF * Other
CONSTRUCTION �/�De)
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.
Will any second-hand or ungraded lumber be used? If so, for what?
Foundation wall material j' - Thickness
Depth of foundation below grade (to bottom of footing) Lf.!
Will there be a cellar? Heated or unheated? Floor sq. footage sq ft
Will there be. a basement? iv Will any portion be used as living space? h,'
(If so, what portion? sq.ft. - - Type of use?
Type of roof - sloped/flat/shed/other , Material of roof
Size, wood studs "X " spacing "o.c. length ft.
Joists(floor beams) 1st. floor "X " spacing "o.c. span ft.
Joists (floor beams) 2nd. floor "X " spacing "o.c. span ft.
Overlays(ceiling beams) "X " spacing "o.c. span ft.
Roof rafters "X " spacing o.c. span ft.
Roof trusses(pre-engineered) spacing "o.c. span ft.
Exterior wall finish Of what material?
Interior wall finish
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
Is there to be an opening between garage and dwelling? _ If so will a Fire-rated
door, enclosure, and self-closing device be provided?
Will a flue-lined chimney be installed? 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 Qbury AFFIDAVIT STATE OF NEW YORK
County off 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 true 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.
SWORN TO BEFORE ME THIS Signature
Owner, owner's' agent,arcnitect,gb'ntractor
day of19 ,4"L (f
Notary Public, Warren County, N.Y.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
SPECIAL CONDITIONS OF THE PERMIT:
By
_Town of Queen iury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR' S REPORT
NAME T;4_071 A 5 CLJYR,/
LOCATION Z9ad gAJ9
Date I / g/ $6 Permit No. Ta.-37 3
* * * * * * * * * * * * * * * *
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
1\\)(\i ' .
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
ELECTRICAL INSPECTION v Final Building Survey
CLoS - P 4-6--
Next scheduled Inspection(call when ready)
Remarks- - ,/�
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