87-776 BUILDING
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WARREN COUNTY, NEW YORK m:
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PERMISSION i,hereby granted to Robert Mohr u,
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OWNER of property located at 8eo*n-b]y Point Street, Road o,Ave. �
in the Town ofOueensbu,y'To Construct o,place a repair to existing dock
a, 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 Ouaonobvry Building and Zoning Ordinance.
1 owmsn'sxou,o,�i,
� Same
z. CONTRACTOR o,au/Losn'SName
John Mauou �
o. CONTRACTOR v,BUILDER'S Aou,ea
11.0. Box box 86
C1everdmle, N.Y.
4. ARCHITECT'S Name |
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n. AnoH/reor'S Address �f
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a. TYPE m Construction— (Please indicate uvx)
< )Wood Frame ( > mmwon,v < ) ame/ 10
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r. PLANS and Specifications
No. Repair of existing dock as per plot plan, oparjfloutiuum
applicatiot-,. c
o. p,ovo,em Use
Dock
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$ 1I^00 PERMIT FEE PAID —THIS PERMIT EXPIRES Joom l^ 19 G& o
(if a longer period is required an application for un extension must uo made»u the Building and Zoning inspector o/t'
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town mouoon,uurv��ommooxniuw da
te.)
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Dated ut the Town ofOuoon»bu,vthis 18th Day of Nove�6er 10 87 /
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SIGNED BY
av for the Town ofQunon,bu,y
xmnnunu�un/no| �»'»n� �
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TO BE COMPLETED BY BLDG. DEPT.
Application No.
_quill of QueenJlury Permit Issued 19 if,)WN CE =:r'i, ,,,-, -
BUILDING and ZONING DEPARTMENT Permit Expires 19 '' � ( r'
, ,. ,, ,,
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation 1,- :� d
' - ''
Queensbury, New York 12801 Variance No. '
Site Plan Review No. ®V 161987
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Approved by: T
6UI D€NG & CODE DEPT.
6' APPLICATION FOR ��0e)
BUILDING AND ZONING PERMIT S 44-
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* * * * * * * * * * * * * * * * * * * * * * * * * * * *
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: Robert M. Mohr
P.O. Address c/o John A. Mason, P.O. Box 86 , Cleverdale , NY 12820Te1. 656-9956
Property Location: Assembly Point Tax Map No. 5 / 1 /•17
Street number or building lot number
Subdivision name (if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
John A. Mason P.O. Box 86 , Cleverdale . NY 12820 656-99h
Name P.O. Address Tel. No.
Name of builder John A. Mason Address P.O.Box 86 ,Cleverdale Tel. 656-9956
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
XXOther work (describe) repair set-back dimensions from property lines. Give
street and number or lot number and indicate• whether interior or corner lot. Show location
FOR DEMOLITION PERMIT, STATE SIZE AND **
r.....
LOCATION OF STRUCTURES AFFECTED. of water supply and location and configuration
* of septic disposal area.
wolow''' * COMPLETE INFORMATION REQUIRED BELOW.
* Size of property ft X ft.
* Existing building(s) Size ft X ft.
*
PROPOSED BUILDING AND USE: * Existing building(s) Use
Size of new structure ft X ft * _
Foundation-pier/slab/crawl/partial/full * Proposed building, distance from property line
(circle one) *
* Front yard ft Rear yard ft
No. of stories (habitable space) * Side yards ft and ft
Height (grade to ridge) ft. * If on corner, setback from side street ft
If residential, no. of families
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
Ranch Contemporary Log cabin * Other
Raised ranch Mansion Duplex * If addition, what will use be?
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
* * * * * * * * * * * * * * * * * * Private storage building
+ESTIMATED MARKET VALUE OF * Other
CONSTRUCTION *
$.„ 1 , 000 . 00
INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
Form BPA 4/86 and-vl
BUILDING PERMIT APPLICATION CONTINUED -
ti
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 Thickness
Depth of foundation below grade (to bottom of footing)
Will there be a cellar? Heated or unheated? Floor sq. footage sq ft
Will there be a basement? Will any portion be used as living space?
(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 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 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.
T.
SWORN TO BEFORE ME THIS Signature
r
Owner owner's agent,arcnitect,contractor
day of 19
Notary Public, Warren County, N.Y.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
SPECIAL CONDITIONS OF THE PERMIT:
By
PROFILE VIEW LOCATION SKETCH
existing 8'x36 ' section :/\ Harris Bay
damaged by ice o
.
1.
ordinary • .?
high w ter
19_ 93 -k___ yam' •
ordinary �` �� Rt .
low water bt,3 Dunhams 9L
8 ' 1 6 1 ' 8' 16 ' 1 8 ' I 317. 7 _ 0 Bay . Ml HR
I I I ,
X=existing solid cribs
LAKE GEORGE
2 t —��- 0 7-0 2000 0 1000 1 1 0
scale in feet scale eQt
Taken from:L. G.Power 6quadron 1971
4
2 a Q 0 2j0 PLAN VIEW ;
scale in feet \
LAKE GEORGE
-crib location
8' li,i 36.
ti`ik
6,�\`
12, �' 6, `\ �`
61 k�yY/
- - _ ordinary
Olow water .u;
317 . 74 '
/351;
--""� ordinary 2
PURPOSE: docking facility high water
DATUM 319 . 93 '
ADJACENT PROPERTY OWNERS: • IN Lake George
0 Dr. Frederick Seitz AT Assembly Point
COUNTY OF Warren STATE NY
C) Mr.. Myron Rapaport
APPLICATION BY John A. Masoi
SHEET 1 OF 1 DATE 11/1/87
B-3
Permit Authorization
•
John Mason is authorized to act as my agent in obtaining permits
from the Army Corps of Engineers and the New York State Department of
Environmental Conservation.
SIGNED: G 7//• C 1l�C�---"'"'
ADJOINING IANDOWNERS
1 . ) Dr. Frederick Seitz
R. University
1230 York Avenue
New York, NY 10021
2 . ) Mr. Myron Rapaport
Burnt Ridge Road
Lake George, NY 12845
LOCATION SKETCH
cj -Seitz
-MOHR
Rt . 9L ' I -Rapaport
Burnt Ridge Road
Old Asembly Point
Road
New Assembly Point Road
W
,D -- 1-1Y
TOWN OF QUEENSBURY
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION REECEIVED
NAmE 1 , ' 2( 7nit---k-„,
LOCATION
DATE V j/ /47 PERMIT# j'q- '7'7
TYPE OF STRUCTURE/0j4
RECHECK
FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
FOOTING FOUNDATION BACKFILL _FRAMING
ROUGH PLUMBING FINAL ELECTRICAL SEPTIC
INSULATION WOODSTOVE/FIREPLACE
REMARKS� __J
APPROVAL
CHIMNEY HEIGHT/LOCATION N/A YES NO
B VENT/LOCATION
PLUMBING VENT
ROOFING
SIDING
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES
FURNACE/HOT WATER OPERATING
BASEMENT INSULATION/DUCTWORK
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS-S
HANDICAPPED ACCESS
SMOKE DETECTORS
BATHROOM FANS/WHOLEHOUSE FANS
ALL PLUMBING FIXTURES OPERATING
GARAGE FIRE PROOFING
DOOR CLOSERS
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS
DUMPS TER
SITE PLAN/VARIANCE REQUIREMENTS
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C
COMMENTS:
cdketk
ARRIVE
DEPART
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