6986 BUILDING PERMIT
TOWN OF QUEENSBURY 6986
No.
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Helen Moore
Lake eorg
OWNER of property located at Fielding Road, Cleverdale on Cttreet,F�oad or Ave.
in the Town of Queensbury,To Construct or place a Addition to dock
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. 0
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1. OWNER'S Address is 38 Grant Ave.
Glens Falls, N. Y.
2. CONTRACTOR or BUILDER'S Name
3. CONTRACTOR or BUILDER'S Address
O PI
4. ARCHITECT'S Name C
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5. ARCHITECT'S Address : (D :C1
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6. TYPE of Construction—(Please indicate by X)
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( 1 Wood Frame ( )Masonry ( )Steel ( )
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7. PLANS and Specifications 3 2' north of deck and 3 ' east of deck
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No.
per plot plan and application submitted. m
8. Proposed Use
Dock
$ 10. 00 PERMIT FEE PAID—THIS PERMIT EXPIRES Nov. 1 19 81
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the I-.
town of Queensbury before the expiration date.) ct
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Dated at the Town of Queensbury this 13th Day of July 19 81
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SIGNED BY h G for the Town of Queensbury p,
Building and Zoning Ittipector n
TOWN OF QUEENSBURY ' (SpaCe inside block to be filled in b,
WARREN COUNTY. NEW YORK Building Inspector)
Application for Application No. :
pp Permit Issued 19
BUILDING AND ZONING PERMIT ►n►it Expires. 19
%c+nine District
. \Any of wort,
THREE 131 Copies of a PLOT PLAN, Drawn to scale \1►1, ""•cl by
showing the actual dimensions of the lot to be built ttenialICf'
upon, The exact size, and location on the lot of the
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION.
pp 1 TOWN OF QUEENSBURY
10--..[3 , --/ Ii )IJIDATE RECEIVED
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK JUL 1 31981
ANSWER ALL OF THE FOLLOWING. Am. /o 0.2 r e_e. rpj,
The undersigned hereby applies for a permit to do the following week 7l$19 a 1I2I3l4I5t6
which will be done in accordance with the description, plans and specifi-
II 9999cations, and such special conditions as may be indicated on the permit.
i
The owner pr of this roperty is:
. •ifef: 7
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(NA•,E1 .
The person responsible for supervision of the work insofar as the Buildipg.Code and the Zoning Ordinance apply is:
(NAME) (P,O ADDRESS)
Name of Builder Address
Name of Plumber Address
Name of Mason Address
Lot Number Unit Estimated value of proposed work S
Name of Street . • .` .
Name of Village ,►. .ekt% .l n. gq. Side of
street: north 0, east 0, south awest 0
'
Nearest Cross Street
Distance front this -ross street Ft.
Property is north ❑,south 0,east i i,west 0 from Cross Street
If on Corner, which corner, northeast ❑, northwest ❑, southeast Q. southwest
(Designate by marking with an "X" in the correct space.)
NATURE OF PROPOSED WORK OCCUPANCY
0
Main Building
Construction of a new building. One family dwelling El
0 Addition to a building. Two-family dwelling 0
ElAlteration to a building. , , , . -family apartment house ❑
0 Demolition of a building. Store building ❑
-car attached garage ❑
Other:
Accessory Building
One-car detached garage 0
0 Other work. Describe:.3•4.-•l. • /. . • . . . Two-car detached garage • ❑
Private chicken house ❑
} Private storage building CD
TO C .5� i ✓t., C 1r/h q_ d c l C 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 buildings) in dotted line and existing
lluilding(s) in solid line.
Size of property ft. x ft.
Size and use of existing buildings, if any
i W Size of proposed building ft.x ft.
Height(from grade to ridge) ft.
Front yard ft.
Side yards ft. and ft.
Rear yard ft.
SOUTH If on corner,setback from side street ft.
Note: All distances ore net, as measured from street side
line to nearest part of building.
(OVER)
7-73—M .
(cont'd.)
BUILDING SPECIFICATIONS.,
Kind of construction: Wood frame, fire safe, etc.?. . . . . . . . . . . . . . . . • • . . . . . . . . .. . . . . . . . . . • • • • . . • • . . . . . . . . . . . . . • •
Will any second-hand lumber be used? If so, for what?
Material of foundation walls Thickness
Depth of foundation walls below grade Continuous foundation?
Will there be a cellar? If so, material of cellar floor
Type of roof: Sloped or flat? Material of roof
Size,wood studs „x ",spacing "a.c.,length • ft.
Size, floor beams, 1st floor
x ", spacing . "o.c.,span ft.
Size, floor beams, 2nd floor
x ", spacing "o.c.,span ft.
Size,ceiling beams "x ", spacing "o.c., span ft.
Siie, roof rafters or beams " x ", spacing "o.c.,span ft.
Exterior finish With what material?
Finish of interior walls
If garage is to be attached,of what material is wall between garage and main building to be constructed?
Is there to be an opening between garage and building?
Kind of heating system Oil burner or coal?
Will a flue-lined chimney be provided? . Depth of chimney foundation below grade
Height of chimney above roof
Will there be a fireplace? Depth of fireplace hearth
Will a toilet be installed?
Will a kitchen sink be installed and connected to water supply?
Water supply (public water supply or pump)
Distance of cesspool from any private well feet
Will drainage system be provided with required traps,cleanouts,and vents?
AFFIDAVIT
Town of Queensbury
County of Warren
State of New York
I swear that to it bey r of my knowledge and belief the statements contained in this application,together with the plans and specification sub-
mitted, are a true and co.i. lete statement of all proposed work to be done on the described premises and that aA ions of the BUILD-
ING 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 P4"4 OWNER.OWNERS AGENT,ARCHITECT.CONTRACTOR
day of 19
- --- NOTARY Punttc, WARREN COUNTY. N.
SPECIAL CONDITIONS OF THE PERMIT:
By ..