91-422 TOWN OF QUEENSBURY .:uuiiy Fee Paid (�I
111a 1 BUILDING & CODES DEPARTMENT permit # q( -
APPLICATION FOR: P ES-DECKS-
DOCKS BOATHOUSE' 17 1991 Est. Cost
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTR ODEO & caetRWEWWER 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. TWO SETS OF STRUCTURAL PLANS SHALL BE SUBMITTED
WITH THIS APPLICATION.
Owner of Property: PQM.1 KKOX .
P.O. Address 12- Co1UTw / i&- .4-1,6attAl 11N Faa io Phone # lik4-23-si•
Property Location NSSevw btli V+ Rd Al Se )c 04- Tax Map # 7. -I( i
liceEui ? NY12 (
Subdivision Name (If applicable) AV
PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES:
Name: saw • Address Phone#
BUILDING SPECIFICATIONS:
Type of work to be done: Porch Deck Dock Boathouse (Circle one)
Size of Structure to be built (square footage : 4ac oic• gxg-to(
Foundation Material : Width Thickness C2c73 60Ck
Depth of Footing, below grade: 7-tp2&- LP_iA ' 5Pi-ceD
Size of Posts or Studs: x x Long
Size of Floor Joists: x x Span 4rrACEi °
Decking or Flooring Material : (),'Else. Lti',I(lASQ P7WL TNIV-S
How will Porch or Deck be fastened to building? f) pjva beck;N Z.
If Roof Will Be Installed, Answer Following Questions:
Size of Posts or Studs: x x Long
Roof Rafters: x Spacing Span
Roof Trusses (pre-engineered spacing) : Span
Type of Roof: Sloped Flat Shed Other (Circle one)
Material of Roof:
ZONING INFORMATION:
TWO PLOT PLANS MUST BE PREPARED AND SUBMITTED, drawn reasonably to scale and attached
hereto, showing clearly and distinctly all buildings, whether existing or proposed and
indicate all set back dimensions from property lines. Show location of water supply and
location and configuration of septic disposal area. S e z Cattail') 0tivt ,42
eula
rt : ft. x ft. /Jl�B;F N f (VIID1eS
Size of Prope y
Existing building(s) : Size ft. x ft. Pr°)`
24 .
Size ft. x ft.
Use of Existing building(s) : •
Proposed structure;-ai stance from r e-r i=iiie i - — _
Front yard ft. Rear yard ft.
.N Side yards ai, ft. and 4,. ft.
If on corner, setback from side street: ft.
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