6367 BUILDING PERMIT
TOWN OF QUEENSBURY No. 6367
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to James and Deborah Mason
5
OWNER of property located at Old Assembly Point Road Street,Road or Ave. En
in the Town of Queensbury,To Construct or place a Addition to dwelling (deck)
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.
134
1. OWNER'S Address is R. D. #1
fi
Lake George, New York
Iv
2. CONTRACTOR or BUILDER'S Name
O
John Mason
3. CONTRACTOR or BUILDER'S Address
Box 86
Cleverdale, N. Y.
4. ARCHITECT'S Name 0
1-3
IZ
5. ARCHITECT'S Address
5
CS'
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6. TYPE of Construction—(Please indicate by X) b
O
(X)Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications o
Nol2 'x24 ' per plot plan, specifications and application
submitted.
8. Proposed Use
One—Family Dwelling (deck added)
0
0
$ 10. 00 PERMIT FEE PAID—THIS PERMIT EXPIRES Dec. 1 19 8 0 O
(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.)
fD
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Dated at the Town of Queensbury this 3 0t by of May 19 8 0 N
SIGNED BY for the Town of Queensbury
Bu ding and Zoning In ctor
t
TOWN OF QUEENSBL aY
(Space inside block to lx filled in by
WARREN COUNTY, NEW VOi K Building Inspector)
Application for ►►)e.►tie►n No.1'rrnut (s.ue d 14
BUILDING AND ZONING PERMIT ►►it Expires. 1g
i:onn►� District
THREE (3) Copies of a PLOT PLAN. Drawn to scale \Pier„e(•e) he
showing the actual dimensions of the lot to be built I.e n►at►(�_
upon, The exact size. end location on the lot of the
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION.
TOWN OF QUEENSE.re.
.5-- / -• 3,6 May 27, 1980 RECIEDY2
^:JE
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK MAY 3 U 9980
ANSWER ALL OF THE FOLLOWING.
The undersigned hereby applies for a permit to do the following work . `�1 1 2 {��
which will be done in accordance with the description, plans and -pecifi- . 1, 19. . 2I ! j3I4I5I6
cations, and such special conditions as may be indicated on the permit.
The owner of this property is:
James & Deborah Mason RD# 1 Assembly. Pt„, Lake George, . NY. . 12845
(NA 'E) IP 0 ADDRESS)
The person responsible for. supervision of the work insofar as the Building Code and the Zoning Ordinance apply is:
. . . . . .John, Nas.cn. . .P..0.. .Box. .86. .C1eve.rdale.,. NY. . 12.820
(NAME) IP 0 ACDRESSI
Name of Builder John Mason Add,.esS . P. O. Box 86 Cleverdale a NY
Name of Plumber John Mason AddressP. O. Box 86 Cleverdale, NY
Name of Mason. . . .Jo.hn. .Ma.son Address . P. O. Box .86 . C.leverdale,. NY . .
Lot Number Unit• Estimated value of proposed work S $ 000.00
Name of Village . . A$,5e.mkly .Pozz�.t
Name of Street Old Assembly Pt, Road Side of street: With O, east 0, south 0. west
El
Nearest Cross Street NYS Route 914 Distance fro' n thi'. -rocs street 2000 Pt
Property is north (3,south 0,east i i,west 0 from Cross Street
If on Corner, which corner, northeast 0, northwest ❑, southeast P couibwc t
(Designate by marking with an "X" in the correct Space.)
NATURE OF PROPOSED WORK OCCUPANCY
El Construction of a new building. Main Building
O Addition to a building. One family dwelling I�
❑ Alteration to a building. Two-family dwelling ❑
❑ Demolition of a building. . . -family apartment house ❑
Store building [�
-car attached garage L,
Other•
Accessory Building
❑ Other work. Describe:
e P K One-rat detached garage
Two-car detached garage • ❑
Private chicken house [I
Private storage building ❑
. (A) Lk (I) 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-
NO"RTN posed buildings,and the location of all existing buildings.
Show proposed building(s) in dotted line and existing
huilding(s) in solid line.
Size of property 97 ft. x . 375 ft.
Size and use of existing buildings, if any
24 x 70
to
# w Size of proposed building 12 ft.x . . . . .2k. . . ft.
Height (from grade to ridge) 25 ft.
Front yard 195 It.
Side yards 25 ft. and 35 ft.
Rear yard 110 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.►
Kind of construction: Wood frame, fire safe,etc.?. . . . . . . .wood ,fr.P.me, , . • , , . . . . . . . . . . . . . . . . . . . . . . . . . .
Will any second-hand lumber be used? no If so, for what)
cured concrete footin ,36" x 36"
Material of foundation walls p r gS T►�ickness
Depth of foundation walls below grade 3 Continuous foundation? no
Will there be a cellar? no l If so, material of cellar floor N/A.
Type of roof: Sloped or flat? N✓A Material of roof . . . N/A
Size,wood studs — "x — ",spacing — "o.c.,length — • ft.
Size, floor beams, 1st floor 2 "x 8 ", spacing lb "o.c.,span 12 ft.
Size, floor beams,2nd floor — "x — ", spacing — "o.c. span —
ft.
Size,ceiling beams — "x — ", spacing — "o.c., span — ft,
Site, roof rafters or beams — "x — ", spacing — "o.c.,span — ft.
Exterior finish With what material? —
Finish of interior walls. .N/A. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If garage is to be attached, ofA
Awhat material is wall between garage and main building to be constructed?
Is there to be an opening between garage and building? N/A
Kind of heating system N A. Oil burner or coal? N/A
Will a flue-lined chimney be provided? N/A Depth of chimney foundation below grade N/A
Height of chimney above roof. . . . . . .N/A. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Will there be a fireplace? No Depth of fireplace hearth N/A
Will a toilet be installed?.N9. . . . . . . . . . . . . . . . . . . . .'. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . .
Will a kitchen sink be installed and connected towater supply? N/A
Water supply (public water supply or pump) NIA
Distance of cesspool from any private well N/A. feet
Will drainage system be provided wit'.: required traps, cleanouts, and vents? N/A.
Town of Queensbury ( AFFIDAVIT
County of Warren
State of New York
I swear that to tr rr4 fof my know,ledge and belief the statements`contained in this application,together with the plans and specifications sub-
mitted, are a true and co... 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 work shall be complied with,whether specified or not,
and that such work is authorize: by the owner.
Sworn to before me this Signature - �'` /
/ �-�- OM(NE .OWNERS AGENT.ARCHITECT.CONTRACTOR
day of.....l.. - `'( i. 19(IP
NOTARY PUBLIC. WARREN COUNTY. N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
•
•
By
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