Loading...
87-848 CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date 19 _ This is to certify that work requested to be done as shown by Permit No. 87-848 has been completed. This structure may be occupied as a One Family Dwelling Location Hillman Rd. , Cleverdale Dr. & Douglas Provost Owner By Order Town Board TOWN OF QUEENSBURY Building & Zoning Inspector BUILDING PERMIT TOWN OF QUEENSBURY No. 87-848 z WARREN COUNTY, NEW YORK o PERMISSION is hereby granted to Dr. and Douglas Provost OWNER of property located at Hillman Rd. Cleverdale Street, Road or Ave. in the Town of Queensbury,To Construct or place a Alteration to one family 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. 1. OWNER'S Address is 7 Horicon Ave Glens Falls, N. Y. 12801 w 2. CONTRACTOR or BUILDER'S Name John Mason ty 0 Crq 3. CONTRACTOR or BUILDER'S Addresscn a' P.O. Box 86 Cleverdale, N.Y. o 0 4. ARCHITECT'S Name m rt 5. ARCHITECT'S Address I—• I� 6. TYPE of Construction—(Please indicate by X) 0 ( )Wood Frame ( ) Masonry ( )Steel ( ) a. 7. PLANS and Specifications I� No. 24' x 32' as per plot plan, specifications and application. t C 0 n n. 8. Proposed Use Alteration to inside of one family dwelling (converting attic into • � loft and bath) $5.00 C/O $ 40.00 PERMIT FEE PAID —THIS PERMIT EXPIRES July 1, 1g 88 n (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.) N• Dated at the Town of Queensbury this 9th Day of December 19 87 0 SIGNED BY Y� / Gt-C�c Z2, /C%�%� o for the Town of Queensb ry Building and Zoning Inspector /L,re• N TO BE COMPLETED BY BLDG. DEFT. ' . • �] / Application No. �-.--.- otun o Queeniur y Permit Issued 19 -� BUILDING and ZONING DEPARTMENT Permit Expires 19 J LJ \P ``L • Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation X/ "(�Queensbury, New York 12801 ' Variance No. f✓l DEG 9198? Site Plan Review No. K/A /. - 1-I D Approved by: ZI,'1LCAiNG c`k CODE DEP 1 APPLICATION FOR - ef, 5©d EUILDING AND' ZONING PERMIT i : . *. * * . * * * *1 * * * * * it: * * * * '* * * .* *. * * * * * if. * * * * 4* * * * * * .* 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: Dr. - and Douglas Provost P.O. Address 7 Horicon Avenue. Glens. Falls , N.Y. 12801 Tel. 793-8220 - Property Location: Hillman Road Cleverda.le Tax Map No. 11 / 1/• 1 . 10 . Street number or building .lot number • Subdivision name (if applicable) Takundewide THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS: . John A. Mason . P.O. Box 86 . Cleverdale, NY 656-9956 Name • P.O. Address Tel. No. . Name of builder Sunsoval, Inc Address P.O. Box 86 CleverdalTel. .656-9956 Name of plumber ' H Address H - 11 Tel. Name of mason • Address - •. H Tel. ii _ - - NATURE OFPROPOSED WDRK: * 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, X 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 ' * 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. - * Size of property See Enclodx ft. • . * Existing building(s) Size '24 ft X 32 ft. PROPOSED BUILDING AND USE: * Existing building(s) Use S .F.R.' ' Size of new structure 24 ft:X 32ft * . 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) 2 * Side yards ft and ft Height (grade to ridge) Y22 ft. * If on corner, setback from side street ft If residential, no. of families 1- No. of rooms(excluding baths) ' ' ' 7 - - * OCCUPANCY INFORMATION * No. of bedrooms • ' ' 3 * PRIMARY BUILDING - No. of bathrooms • 2 *' X One family dwelling Primary heating system' electric Two family dwelling Type of fuel - . . No. of fireplaces to be installed - - *_ Multiple dwelling / Number of units Will a wood stove be installed? - * Permanent occupancy Central Air..conditioning? no-: * X Transient occupancy * Business • BUILDING STYLE, PRIMARY STRUCTURE - . Industrial -Ranch - Contemporary Log cabin *-7-other ' Raised ranch -Mansion Duplex * If addition, what will use be. same Split level . Old style . Bungalow * Cape Cod (Cottages 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 $..2Q..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 - BUILDING SPECIFICATIONS: - Type of .construction, wood- frame, fire safe,etc. wood frame Will any second-hand or ungraded lumber be used? If so, for what? No • Foundation wall material cement blocks Thickness 10" Depth of foundation below grade (to bottom of footing) 4 ' 0" Will there be a cellar? No Heated or unheated? - Floor sq. footage ' - sq'ft Will there be .a basement? No 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 asphalt shingles Size, wood studs 2 "X 4 " spacing 16 "o.c. length 8 ft. Joists(floor beams) 1st. floor 2 "X 10" spacing 16 "o.c. span 12 ft. Joists (floor beams) 2nd. floor 2 "X 10" spacing .16 "o.c. span 12 ft. Overlays(ceiling beams) 2 'X 8 " spacing 16 "o.c. span 12 ft. Roof rafters 2 "X 8 " spacing 16 o.c. span 12 ft- Roof trusses(pre-engineered) spacing - "o.c. span - ft. Exterior wall finish siding Of what material? vinyl Interior wall finish sheetrock 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? No If so will a Fire-rated door, enclosure, and self-closing device be •provided?Will a flue-lined chimney be installed? yes . Height above roof 2 ft. 6" Depth of chimney foundation below grade - ft. Depth of fireplace hearth - ft. - in. . Water supply - Municipal or private well Lake George 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. . / �s SWORN TO BEFORE ME THIS . " Signature - •,,,� - .,,' owner's agent,arcnitect,contractor ( day of DCC 19 ' 7 Notary Public, Warren County, N.Y. . SPECIAL CONDITIONS OF THE PERMIT: • • • • By