87-154 BUILDING PERMIT
TOWN OF QUEENSBURY No 87-154
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Jeffrey and Joan Lee
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OWNER of property located at Corner Leo St. and Sherman Ave. Street, Road or Ave. �
Alt. to dwelling (convert attach d ara e t p
in the Town of Queensbury,To Construct or place a f,vrngrPa� P.
at the above location in accordance to application together with-plot plans and other information hereto filed and C-,
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. a03
1. OWNER'S Address is Box 127 Sherman Ave. rD
Queensbury, New York m
2. CONTRACTOR or BUI LDER'S Name
Martin Mosher
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3. CONTRACTOR or BUILDER'S Address
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26 Sugar Pine Lane
Queensbury, NY 12801 (D
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4. ARCHITECT'S Name rt
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5. ARCHITECT'S Address M
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6. TYPE of Construction—(Please indicate by X) C
( )Wood Frame ( ) Masonry 1 )Steel ( )
7. PLANS and Specifications
No. convert attached garage to living area per specifications and
application submitted. o
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8. Proposed Use
One—Family dwelling (attached garage converted to living area) ,ter o
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$ 10.00 PERMIT FEE PAID—THIS PERMIT EXPIRES November 1 19 87 p
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(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the Qq
town of Queensbury before the expiration date.)
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Dated at the Town of Queensbury this 14th Day of April 19 87 rD
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SIGNED BY for the Town of Queensbury N
Building and Zoning Inspector
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t TO BE COMPLETED BY BLDG. DEPT. 4
Application No. 1
own o QueenAury Permit Issued 19 -FOWN
OF QDEL.NSGijF„
BUILDING and ZONING DEPARTMENT Permit Expires 19
Bay and Haviland Road, R.D. 1 Box 98 zoning Designation
Queensbury, New York 12801 Variance No. APR 141987
� Site Plan view No. 1
b���C / k6 / S 6 Approve by: BUILDING & CODE DEPT.
APPLICATION FOR /f1 d r
V �&D
BUILDING AND ZONING PERMIT
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.
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The owner of this property is: �_ � C 2 f��C` J(g(�� A—C
P.O. Address rJ(�X ��C 1 c1��Ch1���\� ���t�15 M s } U `I WR)l Tel.
Property Location: l .(xNu Q,�-, `_u> S' - IAN8_ ' erffigf� A4� Tax Map NO.—/ /
Street number or building lot number
Subdivision name (if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
Name P.O. Address Tel. No.
Name of builder ���a i� �, b�,��( Address (p 1�)0(���i�(�,_ Tel. �-
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,
(nno, chime to exter!_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
F whether interior or corner lot. Show location ,,
} �,� of water supply and location and configuration
� '� of septic disposal area.
g�� MIA1`
l COMPLETE INFORMATION REQUIRED BELOW.
Size of property Q ft X ft.
Existing building(s) Size ft X
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)
No. of stories (habitable space) x Front yard ft Rear yard ft
Height (grade to ridge) ft. x Side yards ' * * ' ' ' ft and ft
If residential, no. of families If on corner, setback from side street ft
No. of rooms(excluding baths) OCCUPANCY INFORMATION
No. of bedrooms
No, of bathrooms PRIMARY BUILDING -
Primary heating system *., One family dwelling
Type of fuel Two family dwelling
No. of fireplaces to be installed
xlultiple 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 $---- 50(01
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.
Will any second-hand or ungraded lumber be used? If so, for what?
Foundation wall material CemeN�Nbc_�_ Thickness
Depth of foundation below grade (to bottom of footing) jt
Will there be a cellar?moo Heated or unheated? (j Floor sq. footage C) 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 - slo ed/flat/shed/other . � Material,-of roof
Size, wood studs"X spacing_ "o.c. length W 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 �;sp _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 4
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 bury
County off Warren A F F 'I D A V I T STATE OF NEW YORK
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.
SWORN TO EFORE HIS Signature --�L� --f -
Owner, n r s agent,archirect,contractor
day o 19
Notary P blic, Warre County, N.Y.
SPE IAL CONDITIONS OF THE PERMIT:
By
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E TOWN OF QUEENSBURY
WARREN COUNTY , NEW YORK
Application for : BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK
STATE ENERGY CONSERVATION CODE
A permit must be obtained before beginning work.
ANSWER ALL of the following:
1. Gross floor area
2 . Type of heat ('C��le-
3 . Is the building mechanically cooled?
4 . Percentage of area of windows and doors
A. Over 16% Only
1 . Uo value of gross area of walls , roof/ceiling and. floors
exposed ,to ambient conditions
2 . Floor ovexx,,heated spaces YES NO
a. Are foundaty` walls insulated? YES. NO
1. If YES , what- is,,.the R value?
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3 . Slab on grade ICE'S NO
a. If YES , what is the R value of insulation around
perime:�-e`r of floor?
4 . Is ba-Bement heated? YES NO
a.. R value of insulation
Type of insulation
B. Under 16% Only
1 . R value of roof and floors exposed to ambient conditions_
2 . R value of exterior walls 3'lo"
3 . 1R value of glazed area
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X 4 . R value of doors I �nAn1 11�5U� ��C� '�• . �
5 . R value of floors over unheated spaces
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;� 6 . R value of slab edge insulation - unheated slab- ) l i�
7 . R value of slab insulation - heated slab
9 R value of heated basement/cellar walls (below q e)
10 . Type of insulation Uiei ' C N I
C. Controls
1 . Thermostat maximum heat setting
D. Duct Systems
1 . Is duct system installed in unheated spaces? YES NO
a. If YES , R value of duct installation
b. R value of duct in other areas
E . Piping Insulation
1 . Size of hot water or cooling carrying .agent pipe
2 . R value of pipe insulation
F. Service Water Heating
1 . Performance efficiency
2 . Temperature control setting maximum
G. For Swimming Pool Only
1 . Maximum heating
Telephone No. C� I �(JC //Uy S
(appli4cif L ' s signature)
BUILDING DEPT.COPY OF APPLICATION FORM 46-EL,NEW YORK BOARD OF FIRE UNDERWRITERS.
FILE THIS COPY WITH BUILDING DEPT.WHEN REQUIRED.
TEMP.tk DATE _.
CITY OR j ``y l
VILLAGE t-_, _f'1 1 t ji1 t -� TOWNSHIP ',�N,�l;'� ,,1-?E ,j COUNTY
STREET AND NO.OR f {
ROAD AND POLE NO. �P_ POLE NO.
BETWEEN WHAT TWO
CROSSSTREETSIS
PREMISES LOCAT -ED? 1-� -y���t t-,tJ L :i �� SECTION BLOCK LOT
OCCUPANT'S -'r BUILDING
NAME _`i� f C'1 ','j' 6 —Tu Ib' "-C�SY OCCUPANCY
OWNER'S NAME
AND ADDRESS 1:• m I jF �'r (x j„I i TEL #;
��; '�V hill,{ �i�.-1' t\1 i-.�:i�- s''11.-1 1 '•11y.Jrl1i'6'� f-�Fi ,�- �, ( 1 14 ,��1= t /CURRENT BY
>,� •.r �;!, ? i. i f•'f 1\ FROM THEIR' <=-
f %- %r v OFFICE
BUILDING �/ WORK /� DEFECTS
IS NEW❑ OLD L� IS NEW El ADDITIONAL LJI' REMOVED ❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETS Lamp RFeceptacles MOTORS HEATERS ixtures BRANCH CIRCUITS OFFICE USE
Lou- ONLY
tion
Ceiling Side Attach't Switch Pendant Bracket No. Type Each No. E;d No. G`"'r'' INSPECTION
Wall Recep'ls Gauge
Out-
side
Sub-
base
Base-
ment
r
1st FL
2nd FI.
3rd Fl.
REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: DO NOT USE THIS SPACE.
This application is intended to cover the above-listed equipment to be inspected but if at time of inspection there is found additional equipment not above listed,
you are authorized to make the inspection and adjust the fee to cover the additional equipment,as provided by the applicant.
SIZE OF ELECTRIC SIGN TOTAL
MAINS FEEDERS LAMPS WATTS
CHARACTER EXPOSED GAS TUBE SIGN
OF WORK CONCEALED TRANSFORMERS OF VA
WORK TO BE (NUMBER) (CAPACITY)
STARTED COMPLETED SIZE OF SIGN
SERVICE OVERHEAD UNDERGROUND MAKER
ENTERS
BUILDING OF SIGN
INSPECT ON REQUESTED
ON OR AS NEAR AS
POSSIBLE NEW OLD
AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES DATE OF
MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. APPLICATION
PRINT NAME ANQ ADDRESS � 1
NAME OF ��''i .p �(SIGNATURE
APPLICANT OF APPLICANT
i-1-•• f f�/ -'� t:•- j��{ f !t J' r� I !4�' t�t'•� _ f L�i
STREET ADDRESS + )/x l ! —���1 j��t{�y `J�', \3��d '� 1�� !M•� TELEPHONE#
�t �—.
CITY OR '•--�-1� 1'S�Vj`� ! ZIP LICENSE NO.
POST OFFICE L t� t- ..,! CODE WHEN APPLICABLE
dr, F1_ (RFV I/RR{ A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING