1986-143 BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-143
WARREN COUNTY, NEW YORK
30� aI—t411cv
PERMISSION is hereby granted to Jack VanLeeuwen
OWNER of property located at Lot 96 Syc amore Drive Street,Road or Ave.
in the Town of Queensbury,To Construct or place a Addition to dwelling (deck/porch) ro
m
at the above location in accordance to application together with plot plans and other information hereto filed and E
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is 8 Sycamore Drive
Glens Falls, New York
2. CONTRACTOR or BUILDER'S Name
French Mt.Enterprises, Inc. rt
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o.
3. CONTRACTOR or BUILDERS Address
RR #1
Lake George, New York
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4. ARCHITECT'S Name
C
M
co
6. ARCHITECTS Address
6. TYPE of Construction—(Please indicate by X)
I N Wood Frame 1 )Masonry I )Steel 1 1
T. PLANS and Specifications .-. a
No. 12'x12' screened porch and 10'x12' deck per plot, specifications N:
and application submitted. x r.
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8. Proposed Use
One—Family Dwelling (deck/porch) p' o
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$ 10.00 PERMIT FEE PAID—THIS PERMIT EXPIRES November 1 1986 w
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the n
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 22nd Day of April 19 86—
SIGNED BY Th 4L a. p for the Town of Queensbury
Building and Zoning Inspector
TO BE COMPLETED BY BLDG. DEPT.
•
Cc7 Application No.
-loamof Queett.fbury Permit Issued 19
BUILDING and ZONING DEPARTMENT Permit Expires 19 TOWN C.= ..L rr\g^
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation •- 20 ('ll 14 fN fi u `.;'' I (I
Oueensbury, New York 12801 Variance No. I[ lS C7 6 u 1 i
Site Plan Review No. APR,(. 161986 ��(l�
�D - FS �(/ Approved by: A.M. al1/6 'ter/..oc
O P.M.
APPLICATION FOR 71819041411213141516
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.
The owner of this property is: JAzk VAV 1PI°11tkOeN/
P.O. Address fA 5yc ,4 n a< Dpt zest y? Tel.
Property Location: Sy r A,.vl,ry(< )'la, Tax Map No. 70 / h / 9 .
Sheet number or building lot number /
Subdivision name (if applicable) "(..It. Aves A PvF.4t56'atfr
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
rolegYC, nnr", ,%f /M,- 4-19r / G ,/ k '-s3o1
Name P.O. Address Tel. No.
Name of builder Address 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,
vl-ddition to a building * drawn reasonably to scale and attached hereto,
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
&Wind tp ARCH - Dvrk * 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 ) 30 ft X 110 ft.
* Existing building(s) Size ft X ft.
*
PROPOSED BUILDING AND USE:
oo y Iz v`c4 " Existing building(s) Use
*
Size of new structure [4 ft X ft
Foundation-pier/slab/craw parti /full * Proposed building, distance from property line
*
(circle one) * Front yard ft Rear yard ft
No. of stories (habitable space) f * Side yards ft and ft
Height (grade to ridge) ft. * If on corner, setback from side street ft
If residential, no. of families
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 * Multiple 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 *
Cd Cottage Other * ACCESSORY BUILDING-
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 $ *
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. Leann I"R/Ftn Y
Will any second-hand or ungraded lumber be used? If so, for what? NO
Foundation wall material row 86rt 14.44. Thickness Pt'
Depth of foundation below grade (to bottom of footing)
will there be a cellar? A/J Heated or unheated? Floor sq. footage 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 - sloped/flat/shed/other Material of roof $Wygtfj
Size, wood studs y "X t., "spacing y "o.c. length g ft.
Joists(floor beams) 1st. floor "X " spacing "o.c. span ft.
Joists (floor beams) 2nd. floor 2 "X F' " spacing / .., "o.c. span /7 ft.
Overlays(ceiling beams) "X y " spacing yy "o.c. span ,I_ ft.
Roof rafters ,g_ "X $ spacing y(m o.c. span /2 ft.
Roof trusses(pre-engineered) spacing "o.c. span ft.
Exterior wall finish Sr eetni Of what material?
Interior wall finish t.
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
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.
SWORN TO BEFORE ME THIS Signature q —.,doc-
er, owner's agent,arcnicect,contractor
day of 19
Notary Public, Warren County, N.Y.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
SPECIAL CONDITIONS OF THE PERMIT:
By
TOWN OF QUEENSBURY
Building Department
`/ /
inspenoe` Due a� 1.16/ko
Name � .g�& 6
Location S'Y! efitiORE La 9 .
Permit No. a Weather
F1 /.93
Dt CKlisee cncO 15Oie.CK Remarks
Excavation
Footing Forms t�Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing .
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railings ///k\::
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation
Walls
(Ceiling
ing��
Buil in Inspector
REMARKS
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