1986-152 BUILDING PERMIT
TOWN OF QUEENSBURY 86-152
No.
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Gary R. LaVoy
OWNER of property located at Fitzgerald Road and on Glen Lake Street, Road or Ave. ?�
in the Town of Queensbury,To 9 t or place a Demolition of dwelling
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
RD #1 Box 167
Glens Falls, New York
2. CONTRACTOR or BUILDERS Name
same
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3. CONTRACTOR or BUILDER'S Address N
at
same Pt'
4. ARCHITECTS Name
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5. ARCHITECTS Address N
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6. TYPE of Construction—(Please indicate by XI w
( )Wood Frame I I Masonry 1 1 Steel 1 1 -
7. PLANS and Specifications
demolition of 2 story franehouse 19'x25' plus 10'x10'
No. addition per application submitted.
m
8. Proposed Use
Demolition of dwelling
$ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES November 1 19 86
(If a longer period is efd an theheerbn ford to extension must be made to the Building and Zoning inspector of the m
town of Queensbury before expiration date.) Y
Y
Dated at the Town of Queensbury this 23rd Day of April 1986 w
SIGNED BY -Mad a. taez. for the Town of Queensbury
Building and Zoning Inspector e
c--/t / TO BE COMPLETED BY BLDG. DEPT.
• ✓o1n o/ Queenatui Application Ho.
Permit Issued 19
BUILDING and ZONING DEPARTMENT Permit Expires 19
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation TOWN CF 4'JiENS^U.^"
Queensbury, New York 12801 variance No. R 12 (N f,' d (� I.'. If
Site Plan Review No. LS l'J IS 0 J L_, u
XV — 1 — 9 Approved by: .APR 2
APPLICATION FOR aP 'rb
A.M. P.M.
71819p4.411121314019
BUILDING AND ZONING PERMIT
* * * * * * ► * * * * * * * * * ► * * * * * * * * * * Y * * * * * ► * * * ►.,►
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/l on the Permit. )
The owner of this property is:.p Lj A Ry tR L/} I/O1 / r'
P.O. Address tell / BOX /r7 i j /lll I F4 6 Tel.,f3' 24,1/
Property Location: r/ 2✓f i1N4. L Tax Map No. 4///1 / 9
Street n�ber or building lot number
Subdivision name (if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
Name (/h/ , I/[J G V] 713 - 91. 3 /
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,
Addition 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
* street and number or lot number and indicate
*FOR DEMOLITION PERMIT, STATE SIZE AND * whether interior or corner lot. Show location
LOWION Op/ STRUCTURES AFFECTED. of water supply and location and configuration
JJPIao/� j (M A- o2 Sint-9 * of septic disposal area.
f nMata Af bkj.` / 1, g r7( ZS/ * COMPLETE INFORMATION REQUIRED BELOW.
�1/G.1// 5 X� Y /o 4���,• * Size of property ft X ft.
fa I 'e- * Existing building(s) Size ft X ft.
*
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) * Front yard ft Rear yard ft
Height (grade to ridge) ft. * 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 * Multiple dwelling / Number of units
* Permanent occupancy
Will a wood stove be installed? —
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 $ *
INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
i9 ., IPA 4/06 JPm2-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 Thickness
Depth of foundation below grade (to bottom of footing)
Will there be a cellar? 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
Size, wood studs "X " spacing "o.c. length 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 "X " spacing 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
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 AFFIDAVI T STATE OF NEW YORK
County o£ 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 Le a
Owner, or's agent,arc it ct,contractor
day of 44444ai, 19
Notary Public, Warren County, N.Y.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
SPECIAL CONDITIONS OF THE PERMIT:
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