1986-163 BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-163
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Lawrence Gottsche
OWNER of property located at Rockwell Road Street,Road or Ave. y
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Alteration to dwelling (roof) -
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in the Town of Queensbury,To Construct or place a at the above location in accordance to application together with plot plans and other information hereto filed and ai
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approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. co
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1. OWNERS Address is RD #1 Box 262 rt
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Glens Falls, New York o
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2. CONTRACTOR or BUILDERS Name
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3. CONTRACTOR or BUILDERS Address
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by XI
11 Wood Frame I )Masonry ( )Steel 1 1
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7. PLANS and Specifications rr
change roof pitch per sketch, specifications and H
No. application submitted. Ai
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8. Proposed Use rt
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One—Family Dwelling (roof pitch changed) o,
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$ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES November
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the H
town of Queensbury before the expiration date.) O
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Dated at the Town of Queensbury this 23rd Day of April 19 86
SIGNED BY Ufor the Town of Queensbury
Building erg Zoning Inspector
TO BE COMPLETED BY BLDG. DEPT.
Cc77 // Application No.
down of Queendbury Permit Issued 19 TOWN C-F 'H -NFr U,'••
BUILDING and ZONING DEPARTMENT Permit Expires 19 ,;,, 1
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation U L V ii
Queensbury, New York 12801. _,_ „IXeriance No. t'
Site Plan Review No. ttNR 22 198UO6e Lti
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Approved by: A.M. ID fl" Me".
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APPLICATION FOR 7I8I9R t I2 I3 I4, I5I6
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BUILDING AND ZONING PERMIT
* * * * * * * * * * * * * * * * * * * * * * * * * * * x * * * * w ♦ * w * • ;•
A PERMIT tyfY*S,Ueg W S& aD BEFORE BEGINNING CON�CTION. ANSWER ALL OF THE FOLLOWING.
The undersigned hereby applies for a Building Perms 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:
A�/ �r..re-+� *de Co
P.O. Address Air f( 2- /rb r f ti7 AK Tel. elyg— f -°
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Property Location: 11 /4r`.*.LJa Tax Map No. 511/ 3/ /S
Street number or building lot number
Subdivision name (if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK A` ARDS BUILDING CODES IS:
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Naer* 4-1* At 4- v +-✓
F.O. Address Tel. No.
Name of builder Address Tel.
Name of plumber Address Tel.
Name of mason Address Tel.
NATURE OF PROPOSED \.ARK: * ZONING INFORMATICN:
_Construction of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED,
Addition to a building * drawn reasonably to scale and ar::ached 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) CAlp/4_ note * set-back dimensions from property lines. Give
fit 4 * street and number or lot number and indicate
FO/D OLIT ION 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 ft X ft.
* 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)
* Front yard ft Rear yard ft
No. of stories (habitable space)
* 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 *
* PRIMARY BUILDING -
No. of bathrooms 'One family dwelling
Primary heating system
* Two family dwelling
Type of fuel % Multiple dwelling / Number of units
No. of fireplaces to be installed Permanent occupancy
Will a wood stove be installed? * Transient occupancy
Central Air conditioning?
* _Business
BUILDING STYLE, PRIMARY STRUCTURE * _Industrial
* Other
Ranch Contemporary Log cabin * If addition, what will use be?
Raised ranch Mansion Duplex
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/o ar/ two car/ car
* * * * * * * * * * * * * * * * * * _Private storage building
ESTIMATED MARKET VALUE OF Other POOL chi-0 /At- OG-
CONSTRUCTION _.$ COO *
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. il...1 40.,._-
Will any second-hand or ungraded lumber be used? If so, for what? kj
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 4s
* /'�'Material of roof JL/L a
Size, wood studs - "X 4 " spacing o.c. length -Y/1h 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 st- "X tpacipg o.c. span // ft. AI .N4r,.."f
Roof trusses(pre-engineered) spabi "o. spaif ,
Exterior wall finish - Of what texial?,
khtetiot'wall finish >• . 1 ..I i „\
If a garage is to be attached, describe mal.$, tp ,lie\usec&b* FIxpEPARATION:
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? Al{ Height above roof ft.
Depth of chimney foundation below grade ft. •
a 9\\ �,
Depth of fireplace hearth ft. in. a ' r `\ •
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
County of Warren AFFIDAVIT 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. '+'�"
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SWORN TO BEFORE ME THIS Signature
Owner, owner's agent,arcnirect,contractor
day of 19
Notary Public, Warren County, N.Y.
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SPECIAL CONDITIONS OF THE PERMIT:
By
I G a //-4 /O/-l7 /XG 7 : 3c 0rn
-lawn Of Queensbury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road. R.D. 1 Box 98
Oueensbury, New York 12801
BUILDING INSPECTOOR'S REPORT, R
NAME LQ.W re,-ce l9 d S �-^ e
LOCATION (90uA c/J.2G( (?q1.
Date /0/2 k/ pee Permit No._FLb—/� 3
x x * * * * • * * fix_ *
APPROVED * * * *
YES
NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
'Framing ✓
Roofing AJg
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs 6 Railings •
Cellar Drain Tile
Concrete Floors
Plbg. reproof MIMS
Gar. Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION:
Foundation
Floors
Wails
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-
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Building Inspector
6/86 and-vl
TOWN OF QUEENSBURY
Building Department
Inepemen Report, Date /tO/n
Name Q T CF 4 4G
Pent No.Location ?L2% 3 Weather ,
Remarks
ExcaVatron
Footing Forms
Footin & Piers
Foundation
Cement Coat
Water roofin
Sackfill
Final Surve
Fri
Shear V J'
Roof Felt
Roofin•
Sidi •
Mason Veneer
Rcu•h Pl .. .
Relief Valves
Wall Board
Ext. Porches MIL
Finished Floor
Interior Trim NSF
& Railin•s
Cellar Dr. Tile =
Concrete Floors
P1.. . Fixtures IMAM
Gar. Fireeroofin•
Door Closers
Chimne
Water Meter Inst. A
Seetic A••roval
Floors
Foundation
Insulation Walls
ceili za
2' :_
g ilding Inspector
REMARKS
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