1986-184 BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-184
/ /'e t Lk_�. WARREN COUNTY, NEW YORK
Harold A. Rathbun, Jr.
PERMISSION is hereby granted to
OWNER of property located at Fitzgerald Road, Glen Lake Street,Road or Ave.
Dock/Sundeck
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
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is RR #1 Box 191C
West Coxsackie, NY 12192
2. CONTRACTOR or BUILDERS Name
Percy Denton
3. CONTRACTOR or BUILDER'S Address
Star Route
Glens Falls, N. Y. "1
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4. ARCHITECT'S Name w
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5. ARCHITECT'S Address
w
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6. TYPE of Construction—Please indicate by XI
1 I Wood Frame I I Masonry ( 1 Steel ( 10
7. PLANS and Specifications
2 docks 5rx24r each with cover to create a sundeck per
No.
O plot plan and application submitted.
B. Proposed Use
Dock/Sundeck
1 19 86
$ 15.00 PERMIT FEE PAID—THIS PERMIT EXPIRES Dec.
(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.)
Dated at the Town of Queensbury this 5th Day of MY 19 86
'�
SIGNED BY /2 f efr P
I for the Town of Queensbury
Building and Zoning Inspector p
. TO BE COMPLETED BY BLDG. DEPT.
OWN OF QUEENSEU""
C7 Application No. p II�' fir-\
U awn of Qieenihury Permit Issued 19 G S U V LS
BUILDING and ZONING DEPARTMENT Permit Expires 19
Bay and Haviland Road, R.O. 1 BOx 98 Zoning Designation 5 iT'3O MAY , 1986
Queensbury, New York 12801 Variance No. 'WAAAA (S a` (- ee. Pry{
Site Plan Review No. p/R 7I8t9 1I2I3I4I6i6
h7V— /—/- / r �. Z Approved by: i
APPLICATION FOR
BUILDING AND ZONING PERMIT i
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *::'*
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: 4/7L- %g/ Jlf7H ///' _T`
P.O. Address
1ft 1 SSo/ 19 j C- v�, CO Sect(/s / "iv - Iat,t4a_ Tel.7r 9OOV
7 fa-Ts 72-
Property Location: r IrtGtg,4Ln 2o- Gin/ L./int Tax Map No. / /
Street numberr or building lot number
Subdivision name (if applicable) II
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
Peic( DEA/Toil.
Name c �/ G,.�. `'�P.O. Address �.�y. Tel. No.
Name of builder 180.( 061//Q/y Address gf/9// Li - 6745A5 (444 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) ydC(( Ca) , * set-back dimensions from property lines. Give
SU&p r * street and number or lot number and indicate
* whether interior or corner lot. Show location
FOR DEMOLITION PERMIT, STATE SIZE AND * of water supply and location and configuration
LOCATION OF STRUCTURES AFFECTED. * 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 -od 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 VTLUE 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. woei Citq(j
Will any second-hand or ungraded lumber be used? If so, for what? Acb
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.
or
Joists (floor beams) 2nd. floor "X " spacing "o.c. an ft.
Overlays(ceiling beams) "X " spa i g "o.c. span i
Roof rafters "X " spacing o. . span ft. IP
Roof trusses(pre-engineered) spaci .c. span ft.
Exterior wall finish Of what material? I
Interior wall finish
If a garage is to be atta h cribe mater al o be sr FIRE SEPARATION:
Is there to be an opening bet garage and dwe ing If so will a Fire-rated
door, enclosure, and self-closing device be p 'dell,
Will a flue-lined chimney be installed? ei. t 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
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. I/�9 j
SWORN TO BEFORE ME THIS Signature I`J a e ' "k ref�'I�k'1iita -
Owner, 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
Inspectors Report Date s/ /A
Name �4�fflTy/✓
' Permit No. ••.•a_ P WeatAer�—
Permit Nu�� --
Remarks
1>®c,K sureaE
Excwda ion
Footin• Forms
Footin• S Piers
Foundation
Cement Coat
Water•roofin•
Backfill
Final Surve �_
nankin.
Shea thin.
•
Roof Felt
Roofin•
Sidin•
• Hasonr Veneer
Roush Pi' .
Relief Valves
Wall Board
Ext. Porches SOW
Floor _-
inStairs
Trim MEWS
b Railin•s
Cellar Dr. Tile
Concrete Floors ��
Pl.. . Fixtures
Gar. Fire•roofin•
Door Closers
Chianie
Water Meter Inst.
Septic A••roval
Floors
Foundation
Insulation Walls
Ceilin
Buildin Inspector
REMARKS
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