1986-366 BUILDING PERMIT
TOWN OF - QUEENSBURY No 86-366
)1 WARREN COUNTY, NEW PORK
PERMISSION is hereby granted to Preston Thomas
OWNER of property located at 111 Country Club Road Street, Road or Ave.
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in the Town of Queensbury,To Construct or place a Alteration to dwelling (replace foundation)
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.
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1. OWNER'S Address is 111 Country Club Road o
Glens Falls, New York
2. CONTRACTOR or BUILDER'S Name
same
3. CONTRACTOR or BUILDER'S Address
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same
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4. ARCHITECT'S Name rt
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5. ARCHITECT'S Address
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6. TYPE of Construction— (Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
replace portion of foundation wall per application submitted.
No.
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8. Proposed Use
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Dwelling (replace foundation wall)
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$ 10.00 PERMIT FEE PAID—THIS PERMIT EXPIRES January 1 19 87
(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.)
GQ
Dated at the Town of Queensbury this 27th Day of June 19 86 0
i a SIGNED BY , �'E4�Z7i for the Town of Queensbury w
Building and Zoning Inspecto di rt
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TO BE COMPLETED BY BLDG. DEPT.
Application No.
own of Queen ilur, Permit Issued 19 -,: E fs, '
BUILDING and ZONING DEPARTMENT Permit Expires 19 ,. i, ,��,,�a IT
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation ftjl
Queensbury, New York 12801 Variance No. '
Site Plan view No J U 1' .s 6 16
9�
&U - 7— /7 Approved A.I. i1 1� ��
4It
APPLICATION FOR
I/OI6/0
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: fifrZeS 10k) --TX0 Al 4._.1
P.O. Address //( Co(.4iy �� (7./c 4 X . Tel. S-2Ca
Property Location: //I Co u , ]`,&L Ou�l X41 . Tax Map No. / /
Street number off 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(), 'jot /1 oI 1l9f Address/7/ CK.,fo Tel. 2 9 2_r"Zm O
Name of plumber Address Tel.
Name of mason plumber/.1
r t Hinl ci9(4 c/ 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,
yC 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
* whether interior or corner lot. Show location
b l�. a _ foal n' r ---,-"' ,-,
TL_ '� �J ,�'�,�.,w D.
of water supply and location and configuration
. - * of septic disposal area.
J..,L y2L (-A-c - gs) YL`r-i q .t,JQ I— * COMPLETE INFORMATION REQUIRED BELOW.
FloLIA/ 0/1'r( CDA-) Lt)A-t C--r * 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 * O uU:(.;C_L.( ,U (o
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 * amity dwelling
Type of fuel * Two family dwelling
No. of fireplaces to be installed * Multiple dwelling / Number of units
Will a wood stove be installed? * ' anent 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 * ' -;.-a:- - -•. a two car/ car
( CIRCLE ONE PLEASE ) * cached garage/.�c�-�,°' . two car/ car
* * * * * * * * * * * * * * * * * * " "Private storage building
ESTIMATED MARKET VALUE OF * Other
CONSTRUCTION LE o a O *$
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-s�fe,t.
Will any second-hand or ungra�i ber be used? If so, for/wh tt-i
Foundation wall material CO AJC- '(j Lo {C S Thickness / Z :
Depth of foundation below grade (to bottom of footing) +-f 7----
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 " spacin "o.c. span ft.
Joists (floor beams) 2nd. floor "X " sp ng "o.c. span
Overlays(ceiling beams) "X " spacing "o.c. span ft.
.Roof rafters "X " spacing o. . span ft.
Roof trusses(pre-engineered) spacing "o.c. span ft.
Exterior wall finish Of what materia .
Interior wall finish
If a garage is to be attached; describe materials o be used for FIRE SEPARATION:
Is there to be an ope.ing between garage an'dwelling? If so will a Fire-rated
door, enclosure, a d self-closing devicerbee provided?
Will a flue-lin chimney be installesl� Height above roof ft.
Depth of chi ey foundation below.__: de ft.
Depth of f' eplace hearth ft in.
Water ly - Municipal offr vate well
SEPTI SYSTEM Distance m 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.
SWORN TO BEFORE ME THIS Signature
Owner, owner's agent,arcnitect,contractor
day of 4 ti/y e___ 19 g1,
Notary Public, Warren County, N.Y.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
SPECIAL CONDITIONS OF THE PERMIT:
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PALL INs (6 r/-s Pt� .boo&,
By
Jown of Quecniurty
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME V i G rgO r1+. a _)
LOCATION // ( Oahrisy Ciu •
Date '7/ '( / _ Permit No. b �{9 —3(('
* * * * * *. * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
v'Backfill (r'
Framing
Roofing
Siding
Masonry Venee
Rough Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings •
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures /
Gar.. Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
Final Building Survey
Next scheduled Inspection(call when ready)
Remarks- -
i/(1), /,11,4
Building Inspecto
6/86 and-vl
Jown of Queeni ur/
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98 •
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
t//(y Jh-0- (>,,�
LOCATION (6,4 Ariry ?, /
14 /) la.
Date / g(v Permit No. 3.(0 -3VD
* * * * *. * * * * * * * * * * * * * * * * *
✓ = APPROVED - YE / NO
r Footing/Pier Forms 0
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures
Gar.. Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
Final Building Survey
•
Next scheduled Inspection(call when ready)
Remarks- -
1/(mA, ,
Building Inspector
6/86 and-vl