1987-032 BUILDING PERMIT
TOWN OF +QUEENSBURY No. 87_32
WARREN COUNTY NEW YOR K
PERMISSION is hereby ran to Dick and Helen Cutting
qg
OWN E R of property located
Street, Road or Ave,
d
in the Town of Queensbury, To Construct or place a Dock FA'
at the above location in accordance to application together with plot plans and other information hereto filed and p,
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
ca.
EARCHITECT'S
ress is
RD #1 Box 283
Queensbury , New York 12801 p
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or BUILDER 'S Name ry.
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or BUILDER S Address
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Adtlress W
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6. TYPE of Construction — (Please indicate by X)
( ) Wood Frame I ) Masonry { ) Steel [ I
7_ PLANS and Specifications
No. 4 ' xl6 ' per plot , specifications and application submitted. .
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_ Proposaid Use �
x
Dock
$ 15 . 130 PERMIT FEE PAID — THIS PERMIT EXPIRES Sept . 1 1987
(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 data.)
Dated at the Town of Queensbury this 17th [lay of _February ig 87
SIGNED BY 122 a4c for the Town of Queensbury
Building and zoning Inspector
� ■ TO BE COMPLETED BY BLDG , DEPT.
._7. O ��ec7eut � heel�( t Application No .
Permit Issued 19 TOWN OF G7lJEE�r . __ .
BUILDING and ZONING DEPARTMENT Permit Expires
Bay and Haviland Road, R. D_ 1 Box 98 Zoning Designation
C)ueensbury, New York 12$01 variance No ,
Site Plan Review No . 'FEB �f
k .L i�7
�Q - �"' Approved y��' � BUILDING 8cCODE D/Efi'T
APPLICATION FOR
FUILDING 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 : a zel'r' *A z r 1.r'ey lv ;r,r �,�.e~ _ _ _ __ ____________________
P. O. Address �n�_l 4� Er.r esr�r' fw.!✓.O Y!/!►,! /PI ►Y �' Tel . 7 .E r "A►T.AG
Property Location ; I.A Aar ,oeo-/ _ rr -- jr` Tax Map No . / / -
Street number or 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 „rnue ,+� ,/r yry�y�„ Address Tel ,
Name of plumber Address Tel .
Name of mason Address Tel .
NATURE OF PROPOSED 'WCJRK : * 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 cleanly and distinctly all building's ,
(no change to exterior dimensions ) whether existing or proposed and indicate all
tether work (describe) f��,.x * 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
LOCATION OF STRUCTURES AFFECTED , of water supply and location and configuration
* of septic disposal area .
COMPLETE INFORMATION REQUIRED BELOW .
* Size of property 4#*�4:5!p� ft X_A/p �ft .
Existing building ( s ) Size ft X ft .
PROPOSED BUILDING AND USE : * Existing buildings ) Use
Size of new structure y ft ?C� 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* Side yards ft and ft
Height ( grade to ridge ) 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
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
Cape Cad Cottage Othe * ACCESSORY BTir.DING-
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 $ Zr .tom
INFORMATION ON BUILDING SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET , TO BE COMPLETED !
Form EPA 4/86 and-vl
BUILDING PERMIT APPLICATION CONTINUED
BUILDING SPECIFICATIONS
Type of construction , wood frame , fire safe , etc . / 1'.d'.� .+F ✓!^' .��
Will any second-hand or ungraded lumber be used? If so , for what ?
1 .Foundation will material 2,;".i ;r 4xAe Thickness, VX V X lei
Depth of foundation below rade (to bottom of footing)
Will there be a cellar?Heated or unheated? - Floor sq. footage sq ft
Will there be a basemen ? Will any portion be used as living space? ,r?
( if so , what portion? sq . ft . - - Type of use?
Type of roof - sloped/flat/shed/other Material of roof
Size , wood studs "X _j0p " spacing ► "o . c . length ,,e447 £t . $ or
Joists ( floor beams ) lst . floor "X it spacing "o . c . span ft .
Joists ( floor beams ) 2nd . floor " X " spacing "o . cw span ft .
Overlays ( ceiling beams ) "X spacing "o . c , span ft .
Roof rafters "X " spacing o . c . span f t .
Roof trusses (pre-engineered) spacing "o . c , span ft .
Exterior wall finish Of what material?
.T n.�e]Ci nr *-�� 1 finish ���..+i.► ^��� �. 'y �'. �"" •'
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? 2f 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 A F F I D A V I T
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 BU =DING 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 ///, nieect , contractor
-
day of 19
Notary Public , Warren County , N . Y .
SPECIAL CONDITIONS OF THE PERMIT :
By-_. --------- ---------_ _---------_-._-_._.
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