1987-028 BUILDING PERMIT
TOWN OF QUEENSBURY No. 87_ 28
p q WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to 5 311ian Markwell
w
Twin Channels Road Street, Road or Ave.
OWNER of property located at
Alt , dwelling (deck) ,
in the Town of Queensbury, To Construct or place a rt
at the above location in accordance to application together with plot plans and other information hereto filed and 3Q
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. m
a1
r-
F2. CONTRACTFOR
ER'S Address is Twin Channels Road
Queensbury , NY
E
W
or BUILDER'S Name
S�
same 0
ro
r
m
3. CONTRACTOR or BUILDER'S Address PO
0
w
a.
4_ ARCHITECT'S Name
5, ARCHITECT'S Address
6. TYPE of Construction — (Please indicate by X)
F-,
{ ) Wood Frame { > Masonry I I Steel [ } in
rt
0
7. PLANS and Specifications
19 ' xll ' per plot and application submitted .
No. ro
I--
t-k
a. Proposed Use
One-Family Dwelling (deck addition)
R.
ro
n
U
$ 10 . 00 PERMIT PEE PAID THIS PERMIT EXPIRES Sept . 1 79 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 data_)
Darted at the Town of Queensbury this 4th Day of February 1987
SIGNED BY for the Town of Queensbury
Building and Zoning Inspector
!Tf To BE COMPLETED BY BLDG . DEFT .
-rower OF QUEEVS .:JI. ,-
�] II Application No . 1�17 t
_fawn o1 �ueenshurrr Permit Issued 19o, [0
BUILDING and ZONING DEPARTMENT Permit Expires 19
Bay and Hawiland Road, R. D. 1 Sox 98 zoning Designation 3 FEB _ 31987
Oueensbury, New York 12801 variance No . {
Site Plan Review/ Now 13UIL ING & CUDE DEFT.
'. '� + Approv G�
`�- / e/ G"d1
APPLICATION FOR `
BUILDING AND ZONING PERMIT
>� 41 >< »
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 . -- - s1i' e +XF
P . Q. Address V S i �r �Y a*' Ll/ Tel .
s ,//�� �I Tax Map No
Property Location : rpl cl iH
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_,~ Address rY' s 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 en/sions) '� whether existing or proposed and indicate all
Other work (describe) e6�,_ set-back dimensions from property lines . Give
* 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 76 ft X ft .
Existing building ( s) Size ft X ft .
PROPOSED BUILDING AND USE : Existing building ( s ) Use
Size of new st ture �ft X�ft
Foundation erf ab/c awl/partial/full * Proposed building, distance from property line
circle one )
Front yard ft Rear yard ft
Na . of s (habitable space ) Side yards ft and ft
Height ( grade t ridge ) ft - If on corner , setback from side street ft
If residentia3 , n of f ilnes
Now of rooms ( exclu ' ng aths ) * OCCUPANCY INFORMATION
No . of bedrooms _
* PRIMARY BUILDIN
No . of bathrooms_ _ * One family dwe ing
Primary heating sy ' em Two family dwel ' ng
Type of fuel
�. Multiple dwellin / rnber of units
No . of fireplac s to be in al
Permanent occup
Will a wood s ve be install d?
Transient occ anc
Central Air c+nditioning? Business
BUILDING STYLE, PRIMARY STRUCTUR * industrial
* Other
Ranch Contemporary Lag 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/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 !
Form SPA 4/86 and-vl
�r
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS :
Type of construction , wood frame , fire safe , etc . bf/ G1 U elirf C
, Will any second-hand or ungraded lumber be used? If so , for what ? //J
Foundation wall material Thickness
Depth of foundation below grade (to bottom of footing )
Will there be a cellar? N Heated or unheated? Floor sq. footage sq ft
Will there be a basemen't?'7Xtt Will any portion be used as living space ?
( If so , what portion? sq. ft . - - Type of use?
A*e of roof - sloped/flat/shed/other Material of roof
Size , wood studs "X " spacing too . c . length ft . f Joists ( floor beams ) 1st . floor L spacing "o . c , span/ ft .
Joists ( floor beams ) 2nd . floor -- -- spacing "o . c . span ft .
Overlays (ceiling beams ) —+'X--- spacing '"o . c , span ft . /
Roof rafters -� - IF spacing O . C . span ft .
r /, '/d�rr
Roof trusses (pe-engineered) spacing "o . c . span ft . e
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-close evice bovided?
Will a flue-lined chimney be installe � ,r' w Height above roof ft .
Depth of chimney foundation below gra t ,
Depth of fireplace hearth fto zn .
water supply - Municipal or priv e well
SEPTIC SYSTEM _ Distance from X private well ( including adjoining properties ft .
(A separate application is n cessary for any repair or new installation of septic system)
Town of Queensbury
County of warren A F F I D A V I T 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 he complied with, -whether specified o not , and that such work is
authorized by the owner . r
SWORN TO BEFORE ME THIS Signature :__
day of lg Owner wner s agent , arcnitect , contractor
Notary Public , Warren County , N . Y .
OF * * * * * * * * * * * * * * * * * * * IF * * * * * * * * * * * * * * At
SPECIAL CONDITIONS OF THE PERMIT :
------
1
J f
4
ti
} r '3� Est e7� It ✓ -