1986-725 BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-725
(.36i • t (4/,W!,\RREN COUNTY, NEW YORK
PERMISSION is hereby granted to Kathryn Brayton
OWNER of property located at le Michigan Ave. Street, Road or Ave.
in the Town of Queensbury,To QIII.Stalttor place a Demolition of dwelling
at the above location in accordance to application together with plot plans and other information hereto filed and r+
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. n
1. OWNER'S Address is
Michigan Ave.
Glens Falls, New York rt
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2. CONTRACTOR or BUILDER'S Name
Roger Thomas
3. CONTRACTOR or BUILDER'S Address
Hadley, NY
4. ARCHITECT'S Name
H'
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5. ARCHITECT'S Address 0
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6. TYPE of Construction—(Please indicate by X)
( Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
No. demolition of 26'x30' 1 story dwelling per application submitted.
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8. Proposed Use
Demolition of a dwelling
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$ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES May 1 19 87
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(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the 0
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 21st Day off October 19 86
SIGNED BY Mdzi "L for the Town of Queensbury
Building and Zoning Inspector e9
TO BE COMPLETED BY BLDG. DEPT. • '
c��J Application No.
- . ✓Ouwn oi QNeen3bur� Permit Issued 19 T s°NN C1F QUE.
BUILDING and ZONING DEPARTMENT . I Permit Expires 19 1 Lit (( I1 V
( 'Ba and Haviland Road R.D. 1 Box 98 Zoning Desi nation t �I i'
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• Queensbury, New York 12801 Variance No. (; 3
' . Site Plan Review No. .. . OCT 1 41986
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�-7 — - 3 Approved b • P' . !® F-C-C Y�.�r
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APPLICATION FOR Le/ /r�= -
' BUILDING AND ZONING PERMIT
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. 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: ,�%, pL / / _v's, /i 8 r,1 Vt !'l/
P.O. Address / / Tel.
Property Location: il4icA) , , ,ip Tax Map No. / /
. Street number,i nl
r building lot number
Subdivision name (if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
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PO' Q r 77 i 0 6.14 4 S • Pudy; a'n k -eje.12-6 - C' 33/?--
Nalfte . P.O. Address 1/ Tel. No.
Name of builder Address. 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) * 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
...1G._x3 b-r ` "i £ y? Qom` dQ� of septic disposal area.
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* COMPLETE INFORMATION REQUIRED BELOW.
_, .. . . * Size of property- ( Q ft X / a0 ft.
. * Existing building(s) Size ft X ft. '
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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
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. (circle one) *
No. of stories (habitable space)'.
* Front yard ft Rear yard ft
Height (grade to ridge) ft. * Side yards f.t 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 ' *
* PRI RY BUILDING -
No. of bathrooms '
Primary heating system ' One family dwelling
Type of fuel * ^_Two family dwelling
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No. ®f f telAloas to 13c inataff0a- * ''',"--'- • --Ulti dwelling / .N-- ' of ►anus
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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 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 ' ' • • .
CONSTRUCTI®N $
INFORMATION ON BUILDING SPECIFICATIONS, QN REVERSE SIDE OF THIS SHEET, TO BE COMPLETED! '
. • Form BPA 4/86 and-vl •
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BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS:
.Type of construction, wood frame, fire safe,etc.
Will any second-hand or ungraded lumber be used? If so, for what?
-Mundation 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.
Joists (floor beams) 2nd. floor "X " spacing "o.c. span ft. •
Overlays(ceiling beams) "X " spacing "o.c. span ft. •
-Roof rafters "X " spacing o.c. span ft.
• Roof trusses(pre-engineered) spacing "o.c. span ft.
-• Exterior wall finish Of what material?
Interior wall finish
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
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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? 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 •
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swear that to the best of my knowledge and belief the statements contained
in this application, together with the plans and specifications submitted, area true and
complete statement of all proposed work to be done (on the described premises and that all -
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• 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's a ent,arcnizect contractor
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day of 19 .
Notary .Public, Warren County, N.Y.
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SPECIAL CONDITIONS OF THl PERMIT:
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