1988-026 BUILDING PERMIT
TOWN OF QUEENSBURY No. 88-26
WARREN COUNTY, NEW YORK o
PERMISSION is hereby granted to William & Marylee Gosline
OWNER of property located at ) Lafayette St. Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Demolition of house
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
25 Blind Rock Rd.
Glens Falls, N.Y. 12801
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2. CONTRACTOR or BUILDER'S Name 0
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Sid Timms cn
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3. CONTRACTOR or BUILDER'S Address
Sweet Rd.
Glens Falls, N.Y.
4. ARCHITECT'S Name
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5. ARCHITECT'S Address c•4
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6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( ) Steel (
7. PLANS and Specifications
No. Demolition of 2 bedroom house at 13 Lafayette St. as per
application.
8. Proposed Use1-6
Demolition
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10.00 88
PERMIT FEE PAID —THIS PERMIT EXPIRES Sept. 1, 19
(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.) ro
Dated at the Town of Queensbury this 3rd Day of FEbruary 19 88
SIGNED BY ,/'7G , ? 2% 2 for the Town of Queensbury
Building and Zoning Inspector /(/f C. .
TO BE COMPLETED BY BLDG: •DEPT. • ' • •
awn o f Queenitur� Application No.
Permit Issued 19 1d3O3000 '8 ON10'7If19
BUILDING and ZONING DEPARTMENT Permit Expires 19 .
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Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation . 696i I Z jJ .
Queensbury, New York 12801 - Variance No.
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Site Plan Review No.- . .afbil
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APPLICATION FOR • ' 'P, l0!/t
BUILDING AND ZONING. PERMIT • - - 'la ` . . .i
* * * * *• * *. * * * .# * * * * *. •* _*_• * * * * 'it * * * it' * •• . • * At * * * *. *D* .
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. 'ANSWER ALL. OF THE FOLLOWING.
The under tgned 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. %AE /ERC
•The owner of this property is: • fV,'J/tCt fit. 0/14A,•//�� . CO-.f fi et t); .
P.O. Address a c 13/ I Roc: - • a, . - •tr . Tel. 792 7 2i• .
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Property Location: L,j 4cSc,v£ i' £ St. • [pr(. - - - Tax Map No. /Oi// / / 3/ '
Street number ok building lot number
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Subdivision name (if applicable)
THE PERSON R��rSPONSIBLE FOR SUPERVISION.OF WORK AS REGARDS BUILDING CODES IS: •
S%�w.. j,crwfJ S wee f . d., � (i'N1' F—A :((r '
Name . . P.O. Address . . • 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
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'OR DEMOLITION PERMIT, STATE SIZE AND * whether interior or corner lot. Show location
LOCATION iel
STRU URES AFFECTED. of water supply and location and configuration
IS � ;S� *..of septic disposal area.
,� 'aowl Ft;oJS£ * COMPLETE INFORMATION REQUIRED BELOW.
-* Size of property • ft X ft.
* Existing building(s) Size ft X ft.
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PROPOSED BUILDING AND USE: * Existing buildings) Use. . '
_Size of new structure ft `X 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.
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 . • *
* PRIMARY BUILDING - •
No. of bathrooms *" One family dwelling •
Primary heating system ' ' '
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 . .
•777Ranch Contemporary Log cabin * Other '
Raised ranch Mansion . Duplex
* If addition, what will use be?
Split level Old style Bungalow *
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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 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?
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.
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: .
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 AFFIDAVIT 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 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. '
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SWORN TO BEFORE ME THIS Signature
Owne , o er's agent,arcnitect,contractor
day of 19 •
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Notary Public, Warren County, N.Y.
SPECIAL CONDITIONS OF THE PERMIT: •
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