1987-386 BUILDING PERMIT
TOWN 4F QUEENSBURY �
No 87 386
WARREN COUNTY, NEW YORK a
LeRoy M. Bishop w
PERMISSION is hereby granted to w
OWNER of property located at 70 Richardson St . Street, Road or Ave.
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in the Town of Oueensbury, To Construct or place a Storage building for Dental Lab
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'SAddressis
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68 Richardson St .
Queensbury , N . Y . 12801 0
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2. CONTRACTOR or BUILDER 'S Name
Same
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3. CONTRACTOR or BUILDER'S Address "a
4. ARCHITECT'S Name
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6_ ARCHITECT'S Address Fri
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6. TYPE of Construction — (Please indicate by X) p
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(Xl Wood Frame i I Masonry 1 1 Steel f ) rt
7. PLANS and Specifications
No. 141 x 141 per plot plan , specifications and application
a. Proposed Use '
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Storage 1uilding for Dental Lab sa
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$ 10000 PERMIT FEE PAID — THIS PERMIT EXPIRES January 1 , 19 88 va
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the r-h
town of Queensbury before the expiration date.) 0
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Dated at the Town of Queensbury this 23rd Day of dune 1987
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SIGNED BY ��'��,� ' - .C. ice._ -Y for the Town of Queensbury r ,
Building and Zoning Inspector
To BE COMPLETED BY BLDG . DEFT.
��7 Application No.
_70&Vn a/ Queen31"ry Permit Issued 19 TOWN 04F Z. ZLAAsa, •'
BUILDING and ZONING DEPARTMENT Permit Expires 19
Bay and Hawiland Road, R. D. 1 Box 98 Zoning Designation
Queensbury, New York 12801 Variance No . 1
2
JUN 221987
1987
f Site Plan Review No . I
f i of Approved BUILDING & C00E DEPT.
LICATION FOR / r . od
3UILDING 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 wil;L
be done in accordance with the description , plans and specifications submitted , and such %
special conditions as may be indicated on the Permit .
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The owner of this property is :
P . O. Address Tel .-79 !i �3t _
Property Location : 70 LEI A Tax Map No . / z _/ Z --3
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. Ad4r+ess Tel . No .
Name of builder l a<a Address Tel .
Name of plumber Address Tel .
Name of mason eat c4zAe. Address Tel
NATURE OF PROPOSED WORK : * ZONING INFORMATION :
Z Construction of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED .
_Addition to a building * drawn reasonably to scale and attached hereto ,
� T a1 + sho. rA A ga , . R .Acl ` a4Zy , " .
(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
FOR DEMOLITION PERMIT , STATE SIZE AND * of water supply and location and configuration
LOCATION OF STRUCTURES AFFECTED.
* of septic disposal area .
,F COMPLETE INFORMATION REQUIRED BELOW .
" Size of property,2'76 X 7,2,45� ft X 3V/. �25 ''ft .
Existing building s) Stze_, ft x S cr ft .
* x
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)
wwwwwww� * Front yard g ft Rear yard Q� ft e
No . of stories (habitable space ) * Side yards ft and ft 4
Height ( grade to ridge ) / ft .If residential , no. of families * If on corner , setback from side street ft
Now of rooms ( excluding baths ) * OCCUPANCY INFORMATION
Now of bedrooms I I
No . of bathrooms w 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
BSUILDING STYLE, PRIMARY STRUCTURE * ' Industrial
Ranch Contemporary Log cabin * Other
Raised ranch Mansion Duplex ► If addition , what will use be3
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 cart car
« * e * * r * * * * * w * * w w se °► Private storage building s„ o9ev Trsq/' ,6. a-6
ESTIMATED MARKET VALUE OF * Other
CONSTRUCTION //}} ��j
INFORMATION ON BUILDING SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED !
Form RPA 4/86 md- vl
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_72(c> r on /g �r'�2mail Thickness
Depth of foundation below grade (t❑ bottom o�ting ) rg "
Will there be a cellar? IM Heated or unheated? Floor sq. footage sq ft
Will there be a basement? ,Vb Will any portion be used as living space?
( If so , what portion.? sq, ft . -- - Type of use?
Type of roof - sloped/flat/shed/other sr�� Material of roof
size , wood studs -'• spacing. � 0,0c . length �ft.
Joists ( floor beams ) 1st . floor"X��" spacing / "o . c . span /'eft . t 'v
joists ( floor beams) 2nd . floor "x spacing "o . c. span €t . =
overlays ( ceilin beams ) "x '" spacing "o . c . span ft.
;4[scf rafters "X�`" spacingo . c . span_ Z49ft. 4f4F7h C'o /% r $ !
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 S&lf-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 O F F I D A V I T
County of Warren 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 ORDINANCi., 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
day of yg
Signature.....
owner ' s ag t , arcnicect, co tractor
Notary Public , Warren County, N . Y .
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SPECIAL CONDITIONS OF THE PERMIT :
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