1987-368 BUILDING PERMIT
TOWN OF QUEENSBURY 87-368
No. �c
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to
Christine D . Sears
OWNER of property located at _ Stevens Road Street, Road or Ave. ,
in the Town of Queensbury, To2l3cmaltimm or place a Demolition — attached garage
at the above location in accordance to application together with plot plans and other information hereto filed and rn
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. ^'
1. OWNER'S Address is
Box 445 RD #4
Queensbury , New York
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2. CONTRACTOR or BUI LQER'S Name F-t
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3_ CONTRACTOR or BUILDER 'S Address cn
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4. ARCHITECT'S Name
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5. A R CIF#ITE CT'S Address r
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6. TYPE of Construction — (please indicate by XI a
i ) Wood Frame ( 1 Masonry l } Steel [ 1
7. PLANS and Specifications
demolition of 32rx27 ' attached garage per application
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8. Proposed Use �
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Demolition attached garage 0
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$ 10 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES January 1 19 88 0
lIf a longer period is required an application for an extension must be made to the Building and Zoning inspector of the M
town of Queensbury before the expiration date.)
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Gated at the Town of Queensbury this 19th Day of ,Tune 19 $ 7 �w
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SIGNED BY for the Town of Queensbury
Building and Zoning Inspector
To BE COMPLETED By BLDG . DEPT .
/r Application No . C v§ N cj' E7
7olvn OIQ"eeresburty Permit Issued 19� u
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BUILDING and ZONING DEPARTMENT Permit Expires 19 — " { L�
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation
Queensbury, New York 12801 variance No . JUN 1 . 19131
Site Plan Rev ' w No . ,c�
�] �-- .2 �►• �- Approved b ILDI G a CODE DEPT.
APPLICATION FOR
FUILDING AND ZONING PERMIT
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION . ANSWER ALL OF THE FOLLOWING .
The undersigned hereby applies far a Building Permit to do the following work which will
be done in accordance with the description , plans and specifications submitted: and sucks
special conditions as may be indicated on the :Permit - . ........
The owner of this property, is : /
P . O . Address
Tax Map No . �'"L./_.J___/
Property Location : lot number
Street number or building
Subdivision name ( if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS :
Name P . O . Address Tel , No
Tel .
Name of builder Address Tel .
Name of plumber Address
Tea
Name of mason
Address
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 ,
* showing clearly and distinctly all buildings .
Alteration to a building
{no change to exterior dimensions ) whether existing or proposed and indicate a
* set-back dimensions from property lines _ Give
Other work (describe)
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 STRU URES AFFECTED . * of septic disposal area .
—� ,,r � ,a_ � * COMPLETE INFORMATION REQUIRED BELOW -
ft X fL -
size of property ft X ft .
* Existing buildings) Size
*
PROPOSED BUILDING AND USE : * Existing buildings ) Use
Size of new structure ft X
f t
Foundation-pier/ slab/crawl/partial/full * Proposed building , distance from property line
(circle one ) * Front yard ft Rear yard ftft
No . of stories (habitable space) * Side yards ft and
Height ( grade to ridge) ft ' if on corner , setback from side street ft
If residential , no . of families * OCCUPANCY INFORMATIC3N
No . of rooms ( excluding baths)
No. of bedrooms PRIMARY BUILDING -
Noo of bathrooms one family dwelling
Primary heating system Two family dwelling
Type of fuel Multiple dwelling / Number of 'units
No . of fireplaces to be installed * Permanent occupancy
will a wood stove be installed? * Transient occupancy
Central Air conditioning? Business
BUILDING STYLE, PRIMARY STRUCTURE * Industrial
Other
Ranch Contemporary Log cabin * If addition , what will use be?
Raised ranch Mansion Duplex
*
Split level old style Bungalow x ACCESSORY BIJILDING-
Cape Cod Cottage other e car/ t car/ car
Town House Detached garage/on Attached garag / two
colonial Row a one car/ two car/ car
(
CIRCLE ONE PLEASE )
Private storage building
ESTIMATED MARKET VALUE of
CONSTRUCTION $
INFORMATION ON BUILDING-SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET + TO BE COMPLETED !
Form BPA 4/86 and-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. Thickness
Depth of foundation below grade (to bottom of footing )
Will there be a cellar? Heated or unheated? _ Floor sq. footage s ft
Will there be a basement? Will an - q y 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 DIXIFspacing "o . c . length ft .
Iaists ( floor beams ) 1st . floor "X " spacing "o . c . span ft .
joists ( fiaor beams ) 2nd . floor "X " spacing "O . c . span ft .
Overlays ( ceiling beams ) lox Is spacing $I 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
Depth of chimney foundation below grade ft . 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
County of Warren A F F I D A V I T STATE OF NEW YORJ<
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, wzhe__ttber specified or not , and that such work is
authorized by the owner . I
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SWORN Tt7 BEFORE ME THISSignatu
day of lg Owner , owner ' scagent , arcnirect , contractor
Notary Public , Warren County , N . Y .
* * * * * * * * * * * * * * * * For * For * * * * * * * * * * For * * * * * * * * r
SPECIAL CONDITIONS OF THE PERMIT :
By