1987-333 BUILDING PERMIT
TOWN OF QUEENSBURY No 87- 3
WARREN COUNTY, NEW YdRK
PERMISSION is hereby granted to Gary and Nancy* Benway
OWNER of property located at 00�1) Luzerne Road Street, Road or Ave.
in the Town of Queensbury, To Construct or place a Addition to dwelling (deck) K
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.
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1. OWNEWS Add ressis Rif #3 Box 218 Luzerne Road
Queensbury , New York 12801
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2. CONTRACTOR or BUILDER'S Name
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3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Namerb
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5. ARCHITECT'S Address �
B. TYPE of Construction — (Please indicate by X)
(x ) Wood Frame I ) Masonry ( ) Steel ( }
7_ PLANS and Specifications a
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No. 12 ' xl4 ' per plot plan , specifications and application '
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B. Proposed Use
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One—Family Dwelling (deck, added)
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$ 5000 PERMIT FEE PAID THIS PERMIT EXPIRES January 1 1988
(if a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Oueensbury before the expiration date,) m
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Dated at the Town of Queensbury this 9th Day of June 19 87
SIGNED BY , "O for the Town of Queensbury
Building and Zoning Inspector
* TO BE COMPLETED BY BLDG . DEPT .
Application No .
Permit Issued 19
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BUILDING and ZONING DEPARTMENT Permit Expires 19 r
Bay and Haviland Road, R. D_ 1 Box 98 Zoning Designation Ilr: rf � ���k1f
Queensbury, New York 12801 Variance No .
,fr Site Plan Review No . JUNI* 4 � 7
Approved by : B19[11fLDl41Ci. c ._ _. __ ..%P r,
APPLICATION FOR
BUILDING AND ZONING PERM I T I
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 : G7ay 96 � �'1"7 " ��;,� �1
P. O. Address n� ,j /� y C;'m ZL j g ? .,e eld Tel y4!ifr
Property Location : Pbd3 i }r . /'p Mf Tax Map No . �-
Street number or building lot number
Subdivision name (if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS :
F
s:�,...r �� .:t 5 Q ry L' .ram: !" �' J'•...r"c. _3'
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 ,
.4-Addition to a buildingf; 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
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 .
ip * COMPLETE INFORMATION REQUIRED BELOW .
* Size of property 6ej ft X C9 s ra ft .
* Existing building ( s) Size �j'� ft XL:�; + ft .
PROPOSED BUILDING AND USE : * Existing building ( s ) Use Niue
Size of new structure .'27 ft X ft
Foundation pie /slab/crawl/partial/full Proposed building , distance from property line
(circle one )
No . of stories (habitable space ) x Front yard�T?� ft Rear yard f',5' 6 ft
Side yards } {' ft and , ., � ft
Height ( grade to ridge ) ft . +
If residential , no . of f i x If on corner , setback from side street ft
No . of rooms ( excluding a h ) * OCCUPANCY INFORMATION
No . of bedrooms * PRIMARY BUILDING -
No . of bathrooms * LuOne 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
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
CONSTRUCTION c
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 . ['t
Will any second-hand or ungraded lumber be used? If so , for what ?
Foundation wall material �fr�]C /' (7 /p� Thickness
Depth of foundation below qr&de (to bottom of footing )
Will there be a cellar? Heated or unheated? Floor sq. footage /f f sq ft
will there be a basement? =1 _will any portion be used as living space? i"rr�R
( If so , what portion? sq. ft . - - Type of use?
Type of roof - sloped/flat/shed/other ,y/p- Material of roof
Size , wood studs " X IF
spacing"o . c . length ft .
Joists ( floor beams ) -+" t:� floor JO spacing & ., � - spaia-� ft .
Joists ( floor beams) '. floor " X� spacings"o . c . span'./ ft. tc,�%� � G/ .- �/y►
Overlays ( ceiling beams ) '"X IF spacing "o . c . span ft .
Roof rafters i� "X " spacing o . c . span ft .
Roof trusses (,pre-engineered) spa cing"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? ,,K If so will a Fire-rated
door , enclosure , and self-closing device be provided? 'kVIP-
Will a flue-lined chimney be installed? R.' 6-x Height above roof izi/dA ft .
Depth of chimney foundation below grade & /J ft .
Depth of fireplace hearth 'Z /)- ft , in . �1/
Water supply - Municipal or private well �s , v xlc GU4 U
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 f eensbuyy
Warren
of warren A F F i D R 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 be complied with, whether specified or not , and, that such work is
authorized by the owner . (21
SWORN TO BEFORE ME THIS Signature � _
t?wner , a is agent , arcnic ct, contractor
day o 19
Notary Publ ' , W&rren County, N . Y .
SPECIAL CONDITIONS OF THE PERMIT :
By
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TOWN OF gUEENSBURY
BU-IANDLDING
ROADS CODES pAgTMENT
SAY &
QUEENSBURYr NEW` YORK 12$fTl
TELEPHONE ( 518 ) I92 -5$32
BUILDING INSPECTOR' S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME V? 14:�
LOCATION _ 33
PIE IT #
DA TE APPROVED
YES NO
FOOTINCIP-1ERS I
MONOLITHIC poll
pR FORMS
FO[JNDAxIO N P
BAC KFI LL' ► PROVAL
ROUGH PLUNKING
,FRAMING
ELECTRICAL ROUGH-IN f
INSULATION:
FOUNDATION �
FLOORS
WALLS
CEILING
FINAL INSPECTION :
CHIMNEY HEIGHT
ROOFING
SILTING ST PS
EXTERNAL PORCHE . —
STAIRsS CLEARANIOE & ILS
PLUMBING FIXTLIRESIRE EF VALUE
INFERIOR TRLIVPRIVACY OORS
FINISHED 'FIRS
GARAGE FIRtEFROOFING
DOOR C LOS#R (S) _��_----
SMOKE DEFECTORS
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION
CERTIFICATE OF OCCUPAN CY MUST BE
A SIGNED DEPARTMENT BEFORE
BUIING
OTHESE PRE FROM
TARE OCCUPIED
REMARKS : ��
IN PECTOR
BUlt.DING and ZONING DEPARTMENT
Bay and Haviland Road, R.O. 1 Box 98
pueensbury, New York 12601
BLSILDING INSPECTOR ' S REPORT
NAME l!J d1V e dJ --
LOCATION
permit Ncr .
Date
* 7L,r * * * * * * * * vt * * * * * *NO
yr � APp PVED -
.0ting/'pier Forms s/ Foundation
waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext , porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
1Plbq . Fixtures
Gar . Fireproofing
Door closers
Smoke Detectors
Chimney
INSULATION :
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
I7RIVFWAy APPROVAL
Final Building Survey��
Text scheduled inspection (call when ready )
Remarks--
Building 111spector
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