1987-433 BUILDING PEFt1111►IT �
TOWN OF QUEENSBUR.Y �
No. ST-433
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to =ICE $0zzLL � Q
OWNER of property located at Street, Road or Ave. O
it
r
in the Town of Queensbury, To Construct or place a 2 CAZ t is
at the above location in accordance to application together with plot plans and other information hereto filed and N
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
t_ OWNEWSAddress. is 22 PAM 80124111' losvift
Q16=0 7411s s RV, T. 1280L
2. CONTRACTOR or BUt LDER S Name
3. CONTRACTOR or BUILDER'S Address
t��lr
4. ARCHITECT'S Name '
5. ARCHITECT'S Address [S
S. TYPE of Construction — (Please indicate by X) ey
('Wood Frame I t Mawnry I ) Steel { l
7. PLANS and Spacificatiorn
No. 30" Y 30' 2 Car detacb*4 sAVeiO Per plot Piait"a •pec'"cnt#.f"S' and
0"11 atiaa. site Plata Br,r+ low no. 16 87 %I
S. Proposes! use
3 Ceyc llatauchad +e
ex
- -- - --- - $ -- 10000 PERMIT FEE PAID — THIS PERMIT EXPIRES
Cif a longer period is requinad an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date_?
87
Dated at the Town of Queensbury this 110th Day of July 19
SIGNED BY f r ,. w r ' for the Town of Queensbury
Bulldingard Zoning Inspector ,£:.
TO BE COMPLETED BY BLDG . DEPT.
/ Application No . 7 ; � }
G►et+n oueen3dur Permit Issued 19 LJ
BUILDING and ZONING DEPARTMENT Permit Expires 19 J `N c) ty �987
Bay and Hawiland Road, R. D. 1 Box 98 zoning Designation SR iJ fw l+ i.7v
Queensbury, New York 12801 Variance No .
Site P1 iew No . f - fL � ��� aE�
G - l ao , 1 , a � J ,/�
APPLICATION FOR
BUILDING 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 will
be done in accordance with the description , plans and specifications submitted, and such
special conditions as may be indicated on the Permit .
----------------------- ____-__-__-/ ---�_j_� ............__.....................
_-----______-
The owner of this property is - // C ry ..w v y/ �.zce_-
P . O. Address Tel .
Property Location : / � Tax Map No . / /
Street number or building lot number
Subdivision name (i£ applicable)
THE PERSON
/RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS :
r'�r=.. Gcc*. c.-�' / � r�-.ICI � 2' ✓�'-�� l�*rrr�=-�.� c'�- .-e �is ,rF`- rt/5'+ /2�' / �/ ,5�"�{='�j./,f"`
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
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 .
COMPLETE INFORMATION REQUIRED BELOW .
Size of property. X //C.Z) ft .
Existing build-ing ( s ) Size ft X ft .
PROPOSED BUILDING AND USE : * Existing buildings ) Use
Size of new struct e 7 ft x reft
Foundation-pier lab/ yawl/partial/full Proposed building , distance from property lane
c rcle one ) /
.� Front yard yz,(,� ft Rear yard S'�f..t ft
No . of stories (habitable space) Side yards Sp ft and :7 z ft
Height ( grade to ridge ) / !; ft * * If on corner , setback from side street ft
If residential , no . of families
No . of rooms ( excluding baths) OCCUPANCY INFORMATION
No . of bedrooms PRI14ARY BUILDING -
No . of bathrooms One family dwelling
Primary heating system '�
Type of fuel * Two family dwelling
No . ,� 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
Ranch Contemporary Log cabin x Other
Raised ranch Mansion Duplex » if addition , what will use be?
Split level Old style Bu w
Cape Cod Cottage Other �c " ACCESSORY BUILDING-
Colonial Row own House _/ _Detached garage/one c two car car
( CIRCLE ONE PLEASE ) Attached garage/one c o 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
T0104 QF [Q"EBNS S
BUILDING AND CODES DEPARTMENT
E
& HAVILAND ROADS 128ak
BAY
3AY 15BUFZY NEW YORK TELEPHONE ( 518 ) 792-
5832
F�3IL3]IY3G IT3SFEcTo S gPPOR�i
INS ECTION RECEIVED
REQUEST FOR
NAME 7 -
IATION PERMIT # - -
APPROVED
DATE YES NO
FOOTINGIPIE QOUR FORMS-,-------�"
MONOLITHIC D V�PROOF"ING�
FOUNDATION/
BACK,FILL APPROVAL_f_�- - --
ROOGH PLUMBING
FRAMING ROUGfi�SNl__
ELECTRICAL
INSULATION :
FOUNDATION
DATI'ON�--- -
F.LOCRS-- --�� �- -
WALLS
EZLTNG ON -- -�
NAL PECTI
I CHIMNEY HEIGHT_
ROOFING
SIDING
EXTERNAL PO > & R LVE
AILSf�
CLEAPANCE LIEF
PLUMBINGIS ru'ALVE
STAIRS~ VIXTUREVACY DOORS
�tIM/PRIVA
INTERIOR LOORS_
FINISHED - FING�� �--
GARAGE F REPROO
DOOR CLO ER (5 ) _-- -
SMOKE D TECTORS_ - r� N
TRICAL INSL'ECTI0 TION ----f
FINAL ELE OVAL OF CONSTRVC7PION_� -- --
FINAL AP ���- r -�"
S T B BE E
CATS OCCUPANCY MU BEFORE
A SIGNED CER'TIFI OF DEPARTMENT
OBTAINED FROM THE BUILDING
ES ARE OCCUPIED :
THESE PREMIS �. �--- f
REMARKS
l�
I SPECTOR
f BUiLD4NG and Z4NIioa S.� 1 Bo' 98
Bay and Fiavilancf Roe Y01"' 12gd1
pueensbury,
IfSSPEC � (}R ' S REPORT
Ei i51 if D 1 f'S G
SAME
LOCATION
..0GA
[7c7t C APPROVED - YES , Nt7
Foeating /paer Farms
Four.da t ion
Waterrr'roof ing
i3a fill
raining
Roofing
Siding r
masonry Vene
,Rough Plumbin
Relief Valves
Ext . Porches
Finished Floors
S nter for Trip'
Stairs & Railings
cellar grain Til
Concrete Floors
P-Ibg - Fixtures
Fi. reproo in�3_-- - -
Gar . ._-----
0onr 'Closers
5rnoke L/etec Ctrs
chimney
zt4E;Uj ATta
FounrlatiQ
Froor. s
walls
ce i i i nL3 I13 SP'ECT I Ot3
FINAL k. I CTRtCA1
APP R(7V A ...----
�yRIVEWA n Survey
Final �»ildi �
,V ection {call when ready
Next 5chedul.ed
insp
Remarks I
I �
13aiiding -Inspector
(i/86 m.ci-vt
_ Wit tr `aC+ienen ARTMENT
' o � CiEPRTME
8L11LDtNC� and zplftlVG R. Q 1 Box 9a
Bay and Havifand New York '1260 1
QueensburY•
REPORN
BUI LD 3 NG I NSF' ECT [7R `'
NAME
]2 e xxn i t
D LE' * * * * * * * * * NO
APPROVED — YES
Footing/Fier Fur[ns
Foundation
waterproofing
fill
Lr,,,�"rami n9
Roo f in9
Siding
Mason Veneer._.— ----'
Bough P'lumbincj --
Relief Valves _ r --- ----
Fxt . porches — — - ---
Finished Floors
Interior Trim
stairs 6 Failings
Cellar Drain Tile
concrete Floors
Plbg - Fixtures
Gar . Fireproof ng
Door closers
Smoke Detect rs
[�I-simneY
IN SUI,ATI ON
Foun dat icy
Floors
Walls
ce i l inc; It3
F2NAL :CTRICAL lr
DRIVEWAY APPRoVALE --�
Final Building, survey
call when ready )
sctledulecl inspection1. 1Z .
Next ,,t.A04- s. -
tc s--
Re ma r �,,,�q G /-
_ � 11 ��� ,1'�-,t•-v C y� 'tea .�
!C7
o r
Cding
fi/f36 mc3--ul
r 1 ' C� /
._.l'own o� �rtteen3bure�
gUILDING and ZONING DEPARTMENT
Say and Haviland Road. R, D. 1 Box 98
lei [[ Queensbury, New York 12801
UI LD I NG INSPECTOR ' S REPORT
� r
NAME
_ /r�
LOCATION
Crate / / / O 7 permit No,
NO
APPROVED -
4-rooting/Pier Forms
Foundation
waterproofing
Backfill
Framing
Roofing
Siding
Masonry veneer
Rough Plumbing
Relief Valves
Ext , Torches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg . Fixtures
Gar . Fireproofing
Door Closers
smoke Detectors
Chimney
IN SL7LATION
Foundation
Flours
Wails_
Ceiling
FINAL F.LECTRI L INSPECTION
DRIVEWAY APPR AI.
Final Buildin Survey ---
Nexel tscheduled inspection {call when ready )
Remarks-
Hui ing Inspector
6/86 and-vl