1987-426 BUILDING PERMIT
TOWN OF QUEENSBURY No. 87_426 �
WARREN COUNTY, NEW YORK
Johnson
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PERM1551DN is hereby granted to Jo �N
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OWNER of property located at Lot Homestead Village : Luzerne Rd . Street, Road or Ave.
in the Town of Queensbury. To Construct or place a Addition to Mobile Home (Roof )
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.
t. OWNER'S Address is
Lot 14 Homestead Village o
Luzerne Rd . rr
Queensbury* , N . Y . 12801 r3
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2. CONTRACTOR or BUI LDE R'S Name �
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Glenn. Gregory p
3_ CONTRACTOR or BUILOER'S Address
Luzerne Rd .
Glens Falls , N . Ye 12801 tort
4. ARCHITECT'S Name r-
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5. ARCHITECTS Address m
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6. TYPE of Construction — (Please indicate by X) F-4
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{M Wood Frame { } Masonry { } Steel ( I Oo
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7- PLANS and Specifications G
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No_ Roof over mobile home per specifications and application n
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8_ Proposed Use a�
Alteration to Mobile home +
$ 10 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES February 1 , 19 88
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(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the O
town of Clueensbury before the expiration date! ro w
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Dated at the Town of Queensbury this 9th Day of July 19 87 o r+
SIGNED BY for the Town of Queensbury
Building and Zoning Inspectorl "„-
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TO BE COMPLETED BY BLDG . DEFT .
Application No .
owirl C1f �iNtee►tyhul'� Permit Issued 19 Q lJ j
BUILDING and ZONING DEPARTMENT Permit Expires 19
Bay and Haviland Road, R. D. 1 Box 98 Zoning Designation JUL 21987
Queensbury, New York 12801 Variance No. _
Site Plan Review No . IBUILDIP CODE DEPT.
Approved by : �`� �
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kol�" APPLICATION FOR �--~-- - �
F�UIEDIN G AND ZONING PERMIT '�' * � �"/'' L `
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 Aproperty is / Te �r yp - `j ____
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P. U. Address } e �.- I r I r" Zr -(zc`s h� t� Tel .
Property Location : Tax Map No ,./ /
Street number or building lot number
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Subdivision name ( if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK/ AS REGARDS BUILDING CODES IS :
V ✓�° �. i C.
Name P . O. Address Yel , No .
Name of builder _Address Tel .
Name of plumber Address T'el .
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
Otly wo k (describe) * set-back dimensions from property lines . Give
II� r 641/r}.--- �y o ry eAr * street and number or lot number and indicate
whether interior or corner lot . Show location
w of water supply and location and configuration
VOR EMOLITION PERMITO STATE SIZE AND
LOCATION OF STRUCTURES AFFECTED . * of septic disposal area .
*
* COMPLETE INFORMAT17 EE I� BELOW .
Size of propert�
* Existing building s) Size- 'ft X ft -
* ! 7—
PROPOSED BUILDING AND USE : * Existing building ( s ) use
Size of new structure ft X ft * _
Foundation-pier/slab/, wl/partial/full * Proposed building , distance from property line
[circle one )
* Front yard ft Rear yard ft
No . of stories (habita eV-
PRI) * Side yards ft and ft
Height (grade to ridge / ft - * If on corner, setback from side street ft
If residential , no . of a
No . of rooms ( ex lud' n a * OCCUPANCY INFORMATION
No . of bedrooms
BUILDING -
No . of bathroom _,,,,,__ * ne family dwelling
Primary heating s Two family dwelling
Type of fuel * Multiple dwelling / Number of units
No . of fireplaces t be installed Permanent occupancy
Will a wood stove b 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 "
Cape Cod Cottage -�ErCFer * ACCESSORY BUILDING-
Colonial Row Ouse * 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 !
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