1987-571 BUILDING PERMIT �
TOWN OF QUEENSBURY No. 87_571 �
WARREN COUNTY, NEW YC?RK o
PERMISSION is hereby granted to John Buchanan
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OWNER of property located at Reardon Rd . Street, Road or Ave.
in the Town of Queensbury, To Construct or place a Addition—Deck and Dock
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
zl RR #5 Reardon Rd .
Box 194
Queensbury , N . Y . 12801
2. CONTRACTOR or BUI LOER'S Name
Same
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3. CONTRACTOR or BUILDERS Address
Same p
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4- ARCHITECT'S Name
5. ARCHITECT'S Address
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B. TYPE of Construction — !Please indicate by X?
rs.
I ) Wood Frame ( ) Masonry I } Steel I l
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7. PLANS and Specifications
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No. Deck to one family & Dock per plot plan and specifications and �.
application .
8. Proposed Use
Deck and Dock to one family dwelling
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$ 15 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES March 1 ' 19 88
Iif a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.} n
Bated at the Town of Queensbury this 26th [lay of August 19 87 R'
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SIGNED BY .�' f f�. G �fC. //�� C.� n_� C. ..�w'""'r for the Town of Queensbury W
Building and Zoning Inspector .
TO BE COMPLETED BY BLDG . DEPT ,
/ Application No .
." o ddee► j "Ply Permit Issued 19 Chi
BUILDING and ZONING DEPARTMENT Permit Expires 19 �
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Bay and Havitand Road, R. D. 1 Box 98 zoning Designation ,
Queensbury, New 'York 12801 Variance No . t J
rI Site Plan Review No . AUG 2
Approved by : BUILDING & CODE DEPT
1 ✓ APPLICATION FOR
EUILDING 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 .
---------------- _--- ...---- .- .� -> /
The owner of this property is : Cf ] >"I �( � L"'l /1 �)L) a i
P . O. Address X',f ] ZL Zr 'cf -, , A° J 77 ox / Tel . -2 2
Property Location : 2--- 2- 2 - ,/ 7�' �I Y t rn A-, ✓ 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 :
/7r / "„ q,c eV ✓J /C _ 5 ' ,/, f' f. ��r "} /7t" Y / `vra L ry-.--tf- / / s- 7. .) j
Name P. O , Address frel . No .
Name of builder r 5 %:-. ti 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 SUBMITTEDr
_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) 2r^r C` v E 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 INFOI2MA�N REQLTIRD B,BLOL� _ Y -
Size of- property ft .
* Existing building ( s ) Size ft X ft •
*
PROPOSED BUILDING AND, USE : * Existing building ( s ) Use
Size of ne structure ft X ft
Foundation-pier/slab/crawl/partial/full * Proposed buildingr distance from property line
(circle one ) * Front yard ft Rear yard LL
ft
No , of stories (habitable space) * Side yards ft and ft
Height ( grade to ridge ) ft • If can corner , setback from side. . street_ ft
If residential , no . of families
No , of rooms ( excluding baths ) OCCUPANCY INFORMATION
*
No. of bedrooms PRIMARY BUILDING No . 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
Contemporary Logy cabin If addition , what will use be?
Raised ranch Mansion Duplex
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
* x * * * * * * * Private storage building .
ESTIMATED MARKET VALUE OF * other /5 � c 1 . 2
CONSTRUCTION
INFORMATION ON BUILDING SPECIFICATTONSr ON REVERSE SIDE of THIS SHEET , TO BE COMPLETED !
Form BPA 4/86 and-vl
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS :
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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 sq ft
Will there be a basement? Will any portion be used as living space ?
( If so , what portion? sq . ft . - - Type of use?
$cZype of roof - sloped/flat/shed/other Material of oof
Size , wood studs -��" X�_.'" spacing '"o , c , length of
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lJoists ( floor beams ) 1st . floor "X I _ __" spacing U, ^o . c . span Ca ft .
3oists ( floor beams) 2nd . floor "X " s acing "o . c . span ft .
verlays (ceiling beams ) "X p "' spacing "o . c . span___ (� ft .
of rafters ""X it spacing o . c . span ft .
Roof trusses (pre-engineered) spacing " o . c . span ft .
Exterior wall finish Of what material?
Interior wall finish
If a garage is to be attached , describe materials to be used for FIRE SEPARATION :
Is there to be an opening between garage and dwelling"> if so will a Fire-rated
door , enclosure , and self-closing device be provided?
Will a flue-lined chimney be installed? Height above roof ft .
Depth of chimney foundation below grade ft .
Depth of fireplace hearth ft . in .
Water supply - Municipal or private well
SEPTIC SYSTEM _ Distance from ANY private well ( including adjoining properties ft .
(A separate application is necessary for any repair or new installation of septic system)
Town of A F F f D A V I T STATE OF NEW YORK
eensbury
Warren County off Warren
I swear that to the best of my knowledge and belief the statements contained
in this application , together with the plans and specifications submitted , are a true and
complete statement of all proposed work to be done ' on the described premises and that all
provisions of the BUILDING CODE , THE ZONING ORDINANCE , and all other laws pertaining to
the proposed work shall be complied with, whether specified or not , and that such work is
authorized by the owner .
SWORN TO BEFORE ME THIS Signature_ �, _ Lr1;�" !--"�_.�'s.--�-�
Tj� /� r , owner ' s agent , arcnirect , contractor
day of lc Theresa teVey
r _�-'• - — Notary Pub13c
Stan of New York Sarstri a �tr;r
NotaryPublic Warren ount Cram mission 480Exp9F174
• Y r N • Y - p 4$Q913T4
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SPECIAL CONDITIONS OF THE PERMIT :
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