1987-637 BUILDING PERMIT �
TOWN OF QUEENSBURY No. 87-637 �
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WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Ronald & Phyllis Williams
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25 Kiley Lane Street, Road or Ave.
OWNER of property located at vl
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in the Town of Queensbury, To Construct or place a
Deck
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.
[10:W:NER'S Address is 25 Kiley LaneQueensbury , N . Y . 12801P,
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CONTRACTOR or BUILDERS Name
Same
IOWA
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3. CONTRACTOR or BUILDER'S Address W
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction — (Please indicate by X) t-
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I YJ 1tkmd Frame ( I MaSOMY 11 Steel 11 f4
7. PLAINS and Spec" mtionus
No. 20 ' x 16 ' per plot: plan , specifications and application .
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B. Proposed Use x
Deck to one family
10a00 April 1 , 19 88
$ PERMIT FEE PAID — THIS PERMIT EXPIRES
(If 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.)
of Sept . 19 87
Dated at the Town of Queensbury this
22nd Dayp
SIGNED BY 2 // 6� 4!! for the Town of Queensbury
Building and Zon!nil I nspector ,/fo9qcr'
TO BE COMPLETED BY BLDG , DEFT
J Application No ,
7ogun o/ 0uee►xsl ur5f Permit Issued 19 T� :Jiff 0F" .t.
, ..;.���iE3isn> ,
BUILDING and ZONING DEPARTMENT Permit Expires 19
Bay and kiaviland Road, RID 1 Box 98 zoning DesignationIMlr, it art
Variance No . a
Queensbury, New York 12801 SE
21
Site Plan Review No . 1%jW
43
✓1 Approved by : - �JI
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 descriptions, plans and specifications submitted , and such
special conditions as may be indicated on the Permit . ......
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The owner of this property is : RQMA (�7 Tel . � `�3
P . O. Address
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Property Location :
1 L� AI�1 Tax 'Map No .
Street number or building lat number
Subdivision name (if applicable) 1
THE PERSON REnONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES9 - .J i
r'I )Q Vl (.7+ t. + L1 3 � !lTel , No . ]
Name P . O. Address
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Name of builder K- 07� { �Jt f "yy Address Tel .
Name Of plumber Address
Address Tel ,
Name of mason
NATURE OF PROPOSED WORK :
ZONING INFORMATION :
Construction of a new building
* A PLOT PLAN MUST BE PREPARED AND SUBMITTEDs,
_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 all
set-back dimensions from property lines . Give
Other work {describe) Il # -1f�
of 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 STRUCTURES AFFECTED . * of septic disposal area .
COMPLETE INFORMATION REQUIRED BELOW .
Size of property f �, ft X Vr�' ft .
Existing building ( s ) Size_feC7 ft K _ft .
sr
PROPOSED BUILDING AND USE : * Existing building ( s ) Use
Size of new structure
VD ft X IG ft
Foundation pie slab/crawl/partial/full Proposed buildings, distance from property line
ft Rear yard �] �i ft
(circle one) Front yard ft
No , of stories {habitable space) Side yards _ M( ft and
ft . ft
Height ( grade to ridge ) if on corner , setback from side street
If residential , no . of families OCCUPANCY INFORMATION
No . of rooms ( excluding baths )
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, Industrial PRIMARY STRUCTURE Other
Log cabin
Ranch Contemporary � if addition what will use be?,
Raised ranch Mansion Duplex
Split level Old style Bungalow ACCESSORY BUILDING-
Cape Cod Cottage other Town garage/oneHouse car car
� Detached garageogarage/onecar/ two
Colonial Row car
CIRCLE ONE PLEASE )
{ Attached garage/one Car/ two car/
Private
storage
building
Other
ESTIMATED MARKET VALUE OF
CONSTRUCTION $ � D - -
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 . Wool
Will any second-hand or ungraded lumber be used? If so , for what ? rC�6
Foundation wall material Thickness
Depth of foundation below grade (to bottom of footing ) +
Will there be a cellar? NO Heated or unheated? Floor sq. footage 3z. sq ft
Will there be a basement , 'Q _Wi.11 any portion be used as living space?
( If so , what portion? sq . ft . - - Type of use?
Type of roof - sloped/flat/shed/other f -" Material of roof
Size , wood studs -- " X " spacing "o . ca length ft .
JOists ( floor beams ) lst . floor 2 " "X __ `� " spacing_ ("o . c . span±g ft .
Ioists ( floor beams ) 2nd , Boar "X of spacing "O . c . span ft .
Overlays ( ceiling beams ) c- . ..._� P� spacing "o . c . span ft .
Roof rafters "X r 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 dwell ing?_.tL:.-- if so will a Fire-rated
door , enclosure , and self- closing device he 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 priva te well Lur- jY ( [ f t ?l _
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 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 ornot , and that such work, is
authorized by the owner .
SWORN TO BEFORE ME THIS Signature _day of 19
_Owner , owner _s agent , arcnxrect , contractor -
Notary Public , Warren County , N . Y .
* * * * * * * * * . * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
SPECIAL, CONDITIONS OF THE PERMIT :
By
1
t3E xssuRY r-�
"r U'4 N dF Q ODES pEP ,TMENT
BA
YT,pa HAVILAN ROADS ypRK 128ok
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S,UEETISSURy + (S 8 ) 792- 832
TELEPH(7NE R 5 pow
ING
RECErV�D
BEQUEST FOR E �{
�
NAME
LOCATION #
p�PpROVED
DATE ? YES NO
FoOTINGIpSERS r-- - �--
MONOLITHSC 'OUR S ING
FOUNDATI[7N/D --��
SACKFILL APPROV
ROUGH PLUMBING
FRAMING ~~~
ELECTRICAL ROUGH N.�-----�"�"'�~
INSVLATION:
FOUNDATION
FLOORS
WALLS
CEILING
INAL INSPECTION
CHIMNEY HEIGHT
ROOFING
SSpING CH S/ BPS
E,?CfiERNA POR
CLL'ARAN E � �LIEF VA
X IS
STAIRS- VS/
PLUMBINGLVE
FSX y DOORS
INTERIOR TRIM/ RSV
FINISHED FYAOR FSNG
GARAGE FIREPR
FOR CLOSER (S )
SMOKE DETECTOR INSPE IONS--�
FINAL ELECTRICAL CONS VCTSON_�� �--�-
- FINAL APPROVAL CIC �~
_ 03C '20 ISSN C,O GUPANCy MUST HE
RE
SIGNED CERTIFI ATE:
LOIN DEPARTMENT BEFO
OBTAINED rRom TH T E OCCUPS
THESE PREMISES
REMARKS :
f
INSPECTOR
tt,
1 own o1 Qteeera ,4i "r
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( / � BUILDING and ZONING DEPARTMENT
i� ijl Say and }-raw+land Road, R.D . l Box 98
{ {Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION '%
Date /rig r� d % permit.
* * * r * * * * * NO
* * * * * * * APPROVEzi D - YE
Cuing/Pier Forms G'G
Foundation
Waterproofing
Backf11
Framing
Roofing
Siding
Masonry Veneer
Rough plumbing
Relief Valves
Ext . Porches
Finished Floors
Interior Trim
stairs & Railings
Cellar Drain Tile
Concrete Floors
pl bg . r ixture s
Gar _ Fireproofing
Door Closers
Smoke Detectors
Chimney
IN SU LAT I ON : 1
Foundation
Floor's
Walls
Ceiling
FINAL ELECTRICAL Il3SPECTION - -
DRiVEWAY APPROV �-
Final Building Survey
ection ( call when ready )
Next scheduled tnsp
Rernarks-
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Bui ding Inspector
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