1987-631 BUILDING PERMIT
TOWN OF +QUEENSBURY �
. 1 -7 _
No• 87`63I
WARREN COUNTY, NEW YORK
�
PERMISSION is her, an
y granted to Dr . & Mrs , S . Karp �
OWNER of property located at UP` w; 9' man..At4 . 1 Ca AL,4 r 1
a
Street, Road or Ave,
in the Town of Queensbu t'ry, To Construct or ,place a Storage Building
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-
I- OWNER'S Address is
Upper Sherman Ave .
eensbury , N . Y . 12801
2. CONTRACTOR or BUILDER S Name
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3. CONTRACTOR or BUILDER'S Address
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d. ARCHITECT'S Name
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5. ARCHITECT'S Address
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S. TYPE of Construction — {Please indicate by X)
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f N Wood Frame I ) Masonry f 1 Steel { }
7• PLANS and Specifications
No. 12v X 16 ' per plot plan s ecificatians and' p application .
8. Proposed Use
Storage building for one family dwelling W
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10 . 00 PERMIT FEE PAID — w
THIS PERMIT EXPIRES April I , 88 u4
(If a longer period is required an application for an extension must be �� m
town of t]ueensbury before the expiration date.) made to the Building and Zoning inspector of the W
t3.
Dated at the Town of Queensbury this 21 s t .
Day of Sept . 99 $7
SIGNED BY
Building and Zoning Inspector far the Town of Queensbury
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TO BE COMPLETED BY BLDG . DEPT . TOWN ?0 r,c '"_. 4Pr B .
awn
No .
awn O/ Queenizury Permit Issued 19 I�
BUILDING and ZONING DEPARTMENT Permit Expires 19 SEP 161987
Bay and Haviiand Road, R. D. 1 Box 98 zoning Designation
Queensbury, New York 12801 variance No . f LULL ; 1'�� - : C :�r_ DEPT,
J Site Flan iew No .
/e ' I c3 Approve by-: (� C�q li
7S / APPL ICATION FOR7 4o
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 .
The owner ofthis property is :
P. O. Address Tel ,
Property Location : t•4 r `. ` �.Vr ti^�^. _�_ Tax Map Noe
St eet number or building lot number
Subdivision name ( if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS :
" r f5s � �...) � err._.. `J (�� �l Sc Y �f ^
Name P . O . Address Tel . No .
Tel .
Name of builder NJ g Address Iltz_. r ,c I
Tel .
Name of plumber N t� Address
Name of mason Tel _
NATURE OF PROPOSED WORK : ZONING INFORMATION :
\,r''/Cons'truction 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 ft x� . � 3t G3ft .
Existing building ( s ) Size ft X ft .
PROPOSED BUILDING AND USE :
Existing buildings ) Use
Sire of new strut e 1 ft X � ln ft
* distance from property line
Foundation-pie sla crawl/partial/full Proposed building ,
circle one ) * Front yard �,c "[ � ft Rear yard Cho } ft ,
Now of stories (habitable space ) 1 ft and Esc\ a ft
Side yards k Q o , p
Height ( grade to ridge ) ft • If on corner , setback from side streetN T+ ft
If residential , no . of families N G
No . of roomz ( excluding baths ) � OCCUPANCY INFORMATION
No. of bedrooms pR BUILDING -
No . of bathrooms C1 A ne family dwelling
w
Primary heating system TH,o family dwelling
Type of fuel Pt Multiple dwelling / Number of units
Noe of fireplaces to be installed N Permanent occupancy
Will. a wood stove be installed? f { Transient occupancy
Central Air conditioning?_ r3 � Business
BUILDING STYLE, PRIMARY STRUCTURE Industrial
�, Other
Ranch Contemporary Loci cabin if addition , what will use be?
Raised ranch Mansion Duplex
split level Old style Bungalow ,
Cape Cod Cottage r- OIL ' ` ` � '� ACCESSORY BUILDING-
Colonial Raw Town House " Detached garage/one car/ two _ car/ car
{ CIRCLE ONE PLEASE )
* sw. Attached garage/one car/ o ca car
* Frivate 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
BUILDING PERMIT APPLICATION CONTINUED
BUILDING SPECIFICATIONS :
Type of construction , wood frame , fire safe , etc . \tK) t \ T g �_
Will any second-hand or ungraded lumber be used? If so , for what ? fV
Foundation wall material Thickness
Depth of foundation below grade (to bottom of footing )
Will there be a cellar? Njn Heated or unheated? Floor sq. footage 1 �. �_ sq ft
Will there be a basement? (NC.:) Will any portion be used as living space ? r s `
( If so , what portion? sq. ft . - - Type of use?
Type of roof - 61iope /flat/shed/other Material of roof
Size , wood studs "X spacing 1 , " o . c . length ft . C
Joists ( floor beams ) 1st . floor " X It
spacing "o . c . span ft .
Joists ( floor beams) 2nd . floor "X " spacing ""o * C . span ft .
Overlays ( ceiling beams ) "x " spacing d. "o . c . span ft .
Roof rafters � " X ^ ��" 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 he 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 forfor any �rrepair or new installation of septic system )
Town of f Warren A F F I D A V I T STATE OF NEW YORK
County of 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
authari ed by the weer ,
SWORN TO ET?ORE THIS Signature--2� -_
Owner , owner ' s ag t , arcnitect , contractor
da o 19
Notary Pu ic , Xa
rren County , N . Y .
SPECIAL CONDITION'S OF THE PERMIT :
By
---------------------------------------
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
gpy � HAVII.AND ROADS
QUEENSBURY, NEW
YO92-5�3 0�
TELEPHONE f
BUILDING INSPECTOR' S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION ff//
DATE - K ^{L PERMTT # /
APPROVED
YES NO
FOOTXNG/PXERS
MONOLITHIC POUR FORMS
FOUNDATION,rDAMP-PROOFING��-
BACKFILL APP VAL
ROUGH PLUMBIN
FRAMING
ELECTRICAL ROUGH-.'IN
INSULATION:
FOUNDATION
FLOORS
WALLS
' ��CEILING
+�..FiNAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING 10
EXTERNAL POR ES/STEPS--�_-�-� T�-
STAIRS-CLEARANCE & RAI
PLUMBING FXXTURES/RELIEF VALVE
INTERIOR T IM/PRIVACY DOORS_
FINISHED F.10ORS_�
GARAGE FIREPROOFING
DOOR CLOc;kR (S)
SMOKE DEFECTORS
FINAL ELICCVRICAL INSPECTION�_�
FINAL APPRf?VAL OF CONSTRUCTION
OCCUPANCY MUST BE
A SIGNED CERTIFICAE O
OBTAINED FROM THE T BU OFDrNG DEPARTMENT BEFORE
THESE PREMISES .ARE OCCUPIEDI'
REMARKS:
INSPECTOR
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