1987-630 BUILDING PERMIT
TOWN 4F +QUEENSBURY No. 87-630
y WARREN COUNTY, NEW YORK
� r Bernice LaCarte Y
PERMISSION is hereby granted to 4i
I
21 Lower Dix Ave .
OWNER of property located at 1 Street, Road or Ave. to
in the Town of Queensbury, To Construct or place a Storage Sized
at the alcove 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.
1 . O WN E WS Address is ro
121 Lower Dix Ave .
Queensbury , N . Y . 12801
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2. CONTRACTOR or BLH LDER'S Name
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Donald Miner
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3. CONTRACTOR or BUILDER'S Address
121 Lower Dix Ave .
Weensbury , N . Y . 12801
4. ARCHITECT'S Name
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5. ARCHITECT'S Address cri
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S. TYPE of Construction — (Please indicate by X) PCa
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I x1 'Wood Frame i ) Masonry I ) Steel
7. PLANS and Specifications
No. 241 x 301 per plot plan , specifications and application
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$. Proposed Use o
Storage shed p"i,
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$ 10 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES April. 1 , .1cia8
(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_)
Dated at the Town of Oueensbury this 21 s t Day of
�'Sept .
]e p t . 19 87
SIGNED BY G[.0 00-1 G! • ,r�Lawe- c� for the Town of Queensbury
Building and Zoning Inspector
To BE COMPLETED BY BLDG . DEFT .
fl
own
Application Noe
.Jow►T of Q"ee►'+ jig4ry Permit Issued 19 TOWN OF Qisl - NSB0R%`
BUILDING and ZONING DEPARTMENT Permit Expires
19
11 1x i] U! I I
Bay and Haviland Road, R. D. 1 Box 98 zoning DesignationLID
4ueensbury, New York 12801 variance No . SEP 11
G. e Site Plan Review No ,
, ' ✓ Approve Y BUILDING I ':OODI ;~ IDE
OLO
APPLICATION FOR
BUILDING AND ZONING PERMIT
A PERMIT MUST Be OBTAINED BEFORE BEGINNING CONSTRUCTION . ANSWER ALL OF THE FOLLOWING *
ereby applies for a Building Permit to do the following work which will
The undersigned h
be clone 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 :
Tel .
P . O . Address / t
Tax Map No . / r
Property Location : lot number
Street number or building
Subdivision name (if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS :
/ w-/�ez ' � S
P . O . Address Tel . Noe
Name
Tel . ?�r�. ' C7G
Name of builder Address !� L "� r � � Tel .
Name of plumber Address
Tel .
Name of mason
Address
IN OFof a new building
OF PROPOSED WORK : * ZC7N I NG INFORMATION :
A PLOT PLAN MUST BE PREPARED AND SUBMITTED ,
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 a
* set-back. dimensions from property lines . Give
Other 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 / GSIJ ft xf .._._„-ft .
* ft X ft _
Existing building ( s) Size
* .•f
PROPOSED BUILDING AND USE : * Existing building ( s ) Use
^
Size of new structure ft Xc� � ft * pro osed ]�uildin distance from roperty line
Foundation-pier/slab/crawl/partial/full * Ia ft
(circle one) Front yard_ ,L0 ..3.ft Rear yard 3 `1
ft
Side yards �
No . of stories (habitable space) /
�. .eft and ---�--� ft
Height ( grade to ridge ) _ !j ft ' If on corner , setback from side street
If residential, no . of families * OCCUPANCY INFORMATION
No . of rooms ( excludi.ng baths) ^�
No . of bedrooms PRI�RY BUILDING -
No . of bathrooms ti/ One family dwelling
Primary heating system Two family dwelling
Type of fuel r 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
Ot he r
Ranch Contemporary Log cabin * If addition , what will use be?
Raised ranch Mansion Duplex
*
Split level Old style Bungalow * ACCESSORY BUILDING-
Cape Cod Cottage Other * r car
Colonial Row Town House Detached garage/one car/ two car/ car
CIRCLE ONE PLEASE
( )
Attached garage/one car/ two car/
* * * * * * * * ,* * ,� .� * * * * * * Private storage building
Other
ESTIMATED MARKET "VALUE OFF
*
CONSTRUCTION
SHEET , TO BE COMPLETED !
INFORMATION ON BUILDING SPECIFICATIONS . ON REVERSE SIDE OF THIS
Form BPA 4/86 and-vl
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS :
Type of construction , wood frame , fire safe , etc .
Will any second-hand or ungraded lumber be used? If so , for what ?
Foundation wall mate ria ickness
Depth of foundation below grade (to bottom of footing ) J ; A4
Will there be a cellar? . L, Heated or unheated? �� Floor sq . footage d sq ft
Will there be a basement? �,.. Will any portion be used as living space ?
( If so , what portion? _sq . f't . - - Type of use?
Type of roof - sloped/flat/shed/other Material . of roof r'
Size , woad studs " X spacing_ "o . c . length rift .
Joists { floor beams ) 1st . floor "X _spacing ^o . c . span ft ,
Toists ( floor beams ) 2nd . floor "X " spacing "o . c , span ft .
Overlays (ceiling bea{yms ) "X " spacing '"o . c . span ft .
Root rafters "X spacing O . C . span ft .
Roof trusses (
pre-engineered) spacing_ "o . c . span ^ � ft .
Exterior wall finish 7 / -- /' / 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 betweeyi garage and dwelling? If so will. a Fire-rated
door , enclosure , and self-closing device be provided?
Will a flue-lined chimney be installed? /S( O 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 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 or not , 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 .
* * * * * * * * * . * * * * * * * * * * * * It * IF * * * * * * * * * * * It
SPECIAL CONDITIONS OF THE PERMIT :
By
Jo urn o� Q"eenyhcere�f
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road. R.p . 1 Box 98
oueensbury, New York 12801
BUILDING INSle�
ECTOR ' S REPORT
NAME C
LOCATION ? al/ / s
Date /
Permit No .
APPROVED - YES i30
Footing/Pier Forms
Foundation
Waterproofing f
Backf i ll
Framing
Roofing
Siding
masonry veneer
Rough Plumbing
Relief Valves
Ext , Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg , Fixtures
Gar . Fireproof ' g
Door Closers
Smoke Detect rs
Chimney
IN STJLATi ON
Foundation
Floors
walls
Ceiling
FINAJ, ELECTRICAL INSPECTION
RIVEWAY APPROVAL,
Final Building Surveys
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ext schedule in, ectlon call when ready )
Res- 0
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Building inspector
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and avifand Ne y ork 12801 I 'Bax
Queenstaury,
S REPORT
gU1LDiNG INSFECTQRt �
NAME
LOCATION
-�-
� - Permit No *
Date t G
* * No
APPRC7VED -
Footing/pier Forms
Foundation
waterproofing
Backfi
I Y,!wFatSiing
(,,•F'oo f i ng
siding
masonry Vene r
Rougy, Plumbin
Relief Valves
Ext . Porches
Finished Floors
Snter icrr 'Trim
& Ra i l i n
stairs _-----
cellar 'Drain T le
Concrete Floo s� _-------"�
F ixtur S
P1bg - r
Gar . Firep
Door Close --
Smol{e 'fret ctors�
Chimney
'IDS SU I A'T LS
Foundat on
Floors
wal1 =
Ceiling SNSPECTIUW
FiNAI FLEC'TRXCAL
f}RIVEWB Y ildin8V 5urvey�- �--�
Final
Z t scheduled insP
ection Ccall when ready ?
Rejnark6-
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B z ding Inspector
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.�Icrwn v� �a,.seen y ,� eere�.
ENT
B%jILDiNG and ZONING DEPAR gOx $S
Bay and FiaViland New Yore, 12801
Clueensbury,
INSPECTOR ' S�'�REPOR'T
MA�7���
NAME
c
LOCATIONG�
Zirl Permit Na .
Date '� * * * * * * YES* " Lao
tingfpier Forms
Foundation
W ate rprOO f i.ng
gackf i.11
Fram:tng
goofing
Siding
,,sonry Veneer
gsaugh pluu* ing
Relief Valves��_ �� �—
,,t, , porches
Finished Floors
Interior Trim
Stairs & Railing's
Cellar Drain Tile
Concrete Floors
Flog . Fixtures
Gar . Fireproofing
Door Closers
Smoke Detectors
chimney
IN SU IAA`t ION
Foundation
Floors
Walls
Ce ll ing INSpFCTION
FxraAxa �x,FCT�ICAI.
Final Building 5uXvey �-
led inspection
call when ready
Next schedu
Remarks-
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Building Inspector
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