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1987-810 BUILDING PERMIT � TOWN OF QUEENSBURY � No. 87-$ 10 z WARREN COUNTY, NEW YORK 2 1 15Fred Alexy , Sr . rr PERMISSION is hereby granted #o �{ i OWNER of property located at •mCwTi=6 Boulevard Street, Road or Ave. u N in the Town of Queensbury, To Construct or place a Loading 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. 1 . OWNER'S Address is 2 Edlson Rd , M Glens Falls , N . Y . 12801rD ca r x 2. CONTRACTOR or BUI LDE WS Name G to Joe Rouller .t 3. CONTRACTOR or BUILDER'S Address Sox 301 Cleverdale , N . Y . H 4. ARCHITECT'S Name pA bC Q C I� to 5_ ARCHITECT'S Address rf r�. 6. TYPE of Construction — (Please indicate by X) 1 Wood Frame I I Masonry { 1 Steel { Concrete Block 7. PLAINS and Specifications G�1 F+• No 12 ' x 12 ' as per plot plan , speci.fleatlons and application . Q S. Proposed Use Add1 tlon of Loading dock r' a w G.. r• 0 ac 10 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES July 1 , 19 $8 0 $ (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the W town of Clueensbury before the expiration date.) Dated at the Town of Queensbury this 2nd pay of December 19 87 SIGNED BY 0�l 'e.C' z-?e for the Town of Queensbury Building and Zoning Inspector , TO BE COMPLETED BY BLDG. DEPT & Jou+n CrieB�� 36sI°t� Application No . Permit Issued 19 BUILDING and ZONING DEPARTMENT Permit Expires 19 i OWN, ( t�l-)E:. . L s� Bay and Haviland Road, R.D. 1 Box 98 zoning Designations Queensbu New York 12801 Variance No. f 11 � r Site Plan Review No . LS NOV2 5 19ur Approved i 1 ' APPLICATION FOR ljfL.f�1fVG�CODE Ll� f]EF'T. BUILDING AND ZONING PERMIT A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. ANSWER ALL OF THE FOLLOWING . The underr;igned 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 : r P . O. Address ��aa �� //G�rC -2 ' Tel . Property Location : L� -�, Lr IG + /� ax Map Noff Street number or building lot number Subdivision name (if applicable) THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS % e- ar, a/' Pr ..-cC r''fr}';• s.�a� }'L� .�x r`!"� Name P. O. Address Tel . Noe Name of builder ����G/ �Co � Address Tel . Name of plumber T Address Tel . Name of mason f . , ,. Address , �'' -- Tel . - Cscs NATURE OF PROPOSES? 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 Other wo k (des ribs} * set-bank dimensions from property lines . Give street and number or lot number and indicate " whether interior or corner lest . Show location FOR DEMOLI ON 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—..'5 ;7 ft x 21�6 ft . * Existing building ( s ) Size ,cy ft Xa a f t . PROPOSED BUILDING AND USE : * Existing building (s ) Use Size a of new structure��ft kz rft `Foundation pie slab/crawl/partial/full Proposed building, distance from property line (circle one ) No . of stories (habitable space ) a * Front yard y'' � ft Rear yard — ft Height (grade to ridge ) ,*'C " * Side yards :! , ss ft and ft If residential, no . of families * If on corner , setback from side street ft No . of rooms ( excluding baths ) OCCUPANCY INFORMATION Nov of bedrooms * PRIMARY BUILDING Nov of bathrooms Ono family dwelling Primary heating system Two family dwelling Type of fuel * Multiple dwelling f Number of units No . of fireplaces to be installed Will a wood stove be installed? Permanent occupancy Central Air conditioning? — Transient occupancy * Business BUILDING STYLE, PRIMARY PRIMRY STRUCTURE * Industrial Ranch Contemporary Log cabin * Other Raised ranch Mansion Duplex * If addition , what will use be? _ 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 ear/ car * * * * * * * * * * * * * * * * * * Private storage building ESTIMATED MARKET VALUE OF * =Other CONSTRUCTION ,,.r+� INFORMATION ON BUILDING SPECIFICATIONS , ON 'REVERSE SIDE OF THIS SHEET, TO BE COMPLETED , Form EPA 4/86 and-vl BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATIONS : Type of construction , wood frame , fire safe , ete . �,�,c - �c / 3 �cc /� •+ C�✓Cz �T Will any second-hand or ungraded lumber be used? If so, for what ? .E/o Foundation wall material Thicknessr r` 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? Type of roof - sloped/flat/shed/other Material of roof Size , wood studs "X " spacing "o . co length ft . Joists ( floor beams ) lst , floor "X spacing "o . c . span £t . Joists ( floor beams ) 2nd . floor "X IN spacing "9 . c . span ft . Overlays (ceiling beams ) "X " spacing "o . c . span ft . Roof rafters "X or spacing o . c . span ft . Roof trusses (pre-engineered) spacing " o . c . span ft . Exterior wail finish /;q , .. Of what material? � .y_� _ c_, ,_ r ./ 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 he provided? Will a flue-lined chimney be instal-led? 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 1 e T D Tl A �Y f l T STATE OF NEW YL7RK 1 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 Signatu -__-_ _____ -=��+►�� Owner , owner ' s agent , arcnizeK , contractor � day of /�,�� / 19 `� Notary Public , Warren County, N. Y . SPECIAL CONDITIONS OF THE PERMIT : By---- ------------- .......... TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS ¢UEENSBURYr NEW YORK 12$0$ TELEPHONE (518) 792-5832 13LJIL.DING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED NAME LOCATION p �^ DATE � r��^ l PERMIT" /i_ / +..) APPROVED YES NO FOOTING/PXERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFI PPROVAL ROUGH PLU ING FRAMING ELECTRICAL UGH-IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING ,SIDING EXTERNAL PORCHES/ST P STAIRS-CLEARANCE S RAI PLUMBING FIXTURES RELIE ALVE INTERIOR TRSM/P ACY DOD FINISHED FLOORS _ GARAGE FIREPR ING DOOR CLOSERS SMOKE DETEC S _! FINAL ELECTRICAL INSPECTION FINAL APPROVAL OF CONSTRUCTION A ,SIGNED CERTIFICATE OF OCCUPANCY MUST OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED? REMARK'S: me 44ISPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVTLAND ROADS QUEENSSBURYs NEW YORK 12801 TELEPHONE (518) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVEDAk, C3� NAME J - LOCATION ,PATE i PERMIT #_ \ l� APPROVED YES INO FOOTING/PIERS MONOLITHIC POUR FORMS FO UNDA XIO N/DAMP-PROOFING BACKFI APPROVAL ROUGH P UMBING AN FRAMING ELECTRICA ROUGH-IN INSULATIO FOUNDATaTO FLOORS f WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCH091STEPS STAIRS-CLEARANCE 6 RAILS PLUMBING FIXTURES/RELIEF VALVE_ INTERIOR TRIM/PRIVACY DOORS FINISHED FLOORS GARAGE FIREPROOFING DOOR CLOSMR (S) SMOKE DETkCTORS FINAL ELECTRICAL INSPECTION FINAL APPROVAL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS : �- 1 j ? 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