1055 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
- Date 19
(ba o\C\k
This is to certify that work requested to be done as shown by Permit.No. 1055. -
has been completed.
This structure may be occupied as a one .-family dwelling.
Location Lot # 8 Ames Place
Owner Donald Clark
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoning Inspector
BUILDING- PERMIT
TOWN OF QUEENSBURY 1055
No.
WARREN COUNTY, NEW YORK 1-'
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PERMISSION is hereby granted to Donald Clark
CJ
OWNER of property located at Lot # 8 Ames Place
Street, Road or Ave.
Cu
in the Town of Queensbury,To Construct or place a one family dwelling.
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
Mason St.
Glens Falls, N.Y.
2. CONTRACTOR or BUILDER'S Name
Bob Dunham -
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3. CONTRACTOR or BUILDER'S Address
Gansvoort, N.Y.
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction— (Please indicate by X)
( X Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
No. 24' X 42' as per plot plan.
8. Proposed Use
Dwelling
$ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES June 1, 197°
(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 Queensbury this 4 Day of December, 19 70
SIGNED BY for the Town of Queensbury
a Building d Zoning Inspector
•
TOWN OF QUEENSBURY
(Space inside block to be filled in by
WARREN COUNTY, NEW YORK Building Inspector)
Application for Application No. • ®
Permit Is. to E' (V. .
BUILDING AND ZONING PERMIT Permit I> IS).
% wing strict .n
• \ ..... r
THREE (3) Copies of a PLOT PLAN, Drawn to scale `\1'1""`c'cl "'
OR
showing the actual dimensions of the lot to be built Keniar & ZOf� NG .INS,.• •7
upon, The exact size, and location on the lot of the II~�If G OE[ $� E�X,
building to be erected or altered MUST BE SUB-
MITTED �F
MITTED WITH THIS APPLICATION. ••
TOWN OF''bUEENSBUR�1
J AT�G I] (�� �1 0__.. -0-°FEE Pj)-XD
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK
ANSWER ALL OF THE FOLLOWING. DEC 1970 The undersigned hereby applies for a permit to do the following work : A.M. P.M.
which will be done in accordance with the description, plans and specifi- ,?I$I9I10I11I12III2I3I4I5IGt
cations, and such special conditions as may be indicated on the permit. A.
The owne his pro erty -
(NAME) (P.O.ADDRESS).
The person respo sibie for •supervision of the work insofar as the Building Code and the Zoning Ordinance apply is:s
(NAME) (P.O.ADDRESS)
Name of Builder 6 �y '') 41'--r.,, Address C—v'1-I
Name of Plumber C.c.) Se..?I Address /T/E .
Name of Mason s Z �y n h a-... Address r-c ' s
Lot Number f Unit Estimated value of proposed work$ ' , 'a L.'
Name of Village '/ w-� 6 C-Ru -e-3-‘r u - -
Name of Street . /4t-,-,_12.- PAD-c Side of street: north ❑, east ❑, south ❑. west ❑
Nearest Cross Street ' .'' ' a n Distance from this cross street ,8°J / Ft.
Property is north 0,south ❑,east �`i west 0 from Cross Street
If on Corner, which corner, northeast ❑, northwest ❑, southeast ❑, southwest
(Designate by marking with an "X" in the correct space.)
• NATURE OF PROPOSED WORK . OCCUPANCY
Construction of a new building. Main Byiltling
❑ Addition to a building. One-family dwelling
❑ Alteration to a building. Two-family dwelling ❑
LI Demolition of a building. -family apartment house ❑
Store building ❑
-car attached garage ❑.
Other:
' Accessory Building
One-car detached garage ❑
Other work. Describe: Two-car detached garage ❑
•
Private chicken house • ❑
Private storage building ❑
Other: •
ZONING SPECIFICATIONS. Fill in for new building, or addition to existing building, or a change of occupancy.
Indicate on the plot plan street names, the location and
• size of the property, the location, size and setbacks of pro-
NORTH posed buildings,and the location of all existing buildings.
Show proposed building(s) in dotted line and existing
Iuilding(s) in solid line.
Size of property 91 ft. x J 3 5 ! ft
Size and use of existing buildings, if any /J ' `J
I.; I..
In
x w r
Size of proposed building . . . Z u ft.x V z ft.
Height (from grade to ridge) /'' ft.
Front yard 3 ft.
. Side yards s. ft. anSI '51 .ft.
Rear yard fJ ft.
SOUTH If on corner,setback from side street ft.. ..
Note: All distances are net, as measured from street side
line to nearest part of building.
(OVER)
(cont'd.)
BUILDING SPECIFICATIONS., ..
Kind of construction: Wood frame, fire safe, etc.2 a a
Will any second-hand lumber be used? . . ."`-?:°.,.v L— . If lo, for what?
Material of foundation walls "`�" d '' K Thickness
Depth of foundation walls below grade 5 - Continuous foundation?
Will there be a cellar? . . t,o If so, material of cellar floor Co =-r-e
Type of roof: Sloped or flat? S(� Material of roof /.s p xi-,..,..,y Ica-..,,Size,wood studs 2- . . . "x �' ", spacing 1 4,. . . ."o.c., length ft.
r
Size, floor beams, 1st floor 2- "x . ", spacing / ' "o.c., span 1 Z ft.
/ •Size, floor beams, 2nd floor "x ", spacing "o.c., span ft.
Size, ceiling beams Z- "x '' ", spacing / 4. . ."o.c., span / Z' ft.
Side, roof rafters or beams "x ", spacing / "o.c., span /b- ft.
Exterior finish 4 ? fs With what material? L2".
Finish of interior walls 54-4.-2-try c, k
If garage is to be attached, of what material is wall between garage and main bui<14ing to be constructed?
Is there to be an opening betweengarage anjl building? — -
Kind of heating system / � /� ,/. Oil burner or coal? ,i�-P
Will a flue-lined chimney be provided? /27� - ) Depth of chimney foundation below grade
Height of chimney above roof 02
Will there be a fireplace? °t,o Depth of fireplace hearth
Will a toilet be installed? �-e...a, - '
Will a kitchen sink be installed and connected to water supply? /-e---,.
Water supply(public water supply or pump) . . . ()?.'-t�. e
Distance of cesspool from any private well 1 D ' feet
Will drainage system be provided with required traps, cleanouts, and vents? . .>l-moo
Town of Queensbury AFFIDAVIT
County of Warren ss.
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 sub-
mitted, are a true and complete statement of all proposed work to be d n the descrmtses and that all provisions of the BUILD- -
ING CODE,THE ZONING ORDINANCE,and all other laws pertaini4 to a propo wor all be complied with,whether specified or not,
and that such work is authorized by the owner. (/J ,z-1Q
Sworn to before e this Signature
GL�! AGENT,=.ia G`.-Af4:-.• . •na
RZ �/ddayof G' e ',p,� 197G
-r-e--s�-e-e -/i-c3 „. /\ RU.SSELL..W. GERLACH
NOTARY PUBLIC, W -RfEN-GOUN-T-Y—N?. Notary Public,State of New to.k
Itesidlnu in S rrtoaa gG461,.y .
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SPECIAL CONDITIONS OF THE PERMIT: ,o9{yl�,rLch,y3!; �.
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tJIL.D N NING.";1NSPE,CTOI .
'OWN OF 'QUE�.NSBURY.
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