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5428 BUILDING PERMIT TOWN OF QUEENSBUR`tf'' No 5428 / fr WARREN COUNTY, NEW YORK P ISSI is Fl�r'i fly grange Elmer X . Evans t=i OWNER of property located at 4 Old Say Road Street, Road or Ave. in the Town of Oveensbury, To Construct or place a Addition to dwellingx 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 ' . D . # 1 Lake George , N . Y . 12845 2. CONTRACTOR or BUILDER 'S Name Same 3. CONTRACTOR or BUILDER 'S Address Same O F-' 4. ARCHITECT'S Name 431 tv r^C C� W 5. A R CH ITE CT'S Address ' 6. TYPE of Construction — (Please indicate by X) (X) Wood Frame € ) Masonry € ) Steel 4 ) 7_ PLANS and Specifications No 20 ' x22 ' per plot plan , specifications and applicationsnu submitted . e• r• rt S. Proposed Use 3 One-Family Dwelling ( additional living area) � rt Q $ 6 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES March 1 1979 m i-i (if a longer period is required an application for an extension must be made to the Building and Zoning inspector of the {� town of CSueensbury before the expiration date.) Dated at the Town of Queensbury this 31 st Day of Augu,s-�t 79 7 8 SIGNED BY � �,, for the Town of Queensbury Building and Zoning Inspector TOWN OF QUEENSSURY � ( Spare inside block to lx• filled in b. WARREN COUNTY. NEW YORK Building Inspt"or) ti11,Tl ;raliun No Application for 4' ir� ri��tr i+�s:rKt 14 BUILDING AND ZONING PERMIT 1'4 " nri1 1a17iT'e Ig r. � , ; v ,M1 l3i�tr;r t THREE ( 3 ) Copies of a PLOT PLAN. Drawn to scale sltowiny the actual dimensions of the lot to be built upon. The exact size. and location on the loft of the building to be erected or altered MUST BE SUB- MITTED WITH THIS APPLICATION. TOWN OF QUEENSS"RIC �iqr[ lJ Y A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK AUG 3 0 1978 /.� ANSWER ALL OF THE FOLLOWING. A.M. G va "� � p' The undersigned hereby applies for a permit to do the following work 71s11i�1. 4y6 which will be done in accordance with the description, plans and specifi- cations, and such special conditions as may be indicated on the permit. The owner of thisproperty is. r C . - 6:s .41 '.'e. rf' . c'. . . . . . . . f"A ,rI 4p o +4C77REgs5Y / The person responsibita. for supervision of the work insofar as the BijPI ding Code and the Zoning Ordinance apply i%: . INIAME} . - . . . . . . . . . . //. 10 o//�`yyANbonEss) , -f . . . .}y./.''. /-:" Lr` i'/ .�,e•t.'" �" _ . //Y/tJ t . . /1 I`.IT./. !- . � . .i ? :F" t' s ^ !�'. C . ' .`•.-"1/ Name of Builder . Address :rI Name of Plumber . . . , . . . . . . . . . . . . . Address Name of Mason -i" !r' s �- - AddruNs . . Lot Number . . . . . . . - . . . . Unit . - - . . . . Estimated value of proposes! work S 3 ° . . . . . . . . . . . . . . . . Name of Village . . . . . . . /.�. . . . . p , Name of Street . . �� �?4� IS ©. V Side of street nctT th 0 , east 12T. south [:3 , west ❑ Nearest Cross Street . . . . . . - Distancefrr;s, l th ;>; 'ross street . . . . . . . Ft . Property is north ❑ , south , east i 1 , west 0 from Cross Street If on Corner, which corner. northeast ❑ , northwest ❑ . southeast gout!twcq't (Designate by marking with an "X" in the corTect sl)Lace.f NATURE OF PROPOSED WORK OCCUPANCY Construction of a new building. Main BuRdding one Tw Addition to a building. -family dwelling Alteration to a building. Iwo-family dwelling E] © D family apartment house Demolition of a building. Store building I . - -car attached garage 0 Othcr� d . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Accessory Building C)ne-car detached garage t� ❑ Other work. Describe: . . . . . . . . . . . . . . . . . . Z'wo-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 locationt size and setbacks of pro- posed buildings, and the location of all existing buildings. MORTM Shaw proposed building(s) in dotted line and existing l;uilding(s) in solid line. Size of property . . . . . �.' . . . . . ft. x ft. Size and use of existing buildings, it any . . - W w Size of proposed building . . t d - . . ft. x _ ft, Height (from grade to fridge) ft. Front yard /. L7✓' . . . . . . . . . . . . . . . . . . . . . . ft, Side vards ft. and . . . -:ram/ 1 ft, Rear yard . . . ,/. Xzz-. f. . _ . . . . . . . . . . . . . . . . . . . . ft. sou If on corner, setback from aide street • . . . . . . . . . . . . . ft. ,Note: All diseartces are nett as measured Dram street side lime to nearest part of building. 7 {OV E R3 BUILDING SPECIFICATIONS.1 Kind of construction: Wood frame, fire safe, ekc.? . . . . , , . .' 1" . . . . . +^.4 "'r.`•}. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Will any second-hand lumber be used? 0 . . . _ . . if so, for whit? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . < < . . . . . Material of foundation walls . _ _ . . . ':ti{ , ? + .eT . . . . . . . . . . . . . . . . . . Thickness . . ,e:'T . . . . . . . . . . . . . Depth of foundation walls below grade . . . s}° ': . . . . . . . . . . . . . . . . • • • - , Continuous Foundation? Will there be a cellar? . . . . s t. . , . . . . If SO, material of cellar floor . . . . . . . . . . . . . . . Type of roof: Sloped or fiat? _ . . S /`� ?� a . , . . . Material of roof . . y, . ^��r: r S ize, wood studs . . . . . . . . . . . . . . . . . 1� . "' x _ . . . . . . . . . _ . . ", spacing b y i . . ."o.c., length . . . . . . , ft. Size, floor beams. Ist floor . . . . . . _ . . " x . . . . . . . . . . . . . . "', spacing _ . . . . .16. . . . . . "o.c_, span _ . . . . . . _ . . . . . . ft. Size, floor beams, 2nd floor x . . . . . . . . . . . . . . . "'. spacing . . . . . . . . . . . . . . "o.c., span . . . . . . , . . . , . . . ft_ Size, ceiling beams . . . . . . . . . . . . . . . . . x ", spacing "o.c., span , . . . . . . . . . . . . . ft- Siz'e, roof rafters or beams . 4,Z. " x �.0 S.6{` . . ", spacing . . . . . . . .� : . . "'o.c., span . . , ,A, G . . . . . . ft_ Exterior finish . . . . . . . _J^V %" ' t With what material? hry�a.r� r i-> Finish of interior walls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . If garage is to be attached, of what material is wall between garage and main buij4ing to be constructed? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Is there to be an opening between garage and building? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Kind of heating system . . . . . . - V ; i. - . • - . . - . . - . . . , Oil burner or coal? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Will a flue-lined chimney be provided? G'•`.LL S . • • • - Depth of chimney foundation below grade . . ._101 . . . . . . . . . . Height of chimney above roof . . . 3 .' . . . . . . . . . . . . . . . . . . . . Will there he a fireplace? _ . . V4%57 . . . . . . . . . . . . . . . . . Depth of fireplace hearth . . . : : _ . . . . . . . . . . . . . . . . . . . . . . . Will a toilet be installed? . . . . . - r- C7. . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , , . . . . . . . . . Will a kitchen sink be installed and connected to water supply? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Water supply (public water supply or pump) . , . , . . J ". .. . . . . . . . . . . . . . . . . . , . . . , , . , . . , , _ . , , . . . . . . . . . _ . , . Distance of cesspool from any private well . . . . . . . . . . . . . A. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . feet Will drainage system be provided with required traps, cleanouts, and vents? . . . . . . . . . . . . . . . . . . . . . . . Town of Queensbury AFFIDAVIT J County of 'Warren State of New York I swear that to tt Aaiof my know,iedge and belief the statements contained in this application, together with the pkam and specificatims oub- mined, are a true and co.l.plete statement of all prupiosed work to be done onthe deaeribed premtsee and that a a of the BUILD- ING CODE, THE ZONING ORDINANCE. and all other laws pertaining'Cy? roposed work be asrnptied with, whether apecil'led or not, and that such work is authorized by the owner. Sworn to before me this Signature . . . . . . [!' - ---. _ Ori ER, O NER'S AGENT, AfiC CT• CONTRACTOR .. . . . . . ..day o#. . . ._ . . . .. __. . . .. . . . . . __. . _. . . _.. , ... . . ..19. . . ... . . NOTARY PUBLIC, WARREN COUNTY* N. Y. SPECIAL CONDITIONS OF THE PERMIT: By . . .. .. .. . . . . . .. .. ... . . ... .. . . . 9rMt7a ,r rc fvcvOil CL-V 3 r kt rr l"i 0' � f7d:�,fCio#/�Y {77�7, i Y.7 10 � yF ; ,z��x`�s<n�'� ."l � _ •5 Y// ram > v 60 14 y y y - �' s7 i'� ,�-'� ' v ` _ / '+� J t•r a„ .. .fit FF C7. ! ' �f mid 4 rjt'y " �t r � � � r #f •#�i. i. i` t �#},y is