1986-603 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 86-603
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Roger and Jackee Vaughn
OWNER of property located at 1 Colonial Court corner Dixon Road Street, Road or Ave.
in the Town of Queensbury,To Construct or place a One—Family Dwelling (alt. roof) 7y
at the above location in accordance to application together with plot plans and other information hereto filed and Q°q
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is 0
Colonial Court
Queensbury, NY
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2. CONTRACTOR or BUILDER'S Name m
Mustardseed Services
3. CONTRACTOR or BUILDER'S Address
Box 46
Glens Falls, New York
4. ARCHITECT'S Name
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5. ARCHITECT'S Address 0
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6. TYPE of Construction—(Please indicate by X)
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( )Wood Frame ( 1 Masonry ( )Steel ( 1 n
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7. PLANS and Specifications
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No. alterations to roof per specifications and application submitted. H.
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8. Proposed Use - py
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One-Family Dwelling (roof alteration) p,
$ 36.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 1 19 87 rt
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(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the rh
town of Queensbury before the expiration date.)
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Dated at the Town of Queensbury this 19th Day of September 1g 86 r+
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SIGNED BY -in a a s���� for the Town of Queensbury
Building and Zoning Inspector
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TO BE COMPLETED BY BLDG, DEPT.-.
c� // Application No.
own ol Queenibur, Permit Issued 19 TOWN OF faUE J�
BUILDING and ZONING DEPARTMENT Permit Expires 19 ®URY
Bay and Haviland Road, R.D. 1 Box 98. • Zoning Designation RECE. Ii. VE -11
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Queensbury, New York 12801 -Variance No.
. - - Site Plan Revi.pw No. 5kr �9�6
M. -5�� - (6-
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-I' ,� -I — 1, 3 Approved y cC P.M.
�718i911��1 u)1)2i3)41516
APPLICATION FOR ALA •L iL3-� . ,
Ay a �16 ,
BUILDING AND ZONING PERMIT
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' 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 of this property is: PoCE6t -SA-cxcV S V A.tw.J 1/G(6/9 Li
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▪ P.O. Address t h,,,E, eamdar Gut5os l-a+A.s 1 u tA k 2,Aa1 Tel.
Property Location: C lo,2,.JEA. 6Z ico.j Mo4h t. Prot co,..„ti.r Tax Map No. / /
Street number 'or building lot number
Subdivision name( (if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
t uss-#va0sttI.) Sgau.,ss 3Au 44 (.t .as rin�.s .1 J..►tit 11-gn r 1 1 - 431E
Name P.O. Address Tel. No.
Name of builder Skutt. 45 Afso.r� Address • Tel.
Name of plumber 1.44 Address Tel.
Name of mason ,,,/A Address ' - - - Tel:
NATURE OF PROPOSED 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 work (describe) * set-back dimensions from property lines. Give
* street and number or lot number and indicate.
• FOR DEMOLITION PERMIT STATE •
SIZE AND * whether interior or corner lot. Show location
LOCATION OF STRUCTURES AFFECTED. ' * of water supply and location and configuration
* of septic disposal area. -
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* COMPLETE INFORMATION REQUIRED BELOW. •
. . * Size of property ft X ft.
* Existing building(s) Size ft X ft.
*. . . . . . . . . . . . . . . . . . . . . . . . .
PROPOSED BUILDING AND USE: * Existing building(s) Use
Size of new structure' ' ft 'X ' ft * '
Foundation-pier/slab/crawl/partial/full * Proposed building, distance- from property line
(circle one) * -
* Front yard ' . • ft Rear yard ft
No. of stories (habitable space) * Side yards ft and ft
'Height (grade to ridge) ft. * If on corner, setback from side street ft
If residential, no. Of families
No. of rooms(excluding baths) ' ' . ' ' ' * OCCUPANCY INFORMATION .
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No. of bedrooms • •
No. Of bathrooms * PRIMARY BUILDING -
Primary heating system • • �( One family dwelling
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Type of fuel • • • * Two family dwelling
No. of fireplaces to be installed • * Multiple dwelling / Number of units
Will a wood stove be installed? * Permanent occupancy
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Central Air conditioning? *. . Transient occupancy
* Business
BUILDING STYLE, PRIMARY STRUCTURE *" Industrial
Ranch Contemporary Log cabin * Other
Raised ranch Mansion Duplex
* If addition, what will use be?
Split level Old style Bungalow �`• �� �� '��~ per`
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 car/ ' car
* * * * * * * * * * * * * * * * * * ' ' 'Private storage building
ESTIMATED MARKET' VALUE OF - -: *' ' Other •
CONSTRUCTION 1_• 0 0
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INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
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Form BPA 4/86 and-vl
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• BUILDING PERMIT APPLICATION CONTINUED -
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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 material Thickness
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 Materials-of roof 5Hr44c1
Size, wood studs Z "X 4 " spacing 14 "o.c. length ft.
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Joists(floor beams) 1st. floor "X " spacing "o.c. span ft. •
Joists (floor beams) 2nd. floor - "X " spacing "o.c. span ft.
Overlays(ceiling beams) 'L "X " spacing ‘hr "o.c. span ZA ft.
Roof rafters 1•• "X , " spacing 14 o.c. span 2¢ ft.
Roof trusses(pre-engineered) spacing "o.c. span ft. •
Exterior wall finish Of what material?
Interior wall finish:• 1/1.," •
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 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 for any repair or new installation of septic system)
Town of Queensbury AFFIDAVIT STATE OF NEW YORK
County of Warren
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 propos d workshal!l be complied with, whether specified or not, and that such work is
authorized the ow er.
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SWORN TO BEFO THIS Signature 0
Owner, owner's age ,arcnitect,contractor
' day of 19 .
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Notary P ic, Warren C unty, N.Y.
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. SPECIA CONDITIONS OF THE PERMIT:
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By
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( 9/dq/ t, /7-711
Jown oi Queeniktry
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION 1, d/OP)) Cf G oc/,,���
pixoi
Date 7/30 /fib Permit No. 36 , e,
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✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing _ 6,Daf
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs &Railings—" a -- -
Cellar Drain Tile \R
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
Final Building Survey ,
Next scheduled Inspection(call when ready)
Remarks- -
A) Pruutt es- vssf?rs
6.5
sU pqo t>'-rs
1,14
Buillding Inspector
6/86 and-vl
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