RC-000372-2016 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
- Community Development-Building&Codes (518)761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: RC-000372-2016 Date Issued: Friday, April 14, 2017
This is to certify that work requested to be done as shown by Permit Number RC-000372-2016
has been completed.
Tax Map Number: 297.14-1-1
Location: 477 RIDGE RD
Owner: PATTEN PROPERTY DEVELOPMENT,LLC
Applicant: PATTEN PROPERTY DEVELOPMENT,LLC
This structure may be occupied as a: SFD 1472 s.f.w/garage 484 s.f.
By Order of Town Board
TOWN OFF QUEENNSSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the
property owner of the responsibility for compliance with Site Plan,
Variance,or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
/
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development- Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number: RC-000372-2016
Tax Map No: 297.14-1-1
Permission is hereby granted to: PATTEN PROPERTY DEVELOPMENT, LLC
For property located at: 477 RIDGE RD
In the Town of Queensbury,to construct or place at the above location in accordance with application together
with plot plans and other information hereto filed and approved and in compliance with the NYS Uniform
Building Codes and the Queensbury Zoning Ordinance
Tvme of Construction
Owner Name: PATTEN PROPERTY DEVELOPMENT)i4eFamily-New $150,000.00
Owner Address: 7 Jackon RD Total Value $150,000.00
South Glens Falls,NY 12803
Contractor or Builder's Name/Address Electrical Inspection Agency
PATTEN PROPERTY DEVELOPMENT, LLC
7 Jackon RD
South Glens Falls,NY 12803
Plans&Specifications
SFD 1152 s.f.w/garage 484 s.f.
$ 303.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Friday,June 23. 2017
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town CrQ1
2016
,jTu
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
PRINCIPAL STRUCTURE APPLICATION Office Use Only
Date: Sia o T I
Permit Na.
Tax Map ID o? 17'7- /4/— ( — I - Permit Fee `1 c
Zone fM D R historic? Yes X No Rec Fee " riv (X4
1
Subdivision Name N A Site Plan#Lot# Subdivision 4
Project Location y`I7 R Rage- 9d, (26V S �
TOWN BD.RESOLUTION 86-207.3: $850 recreation fee for new dwelling units—single family,duplexes/two-family, multiple amity,
apartments,condominiums,townhouses,and/or manufactured&modular homes,but not mobile homes. This is in addition to the t �
permit fee(s).
Primary Owner(s)
Address 614ek1 S rcals
Phone/Email d -en 8 Col ca -
Applicant
sOLw
Address
Phone/Email
Contractor
s a m-p-y
Address
Phone/Email
Contact Person for Building& Codes Compliance: L�IBJ Y1,5 100_-ff�en Phone 510 296_ 15Y
TYPE OF CONSTRUCTION
,/Check all that apply New Addition Alteration 1S,floor sf 2"a floor sf Total sf Height
Single Family V/ t
Two-Family
Multi-Family
(#of units
Townhouse
Business Office
Retail-Mercantile
Factory-Industrial
Attached Garage II��
(1, 2, 3, 4+) "l$� 10,O� 1
Other
Town of Queensbury Building&Codes Principal Structure Application revised January 2016
If commercial or industrial please indicate name of business
Proposed use of building or addition
Source of Heat(circle one) Gas Oil Propane Solar Other
Fireplace: Complete a separate application for Fuel Burning
Appliances&Chimneys �0
Are there structures not shown on plot plan? A f p
Are there easements on the property? /yp
Site Information:
a. Dimensions or acreage of lot 11a'X 67591 37, 6q2 s-F
b. Is this a corner lot? X Yes No
c. Will the grade be changed as a result of construction Yes x No
d. Public water or Private well(circle one) ubli Private
e. Sewer or Private Septic System(circle one) Sewer rivate
Value of all work to be performed(labor or materials) $ 150,000. 00
DECLARATION:
1. I acknowledge no construction shall be commenced prior to issuance of a valid permit and will be
completed within a 12 month period.
2. If work is not complete by the 1 year expiration date the permit may be renewed, subject to fees and
department approval.
3. I certify that the application, plans and supporting materials are a true and complete statement /
description of the work proposed, that all work will be performed in accordance with the NYS
Building Codes,local building laws and ordinances,and in conformance with local zoning regulations
4. I acknowledge that prior to occupying the facilities proposed, I or my agents will obtain a certificate
of occupancy.
5. I also understand that I/we are required to provide an as-built survey by a licensed land surveyor of
all newly constructed facilities prior to issuance of a certificate of occupancy.
I have read and agree to the above:
PRINT NAME: C' ,Yl 5 7. fa#ev1 DATE: 5 ?v1 16
SIGNATURE: DATE: ao 16
For office use only
Operating Permit Issued: Yes No
Occupancy Type
Construction Classification
Assembly Occupancy Limit
Special Conditions
Town of Queensbury Building&Codes Principal Structure Application Revised January 2016
SEPTIC DISPOSAL APPLICATION Office Use Only
Received
DATE: Tax Map ID
TAx MAP ID: o>2 9'] permit No.
Permit Fee
ZONE: Cyt P t,,2
APPLICANT V-i S PHONE/E-MAIL
ADDRESS QJ a as cy I jels.
INSTALLER/ PHONE/E-MAIL
BUILDER S vK-P--
OWNER
ADDRESS
CONTACT PERSON FOR BUIL rNG&CODE COMPLIANCE: Fatter)
PHONE/E-MAIL
RESIDENCE INFORMATION
Year Built #of bedrooms X gallons per bedroom =total Daily flow
1980 or older Garbage grinder installed Yes '/ No
1981-1991 Spa or Hot Tub installed Yes x No
1992-Present 3 - Ib 33d
PARCEL INFORMATION
Topography X Flat rolling Steep slope %Slope
Soil Nature )( Sand Loam Clay Other
Groundwater At what depth:<-" Z T
Bedrock/Impervious material At what depth: -< Z,
Domestic Water Supply t' Municipal Well(if well,water supply from any septic system absorption is_ft.)
Percolation Test Rate: per minute per inch(test to be completed by licensed engineer/architect)
PROPOSED SYSTEM FOR NEW CONSTRUCTION
Tank size 1000 gallons(min.size I,000 gallons,add 250 gallons to size for each garbage cylinder or spa or hot tub
System Absorption field with#2 stone Total length 160 ' ft.;Each Trench 4O r
Seepage Pit with#3 stone AIA- How many: _;Size
Alternative System n/4- Bed or other type:
Holding Tank System /v4 Total required capacity? Tank size #of tanks
Notes: 1)Alarm system &associated electrical work must be inspected by a Town approved electrical inspection agency;2)We will
no longer allow systems to be covered until such time as an As-Built plan is received&approved. The installed system must match the
septic system layout on file-no exceptions.
Declaration: Any permit or approval granted which is based upon or is granted in reliance upon any material representation or failure
to make a material fact or circumstance known by or on behalf of an applicant,shall be void. I have read the regulations and agree to
abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
PRINT NAME: P, as j- Pa 0DATE: S�� //,6
SIGNATURE: DATE: T7'—;9n /6
Town of Queensbury Building&Codes Principal Structure Application Revised January 2016
Town of Queensbury Thomas R.Van Ness
Highway Department Highway Superintendent
742 Bay Road,Queensbury,NY 12804 Home: 518-745-0929
Phone: 518-761-8211
Fax: 518-745-4466 17 David Duel]
•�� Deputy Highway Superintendent
Home: 518-745-0938
DRIVEWAY PERMIT
Date: 5" c3 p 1(,
Applicant Name: 0_+4:P_r)
Telephone No.: 5 r 17 9(a- q(0 5 q
Address to be Inspected 14'77 R j d a e Rd , QbL4
Return.Address: --I Jq cksmrl Rei. S. ins dulls, WV l2�03
Applicant must show exact location and width of driveway(s)to be connected to the highway by placing stakes
at the specified location
The Superintendent of Highways of the Town of Queensbury has reviewed this application. The following action
has been taken:
STEP 1: ( ) Preliminary approval
NEED { ) Slight Swale CY_I S-H t79 Ofyiv ewwl
{ ) Deep Swale fb 10-e
{ ) Level with the road �}
{ ) Level with the top of the paved.wing
Size culvert pipe to be used(if necessary)
( ) 12" ( ) 15" ( ) 18" ( ) 24" ( ) 36"
Preliminary inspection completed by: Date:
Approval by Highway Supt.: or Deputy Supt.:
Upon completion please resubmit this approval permit for a final approval.
.STEP 2: ( ) Final Approval { ) Rejected
Date:
Thomas R.Van Ness,Highway Superintendent David Duell,Deputy Highway Superintendent
Town of Queensbury Building&Codes Principal Structure Application Revised January 2016
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COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
Permit No................................... ....Cert. N O 44900 Cut-in Card No.....................................
Owner...............Q!.....e.P.:7....� t ................................................................ . *'**'**
Location....7.... .. .... ..i.. ..!?�z....... ................................................��.. �........��I.....................
Inst/ablation Consistingonf. .. .. 8. ................. 1. ............
. . ..1 �.........._........................................................................................
.....................................pp.....................s....,,.....................................................................................................................
InstalledBy..............(.. I..I... .!V..................................................Lic.No...................................................
The conditions following governed the issuance of this certificate,and any certificate previously issued is
cancelled:-
This certificate only covers the electrical equipment and installation conditions as of date. Upon the
introduction of additional equipment or alterations,application shall D.hscectipons
omtly made for inspection.
Inspectors of this Company shall have the privilege o aking at any time, and if its
rules are viiollated,the Company shall have the right-to r e hisate.
Date..........l...�.I s/ �.......... INSPECTOR............. ..
.......... ... .................................................................
Member N.AP.A.,I.A.E.1.