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RC-000148-2015 c o N 4° d 0p W N �ct z tet' U oW w 4- _ Cy w ° 0 00 Y' n O 00 0 a� vn � Y� u Eli W o 3 �, as 4.1 cn ccuQ ZCJ 0 � � 6 4i '--� '� �" a SSS •� Q o N W U 00 w; pp Ocn Q F to L) p C3 Qcn p ' to 4-1 e 4-A a z v a Z v p p p W y p u ., ab � �, 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-000148-2015 Tax Map No: 289.20-1-16 Permission is hereby granted to: Rick Chase For property located at: 10 MELDON CIR 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 Tyoe of Construction Owner Address: 10 Meldon Single Family-Alteration $20,000.00 Queensbury,NY 12804 Total Value $20,000.00 Contractor or Builder's Name 1 Address Electrical Inspection Agency Rick Chase 20 Marion AVE South Glens Falls,NY 12803 Plans&Specifications Residential Alteration 650 s.0 $97,50 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,November 2,2016 (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 Queen ry; Mo v r 2,2015 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement PRINCIPAL STRUCTURE APPLICATION Office Use Only Received Date: w --21 Tax Map ID Tax Map ID . ,ezo--l 1 �0 ` Permit No, U OCT 19 2015 Permit Fee Zone Rec Fee Historic Site Yes � No � WTUJ --- Site Plan# Subdivision Name G P. CODE; Subdivision# Project Location .'© �� �( GI� TOWN BD. RESOLUTION 86-2013: $850 recreation fee for new dwelling units—single family, duplexes/two-family, multiple family,apartments,condominiums,townhouses,and/or manufactured& modular homes, but not mobile homes. This is in addition to the permit fee(s). Applicant IR l e Owner Address 190 ,1 Q r I D LA A V e- Address f, C-1, f-de- c-o, 5c U4�C-L� ci�k Phone/E-mail t ! Phone/E-mail Contact Person for Building&.Codes Compliance: �.`�( d,4;us L_ Phone 3 &5 t TYPE OF CONSTRUCTION ✓Check all that apply New Addition Alteration V floor sf 2'floor sf Total sf Height Single Family Toro-Family Com' Multi-Family (# of units Townhouse Business Office Retail-Mercantile Factory-Industrial RC-000148-2015 Greg Tallon Attached Garage 10 Meldon Circle (Hiland Crossings) Residential Alteration (1, 2, 3, 4+) Other If commercial or industrial please indicate of business Town of Queensbury Building&Codes Principal Structure Application Revised September 2015 If commercial or industrial please indicate of business ✓ Proposed use of building or addition 1 5 a-WLc.h-1+ Source of Heat(circle one) Qa Oil Propane Solar Other Fireplace: Complete a separate application for Fuel Burning Appliances&Chimneys Are there structures not shown on plot plan? Are there easements on the property? Site Information a. Dimensions or acreage of lot b. Is this a corner lot? c. Will the grade be changed as a result of construction Yes _,� _ No d. Public water or Private well e. Sewer or Private Septic System Value of all work to be performed(labor or materials) 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: a,'J C a' DATE: SIGNATURE: 0':ZDATE: d aOAS— For /S'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 September 2014 4-42 z 8.03 ce r co 0 L:6 0 Or im..S, tw > & 0 E t:6 5 E u U- 'Zo. a Q t.14