CC-000047-2017 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: CC-000047-2017 Date Issued: Friday, January 26, 2018
This is to certify that work requested to be done as shown by Permit Number CC-000047-2017
has been completed.
Tax Map Number: 307.-1-29
Location: 59 WEST MOUNTAIN RD
Owner: Spencer Montgomery
Applicant: Apex Capital LLC
This structure may be occupied as a: Commercial Interior Alterations 1800 s.f.
By Order of Town Board
TOWN OF QUEENSBURY
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
at Community Development-Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: CC-000047-2017
Tax Map No: 307.-1-29
Permission is hereby granted to: Spencer Montgomery
For property located at: 59 WEST MOUNTAIN 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
Type of Construction
Owner Name: Spencer Montgomery Business Office-Alteration $20,000.00
Owner Address: 59 WEST MOUNTAIN RD Total Value $20,000.00
Queensbury,NY 12804
Contractor or Builders Name/Address Electrical Inspection Agency
Frank Hohman
Plans&Specifications
Commercial Interior Alterations 1800 s.f.
$360.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,February 14,2018
(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/ep�JPirat,,,iJJJon date.
Dated at the Town QuG
eens J // Tu,
u ruary 14,2017
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
PRINCIPAL STRUCTURE APPLICATION Office Use Only
/ Received
Date: / Tax Map ID
Tax Map ID 30 _ l -yg Permit No. C.C.. -OA's -2019r
Permit Fee A NOD'
Zone Ree-Fee 1 ywo'u-, 14104
Historic Site _Yes X No Site Plan#
Subdivision Name Lot# Subdivision#
Project LocationJ`9 il/o,A XW w aiX .
QUcc�l�ir�r /a2
TOWN BO. 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 G 141 -/4 i h Owner GfC Cwt of LLC
Address Address q /�
Phone/E-mail AO� Phone/E-mail JF
G�Co6 ��lGS7s/37'�t,
s-
Contact Person for Building&Codes Compliance: 14:;�a A Q Phone P19-?e1d',TXZ
TYPE OF CONSTRUCTION
✓Check all that apply New Addition Alteration 1"floor sf 2nd floor sf Total sf Height
Single Family
Two-Family
Multi-Family
(#of units
Townhouse
Business Office
Retail-Mercantile
Factory-Industrial
Attached Garage
+
Other �Q u x �► 0
If commercial or industrial please indicate of business
Town of Queensbury Building&Codes Principal Structure Application Revised September 2015
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
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 comer 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; i4!C,b A1093 6a N"/ DATE: l 7
SIGNATURE: A4 7
DATE:
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 2015