RC-000030-2017 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
s
Community Development-Building& Codes (518)761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: RC-000030-2017 Date Issued: Tuesday, May 30, 2017
This is to certify that work requested to be done as shown by Permit Number RC-000030-2017
has been completed.
Tax Map Number: 301.12-2-32
Location: 382 DIXON RD
Owner: Michael Spoerl
Applicant: Michael Spoerl
This structure may be occupied as a:Residential Alterations;725 sq.ft.
new wall and plumbing By Order of Town Board
TOWN OF QUEENSBBUURY
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
OL Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: RC-000030-2017
Tax Map No: 301.12-2-32
Permission is hereby granted to: Michael Spoerl R E VI S .
For property located at: 382 DIXON 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: Michael Spoerl Single Family-Alteration $10,000.00
Owner Address: 382 Dixon RD Total Value $10,000.00
Queensbury,NY 12804
Contractor or Builders Name/Address Electrical Inspection Agency
Michael Spoerl
382 Dixon RD
Queensbury,NY 12804
Plans&Specifications
Residential Alterations;725 sq.R.
new wall and plumbing
$60.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,February 3,2018
(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/exxpiration date.)
Dated at the Town uee ury�y;.—/ / Fri ,F ,2017
SIGNED BY: �^'•,�}// for the Town of Queensbury.
Director of Building&Code Enforcement
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-000030-2017
Tax Map No: 301.12-2-32
Permission is hereby granted to: Michael Spoerl
For property located at: 382 DIXON 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: Michael Spoerl Single Family-Alteration $10,000.00
Owner Address: 382 Dixon RD Total Value 510,000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Michael Spoerl
382 Dixon RD
Queensbury,NY 12804
Plans&Specifications
Residential Alterations;400 sq.ft.
new wall and plumbing
$60.00 PERMIT FEE PAID-TIBS PERMIT EXPIRES: Saturday,February 3,2018
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expirj
ation date.)
Dated at the Town of Qu;ettSbnt9� F�day, �ru 17
SIGNED BY: \J /vl for the Town of Queensbury.
Director of Building&Code Enforcement
PRINCIPAL STRUCTURE APPLICATION Office Use Only
Date: d-30 - 17- Permit No. RC 36-d-017
Tax Map ID Permit Fee
Zone Historic? _Yes _✓No R Fe
Subdivision Name Nb Lot# Site an# 101:2L44$
\ S di 'sion# Nt.W Mn%Lk, l tCS
Project Location _3�z- t� i�.D(� 2.11
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 feels).
Primary Owner(s)
Address
32L \ ;
Kn RA
2..
Phone/Email F CU. ichae,� Zr ` z I cp
Applicant 11
Address
Phone/Email
Contractor
Address
Phone/Email /
Contact Person for Building&Codes Compliance: (�jrV u-CA S PhonkSJl ��(o)-655Z.
TYPE OF CONSTRUCTION
✓Check all that apply New Addition Alt ation 1"floor sf 2"d floor sf Total sf Height
Single Family t/ vl�
Two-Family
Multi-Family
(#of units
Townhouse
Business Office
Retail-Mercantile 017
Factory-Industrial TOWN CF QU—EEN '
SBL RY
COMMUNI DEVELOP
Attached Garage
(1, 2, 3, 4+)
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 Cs 1 rj
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? _Yes _No
c. Will the grade be changed as a result of construction Yes _No
d. Public water or Private well (circle one) Public Private
e. Sewer or Private Septic System(circle one) Sewer rivate
Value of all work to be performed(labor or materials) $ 1 O o O C)
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. 1 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: Ad
/ 9a- d S v er1 DATE: N-30
SIGNATURE: /�GG///� ,� DATE: 0 i -3 0-I7
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
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
Permit No4-'o!0- 2-9 9t_Cert Cut-in Card No.....................................
- NO- 44919
Owner............177,...5
...........................................................................................................
Location.... ;?e.....V X...G.....r........&.;P....../.................................. .........1.......................
InstallaSaid tiop Consisting of ...............
..........................................................................................................
. ..............
....................................................................................................................................................................................
InstalledBy....&...... .............................................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 be promptly made for inspection.
Inspectors of this Company shall have the privilege of making insjfe—clions at any time, and if its
rules are violated,the Company shall have the right- this
Date... ............... INSPECTOR.....xPV ..... ..............................................................
Member N.F.P.A.,1A.E.I.