RC-000064-2017 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: RC-000064-2017 Date Issued: Friday, July 28, 2017
This is to certify that work requested to be done as shown by Permit Number RC-000064-2017
has been completed.
Tax Map Number: 308.8-2-12
Location: 497 SHERMAN AVE
Owner: Sharlene Morehouse
Applicant: Sharlene Morehouse
This structure may be occupied as a: Single Family Dwelling(dining room)
Addition 30 sq. ft. By Order of Town Board
Single Family Dwelling(dining room) TOWN OF QUEENSBURY
Alteration 160 s.f.
Cross Ref.Area Variance Z-AV-7-2017
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-000064-2017
Tax Map No: 308.8-2-12
Permission is hereby granted to: William Morehouse
For property located at: 497 SHERMAN AVE
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: Sharlene Morehouse Attached Garage-Alteration $8,000.00
Owner Address: 497 Sherman AVE Total Value $8,000.00
Queensbury,NY 12804
Contractor or Builders Name/Address Electrical Inspection Agency
William Morehouse
497 SHERMAN AVE
Queensbury,NY 12804
Plans&Specifications
Single Family Dwelling(dining room)
Addition 30 sq.ft.
Single Family Dwelling(dining room)
Alteration 160 s.f.
Cross Ref.Area Variance Z-AV-7-2017
$100.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,March 15,2018
.(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 expiration date.)
Dated at the Town of ueensb •J/feg
c 5,2017
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
4a ADDITION/ALTERATION PERMIT Permit#: (�- �((�► - 2���
APPLICATION Permit Fee: $ 106
rorvn of Quccnsbun
742 Bay Road,Queensbury, NY 12804 Invoice #: b
P:518-761-8256 www.gueensburyl.net
Project Location: '4 CCI ��1 1/
E _
p r � C FEO C L
Tax Map ID #: 3 CJ , 27 — 2 1 2 Subdivision Name: Ing
FEB 2 4 2017
CONTACT INFORMATION:
TOWN OF OUEENSBURY
• Applicant: BUILDING & CODES
Name(s): S kow l e-Ae, r l bf � lse
Mailing Address, C/S/Z: r )er MG; 'ec
Cell Phone: Land Line: �)
Email:
Primary Owner (s)- 1
Name(s): f Yl S
Mailing Address, C/S/Z: Upp VC S C MCLrNC
Cell Phone: A Land Line: �)
Email:
• Contractor(s): 1
Business Name: t�\ lC T CUA Ce
Contact Name(s):
Mailing Address, C/S/Z: LA e C n
Cell Phone: —( Land Line: �)
Email:
• Architect(s)/Engineer(s):
Business Name:
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: A Land Line: �)
Email: 1
Contact Person for Building & Code Compliance: OW,`iQn 1 `(� orel(D USe�
Cell Phone: _�) 7� 6101 _ Land Line:
Email:
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017
PROJECT INFORMATION:
TYPE: Commercial Residential
WOR
CLASS:
—Two-Family _ Multi-Family (# of units )
Townhouse Business Office Retail
Industrial/Warehouse _Garage (# of cars ) _ Other (describe )
ADDITION SQUARE FOOTAGE: ALTERATION SQUARE FOOTAGE:
-11
�� r4
1st floor: 1st floor:
2nd floor: 2nd floor:
311 floor: 3`d floor:
411 floor: 4th floor:
Total square feet: a Total square feet:
ADDITIONAL PROJECT INFORMATIO
1. Estimated Cost of Construction: '
2. If Commercial project, what is the proposed use:
3. Source of Heat (circle one): GasOil Propane Solar Other
Fireplaces need a separate Fuel Burning Appliances & Chimney Application
4. Are there any structures not shown on the plot plan? YES NO xplain:
5. Are there any easements on the property? YES NO
6. SITE INFORMATION:
a. What is the dimensions or acreage of the parcel?
b. Is this a corner lot? YES NO
c. Will the grade be changed as a r ult-cy construction? YES NO
d. What is the water source? PUB_ L PRIVATE WELL
e. Is the parcel on SEWE r a P ATE SEPTIC system?
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017
DECLARATION:
1. 1 acknowledge that no construction shall be commenced prior to issuance of a valid permit and will be
completed within a 12 month period.
2. Ifthework is not completed 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 and/or
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. 1 acknowledge that prior to occupying the facilities proposed 1, or my agents, will obtain a certificate
of occupancy.
5. 1 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 certificate of occupancy.
I have read and agree to the above:
PRINT NAME: si cal,eae_
SIGNATURE: _1 QJY1LP DATE: 2 2
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNIIC�IPAL CERTIFICATE - ELECTRICAL APPROVAL
Permit No KL.................' ! '...Cert.( NO 44844 Cut-in Card No.....................................
Owner......... AS.��..^................... .........
Location.... .. C.A�..................................Q................ ...................
Installation Cons'sting of.lQ.. !lrtfl� .l'��-�1 ��. 1.* ..........................
................................................::.:: :::...........................�............................................................
......................................................_..............................................................................................................................
FAM
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 makin inspections at any time, and if its
rules are violated,the Company shall have the righ�voke thi rtificate.
Date...7nZ ...:./...2................ INSPECTOR ........r...... ... . . Lw. ....................................
Member N.F.P.A.,1.A.E.1.