RC-000124-2017 TOWN OF QUEENSBURY
742 Bay Road, Queensbury,NY 12804-5904 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: RC-000124-2017 Date Issued: Thursday, May 31, 2018
This is to certify that work requested to be done as shown by Permit Number RC-000124-2017
has been completed.
Tax Map Number: 308.8-1-5
Location: 474 SHERMAN AVE
Owner: Dan Abell
Applicant: Dan Abell
This structure may be occupied as a: Residential Alterations 1250 s.f.
Cross Ref. Area Variance Z-AV-34-2017 approved May 24, 2017 By order of Town Board
replace 1,360 sq. ft. roof portion on existing home and to change roofline profile TOWN of QUEENSBURY
Issuance of this Certificate of Compliance 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-000124-2017
Tax Map No: 308.8-1-5
Permission is hereby granted to: Dan Abell
For property located at: 474 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
Tvceof Construction
Owner Name: Dan Abell Single Family-Alteration $19,500.00
Owner Address: 474 SHERMAN AVE Total Value $19,500.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
Residential Alterations 1250 s.E
Cross Ref.Area Variance Z-AV-34-2017 approved May 24,2017
replace 1,360 sq.ft.roof portion on existing home and to change mofline profile
5187.50 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,May 30,2018
(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 ��uc—e^n�sn�/�\ n �ues 17
SIGNED BY: �7r for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
ADDITION/ALTERATION PERMIT Permit#: PC' 11.4 • Wkl'
APPLICATION Permit Fee: $ lb'V.rD9
Town olQueensbun-
742 Bay Road,Queensbury, NY 12804 Invoice#: )14 01
P: 518-761-8256 www.aueensbury.net
Project Location: `/7y a�p�z Sh%rK�&-N
Tax Map ID #: �-.) 8 . k) Subdivision Name:
CONTACT INFORMATION:
• Applicant:
Name(s): A6 A+�A6 in A—
MailingAddress, C/S/Z: -1 S ✓-Fns'
Cell Phone: -( SjK )_ -7!q— 51 Land Line: �)
Email: D-416o�!-u -7SNS /'SOL- LOQ ,.
• Primary Owner(s):
Name(s): Sn-VIA(
Mailing Address, C/S/Z:
Cell Phone: Land Line: J )
Email:
• Contractor(s):
Business Name:
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email: 2 9
Lul
•
Arch itect(s)/Engin eer(s): Swl�� TB��NG8,COF OSBURY
DES
Business Name:
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: -( Land Line: �)
Email:
Contact Person for Building & Code Compliance:
Cell Phone: Land Line: � )
Email:
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017
PROJECT INFORMATION:
TYPE: Commercial Residential
WORK CLASS:
Single-Family Two-Family Multi-Family (# of units )
Townhouse Business Office Retail
_ Industrial/Warehouse Garage (# of cars ) Other (describe )
ADDITION SQUARE FOOTAGE: A AERATION SQUARE FOOTAGE:
1st floor: 12-SC 1st floor:
2"d floor: 2nd floor:
311 floor: 3"floor:
4t'floor: 4t' floor:
Total square feet: 15� Total square feet:
ADDITIONAL PROJECT INFORMATION: CFU
)p
1. Estimated Cost of Construction: $ 1 / ,S60
2. If Commercial project, what is the proposed use:
3. Source of Heat (circle one): as Oil Propane Solar Other
Fireplaces need a separate Fuel Burning Appliances &Chimney Application
4. Are there any structures not shown on the plot plan? YES Explain:
5. Are there any easements on the property? YES AVO
6. SITE INFORMATION:
a. What is the dimensions�or acreage of the parcel?
^ S
b. Is this a corner lot? `� NO
c. Will the grade be changed as a rejs�� ��)he construction? YES
d. What is the water source? IF, PRIVATE WELL
e. Is the parcel on SEWER or a PRIVA SEP1 system?
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017
DECLARATION:
I. I acknowledge that no construction shall be commenced prior to issuance of a valid permit and will be
completed within a 12 month period.
2. If the work 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 I, 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 a certificate of occupancy.
I have read and agree to the above:/�
PRINT NAME: N Tk &tr --
SIGNATURE: 1OA: Zk-- DATE:
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017
NEW YORK ATLANTIC-INLAND, INC.
MAIN OFFICE: (607)753-7118 /Z4
Atlantic-Inland, Inc. is in the process of issuing a Certificate of
Compliance for the electrical installation project as covered in an
application filed with our main office.
Application#: I
Site Address:
!DtV
Electrical Inspector
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MAP REFERENCE: DEED REFERENCE:
BURNT.HILLS SUBDIVISION DAVID &ANTONELLA MARGISON
DKC HOLDINGS, INC;. TO
DATED:JULY 23, 2001 DANIEL W &DENISE A. ABELL
LAST REVISED:JANUARY 17, 2002 DATED MARCH 11, 2017
BY: VAN DUSEN& STEVES, LLC BOOK,5525 PAGE 8
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169 llavxland Road Queensbury, F E LENDING INSTIlUTON.' Queensbury,
Warren County New Yox k N0. DATE DESCRIPTION No. 17
New York 12804 L C-3076
Town of
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D G. 017
(518) "792 " 8474 .0135
New York Lxc. No. 5
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