RC-000616-2017 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-000616-2017
Tax Map No: 308.10-2-5
Permission is hereby granted to: Nadine Balestrino,Anthony Balestrino
For property located at: 469 LUZERNE 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
Tyne of Construction
Owner Name: Nadine Balestrino Single Family-Addition $17,000.00
Owner Address: 469 LUZERNE RD Total Value $17.000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Paul Levesque
170 Cooper ST
Lake George,NY 12845
Plans&Specifications
Residential Addition 440 sq.ft.
1 st Floor
$100.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,October 24,2018
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensb before the a iration date.)
Dated at the Town Queens �Tue er 4,2017
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Oniv
ADDITIONALTERATION PERMIT P--ri`nit#:—r'-'('
APPLICATION Permit Fee:
742 Bay Road,Queensbury,NY 12804 Invoice#:
P: 518-761-8256 www.gueensbury.net
Project Location:
Tax Map ID Subdivision Name:
CONTACT INFORMATION:
Applicant:
Name(s):
Mailing Address, C/S/Z: t
Cell Phone: S-13 Land Line:/ V)
Email:—
Primary Owner(s):
Name(s): &�4w-jvj Oade'shvll<3
Mailing Address, C/ /Z: qO L-uZertxe- A /JFLI
Cell Phone: 9(l Land Line:
Email: J.S 0 a L(6 A 0,6co
@ Contractor(s):
Business Name:
Contact Name(s): pi
Mailing Address, C/S/Z: 1-7o i-,,5e k1-1
CellPhone: Y(8 Land Line: (
Email:— S n ewt rAQ it-toL-,,A - r-o rn
9 Architect(s)/Engineer(s):
Business Name:
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email:
Contact Person for Building & Code Compliance:
Cell Phone: q YIN e- Land Line:
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Email:
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Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017
308.10-2-5 RC-000616-2017
Balestrino, Nadine & Anthony FILE COPS,
469 Luzerne Road
Residential Addition 440 s.f.
REVIEWED FOR
CODE COM TOWN OF QUEENSBURY
BUILDING DEPARTMENT fiance
Based on our limited examination,comp
with our comments shall not be construed as
indicating the plans ana specifications are in
full compliance with the Building Codes of Q
New York State. 1
TOWN OF QU
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Reviewed B '
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NOTICE
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