AST-000460-2017 TOWN OFQ UEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: AST-000460-2017 Date Issued: Wednesday, August 30, 2017
This is to certify that work requested to be done as shown by Permit Number AST-000460-2017
has been completed.
Tax Map Number: 302.17-3-27
Location: 46 HIDDEN HILLS DR
Owner: CHARLES LEMERY
Applicant: JEFFREY INGLEE
This structure may be occupied as a: Residential Addition(roof system) 140 s.f.
By Order of Town Board
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
+E Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: AST-000460-2017
Tax Map No: 302.17-3-27
Permission is hereby granted to: Highland Custom Carpentry
For property located at: 46 HIDDEN HILLS DR
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: CHARLES LEMERY Pavilion $7,000.00
Owner Address: 46 Hidden Hills DR Total Value $7,000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Highland Custom Carpentry
8 Inglee Moutain RD
Queensbury,NY 12804
Plans&Specifications
Residential Addition(roof system)140 s.f.
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,August 11,2018
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queeneueensb
fore the expi ion date.)
Dated at the Town of �ridot
17
SIGNED BY: r the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
ADDITION/ALTERATION PERMIT Permit#: A)
APPLICATION Permit Fee: $
Town of(2yecnsbum
742 Bay Road,Queensbury, NY 12804 Invoice#: lJ.l
P:518-761-8256 www.gueensbury.net
Project Location:
Tax Map ID #: 3 73 7 Subdivision Name:
CONTACT INFORMATION:
• Applicant:
Name(s): Y
Mailing Address, C/S/Z:
Cell Phone: 5�' ) yy e�!i s Land '-
Email: 7`H,w 5,�.�erg, i% horHe /fr �''.►��•`/ lo.rv.
AF
• Primary Owner(s):
Name(s):
Mailing Address, C/S/Z: �� .(. ! r��v-�- �vPr„/s6 �►! /a8��/
Cell Phone: Land Line: 57--�" ) Z6 i...27/s
Email:—
e Contractor(s): JUL 3 1 2017
Business Name: -�1"AzIffall(
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: 5 Land Line:
Email: ApA,-e
• Architect(s)/Engineer(s):
Business Name:
Contact Name(s): gy
Mailing Address, C/S/Z: - /
Cell Phone: �_) �, , f Land Line:
Email:
Contact Person for Building & Code Compliance: f
Cell Phone: Afi-�.� ) /��-may 7;" Land Line: i )
Email: �9� >�--
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017
I
PROJECT INFORMATION:
TYPE: Commercial Residential
WORK
CLASS:
tLSingle-Family _Two-Family _ Multi-Family (#of units )
Townhouse Business Office Retail
Industrial/Warehouse _Garage (# of cars ) _Other (describe )
ADDITION SQUARE FOOTAGE: ALTERATION SQUARE FOOTAGE:
1st floor: /5�� �a,a SJS{�� ��� 1st floor:
2nd floor: 2nd floor:
3rd floor: 3rd floor:
4th floor: 411 floor:
Total square feet: Total square feet:
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction: $ 7 4�rx;
2. If Commercial project, what is the proposed use: lz�/&
3. Source of Heat (circle one): Gas 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 NOAxplain:
5. Are there any easements on the property? YES CNO
6. SITE INFORMATION:
a. What is the dimensions or acreage of the arcel? /eW y %�
b. Is this a corner lot? YES I O —
c. Will the grade be changed as a result githe con u 'on? Y
d. What is the water source? / P661 ,
U LI�` A
e. Is the parcel on SEWER or a PRIVRSEPTIC 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 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: J z
SIGNATUR DATE:
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017
302.17-3-27
(f AST-000460-2017
/ -- --; Lemery, Charles
/ �a y X46 Hidden Hills Dr.
FILE C 0 P` ;Residential Add. (roof system) 140 s.f.
I
1411
TOWN OF QUEENSBURY (_-
BUILDING DEPARTMENT
Based on our limited examination,compliance rev
with our comments shall not be construed as
indicating the plans and specifications are in
full compliance with the Building Codes of
New York State.
JUL 3 1 2017
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