AST-0267-2018 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development- Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number: AST-0267-2018
Tax Map No: 309.15-1-12
Permission is hereby granted to: Steven Joiner Jr.
For property located at: 64 HAVILAND 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: Steven Joiner Jr. Porch-3 Season,Covered,Enclosed $5,000.00
Owner Address: 64 Haviland Ave Total Value $5,000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans& Specifications
3-season porch 237 s.f.
PERMIT FEE PAID -THIS PERMIT EXPIRES: Thursday, May 23, 2019
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Towno d 23, 2018
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SIGNED BY: ed for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only '�"-' Zi°q –1At�
ACCESSORY STRUCTURE Permit#:%
PERMIT APPLICATION Permit Fee:$ /a�-e
Tim u,!t)uriir,hurr /
742 Bay Road,Queensbury,NY 12804 Invoice#: ��
P:518-761-8256 www.gueensburV.net
Project Location: ta-1 J4'P1v;LN os--Z!> IPWAr.-
Tax Map ID #: "; . /,S - Subdivision Name: r'
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CONTACT INFORMATION: i 1 201 1�I
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• Applicant: '�®�
n� T- T0VVN OF QUEEI+IBBUK
Name(s): sri %V/---0 lC. C-
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Mailing Address, C/S/Z: (,gig rJAviLAq,,i,, sotil,
Cell Phone: ;`> ) 7-4y 32"� Land Line:
Email:
• Primary Owner(s):
Name(s):
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email:
• Contractor(s):
Business Name: r=+—�=
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: �_) Land Line:
Email:
• Architect(s)/Engineer(s):
Business Name:
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email:
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Contact Person for Building & Code Compliance:
Cell Phone: Land Lie
Email:
Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017
PROJECT INFORMATION:
TYPE: Commercial Residential
WORK C�L.A�S,S-;`�
6t3, ':-��'���`h• .' C� 1z5 .�:�-+���'1 �2'(� , c�x (� �,�'.T
Deck,Open Porch Solar Panels(w/o rafter upgrades) U C"�r ort Cell Tower
—Shed —Pavilion, Pole Barn,Canopy —Dock —Gazebo
—Detached Garage —Boathouse(with or w/o sundeck) -Season Porch
—Other(description: )
SQUARE FOOTAGE OF STRUCTURE:
1st floor:
ol, Z-51
2nd floor:
Total square feet:
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction:$ 6
2. If Commercial project,what is the proposed use:
3. Are there any structures not shown on the plot plan? YES NO Explain:
4. Are there any easements on the property? YES NO
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:
SIGNATURE: DATE: S� %`f i
Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017
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TOWN OF QUEENSBURY TOk
Carel,
BUILDING & CO EPT.
Reviewed v:
Date:
TOWN
F UEENTBURY
�.,,� .•� DEPARTMENT
Based on our limited examination,compliance
'`�Q`� 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.
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