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RC-0060-2018 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 '4-04=N / Community Development-Building& Codes (518)761-8256 CERTIFICATE OF OCCUPANCY Permit Number: RC-0060-2018 Date Issued: Thursday, July 12, 2018 This is to certify that work requested to be done as shown by Permit Number RC-0060-2018 has been completed. Tax Map Number: 239.12-2-88 Location: 2780 State Rte 9L Owner: Harold Gordon Applicant: Jason Fogg This structure may be occupied as a: Residential Interior Alterations 513 s.f. (converting bath into dressing room,removing closets in bedroom) By Order of Town Board TOWN OF QUEENSBURY „ Issuance of this Certificate of Occupancy DOES NOT relieve the 4.4 property owner of the responsibility for compliance with Site Plan, 4P 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-0060-2018 Tax Map No: 239.12-2-88 Permission is hereby granted to: Fogg Builders Inc. For property located at: 2780 State Rte 9L 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: Harold Gordon Single Family-Alteration $20,000.00 Owner Address: PO Box 275 Total Value $20,000.00 Cleverdale,NY 12820 Contractor or Builder's Name/Address Electrical Inspection Agency Fogg Builders Inc. 166 Stage RD Charlton,NY 12019 Plans&Specifications Residential Interior Alterations 513 s.f. (converting bath into dressing room,removing closets in bedroom) $ 200.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Friday, February 22, 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 Town of een 4h*Jjbwmrry 22,2018 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement Office Use Only ADDITION/ALTERATION PERMIT Permit#: C APPLICATION Permit Fee:$ 2Cr-�, ' Town of Queensbury 742 Bay Road,Queensbury,NY 12804 Invoice#: CA O 1 P:518-761-8256 www.gueensbbury.net Project Location: 4 f W RT I Z-. Tax Map ID#: Subdivision Name: CONTACT INFORMATION: • Applicant: Name(s): JQdad., Mailing Address, C/S/Z: /6� s vatic r� C h /� /!✓� f 2 0 l Cell Phone: (57 P j 4t 21t- 56� Land Line: Email: Jo.6dg n �&q 4 AvL,Uerr5 co/vi • Primary Owner(s): Name(s): CA, ,o (5 csra�d� Mailing Address, C/S/Z: Z 9 EO P,T QeAee is6u,r,y /V v /2X®�t Cell Phone: La ®0 8 Email: • Contractor(s): Business Name: Contact Name(s): V 6V50n Fa,4 Mailing Address, C/S/Z: /,!5r6 �a,ti /-- 12012 Cell Phone: (SIP_ Z It-- a,5,4 Land Line: Email: :yy, • Arch itect(s)/Engi nee r(s): Business Name: Contact Name(s): LG U LC NY Mailing Address, C/S/Z: Cell Phone: �_) Land Line: FEB 132018 Email: BUILDING&CODESRY Contact Person for Building & Code Compliance: C Cell Phone: Land Line: � ) Email: Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017 PROJECT INFORMATION: TYPE: Commercial `d 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: ALTERATION SQUARE FOOTAGE: 1st floor: 1st floor: -'r/3 2nd floor: 2nd floor: 3rd floor: 31d floor: 411 floor: 411 floor: Total square feet:_� _ Total square feet: �..� ADDITIONAL PROJECT INFORMATION: 1. Estimated Cost of Construction: $_ 2 2. If Commercial project, what is the proposed use: 3. Source of Heat (circle one): Gas Oil ropane Solar Other Fireplaces need a separate Fuel Burning Appliances&Chimney Application 4. Are there any structures not shown on the plot plan? YES NO Explain: 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 result of the construction? YES NO d. What is the water source? PUBLIC PRIVATE WELL e. Is the parcel on SEWER or a PRIVATE SEPTIC system? Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017 DP'CLARATION: 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 a certificate of occupancy. I have read and agree to the above: PRINT NAME: SIGNATURE: DATE: Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017 INSPECTION WORKSHEET (005062-2018) Town of Queensbury - Building and Codes - Fire Marshal 742 Bay Road - (518) 761-8256 Building (518) 761-8206 Fire Marshal Case Number:RC-0060-2018Case Module:Permit Inspection Date:07/12/2018Inspection Status:Passed Inspector:Charles DyerInspection Type:Residential Final Inspection Job Address:2780 State Rte 9LParcel Number:239.12-2-88 Lake George, NY 12845 Contact TypeCompany NameName Granted PermissionFogg Builders Inc.\[Fogg Builders Inc.\] , Primary OwnerGordon, Harold ApplicantFogg, Jason ContractorFogg Builders Inc.\[Fogg Builders Inc.\] , Checklist ItemPassedComments General CommentsYESFor final for bathroom / bedroom alterations 4 inch Building Number Address visible from roadYES 3" Plumbing Vent through roof minimum 18 inchYES Roof Complete / Exterior Finish CompleteYES Interior privacy/trim/doors/main entrance 36YES Bathroom / Kitchen WatertightYES Low flow toilet 1.3 gal/flushing cycle -YES showerhead/faucet Smoke Detectors: Carbon MonoxideYES Outside every bedroom areaYES Inter ConnectedYES Battery backup: _____YES Crawl Space Access 18 x 24YES Bathroom Fans, if no windowYES Plumbing fixturesYES Fin Elect; Energy Saving Light Bulbs 50 PercentYES Arc Fault Breaker Habitable SpacesYES As Built Septic SystemYES OK to Issue C/OYES Dyer, Charles (Inspector) Jul 12, 2018Page (2) RT. 91, , 46 .63' r, . cP 181.92 < N 1 > LANDS OF 1� LANDS OF & v 1� JOHN WALLACE RICHARD BELL r ECEUVE B -40. . D FEB 13 2013 -1 TOM DI GUEENSB 8 CODES Y � LANDS OF A. ROBERT STEWART 45. 0v $• Ot 35 . 00 2 .,� �• --�. -- �"` existing well 1f / +12 5' O vi \ N LANDS OF ` ~` ��p j - HARRIS BAY YACHT CLUB O . `" existing septic W C. nk X PERMIT PLOT PLAN. tan _ 00) .0 HAVE PERSONALLY MEASURED THE DISTANCE �� �� js FROM THE PROPERTY LINES TO THE y +; PROPOSED STRUCTURE(S)OR SIGN(S) Application � � � Q �" �,�; ANDS OF c>Q Z cif A = proposed carport SIG ATURE DATE �),• E N C N �y � 0 � � B = existing workshop and r 'a C:) •N M C F, QJ ..1`+�''f�' d boat storage - . NC7C C = existing 'storage shed .. ... ZonfnggAd infstr t z ±200' along share TQwN of QUEENSRU = existing single family F residence z MR. A. ROBERT STEWART LAKE GEORGE SCALE 1"=50' 0" APPROVED BY DRAWN BY PAH DATE 9/14/92 REVISED o z PLOT PLAN DRAWING NUMBER 0 STOCKDRAFTING FORM NO.10t41 - 4L= Jul. /j. /UlU,. 1 11PM :,,q,10IA (k• .------- — — ,'e— ..,.% . , ; ,,`, 5„.„ „ r, No. 4260 P. 9/10 MIDDLE DEPARTM SPECTION AGENCY INC c>- <<a , e� Wccea.that the electrical wiring to the electrical equipment listed below has been examined and is a N Owner: Chip Gordan Date: 07/11/2018 Occupant: • fit:; • i`.1-�.`.�i Bathroom t.ocation2780 Route 9b •J� OccupancySin !e FamilyDw . Queensbury, Warren Co. NY fJ* j, Applicant: g 9 C) j Fogg Builders _ • �d� f: v ' 69 6 j 166 Stage Rd _.,.,...-- -.Kt-Y_ �� �`�� Ballston Lake, NY 1201;9' `- -.• - • rr.:, :>> L cg, �� Joseph A.Holmes `'• raj k'''r>> No. _ i r`. ^032676'101203EL -..I <<j '`c� Equipment: • - - - :._.. i . . -<<- • 0100 Amp. Sub Panel; 15:-SwitcFtes, 21 -Receptacles,--•1.6•=`Fixtures;-2-=Vent Farts-;-.2-Smoke Detectors ;7 • 0 rf-) %&. This certificate applies to the electrical wiring to the electrical equipment listed immediately null and void. This certificate applies only to the use,occupancy and >>,4 ) above and the Installation inspected as of the above noted date based on a visual ownership as indicated herein. Upon a change In the use,occupancy or ownership 1; ') inspection. No warranty is expressed or implied as to the mechanical safe effl- of the properly above,this certificate shall be immediate) null and void. `f t�) safety, p P rty indicatedy •E� ciency or fitness of the equipment for any particular purpose. This certificate shall In the event that this certificate becomes invalid based upon the above conditions. C be valid for a period of one year from the above noted date. Should the electrical this certificate may be revalidated upon reinspection by Middle Department ���. system to which this certificate applies be altered in any way,including but not limit- Inspection Agency, Inc. An application for Inspection must be submitted to Middle rt?i r%,) ed to,the introduction of additional electrical equipment and/or the replacement of Department Inspection Agency, Inc.to initiate the inspection and revalidation r% any of the components installed as of the above.noted date,this certificate shall be process. A Fee will be charged for this service. `.4 �� .r _ r r�i!:,,,i i�7,->:i`1.,,,�..�1:„>%.•r%: ;•. l'1-'1 >�•r il•: is,,,. . ,, ..r:: ,o,,, ..;'T. /?,,, 1{r r ��'� V��:�.�-�:�,•v✓�6�_:%�::�!=t�:�Gu!Gv'SG�L::i>G�= wv�.�:,1. ✓�`i 4;-�`✓:•v'rf�ir`i;tii`r`ri'f er`v ri`ram .�5 ii`;i";i .i}�� .i ,"=%l• . . „...........„----5-\\ n, E c E V E. . JUL 211 2018 \g • TOWNOFCU1wE at3URY • —00 ka©- It)