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RC-0062-2018 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development - Building& Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: RC-0062-2018 Date Issued: Monday, April 30, 2018 This is to certify that work requested to be done as shown by Permit Number RC-0062-2018 has been completed. Tax Map Number: 301.19-1-3 Location: 694 SHERMAN AVE Owner: Michael Duggan Applicant: Michael Duggan This structure may be occupied as a: Residential Interior Alterations Roof Repair from Storm Damage from September 2017 By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy 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-0062-2018 Tax Map No: 301.19-1-3 Permission is hereby granted to: Michael Duggan For property located at: 694 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 Type of Construction Owner Name: Michael Duggan Single Family-Alteration $2,500.00 Owner Address: 861 Sherman AVE Total Value $2,500.00 Queensbury,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications Residential Interior Alterations Roof Repair from Storm Damage four September 2017 $ 200.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Thursday,February 28, 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 ZBens dne y ebr ry 28, 2018 4 for the Town of Queensbury. SIGNED BY: Q rY Director of Building&Code Enforcement Office Use On(Vi b ADDITION/ALTERATION PERMIT Permit#: 'Rc C0a ,x0l g, ` - APPLICATION Permit Fee:$ caUU= �'► �� Town of ouueensbury 742 Bay Road,Queensbury,NY 12804 Invoice#: 10 3 P:518-761-8256 www.queensbury.net Project Location: 1 el Tax Map ID#: Subdivision Name: l �� CONTACT INFORMATION: 301 . 19^1 ^ -15 FEB 14 2018 f ® Applicant: TOt a car QUEE SBURY CO 11I'elLlr",i _ F"cEYELOPIVENT Name(s): I ke- e-e n - Mailing Address, r S/Z: _ f Cell Phone: s/ ) " oC Land Line: �_) Email: rD r Primary Oyyner s Name(s): Mailing Address, C/S/Z: Lta.vi. '- Cell Phone: Land Line: _L Email: Y/ ® Contractor(s): Business Name: /i/oN -; Contact Name(s): Mailing Address, C/S/Z: Cell Phone: Land Line: � ) Email: • Arch itect(s)/Engi nee r(s): 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: (0(a Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017 PROJEd 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: n�j Haas ALTERATION SQUARE FOOTAGE: � Q �, © �� � 1st floor: 'ra�16vq 1st floor: 2nd floor: ^ I 2nd floor: _ 1 3rd floor: L �o��a �- � i�s 3cn floor: 411 floor: � � 4 floor: Total square feet: r �c�/S Total square eet: 'b qu s P_V ADDITIONAL PROJECT INFORMATION: 3 (] �2G�f Ar �rr� S� S�1 1. Estimated Cost of Construction: $ c>), 2. If Commercial project, what is the proposed use: 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 NO xplain: 5. Are there any easements on the property? YES NO �At Qr-'VA 6. SITE INFORMATION: a. What is the dimensions or acreage of thepcel. ��b. Is this a corner lot? YES c. Will the grade be changed as a result of the constr tion. YES NO d. What is the water source? IVATE WEL e. Is the parcel on SEWER or a PRIVATE SEPTI system. ell 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. 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: 2/13 •� ,D SIGNATURE: DATE: Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017