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RC-0198-2018 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-0198-2018 Date Issued: Thursday, November 1, 2018 This is to certify that work requested to be done as shown by Permit Number RC-0198-2018 has been completed. Tax Map Number: 295.19-3-21 Location: 19 OWEN AVE Owner: Marcia Pooler, Bruce Pooler Applicant: Bruce Pooler This structure may be occupied as a: Residential Addition 504 s.f. By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the ra40 4 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. -- --T` ` TOWN OF QUEENSBURY ! i -, .,_� 4 3G 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 ,-� +:, I �._ Community Development-Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: RC-0198-2018 Tax Map No: 295.19-3-21 Permission is hereby granted to: RL Chase Builder For property located at: 19 OWEN 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: Marcia Pooler Single Family-Addition $54,845.00 Owner Address: 19 OWEN AVE Total Value $54,845.00 Queensbury,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency RL Chase Builder 20 Marion AVE South Glens Falls,NY 12803 Plans&Specifications Residential Addition 504 s.f. $ 250.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Saturday,May 4,2019 (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 o : ueen''. ; rida ./ ' _ 1.18 , l SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement 'R Office Use Only r '} -' •' ADDITION/ALTERATION PERMIT Permit#: YZC -61 f - 'i.Or-- APPLICATION Permit Fee: $ Zen,o Town of Queensbury 742 Bay Road,ttueensbury,NY 12804 I'voice#: a 3 2g P:518-761.8256 www.queensburv.net C E 1 U Project Location: )% ® t9t / ie R2 Tax Map ID #: 2-i'S' lot-_3— Z- i T" vb itsmity iiR‘ BUILDING&CODE s CONTACT INFORMATION: • Applicant: Name(s): 42fie. Reol,64 Mailing Address, C/S/Z: /9 610J6 t1 Ai/c en 6i1S,ci2-Y 4/y /L/OV Cell Phone: ( ./15 ) Z.2 - 95- 7 Land Line: ( ) IJIA r Email: fielei/&r 5-3 4 tiaAifte .cool • Primary Owner(s): Name(s): A llvzg * ,1?g2€MA Pc.61_64. Mailing Address, C/S/Z: /9 dwemv ,,4 eliUE6-ttiSiSr'1t%, VY / Z�q. Cell Phone: (S'/ej ) 222 -IsA-7 Land Line: ( ' ) ,/,'A Email: ,00/cor c3 ea irAibo .e.o pot • Contractor(s): Business Name: ?L. 1.,t,,4S6" ntw.wi2( Contact Name(s): kte.ki,44.0) CRAKE Mailing Address, C/S/Z: 20 AM2ro t. /d t/ .COt>TS 6L:-doS 1,2GS A')/ 12 go3 Cell Phone: ( 5/$ ) JL / - ale � , Land Line: ( ) ®v/.4 Email: • Architect(s)/Engineer(s): Business Name: Contact Name(s): PET 3 QQ.,4/91,Jy Y Mailing Address, C/S/Z: 210 , 'Ok &Y ST G/fP,i UToitl , kV /2 0/9 Cell Phone: ( 5)1 ) 'eZ2 - 5 0A ,J Land Line: ( ) A /4 / Email: 0 J b/oa J/ . d 3('0 411.44,tiad . eo,s, Contact Person for Building & Code Compliance: )6 eU6f Poe& ui Cell Phone: ( ,5) d ) 222-9S.1 7 Land Line: ( ) N/14 Email: Deo/e r S-3 X t i.,,,,- , co.+a Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised March 2018 is PROJECT INFORMATION: TYPE: Commercial Residential WORK CLASS: \ 'Single-Family Two-Family Multi-Family (#of units Townhouse Business Office Retail • Industrial/Warehouse _Garage (#of cars ) ,)COther (describe YS e,-1-7s G ) ADDITION SQUARE FOOTAGE: ALTERATION SQUARE FOOTAGE: 1st floor: '(•' .20 /° :aLF/f. l' " 1st floor: 2nd floor: 2nd floor: 3rd floor: • 3rd floor: • Basement (habitable space): Basement (habitable space): • Total square feet:- .b ,. Total square feet: ADDITIONAL PROJECT INFORMATION: 1. Estimated Cost of Construction: $ 5-9 qr 2. If Commercial project, what is the proposed use: 3. Source of Heat (circle one): 121211 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 6. SITE INFORMATION: I a. What is the dimensions or acreage of the •arcel? gas ,s 2 5-0 C.71 Ate, • b. Is this a corner lot? YES NO . c. Will the grade be changed as a result of the construction? YES 9) d. What is the water source? T PUBLI PRIVATE WELL e. Is the parcel on SEWER or a(PRIVATE SEPTICDystem? Town of Ctueensbury Building&Code Enforcement Addition/Alteration Application Revised March 2018 DECLARATION: • • 1. I 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. I 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. I acknowledge that prior to occupying the facilities proposed I, or my agents, will obtain a certificate of occupancy, 5. I 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: . 1)46. P©©1.�R SIGNATURE: DATE: V-26-/ ' • • Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised March 2018