RC-0399-2018 c TOWN OF QUEENSBURY
I I 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: RC-0399-2018
Tax Map No: 290.6-1-57
Permission is hereby granted to: Sean Culligan
For property located at: 4 GLENMAR 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
Type of Construction
Owner Name: Sean Culligan Single Family-Alteration $40,000.00
Owner Address: 4 Glenmar DR Total Value $40,000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
MJ Contracting
1838 County Route 43
Fort Edward,NY 12828
Plans&Specifications
Addition to garage 567 s.f.
Alteration to existing deck 568 s.f.
$ 450.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Thursday, July 11,2019
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Quee before t xi)* tion ,`e.
Dated at the Town Quee b • We_i•- ,July 11,2018
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
•._ Office Use Only
ADDITION/ 4/41A4T-2 it tt: 2)77-7.J:it
APPI _`-aCEOVE Tr it Fee:$ 4/57)i OD
Town of0,yeenibuiy
742
Bay Road,Queensbury,NY 12804et
I 111 JUN 25 2018 cioice#: 0 51(9
P:518-761-8256 unam.queensbury.n - I
TO' 'N OF QUEENSBURY
Project Location: A (,‘EtutAkE Dv.tv RI IIMNG ; CODES
Tax Map ID #: 2.10.6 - I - Si Subdivision Name: c-votatk4o7.&T
CONTACT INFORMATION:
* Applicant:
Name(s): cat‘i COW i3AtatEltN COON
Mailing Address, C/S/Z: q 6t..E.m.iscoz_br
Cell Phone: (gt9, ) Land Line: (
Email: .C.:iki1/411"1"14E.C.AE.VISKirtra.. et 1/44 -00 .00.11
• Primary Owner(s):
Name(s): ‹i‘ t
Mailing Address, C/S/Z:
Cell Phone: ( Land Line: (
Email:
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• Contractor(s):
Business Name: ta cot.irEALT‘146
Contact Name(s): iv(104AEL
Mailing Address, C/S/Z: k t"St, (Do kAN.1 \ITC 4S 'Fox:Ebvatkg.t, 041 laze
Cell Phone: (. 'Ie ) 19(0 WM0 Land Line: (
Email:
* Architect(s)/Engineer(s):
Business Name: xio.u,k,vixtkc:,, 4WItA-tiktAS
Contact Name(s): ‘Nwi
Mailing Address, C/S/Z: 5,09 C.) ..EtNi.Y7 f IUD(
Cell Phone: ( Land Line: ( ) 79g
Email: KS comit.kc-rtt.iLiots AOL..0.3141
Contact Person for Building& Code Compliance: epit4
Cell Phone: (sic? ) sgto tSS3 Land Line: (
Email: St94.4-rve..tke..PE.Welz yA OW-EaM
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised March 2018
i
Mil fNFORMATION:
TYPE: Commercial ) Residential
WORK CLASS:
Single-Family Two-Family Multi-Family(#of units )
Townhouse Business Office Retail
Industrial/Warehouse >( Garage (#of cars 1 _) Other(describe 11a.e.t .2etN- ?iws
ADDITION SQUARE FOOTAGE: ALTERATION SQUARE FOOTAGE:
1st floor: c4,77 1st floor: s-(A
2nd floor: 2nd floor:
3rd floor: 3rd floor:
Basement (habitable space): Basement(habitable space):
Total square feet: S( t Total square feet: cU
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ADDITIONAL PROJECT INFORMATION:
1. . Estimated Cost of Construction: $ r-IO,DO�
2. If Commercial project,what is the proposed use:
3. Source of Heat(circle one): Gas Oil Propane Solar Other k,itt ic{EAl
Fireplaces need a separate Fuel Burning Appliances&Chimney Application
4. Are there any structures not shown on the plot plan? YES & Explain:
5. Are there any easements on the property? YES _ O
6. SITE INFORMATION: •
a. What is the dimensions or acreage of the parcel? i.3c Mitt:
b. Is this a corner lot? ✓ NO
c. Will.the grade be changed as a result of the constru ' . YES • RIM
d. What is the water source? PUBLIC IVATE WEJ,.V
e. Is the parcel on SEWER or a PRIVATE SEPTIC system? .EP`C
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Town of Queensbury Building&Code Enforcement • Addition/Alteration Application Revised March 2018
d .
Y S /'�
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 thework 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.
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.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.
•
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I have read and agree to the above:
PRINT NAME: SCAN Cm- kcsikiN
SIGNATURE: DATE:
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Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised March 201E
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