RC-0422-2018 TOWN OF QUEENSBURY
iz
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: RC-0422-2018
Tax Map No: 295.6-1-48
Permission is hereby granted to: Catone Construction
For property located at: 28 SARA JEN 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: Linda Ball Single Family-Addition $18,950.00
Owner Address: 23 Lambert DR Total Value $18,950.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Catone Construction
1470 RIDGE RD
Queensbury,NY 12804
Plans&Specifications
140 sq.ft.residential addition to extend kitchen.
140 sq.ft.residential addition to existing garage(for a shop)
Total: 280 sq.ft.
$ 250.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Wednesday,July 17,2019
(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 ury; ues% , 1 1 2018
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
ACylDI71OIV/Al,7'EliAT9t71ti9 PERMIT Permit;: RZ. — l
APPLICATION Permit Fee:$ c2 -Town of Queensbury
742 Bay Road,Queertsbury, NY 12804 Invoice#: 40/4/
P:518-761-8256 www.queensbury.net
Project Location: A i' .5 plf -Jar b-f)
Tax Map ID#: & '1- ` 8 Subdivision Name: /eh
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CONTACT INFORMATION:
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O Applicant:
Name(s): e c ��`` ‹ TO\ °L ,.. . ;R��
f 'Ivy a•. } n r �.C.: ,rr•, c .�1:
Mailing Address, C/S/Z: 14 'R• Geevu
Cell Phone: ( 51r ) 3i5i- i3S / Land Line: ( )
Email: e D-A;�e C60.3 -f..c A7 Alto. -
• Primary®wner(s): net) owk.e-( bb 01- c r7 bidet g
Name(s): j.i n d a, ecull
Mailing Address, C/S/Z: 23 )-Arnb.vy4 dV i ve,
Cell Phone: ( ) Land Line: (5i k ) -07-X3 kt°I
Email: i boil) aot At4., road rin}ncv, ton-)
O Contractor(s):
Business Name: C14-4 C6nsA--rta�} �r
Contact Name(s):
Mailing Address, C/S/Z: c�eews
Cell Phone: ( S)& ) 34.)- O4 3 5 Land Line: ( )
Email: CA-Lit— Cc - _ &) 'kL o,) .
• Architect(s)/Engineer(s):
Business Name:
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: ( ) Land Line: ( )
Email:
Contact Person for Building& Code Compliance: t'+U --
Cell Phone: ( S'JY ) 3C/c i 3 s Land Line: ( )
Email: CA-16rtco2s4e-cL J /citiGO
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised March 2018
PROJECT INFORMATION:
TYPE: Commercial V Residential
WORK CLASS:
Single-Family _Two-Family Multi-Family(#of units
Townhouse Business Office Retail
Industrial/Warehouse I Garage (#of cars a- ) Other(describe • )
744C1;Ek refc'
ADDITION SQUARE FOOTAGE: ALTERATION SQUARE FOOTAGE° 94,0
1st floor: v � e±01)))1^-
` � 1st floor: 1 �f
2nd floor: • `� 2nd floor:
3rd floor: 3rd floor:
Basement(habitable space : Basement (habitable space):—
Total square feet: ° Total squar eeto 1-4 0
ADDITIONAL PROJECT INFORMATION:
1. . Estimated Cost of Construction: $ -, • I41Pt'6-' t,,,r ,,4 Si ��,�� 1b0 `IS 4 +�
2. If Commercial project, what is the proposed use:
3. Source of Heat (circle one): dal 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 CIO Explain:
5. Are there any easements on the property? YES .
6. SITE INFORMATION: •
a. What is the dimensions or acreage of the_parcel?
b. Is this a corner lot? YES
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? .
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Town of Queensbury Building&Code Enforcement • Addition/Alteration Application Revised March 2018
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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. -
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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: •
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PRINT NAME: 1,th3ox 6ea
SIGNATURE: 4Ltufat.. 10 AAA_ DATE: G /2 l
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Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised March 2018