AST-0618-2018
TOWN OF QUEENSBURY
742 Bay Road, Queensbury, NY 12804-5904 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: AST-0618-2018Date Issued: Friday, February 8, 2019
This is to certify that work requested to be done as shown by Permit Number
AST-0618-2018
has been completed.
289.15-1-34.14
Tax Map Number:
74 SURREY FIELD DR
Location:
Josephine Burgess
Owner:
Hilltop Construction
Applicant:
This structure may be occupied as a: 3-season porch 168 sq. ft.
Adding 48 sq. ft. to attached deck
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance 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.
leilt)
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
`'i M Community Development - Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: AST-0618-2018
Tax Map No: 289.15-1-34.14
Permission is hereby granted to: Hilltop Construction
For property located at: 74 SURREY FIELD 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: Josephine Burgess Porch-3 Season,Covered,Enclosed $30,000.00
Owner Address: 74 Surrey Fields DR Total Value $30,000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Hilltop Construction
51 Crowley RD
Hudson Falls,NY 12839
Plans&Specifications
3-season porch 168 sq.ft.
Adding 48 sq. ft.to attached deck
$ 125.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Thursday,October 3,2019
(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 .=to.
Dated at the Town Quee bury; 4W:. ' -�;.y, October 3, 2018
SIGNED BY: If \ for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
; ADDITION/ALTERATION PERMIT Permit#:-45-1"6,1?)-Oi ?
APPLICATION ,tc,
Permit Fee: $ /,-�
(own of(Zuccnsbun
742 Bay Road,Queensbury,NY 12804 Invoice#: 'CNN('
P:518-761-8256 www.queensbury.net
Project Location: 'ti SL41(E ( fTe IJDr1 e_ -61 ECEUVIE nn
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Tax Map ID #: g9/S-1"34/'-/- Subdivision Name: SEP 2 7 2018
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TOWNOF QUEENSBURY
CONTACT INFORMATION:
COMMUNITY DEVELOP MEPT
• Applicant: •
Name(s): ) \O OCcrl`(- 0_-__*-k 0
Mailing Address, C/S/Z: j 1 C c _C-•-CDV • R ccc c � Sar Fit (l5 M I "1
Cell Phone: C3 W ) . 9- 'f-Ioci Tow, c A Land Line: ( .`ors' ) T9?-6 13
Email: O' inck GL - t,-N ' "k-c..)100 011StCULCZtt Oen CCU . CoWA
• Primary Owner(s):
Name(s): PTO "U raj S3
Mailing Address, C/S/Z: r1 _q urr� Fi e( ci �k�‘ u a (6? t,„ e,f\5(ckv-v KR f B'Ul
Cell Phone: j ) Land Line: (31 F ) 743 - Y743
Email: biktrelP5 e)SC__L- i (Lon
• Contractor(s):
Business Name: fk t\\*--cT
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: ( ) Land Line: ( )
Email:
• Architect(s)/Engineer(s):
cm
Business Name: --C' Lix_ve .c\ A
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: ( ) Land Line: ( )
Email:
Contact Person for Building & Code Com liance: 1 or- `�eC'ki: R.
Cell Phone: (51 Q act,s g `
7 l Land Line: 51 79 C' 33
Email: 1 C.)m S 12 �'k`YV-cT c it rt\ x c'C\ ov " c . LC vi,-‘
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised March 2018
PROJECT 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 FOOTAG : ALTERATION SQUARE FOOTAGE:
r
1st floor: /6 Si (f 'xi ) S�°�So n b�� 1st floor:
2nd floor: 2nd floor:
3rd floor: 3rd floor:
Basement (habitable space): Basement (habitable space):
Total square feet: A? V Total square feet:
� 1
ADDITIONAL PROJECT INFORMATION: -?� � � � 0.1 & S
1. Estimated Cost of Construction: $ 00 (--)
2. If Commercial project, what is the proposed use:
3. Source of Heat (circle one): Gas Oil Propane Solar Other KO nPorck
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 61-0
6. SITE INFORMATION:
a. What is the dimensions or acreage of the cel? LS A. )0 o/
b. Is this a corner lot? YES NOJ
c. Will the grade be changed as a result of the construction? YES i (1%\,...L.LOD
d. What is the water source? PUBLIC PRIVATE WELL N
e. Is the parcel on SEWER or a PRIVATE SEPTIC system? NJ A-
Town of 4ueensbury Building&Code Enforcement Addition/Alteration Application Revised March 2018
DECLARATION:
l. 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: I1 1, \to�E'c
SIGNATURE: -1(..- M DATE: �'7- G/
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised March 2018
" " Feb. 22, 2019 12 21PM'''•�'MDIaMaVke:'4zwtv=r= ;;r , ,�� • - y,A,, ;;,.,,;, No. 7332 � P. 4/4_
...n i <• � i3v,1•`-.n` -'i>l''s,_;.C�, ,L`, ��C +.„,,,,vS. %tCs' ?.`,'�.{ >"�'t-m00% ^�,S, A-
MIDDLE DEPARTMENT INSPECTION A45)
GENCY, INC. i;�
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sat `ea that the electrical wiring to the electrical equipment listed below has been examined and is approved as
`?) being in accord with the National Electrical Code, applicable governmental, utility and Agency rules in effect on the date lig
inoted below and is issued subject to the following conditions. 1'
(.. i r,
Owner: Date:
P. Burgess02/06/2019 a)
c�
1 Occupant; Location:
1st Floor Rear 74 Surrey Field Drive a
0 Occupancy:
Singfe Family Dwg. Queensbury, Warren Co. NY Sl
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Applicant: 7 r.�l
p
Hilltop Construction <-'�
g Cindy Albrecht
Gal
51 Crowley Rd. :,s5
(x Hudson Falls, NY 12839 .
' Joseph eph A_Holmes) No.
rsa
L6 �•
-2lc Equipment: •
h j 5T- h to.L b . �.y�.?
,};'��3-Switches; 6-Receptacles;4- Fixtures; 1 -Arc Fault Breaker , "
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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 � )
In above and the installation inspected as Ot the above noted date based on a visual ownership as indicated herein. Upon a change in the use,occupancy or ownership f'')
�Ul inspection. No warranty is expressed or implied as to the mechanical safety, efi-+• of the property Indicated above,this certificate snail be immediately null and void. C�'J
"7� 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, G.
}} be Valid fora period of one year from the above noted date. Should the electrical tnis certificate may be revalidated upon reinspection by Middle Department
l 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
�•
�) etl to,the introtluotion of eotlitional electrical equipment and/or the replacement of Department Inspection Agency, Inc. to initiate the inspection and revalidation ���
any or the components installed as of the above noted date,this certificate shell be process. A fee will be charged for this service. 4
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INSPECTION WORKSHEET (000809-2019)
Town of Queensbury - Building and Codes - Fire Marshal
742 Bay Road - (518) 761-8256 Building (518) 761-8206 Fire Marshal
Case Number:AST-0618-2018 Case Module:Permit
Inspection Date:Thu Feb 7, 2019 Inspection Status:Passed
Inspector:Charles Dyer Inspection Type:Accessory Structure Final
Job Address:Parcel Number:74 SURREY FIELD DR
Queensbury, NY 12804
289.15-1-34.14
Contact Type Company Name Name
Contractor Hilltop Construction
Granted Permission Hilltop Construction
Applicant Hilltop Construction
Primary Owner Burgess, Josephine
Checklist Item Passed Comments
1/2" Gypsum or House Wall and Gable NO
Building Inspector Notes NO 2/7/19 for 3 season porch addition completed
Handrail 4 or more risers YES
Guard at deck, porches 36" or more YES
4+ Deck Joist Ledger Connections-24" From
Ends
YES
Deck Ledger-Bolted per Code YES
Fin Elect; Energy Saving Light Bulbs 50 Percent YES
Feb 07, 2019 Page (1)
INSPECTION WORKSHEET (000809-2019)
Checklist Item Passed Comments
Engineer or Architect Approval NO
Site Plan / Variance required NO
Okay To Issue CC YES
Feb 07, 2019 Page (2)
Dyer, Charles (Inspector)
. ..,
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-_____ SEP 2 ? 2018
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