RC-0007-2019 ,0116,
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-0007-2019
Tax Map No: 315.7-2-80
Permission is hereby granted to: Gauthier Skilled Craftsman,LLC
For property located at: 192 HUDSON POINTE BLVD
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: Stephen Pratt Single Family-Alteration $87,000.00
Owner Address: 192 Hudson Pointe BLVD Total Value $87,000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Gauthier Skilled Craftsman,LLC
4732 State Rte 40
Argyle,NY 12809
Plans&Specifications
Interior Renovations 800 s.f.
$ 240.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Monday, January 20, 2020
(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 Queensbury; Friday, January 18, 2019
SIGNED BY: ( ,i)j 4 for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
,
ADDITION/ALTE : 4� - 0 D�� cl
APPLI A ► s. �� E O Vjr Fee:$ 2`( 00
42 Bay Roa ,Queensbury,NY 12804 JAN 1 0 2013 lnvo #t: ( I S I
P:518-761-8256 www.queensbury.net
TQWN�Q F``QU��EENSBURY
Project Location: I Ci c,. �vg s p^ Po ,3��$�11IBIFA ANOI DES
Tax Map ID#: c, ( - Z- - L� Subdivision Name: au'ch 1 `
CONTACT INFORMATION:
• Applicant:
Name(s): G<s-c < (A 2, c,�
Mailing Address, C/S/Z: 41 �'t S-�. 4 0 A r yW' Y I? P 0
Cell Phone: ( ) i32.- lc66 Land Line: ( )
Email:
• Primary Owner(s):
Name(s): .Sf ev t 1- A- Pr c .
Mailing Address, C/S/Z: I `AZ Mvca
Cell Phone: ( S t? ) ?cI 0- Land Line: ( )
Email:
• Contractor(s): tii
Business Name: G�cJ � x% �C S�� �Pam` C pc, s t- ,4N
Contact Name(s): Ger-c.1 j Ric f
Mailing Address, C/S/Z: `}7 3 2. # . �.� . �(� it r%La i e ,n Y I 2?C
Cell Phone: ( S C$ ) )1-1 S 6 6 Land Line: (
Email:
• Architect(s)/Engineer(s):
Business Name: (...3
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: ( ) Land Line: ( )
Email:
Contact Person for Building & Code Compliance: GC R-)v-�
Cell Phone: ( 5'18 ) c13 t-I S 6 d Land Line: ( )
Email: _\ecr`� 5C u \e'cC. OfLA
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised March 2018
t i
PROJECT INFORMATION:
TYPE: Commercial Residential
WORK CLASS:
�ingle-Family _Two-Family _Multi-Family(#of units )
_Townhouse _ Business Office _ Retail
_ Industrial/Warehouse Garage (#of cars ) _Other(describe
ADDITION SQUARE FOOTAGE: ALTERATION SQUARE FOOTAGE:
1st floor: 1st floor: y6 0
2nd floor: 2nd floor: CJ
3rd floor: p 3rd floor:
Basement (habitable space): Basement (habitable space): C�
Total square feet: 0 Total square feet: 0—
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction: $ 2 7 O U 0
2. If Commercial project, what is the proposed use:
3. Source of Heat (circle one): (ash 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 10
6. SITE INFORMATION:
a. What is the dimensions or acreage of the rcel? S
b. Is this a corner lot? YES NOS
c. Will the grade be changed as a res (t oft e construction? YES OJ
d. What is the water source? UBLIC PRIVATE WELL
e. Is the parcel on SEWER or a PRIV TIC system? P(; r se4 1-t c
Town of Queensbury 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: GQfc 2
SIGNATURE: / Jj DATE: I
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised March 2018