2004-740 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761=8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040740 Application Number: A20040740
Tax Map No: 523400-295-017-0001-027-000-0000
Permission is hereby granted to: MANMFJ,RATTM. STAC EY
For property located at: 57 WILLOW Rd
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 Value
Owner Address: ALEX FRANK
STACEY MANDELBAUM Shed/Storage Sheds $1 , 0. 0
57 WILLOW Rd Total Value $120000
QUEENSBURY, NY 12804
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2004-740
192 SQ FT STORAGE SHED
$20.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday, September 30, 2005
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the T wn o zr/qv;
say, September 30, 2004
Z
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Building Permit Rcata®n .
T'owa of Queensbury—Dept of Com==ity DcwIopm=t, 742 Bay Road,Queensbury,NY
(518)761-8256
A p 't=aist be obtained before begianing coast mctioa- Peemat File x0.
No inspactioa-%r11 by made until applic=•t ba•received a Pee Paid
valid builder permit. AR applioaata' spaces on this Pwc.Pee Paid S
appUestion=mwtbe eampletod and znust appear ou the Reviewed B . 11
appliaaadoa form.
Applicant S-We- Wl a vt A� ku m Owner.' Somme a q
Address- as M. _U t" Address:/ 5 LA4 `1
VY
Phone#(01) .-S�1 �� Phone#¢
rgaperey»*Carlos Lot N-I bar: ! House Nu=ber 5-+- / Al e ar r
Subdivision Namo: VI vie S Tsx M2p'N•u=ber: 2 04-
I dooellow Building: sidence /samffiorcbI 'Estimated Market Value of Construction:$
t� Additlow 4� -,/ grew If ea Addition,wbat will use of new addition be?
� Altcaatior�; sead4l�Esa/ ca�aGrclog
� "t3feAi�sbsngo��sberd+ oY s4za: ze�dernBS/60�.'1 -
i;FM � CfS w�9'rSC(d�iar3ba3
Check P'Floor d Moor Other IIoor 'Total
B�ilosv sq.ft. sq.t#. Sq.ft. Squaro Peat
® Tvvo.fmnUv dwellinz
tit Townhousa
z7 Mil*Of AvAts
dw
a OifceI UD
® Iviexi].o
® Z car:defachned o
D 2 ear detarlsed garageRY
0 . 3 car detached Waraga E 1 asr Chad ga. o 1
0 3 ear atterfteal gsw.ga
® stun building
coxwaervIel
c/ St=20 building v 1 z l v
0
Whai is time proposed height of the structurq � feet itaacTses
'dill any second-bated or Xtagradcd lumber be used? It so,for ghat? 1 0
`HYPO of Heating Systosn. electric/ oil / gas/-Wood /forocd'hot air! baseboard other: kOAIE
Number of Ek"bcaacs to be in.oled N=ber of i &gffstaves to be installed 90kk
List below the persons) super-eisian of work as rogue to building codes:
Nalnet Address- Phan®Number
B
Plumber
Ii�son
131ea�ioi,ga
TPbclaktas, please sign below afr you have c=&Uy"road tIw statement
T®the best of my 3mowledge tbn atatcraonb cowzinsd in this application,together with the plans and spociflcations
submitted,=a a tme and oompleto statement of can proposed worse to be donne ou tho described promises and that a2
pioviglens of the Building Code;the Toning Ordinance rind ali.other laws pertaiming to the propascd wo3i6 abaU be comphod
with,whothar epocMaad or noted,and that auoh work is authorised by the owner. Further,it is=Aarstood that I/we sitinll
mbtait,prIor to a `C=dfiieato of Occupancy of CertHicato of Complisaco boiag issued,as roquested by tho Zoning
AdZWWatra for or Director o$Bnilding and Codes. ds VAffL ett=by a licensed surveyor,d=am to scale,showing actual
lcondon of all now. on.
Signature- ior,owner's agent,architect;contractor
®'M
TOO/TOO In XVa ST=VT NIOAT VOOZ/CT/60®m
matt. �
ION OF QUEENSBURY BLIILf ING DEPARTMENT C)CC��.
Bawd on odr limited examination, (1
compliance with our comments shall // G
not a construed as indica6nq the � �
plans and specifications are-in full
EI
compliance with the-Building Caries
of New Yoris State.
SEP 1 7 2004
TOW
s Iry y� BUILDING AND CODE Y
4 �
p
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NG
'ate'la...,i.e...J , '(-oK k•C� s
r
l REVIEWED D
DATE