RC-000289-2016 yrmro wmwro, ,i,n TOWN R N O F QUEEN S B U y,.'M. .1.
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742 Bay Road„ Queensbury,NY 12804-5904 (518)761-8201
�h Community Development - Building & Cedes (51 S) 761-8256
BUILDING PERMIT
Permit Number: RC-000289-2016
Tax Map No: 300.-1-40.2
Permission is hereby granted to: :fason Sankey
For property located at: 48 INGLEaE:; MOUNTAIN RD
In tlae 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 Coning Ordinance
Type of Construction
Owner Narne: Jason Sankey Attached Garage-New $40,000.00
Owner Address: 48 Inglee Mountain RD Total Value $40,000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection.Agency
Pete Sankey
Plans&Specifications
Attached Garage
I st floor: 900 sq.ft.
2nd floor: 900 sq. f3.(storage only)
Total: 1,800 sq. ft.
$ 270.00 PERMIT FEE PAID -TI-IIS PERMIT EXPIRES: Saturday, May 20, 2017
(If a longer period is required, an application for an extension must be made to the code Enforcement Officer
of tfae Town of Queensbury before tine expiration date.)
Dated at the Town Quee awry; Wec sd 25, 2016
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
Date: �` �.
a 4 p
Tak Map 1. '
Permit Fee
Zone Historic? e,s No Ree Fee _
.� —
Subdivision Name l:.,ot# Site Plan
Subdivision
Project Location ? ....___—
TOyl N' U RESOLUTION N S'6-2013: $ St0 recreation fee for new dwelling units—single family,duplexes/two-family, multiple family,
apartments,condominiums,townhouses,and/or manufactured&modular homes,but not mobile homes. This is in addition to the
permit fee(s).
Primary Owner(s)
Address 1'2,e',6LL
phonefErnail r
Applicant
Address
Phone/Email
Contractor KAI
s5 1. C
w
Phone/Ernail
Contact Person for Building & CodesCompliance: _y 4,4 V- Phone
,/Check all Haat apply l New Addition alteration I floor sf 2nd floor sf Total sf Height
Single Family
Two-Family
Multi-cannily
(# ofunits
Townhouse
Business Office
Retail -Mercantile
Factory-Industrial
Attached Garage
Other
Town of Queensbury Building&Codes Principal Structure Application revised January 2016
If commercial or industrial please indicate name of business
Proposed use of building or addition
Source of Heat(circle one) Gas Oil) Propane Solar Other
Fireplace: Complete a separate application for Fuel Burning
Appliances&Chimneys
Are there structures not shown on plot plan? ACA
Are there easements on the property? S
Site Information:
a. Dimensions or acreage of lot / , y
b. Is this a corner lot? Yes No
c. Will the grade be changed as a result of construction Yes No
d. Public water or Private well(circle one) Public vate
e. Sewer or Private Septic System(circle one) Sewer 'vate
Value of all work to be performed(labor or materials)
DECLARATION:
1. I acknowledge no construction shall be commenced prior to issuance of a valid permit and will be
completed within a 12 month period.
2. If work is not complete by the I 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 /
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: S G DATE: t�
SIGNATURE: DATE:
For office use on
Operating Permit Issued: Yes No
Occupancy Type
Construction Classification
Assembly Occupancy Limit
Special Conditions