RC-000398-2016 TOWN OF QUEENSBURY
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742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development- Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number: RC-000398-2016
Tax Map No: 308.8-2-20
Permission is hereby granted to: Maurice Paddock
For property located at: 23 LEO ST
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: Maurice Paddock Single Family-Alteration $8,000.00
Owner Address: 23 Leo ST Total Value $8,000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Maurice Paddock
23 Leo ST
Queensbury,NY 12804
Plans& Specifications
Detached garage alterations to 2nd floor only;recreation room and office with full bathroom;(no sleeping quarters).
544 sq. ft.
$ 81.60 PERMIT FEE PAID -THIS PERMIT EXPIRES: Saturday,June 24,2017
(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; /�'�ed e d 29,2016
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
PRINCIPAL STRUCTURE APPLICATIUI''+1 Office Use Only
Received
Date: 4P Ja--7 Tax Map ID
Tax Map ID - Permit No. l�C— 3 O!
j �� �� ?w Permit Fee 5V (�� ZL-dkT ze-7 7i
Zone Rec Fee
Historic Site Yes N Site Plan 4
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Subdivision Name Lot# Subdivision
Project Locations p ,
TOWN BD. RESOLUTION 86-2013: $850 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).
Applicant07 ___ _-Owner
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Address '.— �% Address < <
AY
Phone/E-mail Phone/E-mail
Contact Person for Building&Codes Compliance: �r/cU K Phone
tNo
TYPE OF CONSTRUCTION
✓Check all that apply New Addition AIteration I5'floor sf 2n'floor sf Total sf Height
Single Family
Two-Family
308.8-2-20 RC 398-2016
Multi-Family Maurice Paddock, Jr.
(4 of units 23 Leo Street
2nd fLr garage alterations (detached)
Townhouse
Business Office
Retail -Mercantile
Factory-Industrial r"J/
Attached Garage ,
(1, 2, 3, 4+)
Other R t'l `( -9;��, vl
If commercial or industrial please indicate of business C
Town of Queensbury Building&Codes Principal Structure Application Revised September 2015
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?
Are there easements on the property?
Site Information
a. Dimensions or acreage of lot
b. Is this a corner lot?
c. Will the grade be changed as a result of construction Yes No
d. Public water or Private well
e. Sewer or Private Septic SystemM 12
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 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/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: �' '' C�� ' DATE: 1l�
SIGNATURE: TE:
For office use only
Operating Permit Issued: Yes No
Occupancy Type
Construction Classification
Assembly Occupancy Limit
Special Conditions
Town of Queensbury Building&Codes Principal Structure Application Revised September 2015