RC-000332-2015 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
at Community Development-Building&Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: RC-000332-2015 Date Issued: Friday, December 2, 2016
This is to certify that work requested to be done as shown by Permit Number RC-000332-2015
has been completed.
Tax Map Number: 308.5-1-1
Location: 393 WEST MOUNTAIN RD
Owner: George Mackey
Applicant: George Mackey
This structure may be occupied as a:Kitchen Renovations 276 s.f.
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the r ) //1 4 k.—
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.
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-000332-2015
Tax Map No: 308.5-I-1
Permission is hereby granted to: George Mackey
For property located at: 393 West WEST MOUNTAIN 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 Construction
Owner Name: George Mackey Single Family-Alteration $15,000.00
Owner Address: 393 West Mountain RD Total Value $15,000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
Kitchen Renovations 276 s.f.
$60.00 PERMIT FEE PAID-TIES PERMIT EXPIRES: Thursday,November 17,2016
(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 eensbu •j
�i]ond 3,2015
SIGNED BY: /wJ for the Town of Queensbury.
Director of Building&Code Enforcement
✓ 11. �C � ��DO
PRINCIPAL STRUCTURE APPLICATION Office Use Onlv
Received
Date: - �' Z a 1 S �" Tai glap 1D
Permit No. PIC- 600 Z -ZD(S
Tax Map ID b s 9WV 13 2015 Pemiit Fee LV &0.
Zone Rec Fee
Historic Site _Yes X Nc TOWN OF QUEENS6 Site Plan#
BUILDING & CODF_ „Subdivision#
Subdivision Name Lot#
Project Location 3q 3 0&duuR
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 feels).
Applicant (Y 02 Gc ACK r Owner GFoa6"v-
Address 93 GJt�s% ; /Z J Address
Q�PP�sg�c , W /2goV
Phone/E-mail SI 9 - 7 y yt _ 5_0b G Phone/E-mail
�r,1mtc �cey ID PSS.
Contact Person for Building&Codes Compliance: (7��� /�-' /�� Y Phone S' -74`/-5"/6
TYPE OF CONSTRUCTION
✓Check all that apply New Addition Alteration 1 s<floor sf 2'floor sf Total sf Height
Single Family x x 27{o S f
Two-Family
Multi-Family
(#of units )
Townhouse
Business Office
Retail-Mercantile
Factory-Industrial
Attached Garage
(1, 2, 3, 4+)
Other
If commercial or industrial please indicate of business
Town of Queensbury Building&Codes Principal Structure Application Revised September 2015
1
Proposed use of building or addition 04'e4-
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? A41
Site Information
a. Dimensions or acreage of lot / q c R<'
b. Is this a corner lot? P a
c. Will the grade be changed as a result of construction _ Yes k No
d. Public water or Private well _F,,01-1 C'
e. Sewer or Private Septic System PM1i 0,9 rc
SFp
Value of all work to be performed (labor or materials) Is ti, o oo.o
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. 1 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: ���� i`0 i��7 DATE:
SIGNATURE: DATE:
T"
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
TOWN OF QUELNSSURY
BI ILOislv '� EPT. TOWN OFQUEENSBURY
p BUILDING DEPARTMENT
Reviewed"�wGd '�/' with our comm neted ts sh art„nfabe con trulednas
Date: L 2G t indicating the plans anu specifications are in
1. full compliance with the 3uilding Codes of
New York State.
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FILENAME: PSI Mackeycabinets
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PRODUCT LINE: allen loth
DOOR STYLE: annscrofl
NOTIC FINISH: cream paint with brown glaze
OVERLAY: full
CONSTRUCTION: "select"
KRAFT PAPER I = — SKU: 577599
MUST BE COVER D BY PROMO SKU: same 5"599
20%off scan sheet promo Nru Oct 30th
NON•COMBUSTIBTOP MOLDING: DING and CMB WD
LIGHT RAIL MOLDING: none
OO CEILING HEIGHT: 951/2"
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PSI Mackey cabinets.kit All77� Drawing#: I
GEORGE MACKEY GLENS FALLS
820 ROUTE 9
q. r 393 W MOUNTAIN RD
QUEENSBURY, NY 12804
,wr QUEENSBURY, NY 12804 6160
518-744-5066 167753
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www.HomeDepot.com Page 1 of 4 Printed By: RICK Date Printed: 11/12/2015 2:11 PM