RC-000280-2016 TOWN OFQ UEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: RC-000280-2016 Date Issued: Friday, October 13, 2017
This is to certify that work requested to be done as shown by Permit Number RC-000280-2016
has been completed.
Tax Map Number: 289.17-1-46
Location: 149 BIRDSALL RD
Owner: Annie Dineen,Kevin Dineen
Applicant: Kevin Dineen
This structure may be occupied as a: Detached Garage Alteration 107 s.f.
Cross Ref. AV PZ 208-2016 and SP PZ 202-2016 By Order of Town Board
Note: no kitchen allowed or approved for a kitchen-Zoning Administrator;C. TOWN OF QUEENSBURY
Brown
Issuance of this Certificate of Compliance DOES NOT relieve the
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-000280-2016
Tax Map No: 289.17-1-46
Permission is hereby granted to: Corhouse Construction,LLC
For property located at: 149 BIRDSALL 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
Owner Name: Annie Dineen Other-Alteration $20,000.00
Owner Address: 360 N Oak ST Total Value $20,000.00
Hinsdale,IL 60521
Contractor or Builder's Name/Address Electrical Inspection Agency
Corhouse Construction,LLC
25 Jacobie RD
South Glens Falls,NY 12803
Plans&Specifications
Detached Garage Alteration 107 s.f.
Cross Ref. AV PZ 208-2016 and SP PZ 202-2016
Note: no kitchen allowed or approved for a kitchen-Zoning Administrator,C.Brown
$60.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,September 22,2017
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expir
ation date.)
Dated at the Town of ens ursd y Se 22,2016
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
PRINCIPAL STRUCTURE APPLICATION
Office Use Only
Received
Date: Tax Map ID
Tax Map ID �9GQ - 1 -w r �9 ] 1�/_ Permit No.
Zone
S` Permit Fee of 5$&
Rec Fee
Historic Site _Yes j No Site Plan#
Subdivision Name 0 I Lot# Subdivision#
TOWN BD. RESOLUTION 86-2013: $850 RECREATION FEE FOR NEW DWELLING UNITS - SINGLE
FAMILY, DUPLEXES/I'WO-FAMILY, MULTIPLE FAMILY, APARTMENTS, CONDOMINIMUMS,
TOWNHOUSES,AND/OR MANUFACTURED&MODULAR HOMES,BUT NOT MOBILE HOMES. THIS
1S IN ADDITION TO THE PERMIT FEE.
Applicant �N ►"�Nt�l�' P,4 Owner
Address 3�DOAe Address
Ns��Le - - L co5a
Phone/E-mai! nn-�1'�A� Phone/E-mail
Contact Person for Building&Codes Complian RtAU►15Ya SAW �,12�;rU
Phone 'M—OOP%
�cu i �tv r-
dF + .X:7
TYPE OF CONSTRUCTION1 J
_7T3- cvu 7Nq- S85�
Check all that apply New Add#' •t•4 11 flnor 5f 2n°floor sf TRI r e t w_
Single Family
Two-Family 09 2016 U
Multi-Famity �� Y
BUILDII 4G &CODES
(#of units
Townhouse
Business Office
Retail -Mercantile
Factory-Industrial
Attached Garage
(1, 2, 3, 4+) M yp
Other
Town of Queensbury Building&Codes Principal Structure Application Revised September 2014 ���G
r If commercial or industrial please indicate of business A
Proposed use of building or additions
Source of Heat(circle one) as Oil Propane Solar Other
Fireplace: Complete a separate application for Fuel Buming
Appliances&Chimneys tA/A— ��N�
Are there structures not shown on plot plan? p
Are there easements on theproperty? �
Site Information
a. Dimensions or acreage of lot
b. Is this a comer 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 System J
Value of all work to be performed(labor or materials) $ p
DECLARATION.•
1. I acknowledge no construction shall he 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:
SIGNATURE: DATE: A � ll�o
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 2014