RC-000586-2017 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: RC-000586-2017 Date Issued: Thursday, October 26, 2017
This is to certify that work requested to be done as shown by Permit Number RC-000586-2017
has been completed.
Tax Map Number: 290.13-1-20.2
Location: 40 MASTERS CMN NORTH
Owner: John Wright
Applicant: Mike Bell
This structure may be occupied as a: Residential Alteration 30 s.f.
Egress window By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the ro )JW 4t
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
CERTIFICATE OF OCCUPANCY
Permit Number: RC-000586-2017 Date Issued: Thursday, October 26, 2017
This is to certify that work requested to be done as shown by Permit Number RC-000586-2017
has been completed.
Tax Map Number: 290.13-1-20.2
Location: 40 MASTERS CMN NORTH
Owner: John Wright
Applicant: Mike Bell
This structure may be occupied as a: Residential Alteration 30 s.f.
Egress window By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the j
�otproperty owner of the responsibility for compliance with Site Plan, Y
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-000586-2017
Tax Map No: 290.13-1-20.2
Permission is hereby granted to: Mike Bell
For property located at: 40 MASTERS CMN NORTH
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
Tvne of Construction
Owner Name: John Wright Single Family-Alteration $6,000.00
Owner Address: 40 Masters Common N Total Value $6,000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Mike Bell
P.O.Box 294
Warrensburg,NY 12885
Plans&Specifications
Residential Alteration 30 s.f.
Egress window
$60.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,September 20,2018
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensb=before the Mirati n date)
Dated at the Townf Queen W y,September 20,2017
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use 0i-.IV
,. ADDITION/AL17 �,:
(�C- WO�;I� 7
APhLIE C Fee. $
Torun of Queensbury
742 Bay Road,Queensburry,Ny 12804 14 2017 i e#: �d--
P: 518-761-8256 www.gueensbury.net
QUEENSBURYPir®ject I®cati®no J { mjG& CODES
[I ax Map I® 4, o��lr� � [ 3 —)—2AZ Subdivision Name.*
CONTACT INFORMATION'
Applicant
Mailing Address, C/S/Z: i�ZLl
Cell Phone: _) �a Iy 3 I and Line:
Email: A,\ , Iri,l cgv,, {SL�,�1
Primary Owner(s):
Name(s):,AJI
Mailing Address, C/S : 116 A43fietS
Cell Phone: Land Line:
Email:
o
Contractor(s).
Business Name: / "/ e,
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: SIS ) �2-3 1'Y_?I L Line: � )
Email:
® Architect(s)/Engineer(s):
Business Name:
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: Land Line: � )
Email:
Contact Person for Building & Code Compliance: ���' C uN, c4 UR. �6"'o CA-r t
Cell Phone: Land Line:
Email:
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017
w
'PROJECT INFORMATION:
TYPE: Commercial � Residential
WORK CLASS:
Single-Family _Two-Family _ 'Multi-Family (#of units )
Townhouse Business Office Retail
Industrial/Warehouse _Garage (#of cars ) _Other (describe )
ADDITION SQUARE FOOTAGE: ALTERATION SQUARE FOOTAGE:
1st floor: 1st floor:
211 floor: 2nd floor:
3rd floor: 3rd floor:
4th floor: 4t' floor:
Total square feet: Total square feet: C
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction: $ 4
2. If Commercial project, what is the proposed use:
3. Source of Heat (circle one): ,Gas Oil Propane Solar Other
Fireplaces need a separate Fuel Burning Appliances &Chimney Application
4. Are there any structures not shown on the plot plan? YES Explain:
5. Are there any easements on the property? YES NCO
6. SITE INFORMATION:
a. What is the dimensions or acreage of the parcel?
b. Is this a corner lot? YES " tQ
c. Will the grade be changed as a result of the construction? YES I�Q
d. What is the water sou ce? PUBLIC PRIVATE-WELL
e. Is the parcel o SEWE�or a PRIVATE SEPTIC system?
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017
DECLARATION:
1. 1 acknowledge that no construction shall be commenced prior to issuance of a valid permit and will be
completed within a 12 month period.
2. If the work is not completed by the 1 year expiration date the permit may be renewed, subject to
fees and department approval.
3. 1 certify that the application, plans and supporting materials are a true and complete statement and/or
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. 1 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; ���c,�=�
SIGNATURE: r` DATE: t
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017
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MAP REFERENCE:
MASTER'S COMMON NORTH I E C IE fl W E �
DATED. AUGUST 26, 1987
BY: VAN DUSEN & STEVES
FILED: MARCH 10, 1988 { SEP 14 2017
DRAWER 17 FOLDER 1
j TO WN OF QUEENSBURY
BUILDING&CODES
RF
LOT 29
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LOT 28
r� Q 33,532.51 sq ft'
1 ,, ° 0. 77 acres
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! 255 6,50 �
290.13-1-20.2 RC-000586-2017
Wright, John
ommon North
PERMIT PLOT PLAN 40 Masters C 30 S.$.
I HAVE PERSONALLY MEASURED THE DIOTANCE• � LOT 27 Res. Alt. (egress window)
FROM THE PROPERTY LINES TO THE RF
PR?�P,OSE� S�;RUCTURE(S) OR SIGN(S)
SIGNATURE DTET � ��,� ��'�4 ±pL .�,���,�
� �
tib- Y Fx _
Date October 12, 200
g ! �V e 'U"AUTHORREIj ALTERATION CR ADDITION TO A SURWY _ SC0.�e 1'= 30',,.
A ����....111J - MAP BEARING A if D i.A„D SURVEYORS SEAL iS A Map ,of a Survey made for
9^ NOTATION OF Sf6noN'A'I `.x1B-DINSIGI z OF THE g� -
(�(, NEW YOIPoC STATE EDUCA710N L"- 4,
�("""�j A ONLY COPIES,i"RI THE IXi1,C�yNAL AN h U SUR!£Y - - - -
.h�eR~•.1/,' ill`".'/ SELLk4AM$ NtLH N�CPog ERE OF(tE LAND TRUE ORS a ^�
'CERTIFM.A w t3i15'ARE TO BE yNJD TRUE CORES` M HUGHES
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1F95 SURVEY W NOICA-tkREON SIGNIFY THAT - � � - - - -
]� EXISTING CODE PREPARED Ill ACCORDANCE 9ATH THE - -
By
L a iad S i.r r e o r LAND SJRYEYOf�3:SAS CERT FICA710NS SHAH RUH CNL?RACTKEM LAW SURVEYORS �Y�
TO ME PERSON f�VMpM ME-SURVEY IS PREPARED.ANO - - - ���'��')
ON HIS BEHALF lU THE TIRE SVNPANY,GOYERPUiENTAL - -
169 Haviland Road Queensbury, New York 12804 T THE YA555`GNE�of THE�,UNIG INSTITURCN.' yj y 1 10/18/05 NAME CHANGE '
' �"° LIS,m HEREON,AND Town of Queensbury, Warren County, York HUGHES
(518) 792-8474 New York Lie. No. 50135 NO., : DATE DESCRIPTION DWG. NO. MCN-28