RC-000117-2017 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-000117-2017 Date Issued: Thursday, August 24, 2017
This is to certify that work requested to be done as shown by Permit Number RC-000117-2017
has been completed.
Tax Map Number: 301.14-2-10
Location: 58 MCECHRON LN
Owner: ROBERT SCOTTO-LAVINO
Applicant: ROBERT SCOTTO-LAVINO
This structure may be occupied as a:Attached Garage Addition 490 s.f.
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy 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
#E 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: RC-0001 17-2017
Tax Map No: 301.14-2-10
Permission is hereby granted to: Rick Chase
For property located at: 58 MCECHRON LN
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: ROBERT SCOTTO-LAVINO Attached Garage-Addition $20,000.00
Owner Address: 58 McEchron LN Total Value $20,000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
RL Chase Builder
20 Marion AVE
South Glens Falls,NY 12803
Plans&Specifications
Attached Garage Addition 490 s.f.
$73.50 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday,April 3,2018
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury beforethe ex iratiokoAT,2017
n da
Dated at the Town o mens
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
f
Office Use Only
"fes" ADDITION/ALTERATION PERMIT Permit#:
APPLICATION Permit Fee: $ `JC
roar, of c�ucershun
742 Bay Road,Queensbury,NY 12804 Invoice#:
P:518-761-8256 www.gueensbury.net
Project Location: t Er- na Lo ,
Tax Map ID #: -_2t 1. (1.� ' 2-►D Subdivision Name: 71,'e
CONTACT INFORMATION:
• Applicant:
Name(s): iSok Scop &-' - "Vilna
Mailing Address, C/S/Z: Se Olt, C� z�
Cell Phone: S7/e ) 7-71- `6/ Land Line: �_) I IN C 19
Email:
MAR 2 7 2017
• Primary Owner(s): TOWN OF
Name(s): < - QUEENSB
Mailing Address, C/S/Z: S
Cell Phone: Land Line: � )
Email:
• Contractor(s):
Business Name: 'R,/-. G- :0'e [30i' ld f'
Contact Name(s):
Mailing Address, C/S/Z: ? Cl Chit -' "N AVL S o o C;�- Ark S
Cell Phone: (--C4 ) 3G/- -3LC"L Land Line: ( -5-4 >
Email:_. _CIG,�►ccs-eho'j �eCA it) V cc.,�b . I� I?, CeM
• 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: -I 1\AVit'c1 C�'Qs
Cell Phone: ( SI4 ) J /-sS'�� Land Line: �)
Email:
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017
s
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:
2nd floor: 2nd floor:
3rd floor: 3rd floor:
4th floor: 4th floor:
Total square feet: %Q Total square feet:
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction: $ �f OC�C�.6)6
2. If Commercial project, what is the proposed use: r
3. Source of Heat (circle one): Gas Oil Propane Solar Other /�./oe-
Fireplaces need a separate Fuel Burning Appliances & Chimney Application
4. Are there any structures not shown on the plot plan? YES NO Explain:
5. Are there any easements on the property? YES NO
6. SITE INFORMATION:
a. What is the dimensions or acreage of the parcel?
b. Is this a corner lot? YES
c. Will the grade be changed as a result of the construction? YES O
d. What is the water source? UBLIC PRIVATE WELL
e. Is the parcel on SEWER or a PRIV SEPTIC system? c✓ _
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: a -�c� � -�G,�i0 a
SIGNATURE: J��"Z— L4?MP_ e� DATE: .3
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017