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RC-0005-2018 f TOWN OF QUEENSBURY IL 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: RC-0005-2018 Date Issued: Wednesday, May 9, 2018 This is to certify that work requested to be done as shown by Permit Number RC-0005-2018 has been completed. Tax Map Number: 301.12-2-51 Location: 14 HEINRICK CIR Owner: Robert Keenan, Dawn Keenan Applicant: The K. Kristel Company This structure may be occupied as a: Residential Interior Alterations 504 sq. ft. converting 2 bathrooms into 1 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, yy 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 h Community Development - Building & Codes (518) 761-8256 BUILDING PERMIT Permit Number: RC-0005-2018 Tax Map No: 301.12-2-51 Permission is hereby granted to: The K. Kristel Company For property located at: 14 HEINRICK CIR 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: Robert Keenan Single Family-Alteration $19,700.00 Owner Address: 14 Heinrick CIR Total Value $19,700.00 Queensbury,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency The K. Kristel Company 9 Pinewood Hollow RD Queensbury,NY 12804 Plans&Specifications Residential Interior Alterations 504 sq. ft. converting 2 bathrooms into 1 $ 200.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Wednesday, January 16, 2019 (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 To a sbury /� Otrary 16, 2018 SIGNED BY: �d for the Town of Queensbury. Director of Building&Code Enforcement s { Office Use Only ADDITION/ALTERATION PERMIT Permit#: �. - APPLICATION Permit Fee: Town of Queensbury 742 Bay Road,Queensbury,NY 12804 Invoice#: P:518-761-8256 www.gueensbury.net Project Location: -1 �G +r►,^i GK �' Tc�e #: 301, f Z " Z Tax Map ID - Subdivision Name: ---- CONTACT INFORMATION: k "i JAN 0 48 2Q1 • Applicant: Uv Mailing Address, C/S/Z: �►�� No1�ow ©,zd QU(fe-0s �L' Cell Phone: ( I`� ) 7ct - �6b7 Land Line: Email: �66h1 • Primary Owner(s): I� Name(s): ';obe - 0Ciw� I'� ectan Mailing Address, C/S/Z: l y l e-ig r,c4 C�r�c weer, �bu�� l, I2-PY Cell Phone: 5(�g ) _ iq\—n D 1 Land Line: Email: ffV Ge,,nan dol • Contractor(s)• Business Name: /1 /�pis L Contact Name(s): X o c1 Kf r5 Mailing Address, C/S/Z: iAe-i.1 140.l o,,, !°mod Qy cns �.� /Z�?Oy Cell Phone: ( 5fr - ) W1( -MO? Land Line: Email: drat),eor"' • Arch itect(s)/Engineer(s): Business Name: Contact Name(s): Mailing Address, C/S/Z: Cell Phone:��) Land Line: Email: Contact Person for Building & Code Compliance: Cell Phone: ( 6� ) 796 --1602 Land Lin : Email: Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017 G PROJECT INFORMATION: TYPE: Commercial JResidential TRK 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: 5L`` -2- ;� �dor✓t S 2nd floor: 2nd floor: 31d floor: 3rd floor: �G�t�'f ?oc"k 41h floor: 4th floor: Total square feet: Total square feet: ADDITIONAL PROJECT INFORMATION: 1. Estimated Cost of Construction: $ 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 Bur 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 ONO 6. SITE INFORMATION: a. What is the dimensions or creage of the parcel? 1 b. Is this a corner lot? YES NO c. Will the grade be changed as a result of the construction? YES d. What is the water source? PUBLI PRIVATE WELL e. Is the parcel on SEWER or PRIVATE SEP IC system? Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017 • DECLARATION: I. 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 thework 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: �Oc1F SIGNATURE: l 6"1 � DATE: 1 Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017