RC-0166-2018 lOOk 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-0166-2018 Date Issued: Monday, August 6, 2018
This is to certify that work requested to be done as shown by Permit Number RC-0166-2018
has been completed.
Tax Map Number: 290.14-1-28
Location: 385 HAVILAND RD
Owner: Melanie Dillman, SCOTT DILLMAN
Applicant: Patrick Burke
This structure may be occupied as a: Attached Garage Addition 494 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
j' 742 Bay Road, Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: RC-0166-2018
Tax Map No: 290.14-1-28
Permission is hereby granted to: Patrick Burke
For property located at: 385 HAVILAND 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
Woe of Construction
Owner Name: - Melanie Dillman Attached Garage-Addition $25,000.00
Owner Address: 385 HAVILAND RD Total Value $25,000.00
Queensbury,NY 12804
Contractor or Builder's Name J Address Electrical Inspection Agency
Plans&Specifications
Attached Garage Addition 494 s.f.
$ 175.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Friday,April 26,2019
(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 Town 5b;�P
4TA'vw
26,2018
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
ACCESSORY STRUCTURE
Permit#:
PERMIT APPLICATION Permit Fee:$ )'4F.>,o-o
'rown of tZ?acnsbury
742 Bay Road,Queensbury,NY 12804 Invoice#: 026 2'
P:518-761-8256 ww�w.a.aufieensb�urrv.net Project Location: _Y_� 1 ►7 AV IrAWJ
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Tax Map ID#:
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CONTACT INFORMATION: _-
TOWN Oi"QUEEN56uRy
• AppH r`lt: BUILII NG&COLIFES
Name(s): 7177�`1 J � tAfk
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Mailing Address, C/S/Z: q _� 6
Cell Phone: Cq_s Z 7S Land Line: ( `-
Email: Fir- c I7 /� nti�tin r�.Ve.
• Primary Owner(s):
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Name(s): h d&ir,J� I tk6�
Mailing Address, C/S/Z: _19 8s 44 W� f-V
Cell Phone: -Land Line: ( )
Email:
• Contractor(s); J
q,,r_1 ���Business Name: r
Contact Name(s): Iir'. l �t.,41�_
Mailing Address, C/S/Z: 0/3 �, �,� /fl
Cell Phone: UD 22 Z_—�7 �` Land Line: --._,.
Email: 1 1 -7 �af.Gr.1I
• Architects)/Engineer(s):
Business Name: LJ,1 fog.
Contact Name(s):
Mailing Address, C/S/Z: 6
-Ge+H to��C: ( �`lam )_-7 9 I q 6 �_I--
Email:
Contact Person for Building p&Code Compliance: PmLIJ tw��
Cell Phone: - 4 7 Land Line: ( �6
Email: c,r- e_ 7 6 C
Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017