AST-0510-2018 TOWN OF UEENSBURY
'iiL."1,
Q_ ,, �I,' 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
;, `. . r Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: AST-0510-2018 '
Tax Map No: 301.13-1-2
Permission is hereby granted to: Andrew Hirschklau
For property located at: 563 WEST MOUNTAIN RD
i
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: Andrew Hirschklau Deck - $1,000.00
Owner Address: 563 West Mountain RD Total Value $1,000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications 1
. Deck 573 s.f.
$ 125.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Saturday,August 10,2019
(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 ex4piration 4 ate.)
Dated at the To of Que j F'i•. i _ugust 10,2018
SIGNED BY: for the Town of Queensbury.
,
Director of Building&Code Enforcement
Office Use Only
ACCESSORY S r ' E J E mit#: A c- t r 6 CIO
PERMIT APP F ATION . P rrnit Fee:$ 1 Z-ST 00
Town of Q eensbury AUG 0 9 2018
742 Bay Roads Queensbury,NV 12804 nvoice#: 0 7 /2
P:51B-761-8256 w vw.queensbury.net TOWN OF QUEENSBUIZ I
BUILDING&CODES
Project Location: 90 S (Jcs1" Ar7v A . g y
Tax Map ID #: 3 o d A 1 '--Z Subdivision Name:
CONTACT INFORMATION:
e Applicant:
Name(s): 4,?r +' /Pack041
Mailing Address, C/S/Z: 53 GAO" ,in) J2 Qui€41.41
Cell Phone: (9-73 ) 9-13-d$5 Land Line: ( ---)—
Email: AItrsrlik14019/4 &fm n1. COI'
Primary Owner(s):
Name(s): 5
Mailing Address, C/S/Z:
Cell Phone: ( ) Land Line: ( )
Email:
Contractor(s):
Business Name:
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: ( ) Land Line: ( )
Email:
® Architect(s)/Engineer(s):
Business Name:
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: ( ) Land Line: ( )
Email:
Contact Person for Building & Code Compliance:
Cell Phone: ( ) 9111le
i Land Line: ( )
Email:
Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017
-F
PROJECT INFORMATION:
TYPE: Commercial r Residential
WORK CLASS:
10 Deck,Open Porch Solar Panels(w/o rafter upgrades) Carport Cell Tower
Shed _Pavilion, Pole Barn,Canopy Dock Gazebo
Detached Garage _Boathouse(with or w/o sundeck) _3-Season Porch
Other(description:_ )
SQUARE FOOTAGE OF STRUCTURE:
1st floor: � 3
2nd floor:
Total square feet: 4 5
ADDITIONAL PROJECT INFORMATION:
•
1. Estimated Cost of Construction:$ /ric,a
2. If Commercial project,what is the proposed use:
3. Are there any structures not shown on the plot plan? YES NO Explain:
4. Are there any easements on the property? YES
DECLARATION:
1. I 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. I 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. 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: ()(W k5d4 (A k
_3U SIGNATURE: / DATE: (q/f )
Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017
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Lands N/F h PP 5�IT PLOT PLAN
Michael & Share,,.
I ffV RSONALLY MEASURED THE_DISTANC /
,Iron Pipe Found FROM THE PROPERTY LINES TO T
E C E Eo PRO ED STRUCTURE(S) OR (I S) �\
D O�G �9r
Copped Iron
AUG 0 9 2018 Rod Set SIGNATURE o f O
/ Nip Ret z
TOWN OF QUEENSBURY
BUILDING&CODES �' sOOO
�h• Iron Pipe Faun /
Lands NA Of L d
Joseph it Mario Leuci Lands N/F Of
8781150 Joseph & Mario Leuci w= utrI Pole
8781147 ® =Drilled men
/ — Sign
Tree
M box
Fence Lines
-%
Area
X_ d
,X` \ ran Rod Found al
x' Carped Iron �` r Sr4Y Mop References:
Set =" ,b'�ni. - n
Mop Of A Survey Made For
>- r y ✓, ,t t Joseph it Mario Leuci
Doted.• 26 April 1994
Revised.• 31 May 1994
. ,.
By. Von Dusen & Stev>°s
SRO/ Mop Of Lands Surveyed For
James Marto
Dated: 27 December 2000
Last Revised: 16 February 2002
nV / By. Wayne R. Raymond
Map
nnGV' Deed References.•
of a survey for k AJ 23 Barbaro A. Morincic
To
Andrew Hirschklau Y - x
• �-�� •k- `; - `�� � \{ ��X' - �� � Barbaro A. Morincic
'* YY Dated: 25 April 2008
p Se- Book 3539 Page 310
5ltuate In '>., ,
Town of Queensbury County of Warren
State of Vew York
5cale: 1" = 20' feet Date: 26 Februa 2018 ."
rY Lands N/F Of
M e Joseph & Maria Leuci '\ =8781147 Mapping Notes:
�.Dielkia8o
5urveyorsf liEneyn—
ur.E ceoRce,n.wvowc izaas Only title surveys beanng the maker's
embossed seal should be ral ed upon since
other than embossed-seal copies may contain
unauthorized and undetectable modil'i"tons,
deletions.additions,and changes.
unauthorized alteration or addition to a survey map
/ beanng a licensed land surveyor's seal is a violation
TMPI.•OU 301.13_2_2(new)
of section 7 .5ut,-clivi5ion2,of the New York State
0U 123-1_11.1 (old) / Education law.