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RC-0144-2019 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-0144-2019 Tax Map No: 296.14-1-52.2 Permission is hereby granted to: Dean(Jake) Howland For property located at: 68 COUNTRY CLUB 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 Type of Construction Owner Name: Dean(Jake) Howland Porch-3 Season,Covered,Enclosed $8,000.00 Owner Address: 68 COUNTRY CLUB RD Total Value $8,000.00 Queensbury,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency Dean(Jake)Howland 68 COUNTRY CLUB RD Queensbury,NY 12804 Plans&Specifications Screened porch 205 s.f. $ 125.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Friday,March 27,2020 (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 of Queensbury; Thursday, March 28, 2019 SIGNED BY: 4 � for the Town of Queensbury. Director of Building&Code Enforcement Office Use Only ACCESSORY STRUCTURE Permit#: RC 1`-1'ii--.1 C1 ` PERMIT APPLICATION Town ofQi ee bury Permit Fee: $ 742 Bay Road,Queensbury, NY 12804 P:518-761-8256 www.queensbury.net Invoice #: 3a 3 Project Location: _68 Country Club rd Tax Map ID #: 296.14-1-52.2 Subdivision Name: ¢gmi—._ FE -,, CONTACT INFORMATION: LMAR 2 5 2Q19 tja • Applicant: Name(s): _Dean Howland TOWN OF QUEEN-,BURY OOMMUN " ` VEL._PMENT Mailing Address, C/S/Z: _68 Country Club rd._ Cell Phone: _(518)791-7011_ Land Line: _( ) Email: jake@howlandconstruction.com • Primary Owner(s): Name(s): _Dean Howland Mailing Address, C/S/Z: _Same Cell Phone: _( ) Land Line: _( Email: ►Z� Check if all work will be performed by homeowner only • Contractor(s): Workers' Comp documentation must be submitted with this application Contact Name(s): Sec COAStruc4, Contractor Trade: Mailing Address, C/S/Z: Cell Phone: _( ) Land Line: _( Email: **List all additional contractors on the back of this form • 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: Dean Howland Cell Phone: _(_518)791-7011 Land Line: _( Email: Accessory Structure Application Revised February 2019 PROJECT INFORMATION: TYPE: ❑ Commercial ® Residential WORK CLASS: ,ogrDeck, 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:_205 Screerec{ ` 2nd floor: Total square feet:_205 ADDITIONAL PROJECT INFORMATION: 1. Estimated Cost of Construction: $_8000.00 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 © NO 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: ejliat l ti - � SIGNATU&e.— DATE: .3/Z..(/r Accessory Structure Application Revised February 2019 Map Reference Map of. . . Lloyd f. Jone5, Jr. By: Van Du5en * 5teve5 Date: 25 September 2007 Last Revl5ed: 9 April 2008 } urt. MAP LOT 1 Capped Rod Found 583 05 5 10011E Capped Rod Set P BCD g Capped Rod Set 2D'± 325,531 QO Copped Rod Found 156' L OT 2 GARAGE Area = 1 . 21 ± acres 1 - i (\/�J CO U Grave/ Drive & Parking 1 1J O HOUSE Q4 [� Zt 1 Qj 34 \ \ Infiltration Basin Capped Rod Found - --- - 3 73.06 r /n filtr tion Basin Infiltration Basin Capped Rod Set Mapping Notes ti - ----- _ Note: Only title 5urvey5 bearing the maker V _ r ed seal Should be relied upon Sine Copped Rod Set �-.-_,-,�. errbo5s p PER(�417 P T P � ° other than embo55ed-seal copies may c ntain 1 HAVE PERSONALLY h1ASUr�`=�THE DISTANCE 1QQu�A unauthorized and undetectable modif; ions, FROM THE PROPERTY LINES TO THE VV i n additions, and char es. ael�,t o 5, 9 PROPOSED S t T �PE{S}OR SIGN( --_ ` � � /ZS � Shared Access Easement � of a 5U1"Vey for h razed alteration Or addition to a Survey map -�tiTE Per Town of Queensbury -- Unaut o rvATUR Subdivision Approval Capped Rod Set bear;ng a licensed land survcyor'5 Seal i5 a violation Jake & NiCole f; n 720 . Sub-divi5ion2, of the New York State owland o, 5ec i o H Ec;ucat on La�v. 51tuke I1"1 Cert;fic,ation5 on this boundary Survey map Signify -� i c rdance with the Certification Town 4 Queen5burvCounty of Warren that the map was prepare) n ac o current ex,5ting Code of Practice for Land Surveys I hereby certify to Dean H. Howland, 111, Nicole Dubois Howland, State New York adof tea by the. New York State A55ociation of Professional 5urveyor5, Inc, The certification i5 Old Republic Title Insurance Company and Homestead funding Scale : 1 „ = 2feetCorp., Its 5uccessor5 and/or a55f n5, a5 their lntere5t5 ma `-� Date: January 2 j 0 1 I{mtea to the persons for whom the boundary Survey re ared, to the title company, to the g y ma I p ;s prepare appear, that this plat wa5 prepared from an actual governmental ac3ency, and to the lending institution L_O T 3 Survey a d Ma �, eviSed: ! 9 September 20 I �; IFSted on this boundary survey map. on the ground survey according to record p y descrip Final survey/certification. 1,�" �� 1 �i The certifscation5 hereon are not tran5terable, • S • A550 IATf5 Surveyors Engineers The locat;cn of underground improvement5 or - ``�� LAKE GEC)RGE, N W YORK 12845 encroachments are not always known and often must r ~ . A o r If any under round ;m rovement5 or �� ! 9 Septeimber 20 ! 6 by u5tirr atea g p enr✓ro,achrr,ent5 exist or are shown, the improvements Dennis L. Dickinson, L.5': Date QU: 66 G 5 (old) or encroachments are- not covered by thi5 certificate. 1 QU: 29G. 14- 1 -52.2 (new)