applicationtF TOWN OF QUEENSBURYd
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: AST-0436-2018
A
Tax Map No: 226.12-1-56
Permission is hereby granted to: Karl Dutcher Construction
For property located at:377 CLEVERDALE 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: Jeanne Rollins Dock 60,000.00
Owner Address: 330 N Main ST Total Value 60,000.00
Stonington,CT 06378
Contractor or Builder's Name/Address Electrical Inspection Agency
Karl Dutcher Construction
PO Box 294
Cleverdale,NY 12820
Plans&Specifications
Boathouse with sundeck 720 sq.ft.
also resurfacing existing dock)
150.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Saturday,July 13,2019
If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Quee ury before. a e ex irati• +at-.)
Dated at the To of Qu b Fit, 1, -lily 13,2018
SIGNED BY:for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Drily
i (ifp , ,,,4. '
f'110 "A ''''t': . ACESSORY STRUCTURE Permit 4: AST' 3(2 ..--. 0 le
a , ac
PE,PdVin(APPitICA7ION Permit Fee:$ fry) —
Town of Queensbury
V ;ay Road,Queensbury,hilf 102;04 invoice#: ee, (03(.0 6103 7
P:51;-761-8256 wwwoqueensburvmet
Project Location: 77 (71-Cy eto..\311-c_12o0,) („xu-i---cn.000 yvt-y ID E g ,ie 11 Tyril-Z-71
Tax Map ID#: 226 . 12_— I —56 . sybds 1ionName: r_______ .........1....„... : irli
Cor-Tv9ZUN1-57-76EVE76:18VE1"
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CONTACT INFORMATit N.:
I
AD e APplicant;
Name(s): el, u-c IL 20 II i,As Ne- Teoytv kog
N°11-FYQD L
e.r
Mailing Address, C/5/Z: .33011,07x- 1114?i, i, . -_li.v.get . 5fekt;P177611 4'C. T 0.6i28/
Cell Phone: ( IP( ) 5--(62.. - 0 1i OD Land Line; (
Email:
0 Primary Owner(s):
Name(s):Cil 'ice RolitnS 4 Teittthe R r 7/.'n r
Mailing Address, C/S/4- _ 7 330 11 K 111.0-4 CriPee ClAvi fli.r7;-i, e.7
Cell Phone: ( /P( ) 5sa — 0) 0v Land Line: (
Email:61 plc 2? mR ;1 . Ce2,14
1
a Contractor(s);
Business Name: KO 0 1 Du icti-el C6454 Oe bogl
Contact Name(s); /eo it 1 D ti f-d,,ee-
mailing Address, C/S/Z: PC P, oie Zoi q c if ve?3,4,11. ksY /2?2.6
Cell Phone: (Pg ) .3a1 -4/?3 6, Land Line: ( cir ) . 3 21 - 11213.4
Email: ite / 3 0 fe 1,L,.r 05 3 I & afrieui , eorA
Architect(s)/Engineer(s)z,
Business Naine: Di-cr i Ago"k As.So
Contact Name(s): 'Devi^ b tertn. Sc' eN,
Mailing Address, C/S/Z: Pa i.- 0?c 367F RI-R. ' g eo t a\-c 0'•-) Y 1 2r45
Cell Phone: ( 37? ) .3 3c) - 7 ii.57 . . Land Line: (‘,5-/ ) 668 -eit 7.4
Email: a l i egr viS or1 7 8 @ IA-at-I / , Co"I
Contact Person for Building & Code Compliance: kev-L, .7)1,--ir---ke r
Cell Phone: ( 517' ) 3 2j -4e3(0 Land Line: (
Email:
Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017
1
JPRO,Ityrol..MATJiON
Commercial s(- Residential
WORK CLASS:
Deck,Open Porch Solar Panels(w/o rafter upgrades) Carport Cell Tower
Shed Pavilion, Pole Barn,Canopy 70 Dock P-r-e S o , Gazebo
yvk
Detached Garage k Boathouse (with or w/o sundeck) 3-Season Porch
Other(description:
SQUARE FOOTAGE OF STRUCTURE;
1st floor;
2nd floor: 7 2.0
Total square feet: 7 Z C5
ADDITIONAL.PROJECT INFORMATION:
17 Estimated Cost of Construction:$ v Qi 00
2. If Commercial project,what is the proposed use;
3. Are there any structures not shown on the plot plan? YES. - Explain:
4. Are there any easements on the property? YES 010
IDECL.A ATION:
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 a II newly
constructed facilities prior to issuance of a certificate of occupancy.
have read and agree to the above:
PRINT NAME:
p/es
4 !
J (44 r
SIGNATURE: DATE:
L 1/
Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017
RX Date/Time 09/11/2019 12:56 15162731202 P.013
Sep. 11. 2019,.12:45PM MD IA I I No. 0558 P. 13/13 ,
lc;;
1 MIDDLE DEPARTMENT INSPECT ON AGENCY, INC.
a that the electrical wiring to the electrical equipment li 'te below has been examined and is approved as GCadbeinginaccordwiththeNationalElectricalCode, applicable govern
I
n I, utility and Agency rules in effect on the date r
noted below and is issued subject to the following conditions. 1
I
1 IC1, Owner; Date:l • 4."t0 Chuck Rollins1 I09/03/2019
e p
0
Occupant Localr) Dock r i 7 Cleverdale Road • ,
Otxupan ipeensburY,Warren Co. NY
k..) Services r
a Applicant
r I I 0
A. Main Electric i
141 Rix Town Rd P
a. .LCepGnswold,CT 06351 I. • D Ga)
CCU) 1 j
J SR;.16 2019
Joseph A-Holmes ii j(;
No.BW FQES3uRY147524107743EL • . . ' •
ODDS
Equipment: G
r.:
1 -40 Amp.Sub panel;4-Switches;5 Receptacles,:12=Fixtures '• '1Ac 5'_ o j 0
j I fir.:>>
It I 0
vi
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t51 This certificate applies to the electrical wiring to the electrical equipment listed immediate) Inu I end void. This certificate applies only to the use,occupancy and ``,-
01 above and the installation inspected as of the above noted date based on a visual ownership -:I •leafed herein. Upon a change in the use,occupancy or ownership (E
1 inspection. No warranty is expressed or implied as to the mechanical safety,effi- of the pro.=rty diceted above,this certificate shall be Immediately null and void.
CC' aency or fitness of the equipment for any particular purpose. This certificate shall In the even Ith- this certificate becomes invalid based upon the above conditions,'
1. be valid for a period of one year from the above noted date. Should the electrical this certifi late ay be revalidated upon reinspectlon by Middle Department
system to which this certificate applies be altered in any way.including but not limit- Inspection.lgeTrcy,Inc. An application for inspection must be submitted to Middle r;)
l) ed to the introduction of additional electrical equipment and/or the replacement of Department Inspection Agency. Inc. to initiate the Inspection and revalidation (F
any of me components Installed as of the above noted date,this certificate Shall be process. A jee Ill be charged for this service.
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INSPECTION WORKSHEET (BINS-000089-2019)
Town of Queensbury - Building and Codes - Fire Marshal
742 Bay Road - (518) 761-8256 Building (518) 761-8206 Fire Marshal
AST-0436-2018PermitCaseNumber:Case Module:
Mon Jan 7, 2019PassedInspectionDate:Inspection Status:
John O'BrienBuilding FramingInspector:Inspection Type:
377 CLEVERDALE RD226.12-1-56JobAddress:Parcel Number:
Queensbury, NY 12804
Contact TypeCompany NameName
Primary OwnerRollins, Chuck
Primary OwnerRollins, Jeanne
ApplicantRollins, Chuck
ContractorKarl Dutcher Construction
ArchitectDL Dickinson Associates
Granted PermissionKarl Dutcher Construction
Checklist ItemPassedComments
Building Inspector NotesYES1/7/19 Framing Approved
FramingYES1/7/19 Framing Approved
O'Brien, John (Inspector)
Jan 07, 2019Page (1)
FILE COPY
N
JOIST LAYOUT
TOWN OF QUEENSBURY o
A
BUILDING DEPARTMENT
Based on our limited examination,compliance
with our comments shall not be construed as ii
indicating the plans and specifications are in N
full compliance with the Building Codes of o -New York State.
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not to exceed 100 sf.
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Date:
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May
2018
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2018
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20' 0" r N
Face Nail 2xG to N
2x 12 Joist o MIN
16' 0 A'
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Arch. Shingle Post and Top Rail @ 36" 2x12 Joist 16" O.C.
Snow Ice Shield Stainless Horizontal Spindles o
2x6 Rafter 16" O.C. Deck ng y a 3 Z
2x4 PT Sub Deck Frame
1 4" x I 14' MicrolamRubberMembrane iang
2' Sheathing or (2) ply 14" x 9 ' Micro{am
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I max. spac(
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Hurricane clipiolst to beam. R
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Map Reference Q)
REWWNG
Map of... o
Jeanne L. Rollins H,4LT
C#arles J. Rollins
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R f-Q' MAG NAIL SET oBy: Bardm Land Surveying, PC MAGNEnG SOIJNLILNG
Date: 30 October 2017 PROPOSED SUNDECK 1AF
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Proposed Ramp Date: Q
4'W x 14'L± o 'C 3 0 °
Proposed gLandiny FILE COPY
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TOWN OF QUEENSBURY N
Proposed Rarng BUILDING DEPARTMENT R
4'W x f 4'L± 34
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At T Based on our limited examination,,compliance
with our comments shall not be construed as 3 v
AREA indicating the plans and specifications are in Z
a58.+ ACRES full compliance with the Building Codes ofNORTHERLYALONG7HENewYorkState.
MEAN HIGH WATER MARK o 8
OFLAKE GEORGE 215' CD )
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FIR TH PRO RTY LINES TO THE
Rollins, Jeanne & Chuck P PO S CTURE( }OR SIGN(S) 0011 o
377 Cleverdale Road
IGNATu E
r Te Eo
Boathouse/sundeck & dock repair