2008-450 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20080450 Application Number. A20080450
Tax Map No: 523400-309-013-0001-021-000-0000
Permission is hereby granted to: GAYLE M CHALICH
For property located at: 30 OHIO Ave
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 Value
Owner Address: GAYLE M CHALICH Certificate of Occupancy(RES) $19,000.00
30 OHIO Ave Total value
QUEENSBURY, NY 12804 $19,000.00
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans &Specifications
2008-450
RESIDENTIAL REHAB -HUD
$25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Friday,August 21,2009
(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 T of Bens r5, u August 21,2008
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
OFFICE USE ONLY /_r__ -- /
j / `Y � 0
TAX MAP NO. PERMIT NO
FEES. PERMIT RECREATION ENGINEERING '
,
,
'o
(if applicable)
PRINCIPAL STRUCTURE:
APPLICATION FOR ZONING APPROVAL & BUILDING PERMIT
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. APPLICATION IS SUBJECT TO
REVIEW BEFORE ISSUANCE OF A VALID PERMIT FOR CCONSTRUCTION,/N
APPLICANT/BUILDER: V r n i4ft-4 � ( e iL iT OWNER:
� J V 2 unr e- pk A-k kvt �
ADDRESS: 4 1 6 y46 5 �'( t L(_ ADDRESS:
PHONE NOS. - l � ), o e� PHONE NOS.
CONTACT PERSON FOR BUILDING &CODES COMPLIANCE: PHONE:
LOCATION OF PROPERTY: So n 1
SUBDIVISION NAME:
PLEASE INDICATE MEASUREMENTS AS REQUIRED BELOW:
CHECK ALL THAT 0 d o u_ co
APPLY TO YOUR Z F- 0 cn CO H w
PROJECT o� O ►= 0 U_ w Q d = 0
W jLL o h=- ~ 0WZ
Z Q Q NU) 0ILL O U_ a. 2od
SINGLE FAMILY
TWO-FAMILY
MULTI-FAMILY
(NO.of UNITS )
TOWNHOUSE
BUSINESS OFFICE
RETAIL-
MERCANTILE
FACTORY OR
INDUSTRIAL
ATTACHED
GARAGE(1,2,3)
OTHER
IF COMMERCIAL OR INDUSTRIAL-NAME OF BUSINESS:,
ESTIMATED CONSTRUCTION COST: FUEL TYPE: ( �
HEAT TYPE:&I,-5 -j�r6(4--"HOW MANY FIREPLACE(S): AND/OR WOODSTOVES(S):
ZONING CATEGORY: ARE THERE WETLANDS ON THIS SITE?
IS THIS A HISTORIC SITE? i-(0
PROPOSED USE OF BUILDING OR ADDITION:
*Please complete a separate Application for"Fuel Burning Appliances&Chimneys" available in our office B 3-LGL t t-05
QTown of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804
ARE THERE STRUCTURES NOT SHOWN ON PLOT PLAN?
ARE THERE EASEMENTS ON PROPERTY?
I acknowledge no construction activities shall be commenced prior to issuance of a valid
permit. I certify that the application, plans, and supporting materials are a true and
complete state me nt/d escri ptio n of the work proposed, that all work will be performed in
accordance with the NY State Building Codes, local building laws and ordinances, and in
conformance with local zoning regulations. I acknowledge that prior to occupying the
facilities proposed, I or my agents will obtain a certificate of occupancy. I also understand
that I/we are required to provide an as-built survey by a licensed land surveyor of all newly
constructed facili ' s prior to issuance of a certificate of occupancy.
I ha read an agre o the bove.
Signed
Director of Building & Codes: 761-8256 (for questions regarding Building Permits, construction
codes or septic systems)
Zoning Administrator: 761-8218 (for questions regarding required permits, the permit process,
application requirements or to schedule an appointment)
...................... _._..__....._____..--
Permission is hereby granted to the above This application / proposed action described
Applicant to erect or alter the building herein is found to be in accordance with the
o described herein in accordance with said zoning Laws of the Town of Queensbury. 01
Application:
10
01
11
BUIL;INJaV& O RAL ZONING APPROVAL 0
DATE/ ; DATE
0 1
QUESTIONS? CALL 761-8256 OR EMAIL
codes0ci ueensbu ry.net
Office Use Only VISIT OUR WEBSITE FOR MORE INFORMATION
Operating Permit Issued: Yes No www.ciueensbury.net
Occupancy Type:
Construction Classification:
Assembly Occupancy Limit:
Special Conditions:
� .. Town of Queensbunj - Community Development Office - 742 Bay Road, Queensbury, NY 12804