2002-155 TOWN OF QUEENSBURY
742 BayRoad,Queensbury,NY 128045902 (518)761-8201
Community Development-Building&Codes (518)76.1.8256
PTIFICATE f.1F COMPLIANuf'l
Permit Number, P20020155 Date Issued; Thursday,May 16,2002
This is to certify that work requested to be done as shown by Permit Number P20.020155
-has been completed.
Tax Map Number, 523400-301-005-0001-008-000-0000
Location: 794 WEST MOUNTAIN Rd
Owner. . RUSSELL HOWARD
Applicant; RUSSELL HOWARD
This structure may be occupied as a!
By.Orderof Town Board
Storage Building TOWN OF QUEENSBURY
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20020155 Application Number: A20020155
Tax Map No: 523400-301-005-0001-008-000-0000
Permission is hereby granted to: RUSSFLL T40WARD
For property located at: 794 WEST MOUNTAIN 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 Value
Owner Address: RUSSELL HOWARD Storage Building 1,000.00
794 WEST MT.Rd Total Value 1,000.00
QUEENSBURY,NY 12804-0000
Contractor or Builder's Name Address Electrical Inspection Agency
Plans&Specifications
2002-155 1
160 sq ft STORAGE SHED AS PER PLOT PLAN SPECIFICATIONS
(applicant needs AV for side yard setback relief-April 2002. ZBA)
$0.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,May 16,2003
(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 t�ervo Nof QiAn b rsday,May 16,2002
SIGNED BY Ty —for the Town of Queensbury.
V_Director of Building&Z!ode Enforcement
Building Permit Application
Town of Queensbury Dept of Community Development,742 Bay Road,Queensbury,NY
(518)761-8256
A permit must be obtained before beginning construction. Permit File No d�C>ot- c
No inspection will be made until applicant has received a Fee Paid $
valid building permit. All applicants' spaces on this Rec. Fee Paid
application must be completed and must appear on the Reviewed B
application form. ////
Applicant: f t SS TIC..4.2 Owner: � 1� � 1 3 2
Address: . "7qtf ieO Address: -t-ow�,
Q� .us4 L4eY NY logcy` Bata n�' iieSSi,R'y
Phone'#(S'r&-) 7trZ - J Z&'car Phone#
Property Location: Lot Number: 1 House Number
Subdivision Name: Tax Map Number:. . 3 o J S -/-S
,7/`P-(t
? ❑ New Building: residence J commercial Estimated Market Value'of-Construction:$ ,/i 000-'
❑ Addition: residence/ commercial If an Addition,what will use of new addition be?
❑ Alteration: residence/ commercial
❑ No change to exterior size:- residence/com'l
CK . Other work(describe 5714® )
Check OccupancyInformation 1"Floor 2" Floor •Other floor Total
Below sq.ft. sq.ft. sq.ft. Square Feet
o Single family dwelling
❑ Two family dwelling
o Townhouse
❑ Multifamily dwelling
#of units
❑ Office
❑ Mercantile
o-- Manus"acturin 7 — — — -- -
❑ 1 candetaehed garage
❑ 2 car detached garage
q,car detached garage
1 car attached garage
Q 2 car attached garage
a 3 car attached garage
❑ Storage building-
commercial
Storage building-
residential
❑ Other
What is the proposed height of the structure feet inches
Will any second-hand or ungraded lumber be used? If so,for what? Aj
Type of Heating System: electric/ oil / gas I wood /forced hot air/ baseboard/other:
Number of Fireplaces to be installed Number of Woodstoves to-be installed
List below the person(s)responsible for supervision of work as regards to building codes:
Name Address Phone Number
Builder aeSs_ A&WAWo 7 9q W 2
Plumber
Mason
Electrician
Declaration: please sign below after you have carefully read the statement:
To the best of my knowledge the statements contained in this application,together with the plans and specifications
submitted,are a true and complete statement of all proposed work to be done on the described premises and that all
provisions of the Building Code,the Zoning Ordinance and all other laws pertaining to the proposed work shall be complied
with,whether specified or noted,and that such work is authorized by the owner. Further,it is understood that Uwe shall
submit,prior to a Certificate of Occupancy or Certificate of Compliance being issued,as requested by the Zoning
Administrator or Director of Building and Codes,an As Built Survey by a licensed surveyor;drawn to scale,showing actual
location of all ne construction.
;Signature: l� ceSS�C� �= to owner,owner's agent,architect,contractor ^t
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