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BOTH-000406-2016 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 s Community Development-Building&Codes (518)761-8256 CERTIFICATE OF OCCUPANCY Permit Number: BOTH-000406-2016 Date Issued: Friday, August 4, 2017 This is to certify that work requested to be done as shown by Permit Number BOTH-000406-2016 has been completed. Tax Map Number: 227.17-1-8 Location: 28 HILLMAN RD Owner: Benjamin Campbell Applicant: Benjamin Campbell This structure may be occupied as a:288 sq.ft.screened-porch Cross Ref. Area Variance PZ-0156-2016 By Order of Town Board TOWN OF QUEENSSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the property owner of the responsibility for compliance with Site Plan, Variance,or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement Planning Board or Zoning Board of Appeals. TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 ,.. Community Development - Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: BOTH-000406-2016 Tax Map No: 227.17-1-8 Permission is hereby granted to: Benjamin Campbell For property located at: 28 HILLMAN 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: Benjamin Campbell Porch-3 Season,Covered,Enclosed $5,000.00 Owner Address: 28 Hillman RD Total Value $5,000.00 Cloverdale,NY 12820 Contractor or Builder's Name/Address Electrical Inspection Agency Benjamin Campbell 28 Hillman RD Cloverdale,NY 12820 Plans&Specifications 288 sq. ft. screened-porch Cross Ref. Area Variance PZ-0156-2016 $ 50.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Friday,.lune 30,2017 (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 d te.) Dated at the Town flueeMJ 4Tu*y--5, 2016 SIGNED BY: for the Town of Queensbury. Director of Building&Code l;nlorceinent Office Use Only ACCESSORY STRUCTURE APPLICATION Received DATE j - 1 Tax Map ID TAxMAP ID � � ( 1-�- ( � Permit No. TI+ 46b-�kl,ii� ZONING W Permit Fee Rec Fee HISTORIC SITE Yes x No Approvals. I SUBDIVISION NAME Lot# V P2- APPLICANT Z �( � APPLICANT5J ✓� 4�,iVl,!V ✓✓1 F� � OWNER 1j u ll ADDRESS Z 8 }�i��+n'ZLi hi C ADDRESS PHONE ��,O S i S PHONE CONTRACTOR �'t ta-a i, ecl�''l/�7C �� COST OF CONSTRUCTION(ESTIMATED): $ 5,06 d ADDRESS: BUILDING ADDRESS: PHONE: CONTACT PERSON FOR BUILDING& CODES COMPLIANCE ✓ �G�✓�'1 J � PhfONI= V Za S TYPE OF CONSTRUCTION Check all that apply Please indicate measurements as required below Boathouse 1't floor sq.ft. 2nd floor sq.ft. Total sq.ft. Height Boathouse with Sundeck Deck Detached Garage(#of cars`) Dock Pole Barn Porch-open **Porch-3 season, Covered,Enclosed Shed , Other Accessory Structure(s) *`Considered floor area&must comply with FAR(floor area ratio)requirements if located in the WR zone DECLARATION. 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 & complete statement description 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 facilities prior to issuance of a certificate of occupancy. ++ ✓I have read and agree to the above: Print Name: �Cry ,dt�� : ''1(7�L 4 Date: ZZ- Q¢ Signature: J W V Date: - 1 Town of Queensbury Building&Codes Accessory Structure Application July 2014 Warren County Department of Code Enforement Unmarked Structual Lumber {' JUL2016 Certification Mill Name: Mead Lumber Co., Inc. Address: 1288 Vaughn Rd. Queensbury NY 12804 Phone: (518)798-4926 Fax: (518)798-1091 Purchaser: Ben Campbell Project Location: Queensbury Purchase Order# 5163E i a duly authorized representative of the 'k`--61bove n-i6ntione8 MiII;do certify to the Warren County Department of Code Enforcement and the above named purchaser that: The quality and safe working stresses of the unmarked structual lumber provided for the Campbell Residence and under P.O. 51636 issued above mentioned is equal to or exceeds No. 2 grade in accordance with the conditions set forth in the NELMA standard grading rules for Eastern White Pine dimesion lumber and Timbers.