BOTH-000449-2016 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development- Building & Codes (518) 76t-8256
BUILDING PERMIT
Permit Number: BOTH-000449-2016
Tax Map No: 295.12-1-3
Permission is hereby granted to: Martha's Dandee Creme
For property located at: 1133 State Rte 9
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: Martha's Dandee Creme Other Accessory Structure(s) $12,000.00
Owner Address: 1133 Route 9 Total Value $12,000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Dennis LaFontaine
1133 State Rte 9
Queensbury,NY 12804
Plans&Specifications
589 sq.ft.roof over cooler
$ 117.80 PERMIT FEE PAID -THIS PERMIT EXPIRES: Saturday, July 15, 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 date.)
Dated at the Town 20, 2016
SIGNED BY: /Q( for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
ACCESSORY STRUCTURE APPLICATION
Received
DATE �p— TaxMap ID
TAxMAP ID i 7r. l Z�C'r JUL 1 3P(M§No- I
ZONING
f Permit Fee 1 ,A
_CJdJ�t�fF-�aG1A'�- Rec Fee
HISTORIC SITE Yes No Approvals
SUBDIVISION NAME Lot#
APPLICANT ns OWNER
ADDRESS ,� r ADDRESS
03 &99
PHONE 7105- 63 PHONE
CONTRACTOR „/kc_r COST OF CONSTRUCTION[ESTIMATED): $ r r cc.)a
,ADDRESS: BUILDING ADDRESS: 1133 jZM-1rE 7 . C��+S�✓_��
/V e4.)
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PHONE: "7�
CONTACT PERSON FOR BUILDING&CODES COMPLIANCE /J,626d/_S PHONE
TYPE OF CONSTRUCTION
Check all that apply Please indicate measurements as required below
Boathouse 151 floor sq.ft. 2"¢floor sq.ft. Total sq.ft. Height
Boathouse with Sundeck
Deck
Detached Garage (#of cars
Dock
Pole Bam
Porch-open
'Porch-3 season, Covered, Enclosed
Shed
Other Accessory Structure(s) O
**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. r �f
✓I have read and agree to the above: Print Name: S �- J=.-� Date: f r 3 "
Signature: Date: -7-0- 1
i
Town of Queensbury Building&Codes Accessory Structure Application July 2014