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BOTH-000512-2016 TOWN OF QUEENSBURY a 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 , t—, Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: BOTH-000512-2016 Date Issued: Wednesday, May 23, 2018 This is to certify that work requested to be done as shown by Permit Number BOTH-000512-2016 has been completed. Tax Map Number: 239.17-1-13 Location: 3380 State Rte 9L Owner: Dave Silipigno Applicant: Bonacio Construction, Inc. This structure may be occupied as a: Residential Alteration Filling indoor pool with concrete grout--to be used as recreational room By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Compliance DOES NOT relieve the 4t 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 1 , 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development-Building& Codes (518)761-8256 BUILDING PERMIT Permit Number: BOTH-000512-2016 Tax Map No: 239.17-1-13 Permission is hereby granted to: Bonacio Construction,Inc. For property located at: 3380 State Rte 9L 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 TyW of Construction Owner Name: Dave Silipigno Other Accessory Structure(s) $0.00 Owner Address: 3380 State Rte 9L Total Value $0.00 Lake George,NY 12845 Contractor or Builder's Name/Address Electrical Inspection Agency Bonacio Construction,Inc. 18 Division ST,401 Saratoga Springs,NY 12866 Plans&Specifications Residential Alteration Filling indoor pool with concrete grout--to be used as recreational room $60.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,August 3,2017 (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 of eensbuonda u 0l 6 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement C�,15jS�C PRINCIPAL STRUCTURE APPLICATION Office Use Only } Received Date: $I a j (0 Tax Map ID Permit No. 60 l�-512, 2�t l b Tax Map ID Permit Fee to D m. 0 Zonei�aC�ne t��stckrt( Rec Fee Historic Site Yes No Site Plan# Subdivision Name N Lot# N .^ Subdivision# Project Location L ; Lc Ve GeQSjc N`� \any S TOWN BD. RESOLUTION 86-2013: $850 recreation fee for new dwelling units—single family, duplexes/two-family, multiple family,apartments,condominiums,townhouses, and/or manufactured& modular Domes, but not mobile homes. This is in addition to the permit fee(s). Applicant \nCe ���� cr Owner Address �..�,���•� 5 , 5v, e `i�\ Address 3330 "11_ l_o.�t KN lalla`iS Phone/E-mail _ - Phone/E-mail j )� —i-{,`\�-G Oo g nCe @ ` n�.C��.CG(%� �•rheC��c..ca� Contact Person for Building&Codes Compliance: Phone N Ar TYPE OF CONSTRUCTION ✓Check all that apply New Addition Alteration oar-sf- 2n, floor sf Total sf Height Single Family Two-Family Multi-Family (#of units ) Townhouse Business Office AUG 0 4 1016 Retail-Mercantile Factory-Industrial Attached Garage (1, 2, 3, 4+) i Other If commercial or industrial please indicate of business Town of Queensbury Building&Codes Principal Structure Application Revised September 2015 Proposed use of building or addition w Icanoe kC Source of Heat(circle one) Gas Oil Propane Solar Other Fireplace: Complete a separate application for Fuel Burning Appliances & Chimneys O Are there structures not shown on plot plan? N Are there easements on the property? N Site Information a. Dimensions or acreage of lot Q'S'l o,cre S b. Is this a corner lot? N o c. Will the grade be changed as a result of construction Yes X No d. Public water or Private well C wk� e. Sewer or Private Septic System Value of all work to be performed (labor or materials) $ 1(0 +o o d DECLARATION. 1. I acknowledge no construction shall be commenced prior to issuance of a valid permit and will be completed within a 12 month period. 2. If work is not complete 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/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 ofall-newly constructed facilities prior to issuance of a certificate of occupancy. I leave read and agree to the above: PRINT NAME: V nC �'r DATE: 13 SIGNATURE: G� ! /7 r� DATE: For office use only Operating Permit Issued: Yes No Occupancy Type Construction Classification Assembly Occupancy Limit Special Conditions Town of Queensbury Building&Codes Principal Structure Application Revised September 2015