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