RC-000514-2016TOWN OF QUEENSBURYIla742BayRoad,Queensbury,NY 12804-5904 (518)761-8201
MIN lowCommunity Development- Building& Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: RC-000514-2016 Date Issued: Monday, September 11, 2017
This is to certify that work requested to be done as shown by Permit Number RC-000514-2016
has been completed.
Tax Map Number: 309.13-1-68
Location: 24 INDIANA AVE
Owner: CKT VENTURES LLC
Applicant: William Miner
This structure may be occupied as a: Residential Alteration 600 s.f.
Replacing Roof By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance 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: RC-000514-2016
Tax Map No: 309.13-1-68
Permission is hereby granted to: William Miner
For property located at: 24 INDIANA AVE
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 tiled and approved and in compliance with the NYS Uniform
Building Codes and the Queensbury Zoning Ordinance
TyW of Construction
Owner Name: CKT VENTURES LLC Single Family-Alteration 3,500.00
Owner Address: 828 Wall ST Total Value 3.500.00
Diamond Point,NY 12824
Contractor or Builder's Name 1 Address Electrical inspection Agency
William Miner
24 INDIANA AVE
Queensbury,NY 12804
Plans&Specifications
Residential Alteration 600 s.f.
Replacing Roof
90.00 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 ex ° ation date.)
Dated at the Town of ueensb vlon a , gust 8,2016
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
ACCESSORY STRUCTURE APPLICATION
Received
DATE Tax Map ID
T
Permit No.
Ax MAP ID
Permit Fee A 90i
ZONING
Rec Fee
HIsTORICSITE Yes -KNo Approvals
SUBDIVISION NAME Lot
APPLICANT Y vl 1' -' 4y E T V 1' l-L S
ADDRESS Q t °`ADDRESS
PHONE 57 7`_b23A C)9 PHONE
CONTRACTOR l_'/t S 9COSTOFCONSTRUCTION[ESTIMAffiD $
ADDRESS; UILDINGADD S - T -1;A) Q-i-
PHONE: f
e 11 tt
1.1CONTACTPERSONFORBUILDING&CODES COMPLIANCE W X 4."' 1 V\ -T PHONE
TYPE OF CONSTRUCTION
Check all that apply Please Indicate measurements as required below
Boathouse 1'I floor sq.ft. 2nd floor sq.ft. dotal sq.ft.Height
Boathouse with Sundeck
Deck
Detached Garage(#of cars—L) S
r
p o
Dock
Pole Barn
Porch-open
Porch—3 season,Covered, Enclosed
Shed
AUG 4
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. l 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.t 1 t - t'1x°— Date:
Signature: Date: 1
1
Town of Queensbury Building&Codes Accessory Structure Application July 2014
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