BOTH-000287-2015 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 .
Community Development-Building&Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: BOTH-000287-2015 Date Issued: Wednesday, October 12, 2016
This is to certify that work requested to be done as shown by Permit Number BOTH-000287-2015
has been completed.
Tax Map Number: 297.6-1-44
Location: 21 BUTTERNUT HILL DR
Owner: Randy Gross
Applicant: Randy Gross
This structure may be occupied as a: 3-season porch
288 sq.R. By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the J4 1 4t
property owner of the responsibility for compliance with Site Plan, -- ��ll
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
OL Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: BOTH-000287-2015
Tax Map No: 297.6-1-44
Permission is hereby granted to: Randy Gross
For property located at: 21 BUTTERNUT HILL DR
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: Randy Gross Porch-3 Season,Covered,Enclosed $1,000.00
Owner Address: 21 BUTTERNUT HILL DR Total Value $1,000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Randy Gross
21 BUTTERNUT HB.L DR
Queensbury,NY 12804
Plans&Specifications
3-season porch
288 sq.ft.
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Monday,November 7,2016
(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 yeptration da )Dated at the Town f Queen ry; Fr' vember 13,2015
SIGNED BY: ('�s. for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
ACCESSORY STRUCTURE APPLICATION Received
DATE // .. G /.S Tax Map ID
Permit No. !�7`C �'� ' 000V7 -7/j
TAxMarID 3� 2`77. 4 - l - yy permit Fee
ZONING _�l P s Rec Fee
Htsromc SITE _Yes Ac No \-�. Approvals
SUBmyistON NAME u r n /i -/ r!t&& 0�`L/ _
APPLICANT i z) C"7///'OS NOV '15 F
ADDRESS Z Lav {2rnv�hr/l D OF BURY
BUII..DINC- S CODES i
PHONE S/k` 307 -,'_S- 7V PHONE
CONTRACTOR E COSTOFcONSTRUCTION(ESTIMATED): $ o /!0OL7 ,o0
ADDRESS: BUILDING ADDRESS: Dr--
PHONE:
CONTACr PERSON FOR BUILDING&CODES COMPLIANCE ��n/yY PHONE 3o7-"7f<
TYPE OF CONSTRUCTION
Check all that apply Please Indicate measurements as required below
Boathouse 1 B1 floor sq.ft. 201 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 12 X.Z :(z 7 8Y
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: /t r+A/J 1, Date:
Signature: CLiy - Date: i/-6/ ' /S'_
1
Town of Queensbury Building&Codes Accessory Structure Application July 2014