BOTH-000347-2015 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-000347-2015 Date Issued: Tuesday,November 17,2015
This is to certify that work requested to be done as shown by Permit Number BOTH-000347-2015
has been completed.
Tax Map Number: 253.3-1-18
Location: 15 Knolls Road North
Owner: Anne Baldwin,William Baldwin
Applicant: William Baldwin
This structure may be occupied as a: DECK 168 sq.ft.
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
Q— W 742 Bay Road,Queensbury,NY 12804-5904 (518)761.8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: BOTH-000347-2015 —P>P 'LQ\4
Tax Map No: 253.3-1-I8 REVISE
Permission is hereby granted to: William Baldwin
For property located at: 15 Knolls Road North
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
Type of Construction
Owner Name: William Baldwin Deck $1,000.00
Owner Address: 15 Knolls Road North Total Value $1,000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
William Baldwin
15 Knolls Road North
Queensbury,NY 12804
Plans&Specifications
DECK 168 sq.0.
$0.00 PERMIT FEE PAID-TFBS PERMIT EXPIRES: Saturday,November 21,2015
(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 ofn /edn s ay er 26,2014
SIGNED BY: / for the Town of Queensbury.
Director of Building&Code Enforcement
ACCESSORY STRUCTURE APPLICATION Office Use Only
Received
DATE /'? L/ e z Tax Map ID
TAX MAP ID .25 3 , `' Permit No. �
ZONING kZ Permit Fee
Ree Fee
HISTORIC SITE _Yes _No
Approvals
SUBDIVISION NAME O�G�F /x//G//Sn' /Lot#
APPLICANT IL�I���FN�(f -�l/-ff/��/I//= /,wW///G�iJ/A/ OWNER
ADDRESS Z= /6VCG//�S ,Ij�� ./Y ' ADDRESS
PHONE 36 '-JleyG PHONE
CONTRACTOR S E / /` COST OF CONSTRUCTION(ESTIMATED): $
ADDRESS: BUILDING ADDRESS: /S��NI//S /�� •/7 '
PHONE: /p� �
CONTACT PERSON FOR BUILDING&CODES COMPLIANCE fr�rn (SCJ O L p t a PNONE
TYPE OF CONSTRUCTION
Check all that apply Please indicate measurements as required below
Boathouse 1"floor sq.ft. 2nd floor sq.it. Total sq.ft. Height
Boathouse with Sundeck
Deck
Detached Garage(#of cars
Dock
Pole Sam
Porch-open
••Porch—3 season,Covered,Enclosed
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.
✓1 have read and agree to the above: Print Name: 4.7111.41-r Li4 a+a /M Date: // 17/`/
Signature: � ��- Date: ✓�
Town of Queensbury Building&Codes 1
Accessory Structure Application July 2014
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TOWN OF QUEENSBURY
UiLDiNG DEPA.RTNENT
Based on o jr united examination,compMn ej
with our co, mems sl.-.a! no',be construed sS Folies as
° indicating thc-�lams and sPPcifications are ay.• n G �
full cemp!iancs with the Building Codes oP'yj�` 1
o New York Stale. +; ,:' Ire r
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faesaeapits, 'L logo U
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TOWN OF QUEENSBURY 8 JILDING EPARTMENT
Based on our limited examine on, a
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compliance with our :ommen shall
not be construed as ndicatirfg e -
plans and speciflica' nate in f
compliance with the code. x•� �x-
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FILE o Dae• Dov
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aE RM!T ALAN z:
1 HAVE PERSO ALLY 6'IEASURED THE DISTANCE r2c��Iz v `� `
FROM THE PROPERTY LINT=S TO THE DATE
PROPOSED STRU Q E S) OR SIGNO
MAP OF 4 S',RVEY M4;E FOP
SIGNATURE DATE f
WILLIAM A. & ANNE M. BALDWIN
'C.VN OF 111.1 .. 1_uURY WARREN COUNTv . NEW
5, D4"E : SE=TEMBER !6
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MAP FFFRfc .
2nd RE::SmG4 '0 MAP OF Sd'-'ON o%E VanDusen & Ste ves
RIC'uE KNOLLS DEVELOPMENT _AN: SOAVE
BY A. J. Lon'ear ¢ S • �¢..• >"-c ss*
FILED IN 'NARR N C0'_N71 CLERK'S OFF'CE N'!. STATE LC. NO 356:7
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Foundation Inspection Report i
Office No. (518)761-8256 Date Inspection request received: 10 I2GAS
Queensbury Building&Code Enforcement Arrive: am/pm Depart:'apm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initia
NAME: Ww1 PERMIT#: Soil
LOCATION: I CXidl� '4k1 0 INSPECT ON: _LO
TYPE OF STRUCTURE:
Comments y�
Y N
N/AII
t Footings
Piers �\
Monolithic Slab
Reinforcement in Place
The contractor is responsible for
providing protection from freezing Gam- 0
for 48 hours following the placement
of the concrete.
Materials for this purpose on site. 9,t6�
Foundation 1 Wallpour
Reinforcement in Place
Footing Dowels or Keyway in place 42
Foundation Dampproofing
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building &Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/9/2014