AST-000363-2017 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: AST-000363-2017 Date Issued: Wednesday, August 30, 2017
This is to certify that work requested to be done as shown by Permit Number AST-000363-2017
has been completed.
Tax Map Number: 278.19-1-4
Location: 593 Moon Hill RD
Owner: Matthew Brennan
Applicant: Matthew Brennan
This structure may be occupied as a: Deck(freestanding) 180 sq. ft.around
above-ground pool By Order of Town Board
Cross Ref. Z-AV-39-2017 approved June 21,2017 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
OL Community Development-Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: AST-000363-2017
Tax Map No: 278.19-1-4
Permission is hereby granted to: Matthew Brennan
For property located at: 593 Moon Hill RD
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
Tvce of Construction
Owner Name: Matthew Brennan Deck $1,600.00
Owner Address: 593 Moon Hill RD Total Value $1,600.00
Lake George,NY 12845
Contractor or Builder's Name I Address Electrical Inspection Agency
Matthew Brennan
593 Moon Hill RD
Lake George,NY 12845
Plans&Specifications
Deck(freestanding)180 sq.ft.around above-ground pool
Cross Ref. Z-AV-39-2017 approved June 21,2017
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,June 27,2018
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town ueens r / / 4 Tue d 017
SIGNED BY: ('ytrjK(/ for the Town of Queensbury.
Director of Building&Code Enforcement
1,5 ew e-) ,"
Office Use Only
A ACCESSORY STRUCTURE Permit#:�1 343- ;LOC7
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PERMIT APPLICATION Permit Fee:$
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742 Bay Road,Queensbury,NY 12804 Invoice#:
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CONTACT INFORMATION: " Ir— ----- I��
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• Applicant.
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Mailing Address, C/S/Z: S _3 ( r iuN , r F
Cell Phone: ) Land Line: � )
Email: 1 Z
Primary Owner(s):
Name(s): nt
Mailing Address, C/S/Z:
Cell Phone: �_) Land Line:
Email:
• Contractor(s):
Business Name:
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: . Land Line:
Email:
• Architect(s)/Engineer(s): /
Business Name: vI l
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: . Land Line:
Email:
Contact Person for Building & Code Compliance: r G .N
Cell Phone: Land Line: A )
Email:
Town of Queensbury Building&Code Enforcement Accessory structure Application Revised April 2017
PROJECT INFORMATION:
TYPE: Commercial Residential
WOR CLASS:
Deck, pen Porch _Solar Panels(w/o rafter upgrades) _Carport _Cell Tower
ed _Pavilion, Pole Barn,Canopy _Dock _Gazebo
Detached Garage _Boathouse(with or w/o sundeck) _3-Season Porch
Other(description: )
SQUARE FOOTAGE OF STRUCTURE:
1st floor:
2nd floor:
Total square feet:
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction:$_"
2. If Commercial project,what is the proposed use:
3. Are there any structures not shown on the plot plan? YES lfNW Explain:
4. Are there any easements on the property? YES NO
DECLARATION:
1. I acknowledge that no construction shall be commenced prior to issuance of a valid permit and will be
completed within a 12 month period.
2. If the work is not completed by the 1 year expiration date the permit may be renewed, subject to fees
and department approval.
3. 1 certify that the application, plans and supporting materials are a true and complete statement and/or
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. 1 acknowledge that prior to occupying the facilities proposed I, or my agents, will obtain a certificate of
occupancy.
5. 1 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: C 1Jic J r�I
SIGNATURE: DATE. �v
Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017
278.19-1-4 AST-000363-2017
Brennan, Matthew
593 Moon Hill Rd.
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~O Matt& Kristy Brennan
593 Moon Hill Road
freestanding deck for above-ground pool
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Warning and Important Instructions: This is not a final design plan or estimate.EDGENET,INC.assumes no responsibility for the correct use or
output of this program. All information contained on this page is subject to the terms in the disclaimer located at the end of this document.
Advertencia a instrcciones importantes: Esto no as un plan ni una eslimacidn final del diseito.EDGENET,INC, no asumeninguna
responsibilidad del use o de Is salida correcto de este programa.Toda Is informaci6n contenida an esta p6gina est6 conforme a los t6rminos en
la negaci6n, situada en at extremo de este documento.
Copyright®1989-2016 Edgenet, Inc.
Page 5 of 22 Doc ID 9ebeb6d6-ddct-45f6-ae21-833Oc3733aba
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Warning and Important Instructions: This is not a final design plan or estimate. EDGENET, INC.assumes no responsibility for the correct use or
output of this program. All information contained on this page is subject to the terms in the disclaimer located at the end of this document.
Advertence a instrcciones importantes: Esto no as on plan ni one estimaci6n final del diser5o. EDGENET, INC.no asume ninguna
responsibilidad del use o de la salida correcto de este programa.Toda la informacidn contenida an esta p8gina est9 confonne a los t6rminos an
la negaci6n,situada an at extremo de este documento.
Copyright®1989-2016 Edgenet,Inc.
Page 6 of 22 Doc ID 9ebeb6d6ddcl-45t6-ae21-833ac3733aba
edgenet Pro Deck Design TM
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Warning and Important Instructions: This is not a final design plan or estimate.EDGENET,INC.assumes no responsibility for the correct use or
output of this program. All information contained on this page is subject to the terms in the disclaimer located at the end of this document.
Advertencia a instrcciones importantes: Esto no as un plan ni une estimaci6n final del disefio.EDGENET,INC.no asume ninguna
responsibilidad del use o de Is salida correcto de este programa.Tods la informaci6n contenida an esta p6gina estd conforme a los tdrminos en
Is negaci6n,situada an el extremo de este documento.
Copyright®1989-2016 Edgenet,Inc.
Page 2 of 22 Doc 10 9ebeb6d6-ddci-45f6-ee21-8336c3733aba
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278.19-1-4 AST-000363-2017
DATE OF PRlti IG
Brennan, Matthew
�. 593 Moon Hill Rd.
Deck (around pool) 180 s.f. cU -48%21/4,s, C-