AST-000270-2017 n 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-000270-2017 Date Issued: Wednesday, September 20, 2017
This is to certify that work requested to be done as shown by Permit Number AST-000270-2017
has been completed.
Tax Map Number: 289.11-1-28
Location: 5 GLEN HALL DR
Owner: Bernard'Bernie'Gansle
Applicant: Gene Kules
This structure may be occupied as a: 120 sq. ft.3-season screened-in porch with
roof to be constructed on upper/main level of house By Order of Town Board
AV No. 12-2017& SPR No. 14-2017 approvals for this structure are in place. TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the
property owner of the responsibility for compliance with Site Plan, V
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
OL 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: AST-000270-2017
Tax Map No: 289.11-1-28
Permission is hereby granted to: Everything Under Foot
For property located at: 5 GLEN HALL 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
Tvce of Construction
Owner Name: Bemard'Bemie'Gansle Deck $15,000.00
Owner Address: 43 Clifton Walk Total Value $15,000.00
Slingerlands,NY 12159
Contractor or Builders Name/Address Electrical Inspection Agency
Everything Under Foot
189 Main ST
Hudson Falls,NY 12839
Plans&Specifications
120 sq.ft.3-season screened-in porch with a roof to be constructed on upper/main level of house:(plans identify structure
as a deck)
Area Variance No. 12-2017 and Site Plan Review No.14-2017 approvals for this structure are in place.
$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 of Bens�jj /)foes �} J 17
SIGNED BY: /af for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use OnIV
Permit#:AS / 2Z6_ -J617
ACCESSORY STRUCTURE .
o�
PERMIT APPLICATION
en _ -._ _._ Permit Fee: $
Toren of CZeensbury � (( (/
742 Bay Road,Queensbury,NY 12804 y i � .' I-s `J l.' IIvoice#: V �
P:518-761-8256 www.gueensbury.net Aeyl
Project Location: #Wbll F -i - , (J&S,D4
TOWN OF QUEENSBURY
Tax Map ID#: COMMUNITY D
CONTACT INFORMATION:
• Applicant:
Name(s): . ,jizt
Mailing Address, C/S/Z:
Cell Phone: ( SSB' ) - �'i/`y Land Line: � )
Email:
Primary Owners :
Name(s):
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email:
• Contractor(s): �
Business Name: E✓�7Q �1,'xf� �/�/ 1 �
Contact Name(s): S _
Mailing Address, C/S/Z:
Cell Phone: (S9 Land Line: ( Stj�, ) 7W G 7 C?r1
Email:
• Architect(s)/Engineer(s):
Business Name:
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: Land Line: 1 )
Email:
Contact Person for Building & Code Compliance: / 5-
Cell
Cell Phone: q6 'r//G/ Land Line: ( S4/ ) 7 5� - Q79!7
Email:
Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017
PROJECT INFORMATION:
40 � S p ,mss
TYPE: Commercial Residential AV SP 1 17
WORK CLASS:
Deck,Open Porch _Solar Panels(w/o rafter upgrades) _Carport _Cell Tower
_Shed _Pavilion, Pole Barn, Canopy _Dock Gazebo
Detached Garage _Boathouse (with or w/o sundeck) X3-Season Porch
_Other(description: ) / J
SQUARE FOOTAGE OF STRUCTURE: — fOh Irl-1- 1� /
1st floor:
2nd floor:
Total square feet:
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction:$ d
2. If Commercial project,what is the proposed use:
3. Are there any structures not shown on the plot plan? YES ave' Explain:
4. Are there any easements on the property? YES L N
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. Ifthework 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 priorto issuance of a certificate of occupancy.
I have read and agree to the above:
PRINT NAME:
SIGNATURE: DATE:
Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017
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C full com iance with the Wilding Codes of
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(� '[g 7 ,] AGENCY AND LENDING INSTITUITION LISTEN` j HEREON,AND r .,'•""..•'.""„"""""'-'"' ”'"`""'""".•,'""'"""".,""`"'""'.".°
169 Havlland Road Queensbury, New York 12804 TO THE A55IGNEESOFTH2LENDING INSNTJTGtj' u �, Warren o1111ta/, eW York 1 9--12-16 Proposed Deck GANSLe�L
(518) 792lb
--8474 New York Lic. No. 50135
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DATE DESCRIPTION a
W. .. ...... .............. _ .s DWG NO 021 �..-.�..�..
289.11-1-28