AST-0299-2018 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: AST-0299-2018
Tax Map No: 308.8-1-22
Permission is hereby granted to: Tammie Landers
For property located at: 51 SMOKE RIDGE 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
Type of Construction
Owner Name: Tammie Landers Deck $3,500.00
Owner Address: 51 SMOKE RIDGE RD Total Value $3,500.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Kristopher Finley
7 Morgans LN
Comstock,NY 12821
Plans&Specifications
Deck 240 s.f.
$ 125.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Friday,June 7, 2019
(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 r7uee ury; �I a ,2018
SIGNED BY: ,Yj for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
ACCESSORY STRUCTURE Permit#: 20 L6
PERMIT APPLICATION Permit Fee: $ 115 —
Towzt of(Juccinibury
742 Bay Road,Queensbury,NY 12804 Invoice#: 04%/A'C�
P:518-761-8256 ,Ln.A Py, uee9sbur,1.n t
Project Location:54 q I
Tax Ma #:
p ID 31:3'� � � 1-• rya Subdivision Name:
CONTACT INFORMATION:
• Applicant:
Name(s): _ r,C�e c-:s
Mailing Address, C/S/Z: _ \ -jmp`t� "�, cl,a �2c1 > ►e .,r��.�� Yl� la d
Cell Phone: Land Line:
• Primary Owner(s):
Name(s):
Mailing Address, C/S/Z: 51 _p j2;It CcI Q)-z
Cell Phone: ( 15i% ) all-I 59ci,4 Land Line: �' l'i
• Contractor(s):
Business Name:
Contact Name(s. '-r
Mailing Address, C/S/Z: In i
Cell Phone: cN06 ) �13` l� Land Line:
E m a i l: " ter. ?�L)'D,,.CD C-1zi;,n
• Architect(s)/Engineer(s):
Business Name:
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: ( - - Land Line: � )
Email:
Contact Person for Building & Code Compliance:
Cell Phone: A ) Land Yine: � )
Email:
Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017
PROJECT INFORMATION:
TYPE: Commercial V Residential
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) _3-Season Porch
Other(description: )
SQUARE FOOTAGE OF STRUCTURE:
1st floor:
2"d floor:
Total square feet:_QL_A�1
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction: $
2. If Commercial project, what is the proposed use: 1A.
3. Are there any structures not shown on the plot plan? YES NO Explain: J,,2.d.
4. Are there any easements on the property? YES =e 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 certificate of occupancy.
I have read and agree to the above:
PRINT NAME:
SIGNATUR , _ La'Ckc. CS DATE: `AaaJU
Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017