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AST-0392-2018 TOWN OF QUEENSBURY ; I 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development-Building&Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Penuit Number: AST-0392-2018 Date Issued: Friday, July 13, 2018 This is to certify that work requested to be done as shown by Permit Number AST-0392-2018 has been completed. Tax Map Number: 301.20-1-58 •Location: 12 HERESFORD LN Owner: David Colomb Applicant: Norman Perry Contracting This structure may be occupied as a: Deck By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Compliance DOES NOT relieve the (7.440 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. g LL TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 L `f k �� • Community Development-Building&Codes (518)761-8256 BUILDING PERMIT Permit Number: AST-0392-2018 Tax Map No: 301.20-1-58 Permission is hereby granted to: David Colomb For property located at: 12 HERESFORD LN 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 TVDe of Construction Owner Name: David Colomb Deck $17,000.00 Owner Address: 12 HERESFORD LN Total Value $17,000.00 Queensbury,NY 12804. Contractor or Builder's Name/Address Electrical Inspection Agency Norman Perry Contracting 461 CORINTH RD Queensbury,NY 12804 Plans&Specifications Deck $125.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,June 27,2019 (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 of Queensbury; We s ay une ,2018 SIGNED BY: for the Town of Queensbury. Directo of Building&Code Enforcement i Office Use Only ACCESSORY STRUCTURE Permit#: pr51- 035j2- •2©(6 PERMIT APPLICATION Permit Fee: $ 12� Town of Queensbury 742 Bay Road,Queensbury,NY 12804 Invoice#: �rz>f ' P:518-761-8256 www.ciueensburv.net Project Location: 60C CeMws -b6p ' Tax Map ID#: 3 0 -1 Subdivision Name: I )-54 n 1?f el CONTACT INFORMATION: • Applicant: Name(s): Aldr'�xnAP aR'� Mailing Address, C/S/Z: -/h 1 n 6Ut'F1U3hq'r► NY /DL Cell Phone: ( ilT Land Line: �( ) Email: P,01bmA&PA2Q4.,,A jLe. mA)L a c&vv� • Primary Owner(s): Name(s): t>VJ7, r'ta?.0mP Mailing Address, C/S/Z: /�2 94.,p-9R'q—J LA Cell Phone: 9 m a l,�J Land Line: ( ) Email: • Contractor(s,�):l Business Name: /41p .. �� �''"� 6 W01, 14-1 RIIE C E 9 W I Contact Name(s): M i I Mailing Address, ClS/z: ew i ro JUN 2 2 2018 1 IU) Cell Phone: ( �~I� ) '210? -i 6057 Land Line: Email: /A`12�v ovI—t C&-/d- kM1 e. , ►� TOWN OF 6u2U��iV I�tIi�Y • Arch itect(s)/Eng!nee r(s): Business Name: Contact Name(s): Mailing Address, C/S/Z: Cell Phone: ( ) Land Line: ( ) Email: Contact Person for Building & Code Compliances. Cell Phone: ( cs ) Land Line ( ) Email: /�/�-,�riFM � ► I� -� - ( , Cr►� Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017 r PROJECT INFORMATION: t TYPE: Commercial 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: ADDITIONAL PROJECT INFORMATION: I 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 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. 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 prior to issuance of a certificate of occupancy. have read and agree to the above: PRINT NAME: N— al nq-��I:v SIGNATURE: DATE: Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017