AST-0589-2018 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-0589-2018 Date Issued: Thursday, November 15, 2018
This is to certify that work requested to be done as shown by Permit Number AST-0589-2018
has been completed.
Tax Map Number: 289.15-1-34.26
Location: 47 SURREY FIELD DR
Owner: Ellen Barlow, Joseph Barlow
Applicant: Joseph Barlow
This structure may be occupied as a: Removal of existing deck and construction
192 sq. ft. 3-season porch in its place with a 96 sq. ft. deck addition (one step to b By Order of Town Board
built). TOWN OF QUEENSBURY
Total: 288 sq. ft.
Issuance of this Certificate of Compliance DOES NOT relieve the
property owner of the responsibility for compliance with Site Plan, 4
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
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: AST-0589-2018
Tax Map No: 289.15-1-34.26
Permission is hereby granted to: Joseph Barlow
For property located at: 47 SURREY FIELD 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
Type of Construction
Owner Name: Ellen Barlow Porch-3 Season,Covered,Enclosed $5,000.00
Owner Address: 47 SURREY FIELD DR Total Value $5,000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Eddy Enterprises Inc.
PO Box 9
Athol,NY 12810
Plans&Specifications
Removal of existing deck and construction of a 192 sq.ft.3-season porch in its place with a 96 sq.ft.deck addition(one
step to be built).
Total: 288 sq.ft.
$ 125.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Thursday, September 19,2019
(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 uee ; edn, ay/ -•tember 19,2018
SIGNED BY: \ for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
r '!. Permit s': -9'- i fi- )01 g
(411111
ACCESSORY STRUCTURE
PERMIT APPLICATION Permit Fee:$/ 5
Town of Queensbury
742 Bay Road,Queensbury,NY 12804 Invoice#: ®gcQ‘
P:518-761-8256 www.queensbury.net
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Tax Ma ID#: g9•a s-I- 3 , ' o Subdivision Name: •''r (c in.41-7 617
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CONTACT INFORMATION: I M - 1 1\ 1
• Applicant: u t .. , ,_r 2 I
Names A At 7`1/A7 & 1 a illniN .,. UISBUY 1
Mailing Address, C/S Z: ,c �/lse, ��i, ee-�$0it -a.
Cell Phone: ( ) Land Line: I ) 7 '.)G'7
Email: 44,,,e Lin ee2 y f' /9_ 4,, e4 by
• Primary Owner(s): �'
Name(sJosepi? i i t /��� n S. n/ 4 en')
Mailing Address, C/S/Z: 97 ,5,,qRy `ie/ 'Ifi ve., Q4#ee,VSL3Ut' , �Ny /72 ''/
Cell Phone: Land Line: ( �)1 —, 347
Email:
• Contractor(s):
Business Name: 1
y e :e R)sue
Contact Name(s): / f Ph/,,
Mailing Address, C/S/Z: /1/1-: j � �o�3./1e,.
Cell Phone: ( ) i Land Line: ( o/r),6 17-opy‘
Email:
• Architect(s)/Engineer(s):
Business Name:
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: ( ) Land Line: ( )
Email:
Contact Person for Building & Code Compliance: JOS eri 309/?/__ 0
Cell Phone: ( ' ) Land Line: ( /,? ) `r ,,-- . i`''
Email: demerit,Ld&'f ekw. zz, „
Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017
A
PROJECT INFORMATION:
TYPE: Commercial Residential
WORK CLASS:
XDeck,Open Porch Solar Panels(w/o rafter upgrades) Carport Cell Tower
Shed Pavilion, Pole Barn,Canopy Dock Gazebo
Detached Garage Boathouse(with or w/o sundeck) -Season Porch
q)' (11 `)' 7f;1-
Other(description: ) sf
SQUARE FOOTAGE OF STRUCTURE: Ci(e �r.�. ! C(�
1st floor:
2nd floor:
Total square feet: Y 4- '1 ,ytet--
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction:$ C;06d
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
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. I 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. I acknowledge that prior to occupying the facilities proposed I, or my agents, will obtain a certificate of
occupancy.
5. 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.
I have read and agree to the above:
PRINT NAME: K/% e 4L D G/
/ -
SIGNATURE: ij;, ,,,, ` _ DATE: 7
Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017