AST-0691-2018TOWN 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-0691-2018Date Issued: Tuesday, July 23, 2019
AST-0691-2018
This is to certify that work requested to be done as shown by Permit Number
has been completed.
240.5-1-13
Tax Map Number:
0 Hillman RD
Location:
Takundewide Homeowners Assoc.
Owner:
William Mason
Applicant:
This structure may be occupied as a: F-Shaped dock being replaced with Boathouse
with Sundeck, 3114 s.f.
By Order of Town Board
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
I •
, ,
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: AST-0691-2018
Tax Map No: 240.5-1-13
Permission is hereby granted to: Takundewide Management Group Inc.
For property located at: 0 Hillman 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: Takundewide Homeowners Assoc. Boathouse with Sundeck $300,000.00
Owner Address: PO Box 85 Total Value $300,000.00
Cleverdale,NY 12820
Contractor or Builder's Name/Address Electrical Inspection Agency
The Dock Doctors
19 Little Otter LN
Ferrisburg,VT 05456
Plans&Specifications
F-Shaped dock being replaced with Boathouse with Sundeck,3114 s.f.
$ 150.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Friday,January 10, 2020
(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; Thursday,January 10,2019
SIGNED BY: I for the Town of Queensbury.
Director of Building&Code Enforcement
ce/ De:Lkfr - e? rf - �►ti-
Office Use Only l3 I '^Te r- `'0 i 7-a 6 1 8
ACCESSORY STRUCTURE Permit#: vc/_�,�i/ �S
PERMIT APPLICATION Permit Fee:$ / `7S-71)61
Town of Queensbury
742 Bay Road,Queensbury,NY 12804
Invoice If: /&/�
P:518-761-8256 www.queensbury.net
Project Location: C 4-1-1lig 0,4 �E nl y /-2,9 -LAD
Tax Map ID #: 2`/ o . o S- / 3 Subdivision Name: 7-79-1C u,J,p6LJ /
CONTACT INFORMATION: •
• rr:1/4\-)
11
• Applicant: LL J
Name(s): !h/ sor)
Mailing Address, C/S/Z: ,9 X >? s , c. Lz-V tap 4-
Cell Phone: (S'/ g ) - 26 6 oq 3 Land Line: ( Si 8 ) 6 s 6 95- 7-3
Email: if/ eor�
• Primary Owner(s):
Name(s): 7"74XunlDe-(4) De 1,1-0i4-
Mailing Address, C/S/Z: o Ate) se S i c z� vie:40;�c.� ,v y / z:v
Cell Phone: (Sig t, Land Line: ( ) s L q 5-73
Email:
• Contractor(s):
Business Name: rAh— ) o
Contact Name(s): C"i2 j s G 7 R,'3-n.D
Mailing Address, C/S/Z: /°J L'T?'LE c r7E) 4_ ,43-A) ied2,Z,5 BKR,Gr1 ✓7 c:)S9_r4
Cell Phone: ( ) Land Line: ( g'o o ) r 7 e 6 75-6
Email: /fifo Gd 7 0 oc -12 0L-7-04-5 , c.Drn
• 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: Pa"7 N709-s a^)
Cell Phone: ( ) Land Line: (
Email: fj-.6 D V
Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017
PROJECT INFORMATION:
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: # S� O c'K) \
2ndfloor: /`19x SF SuNl7 "IL (1.3 ) ft SiJ12-
T"5J
./y rF R M#
Total square feet: Sc-
2l14
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction:$ 2'D o c 0 0.
2. If Commercial project,what is the proposed use: /J/4-
3. Are there any structures not shown on the plot plan? YES NO Explain:
4. Are there any easements on the property? 112, NO
re4401 4 L /4,1 v(0) v►J -mac o f
DECLARATION: / 5 v �,� -��o ,J
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: Gd 14-c-1 i rr1 "r1 r -5 o(r)
SIGNATURE: �,lJ� ` DATE: /I121/ r
Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017