applicationY
race no_288,P-1=2-Crenun wo_J7-AO |
FEES:PERMIT.RECREATION“ENGINEERING
(if applicable)
PRINCIPAL STRUCTURE:
APPLICATION FOR ZONING APPROVAL &BUILDING PERMIT
APERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION.APPLICATION IS SUBJECT TO
REVIEW BEFORE ISSUANCE OF A VALID PERMIT FOR CONSTRUCTION.
APPLICANT/BUILDER:
Oxani pndComeassaiciboss OWNER:wok Serviced
sgSttenoDSplMonacadDalypeneeeADDRESS:_Livergus\,NY13038ADDRESS:
_BataKatoo,FL 33487
PHONE NOS.Gs 282-SANs
PHONE NOS.
CONTACT PERSON FOR BUILDING &copes cowptiance:{ViKe Noone PHONE(S}lal-5213
Location oF property:(ol Stake Roode 144,Lake Geress,WN 12845"
SUBDIVISION NAME:aja
PLEASE INDICATE MEASUREMENTS AS REQUIRED BELOW:
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SINGLE FAMALY
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BUSINESS OFFICE
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Town of Queensbury «Community Development Office *742 Bay Road,Queensbury,NY 12804
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IF COMMERCIAL OR INDUSTRIAL —NAME OF BUSINESS:
Orsipiot
Communicodisns
estimaTeD construction cost:#4O,0p0 __Fuet TPE:
HEAT TYPE?___o\\x “HOW MANY FIREPLACE(S)__a\a AND /OR WOODSTOVES(S):_a la
ZONING CATEGORY:__2\O__ARE THERE WETLANDS ON THIS SITE?AS
IS THIS A HISTORIC SITE?ad
PROPOSED USE OF BUILDING OR ADDITION:ska:vo Vv
ARE THERE STRUCTURES NOT SHOWN ON PLOT PLAN?no
ARE THERE EASEMENTS ON PROPERTY?ao
*Please complete a separate Application for "Fuel Burning Appliances &Chimneys"available in our office
|acknowledge no construction activities shall be commenced prior to issuance ofa valid permit.|
certify that the application,plans,and supporting materials are a true and complete
statement/description of the work proposed,that all work will be performed in accordance with the
NY State Building Codes,local building laws and ordinances,and in conformance with local zoning
regulations.|acknowledge that prior to occupying the facilities proposed,|or my agents will obtain
a certificate of occupancy.|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.
Ihave read and agree to the aboveBoe>W Kl,)
Director of Building &Codes:761-8256 (for questions
regarding Building Permits,construction codes or septic
systems)
QUESTIONS ?GALL 761-8256 OR EMAIL
codes@queensbury.net
VISIT OUR WEBSITE FOR MORE INFORMATION
www.queensbury.netZoningAdministrator:761-8218 (for questions regarding
required permits,the permit process,application requirements or to
schedule an appointment)
Permission is hereby granted to the aboveThisapplication/proposed action described
Applicant to erect or alter the building describedhereinisfoundtobeinaccordancewiththe
zoning Laws of the Town of Queensbury.
ZONING APPROVAL DATE
Q Town of Queensbury +Community Development Office *742 Bay Road,Queensbury,NY 12804