BOTH-000212-2016 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: BOTH-000212-2016 Date Issued: Friday, May 13, 2016
This is to certify that work requested to be done as shown by Permit Number BOTH-000212-2016
has been completed.
Tax Map Number: 297.6-1-58
Location: 5 COBBLESTONE DR
Owner: Bernadine Verdolino
Applicant: Bernadine Verdolino
This structure may be occupied as a: Deck 580 s.f.
Butternut Hill subdivision By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the 4t
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 QUEL
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742 Bay Road,Queensbury,NY 12804-5904 (518)761-82.0.1
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Community Development - Building & Codes (518) 761-8256
BUILDING DING PERMIT
Permit Number. 130111-000212-2016
Tax Map No: 297.6-1-58
Permission is hereby granted to: Bernadine Vdrdolino
For property located at: 5 COBBLESTONE DR
In the Town of Queensbury,to construct or place at the above location in accordance with application together
with plot plans and other infonnation hereto filed and approved and in compliance with the NYS Uniform
Building Codes and the Queensbury Zoning Ordinance
,FyVe of Construction
Owner Name: Bernadine Verdolino Deck $15,000.00
Owner Address. 5 Cobblestone DR Total Value $15,000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Richard Hoisclaw
131 LAMBERT DR.
Queensbury,NY 12804
Plans& Specifications
Deck 580 s.f.
Butternut.Hill subdivision
$ 50.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Monday,April 17 2017
(If a longer period is required,an application for an extension roust be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town Queen ury; rid A l 2 201
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement.
° Office Use Only
ACCESSORY ST UCT U E APPLICATIONReceived
DATE Tax Map ID
*Lett Permit No.
LAX MAP ID
Fee
60
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LYPE OF Q S-A" C d'�DJV"
Check all that apply Please Indicate measurements as required below
Boathouse 1°t floor sq.ft. 211d floor sq.ft.. Total sq.ft.. sleight
Boathouse with Sundeck
Deck + Ir
Detached Garage(#of ears
Bock
Pole earn
Porch-open
**Porch—3 season,Covered,Enclosed
Shed
Other Accessory Structures)
**Considered floor area&must comply with PAF`•&(floor area ratio)requirements It located In the WR zone
0_EcLAgAMM I acknowledge no construction activities shall be commenced prior to issuance of a valid permit. I certify that the
application, plans and supporting materials are a true&complete statement description of the work proposed',that all work will be
performed In accordance with the NY State Building Modes, local building laws and ordinances; and in conformance with local
zoning, regulations. I acknowledge that prior to occupying the facilities proposed, I or my agents will obtain a certificate of
occupancy. I also understand that 1/We are required to provide an as-built surrey by a licensed land surveyor of all newly
constructed facilities prior to Issuance of a certificate of occupancy.
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✓I have read and agree to the above; Print Dame: AVDate;
Signature: Date:
Town of Queensbury Building&Codes Accessory Structure Application July 2014
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