BOTH-000329-2016 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-000329-2016 Date Issued: Wednesday, June 7, 2017
This is to certify that work requested to be done as shown by Permit Number BOTH-000329-2016
has been completed.
Tax Map Number: 295.14-2-9
Location: 11 WHIPPOORWILL RD
Owner: ROBERT SILVESTRI,Teresa Bertolotti
Applicant: Teresa Bertolotti
This structure may be occupied as a: Deck 238 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, �K
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: BOTH-000329-2016
Tax Map No: 295.14-2-9
Permission is hereby granted to: Richard Fleming, ROBERT SILV'ESTRI
For property located at: I l WHIPPOORWILL 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
Tyne of Construction
Owner Name: Teresa Bertolotti Deck $3,000.00
Owner Address: 11 WHIPPOORWILL RD Total Value $3,000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Richard Fleming
112 Lamplighter Acres
Fort Edward,NY 12828
Plans&Specifications
Deck 238 s.f.
S50.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Saturday,June 3, 2017
(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 oueen e d 8,2016
LP
Jed
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
ACCESSORY STRUCTURE APPLICATION
Received
DATE af3ns1L(12 Tax Map ID
TAX MAP ID Permit No. f_'5L)` 1A- - 3Z - ZCi
ZONING Permit Fee
Rec Fee
HISTORIC SITE Yes YNo Approvals
SUBDIVISION NAME Lot#
APPLICANT SLC tie,� �,�.t mac' i ��vtS Ja OWNER kx- ' q jjexty., a,d -Tides k 1B&/Ao kv
ADDRESS ADDRESS t t� lw�Gam, a r W' ( t * C
PHONE`�� ,3 �� iW'� PHONE SL ^7r1k'_3
-
CONTRACTOR COST OF CONSTRUCTION(ESTIMATED): %�a civ
ADDRESS: /�] c v, #r r C_r r 4 BUILDING ADDRESS: to VNV--1 p:Qn0,Y V-4I Q
PHONE: J,-).) - 9/_zz �7
CONTACT PERSON FOR BUILDING&CODES COMPLIANCE K,' c_k F l Grri ,i Q PHONE 9Z, )I
TYPE OF CONSTRUCTION
Check all that apply Please indicate measurements as required below
Boathouse 15'floor sq. ft. 2"d floor sq. ft. Total sq. ft. Height
Boathouse with Sundeck
Deck '
Detached Garage(#of cars
Dock -� "" -•
Pole Barn
Porch-open
Porch-3 season, Covered, Enclosed UU1 MAY e3 1 221R ii i i
Shed tIAMI _
Other Accessory Structure(s) s ILDI U � BURY
**Considered floor area&must comply with FAR (floor area ratio)requirements if located in the WR zone
DECLARATION: 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 Codes, 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 Ilwe 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: r `' � �'��` Date: yet'l I
Signature: Date: dt
1
Town of Queensbury Building&Codes Accessory Structure Application July 2014
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