BOTH-000382-2016 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-000382-2016 Date Issued: Friday,May 26, 2017
This is to certify that work requested to be done as shown by Permit Number BOTH-000382-2016
has been completed.
Tax Map Number: 288.-1-47
Location: 118 GURNEY LN
Owner: Town of Queensbury
Applicant: TOWN OF QUEENSBURY REC DEPT
This structure may be occupied as a: Pole Barn 1200 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 QUENSBURY
- 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
- Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: BOTH-000382-2016
Tax Map No: 288.-147
Permission is hereby granted to: TOWN OF QUEENSBURY REC DEPT
For property located at: 118 GURNEY LN
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: Town of Queensbury Pole Barn $0.00
Owner Address: 742 BAY RD Total Value 50.00
Queensbury,NY 12804
Contractor or Builder's Name 1 Address Electrical Inspection Agency
Fred Smith
23 VERMONT AVE
Queensbury,NY 12804
Plans& Specifications
Pole Barn 1200 s.f.
PERMIT FEE PAID -THIS PERMIT EXPIRES: Friday, June 16, 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 of ury; pe; 2016, J ,
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
ACCESSORY STRUCTURE APPLICATION Received
DATE ill �o fax Map ID
TAX MAP ID _ 7 � — � � � Permit No.
Permit Fee
ZONING Rec Fee
HISTORIC SITE Yes No Approvals
SUBDIVISION NAME Lot#
.-c. Intra t `� ,� c7 etc c�nS ,Ar
APPLICANT } OWNER LI
ADDRESS rr !+► ADDRESS
7L-ft Z k3 A- �
PHONE1 '� c PHONE 12-
re cl S " yI j_
CONTRACTOR C T''\ C057 OR CONSTRUCTIONrESTIMATED $ _
ADDRESS: L� y �'IYIC y� - �'q V {� 6,11L,ADDRESS:
6, u e �r� �, �
PHONE:
CONTACT PERSON FOR BUILDING&CoDES COMPLIANCE PHONE
TYPE OF CONSTRUCTION
Check all that apply Please indlcate measurements as required below
Boathouse 151 floor sq.ft. AIor} Total sq.It. Height
Boathouse with Sundeck
Deck
Detached Garage(#of cars")
Dock
Pole Barn 11 ,2oo Za
Porch-open
"* Porch–3 season,Covered,Enclosed
Shed
Other Accessory Structure(s)
*'Considered floor area&must comply with FAR(floor area ratio)requirements if located in the WR zone
DEcLARATIom I acknowledge no construction activities shali 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 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: �� � ' I A � Date: � Z0 �b
Signature: Date:
1
1
Town of Queensbury Building&Codes Accessory Structure Application July 2014
FIRE MARSHALS OFFICE
T0717n of Queensbury
742 Bay Roach, Queensbury, NY 12804
" Honre of. Natural Beauty ... A Good Place to [_ ivc `
PLAN REVIEW
TOQ Recreation Dept.
Gurney Lane
288.1-47
6/21/2016
Plan review based on submittals:
• Verify compliance of Locks 1 latches — key locks and thumb turns not
allowed.
• Verify fire extinguisher locations,
• Carbon Monoxide detection (to be discussed)
• Truss ID required
• Verify aisles and storage
• Add self luminous exit sign at man door
Michael J Palmer
Fire Marshal
742 Bay Road
Queensbury NY 12804
firemarshal@queensbury.net
Fire Marshal's Office • P h a n e: 518-761-8206 F a.c: 518-745-4437
'renurrsltal@ r.teensbttti .net - ztr7 W-queensburtt net
Foundation Inspection Report
Office No.(51$)761-8256 Date Inspection Veecd:
Queensbury Building&Code Enforcement Arrive: Depart: am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initia
NAME: G aSAYnP�, AhA ) —To P T#:
LOCATION: SPECT ON: (Q 12.-q,� &V
TYPE OF STRUCTURE: , vy-�
Comments
Y N N/A
Footings ., it
Piers
Monolithic Slab
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on site.
Foundation/Wallpour
Reinforcement in Place
Footing Dowels or Keyway in place
Foundation Dampproofing
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/9/2014
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