BOTH-000755-2016 TOWN OF QUEENSBURY
4ft 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Ntunber: BOTH-000755-2016 Date Issued: Wednesday, March 8, 2017
This is to certify that work requested to be done as shown by Permit Number BOTH-000755-2016
has been completed.
Tax Map Number: 308.7-1-66
Location: 123 RICHMOND HILL DR
Owner: Brian Vanburen
Applicant: Brian Vanburen
This structure may be occupied as a: Deck 240 sq. ft.and enclosed screened
porch 288 sq.ft. (attached to each other) By Order of Town Board
TOWN OF QUEENSSBBURY//
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
742 Bay Road.Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: BOTH-000755-2016
Tax Map No: 308.7-1-66
Permission is hereby granted to: Brian Vanburen
For property located at: 123 RICHMOND HILL DR
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: Brian Vanburen Porch-3 Season,Covered,Enclosed $15,820.00
Owner Address: 123 Richmond Hill DR Total Value $15,820.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Dalaba Construction
116 Old Stage RD
Lake Luzeme,NY 12846
Plans&Specifications
Deck 240 sq.ft.and enclosed screened porch 288 sq.ft.(attached to each other)
$52.80 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday,November 14,2017
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury befojthepiralion dat .Dated at the Town �weenJy\p /( M n ovember 14,2016
SIGNED BY: N /a for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
ACCESSORY STRUCTURE APPLICATION Received
DATE /0 -114 5--116 Tax Map ID '/-
TAxMAP ID �3 �/l/C�-309-60Permit No.
2 e_t.,._
ZONING LS n' 72 !
ewe@
HISTORIC SITE _Yes �No Approvals
SUBDIVISION NAME Th e m is Lot#
fuju
APPLICANT &I;ZN f(.6`ic� !' L/I•srvgr�o z v L W T l'11`^ � "_ �rC (✓ ?��
ADDRESS 41e_I7m'�'I"1 11'/% zatr, .> ADDRESS �� n,✓G
Lt vz rtis�c cry .may, /9IP-al or�-_ws6,,ev Ny 1.1er2=1
PHONE /���``f PHONE .�O'� - G
CONTRACTOR / l/ff��'�i/} /'P COSrOFCONSTRUCTION(ESTIMATED):
ADDRESS: /J�/L� O/C� S2i6'r oec BUILDINGADDRESS: /;?
/z-y, 'I ((/
PHONE: J7r%-G.Z71��
CONTACT PERSON FOR BUILDING&CODES COMPLIAPHONE
TYPE OF CONSTRUCTION
Check all that apply Please indicate measurements as required below
Boathouse 18'floor sq.ft. 21"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
Shed
Other Accessory Structure(s)
""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 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 occup ncy.
✓I have read and agree to the above: Print Name: C"2 u
"'y:E Date: ID /
Signature: Date:
1
Town of Queensbury Building&Codes Accessory Structure Application July 2014
UCI 312015
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TOWN OF OUFFN"SF1.ic N,
TOWN OF QUEENSBURY
BUILDINGDEPARTMENT 3UtLDING $ C cv
Based on our limited examination,compliance
wi;h uw comments shall not be construed as RevieWG _;1'
indicating the plans and sppeclfications are in Date'
full compliance wkn #w 3ufiding Codas of
Now York Steno.
308.7-1 -66 BOTH 755-2016
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