RC-000473-2016 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: RC-000473-2016 Date Issued: Wednesday,November 29, 2017
This is to certify that work requested to be done as shown by Permit Number RC-000473-2016
has been completed.
Tax Map Number: 303.5-1-14
Location: 43 MEADOWBROOK RD
Owner: SIGH MONGER,Ann Monger
Applicant: SIGH MONGER
This structure may be occupied as a: Residential Alteration
Roof over sidewalk 138 s.f. By Order of Town Board
Cross Ref. Area Variance PZ 247-2016 approved Nov. 16,2016 TOWN OF QUEENSSBUR/fY
Issuance of this Certificate of Compliance DOES NOT relieve the (--
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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
QL Community Development- Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: RC-000473-2016
Tax Map No: 303.5-1-14
Permission is hereby granted to: SIGH MONGER
For property located at: 43 MEADOWBROOK 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
Type of Construction
Owner Name: SIGH MONGER Single Family-Alteration $1,000.00
Owner Address: 43 Meadowbrook RD Total Value $1,000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
Residential Alteration
Roof over sidewalk 138 s.f.
Cross Ref. Area Variance PZ 247-2016 approved Nov. 16,2016
$60.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday,November 21,2017
(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 expi tion,,,d////ate.)
Dated at the Town of eensbu , pondot1,2016
SIGNED BY: (((.wwn.. __iiilll���/// ,ar the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
ACCESSORY STRUCTURE APPLICATION
Received
DATE Tax Map ID
TAX MAP ID Permit No. 9r-,- 20(n
ZONING Permit Fee (a0 r ln\i 15 lod
Rec Fee
HISTORIC SITE _Yes No Approvals
SUBDIVISION NAME n Lot# 11�,t
APPLICANT 64 d- A1414 �K�F�'r- OWNER �10�_� k 1-10ncret-
M f 1-Tl� p,,I /1��� J L l r�1
ADDRESS U � 1 I.p.A Ltd) 2t-[DO T� I\�V• ADDRESS � 3 f'iFAdn W r)h0U `\ r\ �.t
Qct,ee Inc �>Lt Y Qu-c--e Vi 5 ID Q,U\71
PHONE - 13 ( C) PHONE 'S I�- hC3 --I;3 (. (
CONTRACTOR a4y4n P COST OF CONSTRUCTION(ESTIMATED): $ 1006,00
ADDRESS: BUILDING ADDRESS: S'A lm e
PHONE:
CONTACT PERSON FOR BUILDING& CODES COMPLIANCE Day C (4A-tin PHONE
TYPE OF CONSTRUCTION
Check all that apply Please indicate measurements as required below
Boathouse 1 floor sq.ft. 2nd 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) 137j
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 Uwe 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: Ma Date: a-as- i
Signature: al Date: _
1
Town of Queensbury Building&Codes Accessory Structure Application July 2014