BOTH-000025-2017 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
et Community Development-Building& Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: BOTH-000025-2017 Date Issued: Friday, July 14, 2017
This is to certify that work requested to be done as shown by Permit Number BOTH-000025-2017
has been completed.
Tax Map Number: 239.12-2-88
Location: 2780 State Rte 9L
Owner: Harold Gordon
Applicant: Morgan Gazetos
This structure may be occupied as a: 365 s.f.boathouse w/sundeck
Cross Ref.AV PZ 229-2016 and SP PZ 228-2016 By Order of Town Board
TOWNOF
QQUEENSBBUURY�/
Issuance of this Certificate of Compliance DOES NOT relieve the
property owner of the responsibility for compliance with Site Plan, -f/�l� iii/YYYiyyA11" V
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-000025-2017
Tax Map No: 239.12-2-88
Permission is hereby granted to: HAROLD GORDON
For properly located at: 2780 Stale Rte 9L
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
Tvce of Construction
Owner Name: HAROLD GORDON Boathouse with Sundeck $45,000.00
Owner Address: PO Box 275 Total Value $45,000.00
Cleverdale,NY 12820
Contractor or Builders Name/Address Electrical Inspection Agency
Morgan Gazetos
57 Chapman ST
Ballston Spa,NY
Plans&Specifications
365 s.f.boathouse w/sundeck
Cross Ref.AV PZ 229-2016 and SP PZ 228.2016
$75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,February 16,2018
(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
Q�CC�SIr ,; hurs a ,F 16,2017
SIGNED BY: (\ L, for the Town of Queensbury.
Director of Building&Code Enforcement
ACCESSORY STRUCTURE AP-71 Use Onl
T�AI� � Office
wa
DATE
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ID
TAX MAP ID 23 q, /z 2 - JAN 3 ) 201 -��- °�. - Zo
ZONING V.I
N OF QUEENBUR'Fee
HisroRfcSRE _Yes No COMMUNITY DEVELRMJ&
Surtoms ON --
[�NAME/�/� Lot# / /
APPUCANT 1 ' I 0 !:1 � Cj-eA OWNER 6J I GVy 1� �'LN^
ADDRESS S'} c..1/� /(.,p,_, L ADDRESS p� L) 1Y3 ZJ l
PHONE ?—b C) — d 1l� L PHONE
CONTRACTOR _ i ' 1 O COST OF CONSTRUCTION(E�SITIMATTIED): $ Q J
ADDRESS: Sr ^ BUILDINGADDRESS:
3.4 , 5 ��
PHONE: '4 a - -- !LL!
CONTACT PERSON FOR BUILDING&CODES COMPLIANCE MU ffj C" lJ� �1`r PHONE 2G
I
TYPE OF CONSTRUCTION
Check all that apply Please indicate measurements as required below
Boathouse 1° floor sq.ft. 2n°floor sq.R 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 occupancy.
✓I have read and agree to the above: Print Name: c-r s, CT oe dc> Date: I 110/1
Signature: .- Date: 11381(l
1
Town of Queensbury Building&Codes Accessory Structure Application July 2014
NIs :
TOWN OFQUEENSBURY 9
TOWN OF BUILDING DEPARTMENT
QUEE,NSBURY Based on ourlimitedexaminaton,complia
BUILDING & CO with our comments shall not be construed �y
E EPT, indicating the plans and specifications ar
U �, 9 S Reviewed y_ full compliance with the Building Codes -
�, fU " New York State.
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Schedule A
� Page 4 of 6
/ . Permit #5234-90-16 RECEIVED
/ TAKE GEORGE PARK COMMISSION /
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Jul. 6. 201 7m 9: 55A MDIA :gppiNo. 9424 P, 7/9
MIDDLE'DEPARTMENT INSPECTION AGENCY, INC.
'eoe, es that the electrical wiring to the electrical equipment listed below has been examined and is approved as
being in accord with the National Electrical Code, applicable governmental, utility and Agency rules in effect on the date
noted below and is issued subject to the following conditions-
Owner: Gordon Date
06/28/2017
Occupant: Dock Locatio
r1780 Route 9L
Occupancy-Single Family Dwg. Queensbury, Warren Co. NY
Applicant r Lakeside Builders
42 Cotherman Drive
Lake George NY 12845
L J
Joseph A.Holmes
NO 3180141368437EL,. '
Equipment:.
4-Receptacles; 3-Fixtures -
This certificate applies to the electrical meting to the electrical equipment listed immediately null and void. This Cenifioate applies only to the use,occupancy and
above and the installation Inspected as of the above noted date based on a visual ownership as indicated herein. Upon a change In the use,occupancy or ownership
inspection. No warranty is expressed or Implied as to the mechanical safety,effi- of the property indicated above,this tamrcate shah be Immediately null and void.
clency or fitness of the equipment for eny particular purpose. This cMficats shah In the event that this certificate becomes invalid based upon the above condhlons,
be vend qr a period of ane year prom the above notetl date. Should the electrical this certificate may be revalidated upon reinspection by Middle Department
aystem to which this ceNhcale applies be altered in any way.Indutling but not limit. lnapecdon Agency,Inc An 0ppleadon for inspection must be sutlrtlidetl to Middle
ed ro,me intraduNon of atltl fional sect cal equipment end or the replacement of Department Inspection Agency, Inc. to Initiate tris inspection end revalidation
Bny or the components installed as of the above nptetl daro,Mis cehilli to shall be protass- A lee will ba charged forthis service.
2017
TOWN OF QUEENS -'
�i gUILDIN K_ r]
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