RC-000231-2015 A=h TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
-- Community Development-Building& Codes (518)761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: RC-000231-2015 Date Issued: Tuesday, October 4, 2016
This is to certify that work requested to be done as shown by Permit Number RC-000231-2015
has been completed.
Tax Map Number: 295.19-3-63
Location: 38 FOX HOLLOW LN
Owner: Daniel Janssen
Applicant: Daniel Janssen
This structure may be occupied as a: Shed Addition 288 s.f.
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the �J
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 Enforc9nent
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: RC-000231-2015
Tax Map No: 295.19-3-63
Permission is hereby granted to: Daniel Janssen
For property located at: 38 FOX HOLLOW 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 Address: 38 Fox Hollow LN Other-New $1,500.00
Queensbury,NY 12804 Total Value $1,500.00
Contractor or Builder's Name/Address Electrical Inspection Agency
Daniel Janssen
38 Fox Hollow LN
Queensbury,NY 12804
Plans&Specifications
shed addition
PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,October 13,2016
(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 Que ry; j
J/T/�tesda , ct er 1 2015
SIGNED BY: /Q for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
ACCESSORY STRUCTURE APPLICATION flegeieed
DATE (C) ly 15 Ta'
I
Tax MAP to 2 'q Permit Ni . _
orr u : eorbit F
ZONING Pleo Fee
HISTORIC SITE _Yes _No TOWN OF QU @NPZV&W
SUBDIVISIONNAME . \Vj tS TL AAA I,. I I� G JCODES 1 , 1
APPLICANT �1rJ IIFNf vrTnl S�1rt./� O
�( WNER ��J}Iv �1R/'�J SS SOV
ADDRESS �J g FDX f f,-LO6l/ G�-n)� ADDRESS 3 g Foy j D t /LQtj � At-A) r;
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PHONE PHONE
CONTRACTOR I rY COST OF CONSTRUCTION(ESTIMATED):
ADDRESS: BUILDING ADDRESS:
PHONE:
CONTACT PERSON FOR BUILDING&CODES COMPLIANCE � � V�tj 5 S PHONE 5LT5 T-0092-_
TYPE OF CONSTRUCTION
Check all that apply Please indicate measurements as required below
Boathouse III 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 — A-�:,n� T , or,)
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 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: DA-,,) V``,'`I 5 St-A) Date: IC� z I S
Signature: Date:
\�
1
Town of Queensbury Building&Codes Accessory Structure Application July 2014