AST-000207-2017 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: AST-000207-2017 Date Issued: Wednesday, May 17, 2017
This is to certify that work requested to be done as shown by Permit Number AST-000207-2017
has been completed.
Tax Map Number: 303.20-1-23
Location: 34 BOULEVARD
Owner: Duane McCarthy
Applicant: Duane McCarthy
This structure may be occupied as a: Open Porch 181 s.f.(front of house,
post-construction) By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the r
property owner of the responsibility for compliance with Site Plan, ���—�YYYY
j A�
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.
Adolbkk TOWN OF QUEENSBURY
742 Bay Road Queensbury,NY 12804-5904 (518)761-8201
1W Community Development-Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: AST-000207-2017
Tax Map No: 303.20.1-23
Permission is hereby granted to: Duane McCarthy
For property located at: 34 BOULEVARD
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
Tyne of Construction
Owner Name: Duane McCarthy Porch-Open $1,500.00
Owner Address: PO Box 82 Total Value $1,500.00
Hartford,NY 12838
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
Open Porch 181 s.f.(front of house,post-construction)
$50.00 PERMIT FEE PAID-TMS PERMIT EXPIRES: Friday,May 4,2018
(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 ens ;�y��/ /nwfor
17
SIGNED BY: (T'�,��// the Town of Queensbury.
Director of Building&Code Enforcement
Office Use OnIV
ACCESSORY STIR GEC [EQ AST- 7 "1o�PERMIT APPLI N 111ile
ee: $ U. GO
Torenof Queensbury• fMAY 0�20i742 Bay Road,Queensbury,NY 12804 : ` —7 Z—T
P:518-761-8256 www.gueensburV.net TOWN OF QUEENS
buHY
�/ Q BUILDING& CODES
ProjectLocation:�3 / I.Y)G(AgyOicri
Tax Map ID#: 3V,7A0 —I—d3 Subdivision Name:
CONTACT INFORMATION:
• A licant: /p,,
Name(s): N AleN
Mailing Address, C/S/Z: 3AAu L41M atti=X6
Cell Phone: ( �l� ) S� Land
Email:
Primary Owner (s):
Name(s): WAV ' T
Mailing Address, C/S/Z: 3"1 &U441/+R &e� N W
Cell Phone: —( 716 SV`941 Land Line:
Email:
• Contractor(s):
Business Name:
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone:—( Land Line:
Email:
• Architect(s)/Engineer(s):
Business Name:
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone:—( ) Land Line: �)
Email:
Contact Person for Building & Code Compliance:
Cell Phone:_�) Land Line: �)
Email:
Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017
PROJECT INFORMATION: t
TYPE: Commercial T Residential
WORK CLASS:
Deck, Open Porch —Solar Panels(w/o rafter upgrades) _Carport _Cell Tower
Shed _Pavilion, Pole Barn,Canopy _ Dock _Gazebo
Detached Garage _ Boathouse(with or w/o sundeck) _3-Season Porch
_
Other(description; )
SQUARE FOOTAGE OF STRUCTURE:
1st floor:
2nd floor: l
Total square feet: qv'
ADDITIONAL PROJECT INFORMATION:: .1101. Estimated Cost of Construction:$ / W '
2. If Commercial project,what is the proposed use:
3. Are there any structures not shown on the plot plan? YES O Explain:
4. Are there any easements on the property? YES NO
DECLARATION:
I. I acknowledge that no construction shall be commenced prior to issuance of a valid permit and will be
completed within a 12 month period.
2. Ifthework is not completed by the 1 year expiration date the permit may be renewed, subject to fees
and department approval.
3. 1 certify that the application, plans and supporting materials are a true and complete statement and/or
description of the work proposed, that all work will be performed in accordance with the NYS Building Codes, local
building laws and ordinances, and in conformance with local zoning regulations.
4. 1 acknowledge that prior to occupying the facilities proposed I, or my agents, will obtain a certificate of
occupancy.
5. 1 also understand that 1/we are required to provide an as-built survey by a licensed land surveyor of all newly
constructed facilities prior to issuance of certificate of occupancy.
I have read and agree to the above:
PRINT NAME: U R ' f�
SIGNATURE: &U^R f ��;Z DATE:
Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017
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303.20-1-23 AST-000207-2017
o McCarthy, Duane
fill 34 Boulevard
Open Porch (post construction) 181 s.f.
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