AST-000268-2017 �4
TOWN OF QUEENSBURY
Ba
742
. y Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building& Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: AST-000268-2017 Date Issued: Wednesday, October 18, 2017
This is to certify that work requested to be done as shown by Permit Number AST-000268-2017
has been completed.
Tax Map Number: 289.13-1-54
Location: 10 BENMOST BUR LN
Owner: ANNE CLARK
Applicant: Linda Clark
This structure may be occupied as a: Removable Dock 30 ft. by 4 ft. (replacing
existing 8 ft.by 25 ft. wooden dock) By Order of Town Board
Identified as Dock"A" TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the
property owner of the responsibility for compliance with Site Plan, !Q
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: AST-000268-2017
Tax Map No: 289.13-1-54
Permission is hereby granted to: TechniDock
For property located at: 10 BENMOST BUR 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 Name: ANNECLARK Dock $0.00
Owner Address: 10 Benmost But LN Total Value $0.00
Lake George,NY 12845
Contractor or Builder's Name/Address Electrical Inspection Agency
TechniDock
PO Box 147
Speculator,NY 12164
Plans&Specifications
Removable Dock 30 ft.by 4 ft.(replacing existing 8 ft.by 25 ft.wooden dock)
Identified as Dock"A"
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,May 30,2018
(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 ex RucsotO,2017
. date
Dated at the Town of ueensb
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
.ACCESSORY STRUCTURE APPLICATION Received
DATE Tax Map ID '..�-pc/- 13 "I -5-t
TAX MAP ID
��,,//�� Permit No. -tel 22b� •?A l�
,�6`7, l3 �-
Permit Fee ' 4SZ
ZONING ;Re;,F� U
HisroRtc SITE Yes No rovals
SUBDIVISION NAME Lot#_
APPLICANT l.._ � � l \0.V' OWNER
ADDRESS /o e) STI 'i� ,' L-u ADDRESS
AN a_yq-S—
PHONE S - I PHONE
CONTRACTOR ���p.� �ocl< Q� COST OF CONSTRUCTIO{N(ESTIMATED): $ I
ADDRESS: E /'v 1 J 6L 'LLI 2A. C1 BUILDING ADDRESS: 1 D � S'i• C�l.f'/-�ItG
PHONE: I - C! � - SS �OL.-'C�� �=YL)
� � �
CONTACT PERSON FOR BUILDING&CODES COMPLIANCE NE
TYPE OF CONSTRUCTION I TUU l 0` J_
Check all that apply Please Indicate measurements as required below
Boathouse I"floor sq.ft. 2n4 floor sq.ft. Total sq.ft. Height
Boathouse with Sundeck
Deck
Detached Garage(#of cars_)
ock 0 d-✓'0r_ O'
POWAare F'x 15 id'al
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 oc�Icupancy./p/ /
,/I have read and agree to the above: Print Name: h j nGf a /(2�aY— �S Date: 7
Signature: .�/ Date: S d o 7
1
Town of Queensbury Building&Codes Accessory Structure Application July 2014
; 1\ ILpT N
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TOWN OF QUEEN .p�.Y S S} 'r S �t.✓ �"... N C
I Ye 1 1 a _`°
BUILDING & C DEDEPT.
Reviewed By: -7R-V m
Date: Ln
r'
m w
TOWN OF QUEENSBURY 00 N U 0
BUILDING DEPARTMENT
�I;.<la< ' Based on our limited examination,compliance
r t':.?Y 2 ZU�� with our comments shall not be construed as
L�--
lr , Indicating the plans and sppeecifications are in
T0 11N OF QUEENSBUr<y - full comdfance with the Bullding Codes of
BU!LDihIG &CbDES New Yoorr(k State,
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PO Box 147,Speculator,NY 12164 Tel:315-826-3000 Fax:315-826-3900 Email:docks@ntcnet.com
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