AST-000265-2017 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-000265-2017 Date Issued: Thursday, May 17, 2018
This is to certify that work requested to be done as shown by Permit Number AST-000265-2017
has been completed.
Tax Map Number: 301.13-2-66
Location: 18 ALGONQUIN DR
Owner: Robert King
Applicant: Robert King
This structure may be occupied as a: 540 sq. ft. deck around above-ground
swimming Pool By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the a; 4 4 t
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
OL 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: AST-000265-2017
Tax Map No: 301.13-2-66
Permission is hereby granted to: Robert King
For property located at: 18 ALGONQUIN DR
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: Robert King Deck $3,000.00
Owner Address: 18 Algonquin DR Total Value $3,000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
540 sq.ft.deck around above-ground swimming pool
$54.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,June 13,2018
(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/gi()ationn date.)
Dated at the Town of ueensb f/ //foes Wae 17
SIGNEDG�sM._`"V ,afor the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
ACCESSORY STRUCTURE Permit#:457- S�O17
PERMIT APPLICATION Permit Fee: $ 51 *6
Tmm of Queensbury
742 Bay Road,Queensbury,NY 12804 Invoice#: (�3�
P:518-761-8256 www.aueensbury.net
Project Location: K14,
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Tax Map ID #: ��-)/ 'd—(off Subdivision Name:
CONTACT INFORMATION: D u
A n fia, 2011
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Name(s): i
Mailing Address, C/S/Z: /_ 7I� S # OWN OF QUEENSBURY
Cell Phone: y )a 'S7it
Email: rte' ^�o�yra�rrr< L�,vn
• Primary Owner(s):
Name(s): &)�P
Mailing Address, C/S/Z:
Cell Phone:) Land Line:
Email:
• Contractor(s):
Business Name: SO—
Contact
OContact Name(s):
Mailing Address, C/S/Z:
Cell Phone:�_) Land Line: � )
Email:
• Architect(s)/Engineer(s):
Business Name: PA
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone:J ) 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:
TYPE: Commercial Residential
WORK CLASS:
Deck,BpeTrr8fch6 Y_Solar anels 4(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: , `T,Ip
Total square feet: �7 '
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction:$0,0� i-b�b
2. If Commercial project,what is the proposed use:
3. Are there any structures not shown on the plot plan? YES /CO)Explain:
4. Are there any easements on the property? YES i Ivo\
DECLARATION: l
1. 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 a certificate of occupancy.
I have read and agree to the above:
PRINT NAME: � p�Qv.J- 1� t ✓1 Q
SIGNATURE: DATE: _ q 1
Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017
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