AST-000428-2017 1111110k 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-000428-2017 pate Issued: Thursday, August 16, 2018
This is to certify that work requested to be done as shown by Permit Number AST-000428-2017
has been completed.
Tax Map Number: 265.-1-76
Location: 1368 BAY RD
Owner: Guy Fullen
Applicant: Kevin Maynard Construction
This structure may be occupied as a: 144 sq. ft. open porch
removing old porch and replacing with new By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the
property owner of the responsibility for compliance with Site Plan, lir"
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-000428-2017
Tax Map No: 265.-1-76
Permission is hereby granted to: Kevin Maynard Construction
For property located at: 1368 BAY RD
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: Guy Fallen Porch-Open $10,000.00
Owner Address: 1368 Bay RD Total Value $10,000.00
Lake George,NY 12845
Contractor or Builder's Name I Address Electrical Inspection Agency
Kevin Maynard Construction
Plans&Specifications
144 sq.ft.open porch
removing old porch and replacing with new
$50.00 PERMIT FEE PAID-TUBS PERMIT EXPIRES: Saturday,July 28,2018
(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 Qyperr� /,/J�/gtday y ,2
SIGNED BY: C r Y for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
ACCESSORY STRUCTURE Permit#: A-S 14j'-,t-o l 7
PERMIT APPLICATION Permit Fee: $
Toren of Queensbury
742 Bay Road,Queensbury, NY 12804 Invoice#:
P: 518-761-8256 www.guu(eeensbury.net t'
Project Location:—#
Tax Map ID #:SZ'3c/OO ' IoS. 1 ' Subdivision Name:
CONTACT INFORMATION: II II
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• Applicant: v
Name s)' tit r�P:?:.;';r;r. . , r-::,,.
( Mama � . r �: ,.rt ;';rnqE(VT
Mailing Address, C/S/Z: (�_oI!l 9A- (4
Cell Phone: IS 18 ):J:n 6 ��l S43 Land Line:
Email: L",. ® Ve ` (A,,.(ar�s—Ll'J C oymkkc,IcAn� ( rn • L�Jh
• Primary Owner(s):
Name(s):
Mailing Addre s, C/S/Z: t S(,9 2v..,Tzeal
Cell Phone:_) Land Line: 3Ss 1
Email:
• Contractor(s)):
Business Name: h
Contact Name(s): r \
Mailing Address, C/S/Z: 'PA 1Z1'X3—
Cell Phone: J ) 4 S`( Land Line: �)
Email: fCe.� ) 1 wti�o.n wCCtrc � ati.
• Arch itect(s)/Ensinee r(s):
Business Name:
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: �_) Land Line: � )
Email:
Contact Person for Building & Code Compliance: ll lh I�A rvialz/i
Cell Phone: ( 51L ) -7010- NSi' Land Line: � )
Email: kle✓Ih(�pICA)IhMttvn /'Gm
Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017
PROJECT INFORMATION:
TYPE: Commercial 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:
Total square feet: y y
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction: $ f o C
2. If Commercial project,what is the proposed use:
3. Are there any structures not shown on the plot plan? YES NO Explain: [csys�v9-
4. Are there any easements on the property? YES NO
DECLARATION:
1. 1 acknowledge that no construction shall be commenced prior to issuance of a valid permit and will be
completed within a 12 month period.
2. If the work 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, focal
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 I/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:
SIGNATURE: DATE:
Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017
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265.-1-76 AST-000428-2017 gd ,
Fullen, Guy & .f„ "CL.
1368
1368 Bay Road
Open Porch 144 s.f.
TOWN OF QUEENSBURY
BUILDING & COE DEPT.
Reviewed BW.
_
Date:
TOWN OF QUEENSBURY
BUILDING DEPARTMENT
Based on our limited examination,compliance
with our comments shall not be construed as
indicating the plans and specifications are in (�j
full compliance with the Building Codes of
New York State. LN
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