AST-000192-2017 ram. TOWN OF QUEENSBURYk
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
'~- Community Development - Building& Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: AST-000192-2017 Date Issued: Friday, October 12, 2018
This is to certify that work requested to be done as shown by Permit Number AST-000192-2017
has been completed.
Tax Map Number: 239.15-1-8
Location: 25 WILD TURKEY LN
Owner: Paul Kasselman
Applicant: Frank Denardo
This structure may be occupied as a: Dock 207 s.f.
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the rtj14 ‘l-15(
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
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: AST-000192-2017
Tax Map No: 239.15-1-8
Permission is hereby granted to: Elite Dock Co LLC
For property located at: 25 WILD TURKEY 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
Tyne of Construction
Owner Name: Paul Kasselman Dock $11,000.00
Owner Address: PO Box 984 PO Box 984 Total Value $11,000.00
Albany,NY 12201
Contractor or Builder's Name/Address Electrical Inspection Agency
Elite Dock Co LLC
PO Box 291
Cleverdale,NY 12820
Plans&Specifications
Dock 207 s.f.
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,May 11,2018
(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 ofeens �hurs y 1 17
7)j
SIGNED BY: / for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
ACCESSORY STRUCTURE APPLICATION
Received
DATE L/ -2;-- / 7 Tax Ma pID
TAX MAP ID a 3 `r, 157 -l— Permit No. lell —2 d 1
ZONING Permit Fee (,°t
Rec Fee
HISTORIC SITE Yes ✓No Approvals
SUBDIVISION NAME i/ Lot#
APPLICANT ��'/?��'�P/i Noa-0D OWNER �f�L/L
ADDRESS G g61G 2ADDRESS PO 130x
PHONE CDC 3 6ZS- PHONE
CONTRACTOR 16,617E, i?o(/C C'O L,L_G , COST OF CONSTRUCTION(ESTIMATED): $
ADDRESS: 0 (SOIL 1 I BUILDING ADDRESS: �2 1 w 10 / ple E LJY
PHONE: �_ /
CONTACT PERSON FOR BUILDING&CODES COMPLIANCE tc"t e /,(s-/A/iy�'40 PHONE 77/;6 /lO�'�y�
TYPE OF CONSTRUCTION
Check all that apply Please indicate measurements as required below
Boathouse 1st floor sq.ft. 2"d floor sq.ft. Total sq.ft. Height
Boathouse with Sundeck
Deck
Detached Garage(#of cars_)
Dock 2 D 7
Pole Barn
Porch-open
**Porch—3 season,Covered, Enclosed
Shed r• , ,
Other Accessory Structure(s)
TOWN OF QUEENSBURY
**Considered floor area&must comply with FAR(floor area ratio)requirements if located in the WR 2060MMUNITY DEVELOPMENT
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 occupancy. /,
✓I have read and agree to the above: Print Name: � Je� Dd Date:
Signature: Date: y2.r-
1
Town of Queensbury Building&Codes Accessory Structure Application July 2014
Schedule A
-- - 239.15-1-8 AST-000192-2017 Page 4 of 5
Kasselman, Paul Permit#5234-96-16 & 5234-99-16
25 Wild Turkey Lane
Dock Only 207 s.f. I
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