AST-000468-2017 TOWN OF QUEENSBURY
jj
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development- Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: AST-000468-2017 Date Issued: Wednesday, October 24, 2018
This is to certify that work requested to be done as shown by Permit Number AST-000468-2017
has been completed.
Tax Map Number: 302.12-1-19
Location: 36 GARRISON RD
Owner: Cynthia Schrock
Applicant: Josh Willis
This structure may be occupied as a: Deck 260 s.f.
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the (1 ,0,40 4 i
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,Queensbdry,NY 12804-5904 (518)761-8201
Community Development-Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: AST-000468-2017
Tax Map No: 302.12-1-19
Permission is hereby granted to: Willis Contracting
For property located at: 36 GARRISON 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: Cynthia Schrock Deck $9,200.00
Owner Address: 36 GARRISON RD Total Value $9,200.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Willis Contracting
4 Pine ST
Hudson Falls,NY 12839
Plans&Specifications
Deck 260 s.f.
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,August 3,2018
(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 Queens ry; Th say 3,2017
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
y ti„ Office Use Oniv
( Pi
ACCESSORY STRUCTURE Permit b 2_0
PERMIT APPLICATION Permir Fee: $ r
Torn of Queensbury
742 Bay Road,Queensbury,NV 12804 Invoice#:
P:518-761-8256 www.gueensburV.net
Project Location: 3 6 Cr,t Rpt,-soA�
Tax Map I® #: 3()z , 12 — - I Subdivision Name:
CONTACT INFORMATION:
• Applicant:
Name(s): Ir .SA Lv G (. t7 s
Mailing Address, C/S/Z: 1/ P ; 2 P
Cell Phone: ( 5 r-' ) 9 SI - 2,5S 3 Land Line: � )
Email:_ i/yiLtIJC01LKAeTi; va 0� Y.4ti.vo Fc0,-
• Primary Owner(s):
Name(s): C Y IV N ;g
Mailing Address, C/S/Z: �6 (, 4 Rl; i_s�7,v R0 y
Cell Phone: /3 ) `/Zq - ny0z/ Land Line: � )
Email:
• Contractor(s):
Business Name: J G L "r, C0 Al G
Contact Name(s): y'TA
Mailing Address, C/S/Z:
Cell Phone: S5 - �'5 ZLand Line: � )
Email:
• Architect(s)/Engineer(s): AUG 0 2 2017
Business Name:
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email:
Contact Person for Building & Code Compliance: ego
Cell Phone: ( 51b B Land Line: � )
Email:
Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017
PROJECT INFORMATION:
TYPE. Commercial � Residential
WORK CLASS:
V 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 STRUCTURED
1st floor: 2-60
2"d floor:
Total square feet:
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction:$ qt
2. If Commercial project,what is the proposed use:
3. Are there any structures not shown on the plot plan? YES NO Explain:
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 thework 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 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: c, VV t t -5-
SIGNATURE:
SIGNATURE: //" DATE: ` 2
Town of Queensb Building&Code Enforcement Accessory Structure Application Revised April 2017
1, >
1
f
x
., 1.
yr V
lige j
e
1
I
00
CD
0 l
_ -i • `- T WN OF QUEENSBURY Q .�
U
ING Based on o r limited DEPARTMENT
I ton ,compliance 4a 70'
I with our co ments sham not be construed asof
I indicating t e plans ana specifications are in p) e
E
NewYorkate. with they Building Codes of e� V O
t H --
P:
- - - - {_
't
rk �
UG
kw
Aix-
IN �I
n
Y.
302.12-1-19 AST-000468-2017
Schrock, Cynthia
36 Garrison Rd.
Deck 260 s.f. %`
PERMIT PLOT PLAN -
I HAVE PERKNALLY MEASURED'THE nISTANCE �_ � "
FROM THE PROPERTY LINES TO THE C
PROP SED STRUT RE(S) OR SIGN(S)
�7Li
!S A URE DATE SEP 1997
1_ Bllf INN AN[) E
• t
f
r '
i J e
e
i
i
T1i
ue
I
! � 1
i j�