AST-000488-2017 kil! ,
TOWN OF QUEENSBURY
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742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
• Community Development-Building&Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: AST-000488-2017 Date Issued: Thursday, August 16, 2018
This is to certify that work requested to be done as shown by Permit Number AST-000488-2017
has been completed.
Tax Map Number: 301.7-1-64
Location: 28 CENTENNIAL DR
Owner: Virginia Rovelli
Applicant: Kevin Maynard Construction
This structure may be occupied as a: Deck 236 s.f.
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, \
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
A.
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: AST-000488-2017
Tax Map No: 301.7-1-64
Permission is hereby granted to: Kevin Maynard Construction
For property located at: 28 CENTENNIAL 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: Virginia Rovelli Deck $15,000.00
Owner Address: 28 CENTENNIAL DR Total Value $15,000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Kevin Maynard Construction
Plans&Specifications
Deck 236 s.f.
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,August 15,2018
(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 ofuesda u st 15,2017
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
ACCESSORY STRUCTURE Permit
PERMIT APPLICATIONrot)
Permit Fee: $ 1
Town of Queensbury
742 Bay Road,Queensbury, NY 12804 Invoice#:
P:518-761-8256 www.queensbW-V.net
Project Location:
Tax Map ID 4: Subdivision Name:
CONTACT INFORMATION:
® Applicant:
Name(s): in_
Mailing Address, C/S/Z: 1030, V24 c3, AA/'
Cell Phone: ( <'J'J (-6 - Land Line:
G.,� -AA1-14 A c-�
Primary Owner(s):
Name(s):
Mailing Address, C/S/Z: .12yo�
Cell Phone: Land Line: c%-3a 3
Email:
ContractorA-sk-
Business Name: KAl2', n6 lnr4-4A A
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email: I N3ij
Arch itect(s)JEngineer(s):
Business Name:
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email:
Contact Person for Building & Code Compliance: K�\
Cell Phone: ( �1 Y , ) -7')(, Land Line:
Email:
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:
Po( Vo
it
1st floor:
Sof
Total square feet: 3�0
ADDITIONAL.PROJECT INFORMATION:
1. Estimated Cost of Construction:$ I.–c-
) , 0 vU
2. If Commercial project,what is the proposed use:
3. Are there any structures not shown on the plot plan? YES �OIxplain:
4. Are there any easements on the property? YES NO
DECLARATION:
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. 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, 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: `( h o' ,\_
SIGNATURE: DATE:
Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017
FILE COPY .
AUG C 8 20147
TOWN OF QUE NSBURY
Re&"
D�lte: t� �--1 301.7-1-64 AST-000488-2017
Rovelli, Virginia
28 Centennial Drive
Deck 236 s.f.
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
full compliance with the Building Codes of
New York State.
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