AST-0220-2018 0110k., TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building& Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Perna Number: AST-0220-2018 Date Issued: Wednesday, August 1, 2018
This is to certify that work requested to be done as shown by Permit Number AST-0220-2018
has been completed.
Tax Map Number: 301.17-3-58
Location: 38 CAITLIN DR
Owner: Phyllis Potter,Eric Potter
Applicant: Eric Potter
This structure may be occupied as a: Shed 180 sq. ft.
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the
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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 Ba Road,Queensbury,NY 12804-5904 518 761-8201
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�►_ Community Development - Building & Codes (518) '761-8256
BUILDING PERMIT
Permit Number: AST-0220-2018
Tax Map No: 301.17-3-58
Permission is hereby granted to: Shed Stop, Inc.
For property located at: 38 CAITLIN 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
Tae of Construction
Owner Name: Phyllis Potter Shed <300 s.f. $5,000.00
Owner Address: 38 CAITLIN DR Total Value $5,000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Shed Stop, Inc.
6854 State Route 4
Fort Ann,NY 12827
Plans& Specifications
Shed 180 sq. ft.
$ 75.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Wednesday, May 15, 2019
(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 To of Qu sbu ,/� *t4eT
15, 2018
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
ACCESSORY STRUCTURE Permit#: C 'l
PERMIT APPLICATION Permit Fee:$ f
f"imn 4(ttwen.,hury
742 Bay Road,Queensbury,NY 12804 Invoice#: ` -3'So
P:518-761-8256 www.gueefnsbury.net
Project Location: Q I�IVA
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Tax Map ID#: �� h r t Subdivision Name: V10 If
CONTACT INFORMATION:
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Applicant: MAY Q 3 1018
Name(s): t fk(,
Mailing Address, C/S/Z: 3£S �',(tl r r f I4 tib ' BURY
Cell Phone: ,P L3 - 3 011 Land Line: �) a lT
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Email: Ut
• Primary Owner(s): f
Name(s): —5 6 a V_ _
Mailing Address, C/S/Z:
Cell Phone:�_) Land Line:
Email:
• Contractor(s): �j
Business Name: w 5 KeJ A -
Contact Name(s): r-OLA4 D v1
Mailing Address, C/S/Z: ( 5�4 �' [, n rT 1Y ( Z
Cell Phone: ) C4Land Line: -f -3 QS5
Email: 3 S l ISD C
• Architect(s)/Eneineer(sl:
Business Name:
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: Land Line: �)
Email:
Contact Person for Building&Code Compliance:
Cell Phone: j, it Land Line: �)
Email:
Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017
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Double Plywood Gussets '(
Doublc Top Plates `~3R- r.--2X4 16'O.+C.rafters \\
! 1/2'4- ly CDX or OSB
Alutnututn Sofit —30 Year
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Sidewalk Plywood Hinges TJA I Wood Siding
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2X4 Press=Treated Pry 4 518"Exterior Grade 5-Plywood Or Raised Panel Or
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Floor Joins s',12" DEPARTNFI�kT DI III nIK1f-% 0
with our comments shah not be construed as Reviewed B
indicating the plans and specifications are in Y -
full compliance with the Building Codes of Date.
New York Slate.
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0 65,12.. 6'wide shed
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301.17-3-58 AST-0220-2018 .
Potter,tteP
Eric
38 Caitlin Drive
Shed 180 S.f.
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PERMIT PLOT PLAN
1 HAVE PE ONALLY MEASURED THE DISTANCE MAY 0 11 2018
FROM T PROPERTY LINES TO THE
TOWN OF OUE SDURY
Pry TURES) OR SIAN( COMMUNI TV DEV OPMENT
SIGNATURE AT
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�2� = 90.00 0
s 5.70.00
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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:
2'floor:
Total square feeet• �y
ADDMONAL PROJECT INFORMATION:
1. Estimated Cost of Construction:$ E L2
2. If Commercial project,what is the proposed use:
3. Are there any structures not shown on the plot plan? YES :NO xplaln:
4. Are there any easements on the property? YES NO
12ECLARATION:
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. 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 1, 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: E-`L L
SIGNATURE: C2�= DATE:
Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017