AST-0138-2018 411111K
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-0138-2018 Date Issued: Tuesday, July 31, 2018
This is to certify that work requested to be done as shown by Permit Number AST-0138-2018
has been completed.
Tax Map Number: 296.14-1-49.
Location: 54 COUNTRY CLUB RD
Owner: Susanne Fulmer,Robert Fulmer
Applicant: Robert Fulmer
This structure may be occupied as a: Detached Garage 750 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, 4 I 4'
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
t
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
- Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: AST-0138-2018
Tax Map No: 296.14-1-49
Permission is hereby granted to: ' Susanne Fulmer,Robert Fulmer
For property located at: 54 COUNTRY CLUB 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
Tvne of Construction
Owner Name: Susanne Fulmer Detached Garage $25,000.00
OwnerAddress: 54 COUNTRY CLUB RD Total Value $25,000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
Detached Garage 750 s.f.
$ 225.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Thursday,April 11,2019
(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 t e expiratio at
Dated at the Town f Quee bury; W ay,April 11,2018
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
t-
Office Use Only
ACCESSORY STRUCTURE Permit#:
PERMIT APPLICATION Permit Fee:$ 225.0
Town of QcensUury
742 Bay Road,Queensbury,NY 12804
Invoice#: Q�-:'tF5
P:518-761-8256 www.aueensburv.net
Project Location: 6-Y eo&ee-�V
Tax Map ID#: �� P 1 — Subdivision Name:
CONTACT INFORMATION:
• Applicant:
Name(s): bl eY- ?p- Sk-,rA h,0 e, �-e W1 '
Mailing Address, C/S/Z: C'e� a�s� � '� e ° � ._ Y /?-P6LJ
Cell Phone: ( 5")P) 9 Land Line:
Email:
• Primary Owner(s):
1
Name(s): � scrom n , m
Mailing Address, C/S/Z: �1�' S � V .)-2 PJ
Cell Phone: ( TA' ) 79 Z. - X 7 Land Line: ( 5Ik ) 5'-ZO
Email: (-'a J l ® ha e-
• Contractor(s): --
Business Name: I� i� FAPR ii 7 ?C11
Contact Name(s):
Mailing Address, C/S/Z: TO-VVN OF QUEENSBURY
Cell Phone: --
Email:
• Architect(s)1Eneineer(s):
Business Name:
Contact Name(s): �,►
Mailing Address, C/S/Z: _ __
Cell Phone: ( ) Land Line: ( ) J
Email:
Contact Person for Building&Code Compliance: Raieref—
Cell Phone: ( �r)k) 7 '16 4 -7 Land Line: ( � �° ) 0 9 — 9 6
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
t/ Detached Garage —Boathouse(with or w/o sundeck) .3-Season Porch
—Other(description: )
SQUARE FOOTAGE OF STRUCTURE:
1st floor:
2nd floor:
Total square feet: s
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction:$ "� �, D
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
i
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. I 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 bya 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: -0- y—
SIGNATURE: - DATE:
Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017
IpERMIT PLO-14 N
I HAVE PERSO ALLY t,EASURED' CISTANCE Map Reference
FROM THE PROPERTY LIN-- TO THE
�^ OR SIGN(S) Map of a wrVeyf�or
PRO PGSED STRUCTURE��) y�� Joseph L *Clernert a 50PrAw
��� k � 6y: D.L
DATE so
SIGNATURE Date.-
(Apt 2
Rod found rNood Qltalos Band
TOWN OF QUEENSBURY 296.14-1-49 AST-0138-2018
,o wt- 9twerod S7$'41 p� BUILDING & CO S T. Fulmer, Robert & Susanne
Ilkf ,� Review , Y � 54 Country Club Road f
,z °'"" ,des Detached Garage 750 s
of
x53o.G31
a'*cm
t roNv
� �L ,;� � rbn and ra.a
H..Wy*W ted Ntrtland
TOWN CIF t;eEEN}`�,kfnn,
x tt7t' it I�VG i�t;yw��!'le � ZONING NOTES:t3U(LL?,F3used�cremu, ! iteo exam�naticTnii�anCe 1. setbacks from Town of Queen
Zoning
I eae.drw.ewru� oar comaenis shag! ;;oi be con. u_d as
�fL CPr�dsun nd*6W4 ana specificationAare in rc &d1nanee effecitm ,Acne 11, 1982 Shoreline
avoiom the Building C es of Setback - 50'
ohV' V; Ne*-W7 State. I Setbac%s:
t !!15 Fronts 30'
V ! (17)RAGS A
9-9-17 Q 51a1e s f5'
� � �, �J Rear = 20'
Area of Wetlands = a it acres U* 3 j C
3
xonty vetoW cano e % Altai � . �
Capped aaa . �-. 2t acm C Cm rpmH: d NI E i.
�s 4 APR 0 2 2018 JJ
2� wood
TOWN OF QUEENSBURY
azs (� ' E0 BUILDING&CODES
_ .Capped ad
CY
..i..ni..rrdrY.uYM s ; Capped Rod Set
Loot & � �1 N7 a p
eu
'taw
of a rv+Gy foru..lYa.N..iia.er roaangw�p
iirwsAll so A I
ls�rlri oriraNaYiai 1 �a
efM�Wr9�� dwaww dk91100
wad ford In
Ce+Oaerpow.os tM sawAm ► h d
a.tw..�.. .,o,aw.o�.�aar i Lot 4 Town of County of Warner
wnwer.�ewscersotMnNosbr t.a9wwjo
.r�e++uyww.ra*9ae��oe.eb.a i state C Newyork
t�tnirrerl9wryoe�.Yic.1Ms oaeias0oa r -��—
wewrsoarrasa.forOW-as�ysmsy I { F+Opy SCale: l' • 6Q>ECt. Dote: 4/�P1'l) 2007
ry.r}geN,ilp"bam�ry.bMs >�tL� C
a.+a.wh.ane..eYi6o� $ i aeNfedt 20 AM 2607
��Y�w1f�F• 1 �,,,�.,,r-...��' ,,a�Y�'"�y�� lti�+ls.��Ylhi ��MA .
ttr owviasor is000 cis cot e�wlerable :`` y w RaMeds G August 2014
14A I,
lks bOAw�d r�dw�owdw�wrAwN a 5111111lf0fs
SM Mot*sup iil m OW 460 90* aetneea: 13 March 2017
is aM�ld Vey, d�+w�wRs or UII9 Q0� t>Ab t6 DEC WetlaneldGwa
not or am*OF tlr wrowma"
or'" , . .s+gcoor.vay,te.o.+ao.ee s,� -A A01L DU:65 2 5.x OW
i
GltJ: 296.14 l 49 G+ewl
1
�• . a fi �' "T WG�»
?l!G'` ti tv/ ttN �'C
fo? 0
" 2 -A
Ma. IJI: 4o 12Cac r i4pht: r,l try # ,,
Lb
PM 4vw. U."t 10 � CL = lot' + t� .AUO
� ��a�
Wi0 U�"SC?= t/u l �a I-�t''u I~'tF '' pt,Ut1P1�..+Yar.
3 d t C,
ED
T ST t OF
.yE A��-
f 1
I �
fQ9 loll au-0.40 I0go
11.0
.p 12L
j j' A
l(10 0
-41 loom
0 ;} t/l
{ F
iilz a
1 � n
L—L-
JoaoI&M i ))
'I OP MI'll
1 L rt
Wit
j
Fn
9 r a3�
jr* 7W 4