AST-0489-2018 /ow_
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-0489-2018 Date Issued: Friday, December 7, 2018
This is to certify that work requested to be done as shown by Permit Number AST-0489-2018
has been completed.
Tax Map Number: 295.19-3-32
Location: 4 FOX HOLLOW LN
Owner: Thomas Shelly
Applicant: Thomas Shelly
This structure may be occupied as a: Open sided detched garage 400 sq. ft.
cross Ref Area Variance Z-AV-48-2018 approved 7/25/2018 By Order of Town Board
Westland Subdivision, Section 14 TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the (104)P 4
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.
'AK 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-0489-2018
Tax Map No: 295.19-3-32
Permission is hereby granted to: Thomas Shelly
For property located at: 4 FOX HOLLOW 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
Type of Construction
Owner Name: Thomas Shelly Detached Garage $16,500.00
Owner Address: 4 Fox Hollow LN Total Value $16,500.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Garden Time
652 QUAKER RD
Queensbury,NY 12804
Plans&Specifications
Open sided detched garage 400 sq.ft.
cross Ref.Area Variance Z-AV-48-2018 approved 7/25/2018
Westland Subdivision,Section 14
$ 175.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Monday, September 23,2019
(If a longer period is required,an application for.an extension must be made to the code Enforcement Officer
of the Town of Queensbury befor e e pirat. d f-
Dated at the To of Qu sb ' eptember 21, 2018
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
f rilliltk\ ACCESSORY STRUCTURE Permit n: 5 �D
- PERMIT APPLICATION Permit Fee:$ 1-79Y-
Town of Qycensbury
742 Bay Road,Queensbury,NY 12804 1 Invoice#: it 3
P:518-761-8256 www.queensbury.net
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Project Location: L/ re(, /4 A i LA S c)
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Tax MapID#° - f &t,
��` /�f �— � � Subdivision Name: �-�.)C� /�� ,+� �S �>< cfSic,)
CONTACT INFORMATION: G 54 o'er i 4-
17-7-) k da~e ' rp 1111
• A • ant: PIh j :, _, -, -: 12
Name(s): n ilkc c In f, Lk._
Mailing Address, C/S/Z: 4 iik ( t,l-c v\ e a S'i 7 TOWN ;I- -��� � r BUR_Y
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Cell Phone: Land Line: (Si ft c
Email:
• Primary Owner(s):
Name(s): 5 t
Mailing Address, C/S/Z: it
Cell Phone: ( /1
_�`�^� Land Line: ( )
Email:
• Contractor(s):
Business Name: A g cie J j i lfn e_
Contact Name(s): Pt hi
Mailing Address, C/S/Z:
Cell Phone: ( ) Land Line: ( )
Email:
• Architect(s)/Engineer(s):
Business Name: ,) il
Contact Name(s): n% /11
Mailing Address, C/S/Z: ,ni A
Cell Phone: ( ) Land Line: ( )
Email:
Contact Person for Building & Code Compliance: (S cam, --S\(\ .1., l
Cell Phone: Land Line: ( ( ) `79 _ -7 3 -7 :3
Email: T S B*- 1.11 6) ,CO-A d C LC ii),).L.z4- A
Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017
f
PROJECT INFORMATION:
TYPE: Commercial Residential
WORK CLASS: () 51 Ae#ecived
Deck,Open Porch Solar Panels(w/o rafter upgrades) Carport Ce Tower
Shed Pavilion, Pole Barn,Canopy Dock Gazebo
X Detached Garage Boathouse(with or w/o sundeck) 3-Season Porch
/ ArCe- Veil‘Cu-,
Other(description: ) w
SQUARE FOOTAGE OF STRUCTURE: +e
11,),Sleot Foy
1st floor: 4 )$c 0-0r4 a-a w rxr1G raj e
nd
2 floor:
Total square feet: `f(Z? S I
ADDITIONAL,PROJECT INFORMATION:
1. Estimated Cost of Construction:$ I v
2. If Commercial project,what is the proposed use: Ce-r5
3. Are there any structures not shown on the plot plan? NO Explain: Stleci 10' 10)..0 S �.
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. 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. I acknowledge that prior to occupying the facilities proposed I, or my agents, will obtain a certificate of
occupancy.
5. 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: L < I,.
SIGNATURE: DATE: 96.1//
Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017
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( GARDEN * TIME )
652 Quaker Road Queensbury, NY 12804 Phone: 518-793-8555 Fax: 518-793-8670
September 21,2018
Town of Queensbury Code Enforcement
RE: 20'x 20'Pavilion
c/o Tom Shelly
4 Fox Hollow Lane
Queensbury,NY 12804
Dear Building Department Personnel:
It is my understanding that the Town has a question of the structural integrity of the referenced 20'x
20'Pavalion to be located in the town and requires a 50 pound per square foot ground snow load.
Attached please find drawings that reflect this requirement. Consequently,the pavilion should be
acceptable for placement in the Town as long as it meets all other requirements.
Please feel free to contact me if you have any questions or comments.
Sincerely,
Frederick D.Troelstra,P.E.
GARDEN TIME,INC.
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SEP 21 2018
TOWN OF QUEENSBURY
BUILDING& CODES