BOTH-000381-2015 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building& Codes (518)761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: BOTH-000381-2015 Date Issued: Monday, February 8, 2016
This is to certify that work requested to be done as shown by Permit Number BOTH-000381-2015
has been completed.
Tax Map Number: 309.5-1-1.1
Location: 158 LUZERNE RD
Owner: Harold Winchell
Applicant: Gauthier Skilled Craftsman
This structure may be occupied as a: Shed 280 s.f.
By Order of Town Board
TOWNOFQUEENNSSBURY
Issuance of this Certificate of Occupancy 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
4?L 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: BOTH-000381-2015
Tax Map No: 309.5-1-1.1
Permission is hereby granted to: Gauthier Skilled Craftsman
For property located at: 158 LUZERNE 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
Tyne of Construction
Owner Name: Harold Winchell Shed $3,000.00
Owner Address: 9 Pinecone DR Total Value $3,000.00
Queensbury,NY 12804
Contractor or Builder's Name I Address Electrical Inspection Agency
Gauthier Skilled Craftsman
30 Delaware AVE
Hudson Falls,NY 12839
Plans&Specifications
Shed 280 s.f.
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Sunday,December 4,2016
(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 ue ; er 10,2015
SIGNED BY: n4
for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
ACCESSORY STRUCTURE APPLICATION
Received
DATE Nv0 v `. Tax-Map ID -11b2, Z5-I - /.
TAx MAP ID 3a 9. 5- 1 - / 1Pe it No. Soo 000 - 15
ZONING I NO Z 5 2PAnit Fee ��-
Rec Fee
HISTORIC SITE _Yes /C No Approvals
SUBDIVISION NAME No RTNw+'t Poc'-�7__ ` —# G -
APPLICANT ;jkV`V166X- &..A .QIC-r_V�F �. OWNER I�t�IZDI.� Wt&jCAk L-L.
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ADDRESS IVI C7 DULPc Nu- A,/tT ADDRESS `L P jLrr-o nl L- DL
/'�n5 r6--r'OL/
PHONE -../n7t��, � ��'I I' (71 �o PHONE
CONTRACTOR (rlJ C COST OF CONSTRUCTION(ESTIMATED): $ ^EOCZ7
ADDRESS: .]v �LAA(k�_+rlt.SL� BU/LDI'NpGADDRESS: ( OCDMI'�/Si Lit`
��• S �� .r S „�/ , Q s j_ Ale) 1IJL"t"QS M ti�p lS�,liL Ze/he f �
PHONE: �
CONTACT PERSON FOR BUILDING& CODES COMPLIANCE Sr 'I A & r7rro0,,,,rt PHONE7,IC- 7Lf(-ol0
TYPE OF CONSTRUCTION
Check all that apply Please indicate measurements as required below
Boathouse 1gfloorsq.ft. 2ntlfloor sq.ft. Total sq.ft. Height
Boathouse with Sundeck
Deck
Detached Garage(#of cars
Dock
Pole Barn
Porch-open
"Porch-3 season,Covered,Enclosed
Shed a F
40
Other Accessory Structure(s)
"Considered floor area&must comply with FAR(floor area ratio)requirements if located in the WR zone
DECLARATION: I acknowledge no construction activities shall be commenced prior to issuance of a valid permit. I certify that the
application, plans and supporting materials are a true &complete statement description of the work proposed, that all work will
be performed in accordance with the NY State Building Codes, local building laws and ordinances; and in conformance with
local zoning regulations. I acknowledge that prior to occupying the facilities proposed, I or my agents will obtain a certificate of
occupancy. I also understand that Ilwe 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: Srf #r Date: /?nV, i I
Signature: Date: V
1
Town of Queensbury Building&Codes Accessory Structure Application July 2014
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