The URL can be used to link to this page

AST-0122-2020Office Use Only ACCESSORY STRUCTURE ermit ag 0122-2029.-- PERMIT APPLICATION entreTownofQueensburyPermitFee:$__V7 742 Bay Road,Queensbury,NY 12804 P:518-761-8256 ywww.queensbury.net Invoice #:__24% Project Location:22 _Novonscad Dv Tax MapID#:7286.20-\-'\-2 Subdivision Name: CONTACT INFORMATION: ©Applicant: Name(s):__AW PEC Mailing Address,C/S/Z:_41 upper Stteemeanw Ave Quéeps purr Cell Phone:(61%)399 55149 Land Line:_() Email:_D ABEL 72545 @ ADL.cowr +Primary Owner(s): Name(s):PAM KENORACES Mailing Address,C/S/2:_92_Noah Wood DR Quezas Ayn Cell Phone:1 30)~3114 Land Line:(S19 )793=-3773Email:Pam(@)Ba<s Minors,Com O Check if all work will be performed by homeowner only Contractor(s):Workers’Comp documentation must be submittedwiththisapplication Contractor Name(s):ABELL COnmsTeirco ON Contractor Trade:_CAR PETYTETMailingAddress,C/S/Z:WU Upper Stereo ee AeCellPhone:(SI€)79G-—S5"14 Land Line:_{) Email:__D ABELL “J54 SD)BOL.Conn **List all additional contractors on the back of this fort ©Architect(s)/Engineer(s): Business Name: Contact Name(s): Mailing Address,C/S/Z: Cell Phone:_()Land Line:_(. Email: Contact Person for Building &Code Compliance: Cell Phone:_().Land Line: Email:, ccesony Stractre Application fevieedFebrary 2019, PROJECT INFORMATION: TYPE:Commercial X_Residential WORK CLASS: ___Deck,Open Porch __Solar Panels (w/o rafter upgrades)__Carport __Cell Tower __Shed ___Pavilion,Pole Barn,Canopy __Dock __Gazebo jetached Garage __Boathouse (with or w/o sundeck)___.3-Season PorchTone (description:Di-car -) SQUARE FOOTAGE OF STRUCTURE: 1st floor: 2"floor:——-/, Total square feet:(30.544.5x 2% ADDITIONAL PROJECT INFORMATION: 1,Estimated Cost of Construction:$350 = 2.if Commercial project,what is the proposed use: 3.Are there any structures not shown on the plot plan?YES (GO?Explain: S Are there any easements on the property?ves (NO DECLARATION: 1.1 acknowledge that no construction shall be commenced prior to issuance of a valid permit and will be completed within a 12month period. 2.Ifthework 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.|acknowledge that prior to occupying the facilities proposed |,or my agents,will obtain a certificate of occupancy. 5.lalso understand that [Ave are required to provide an as-built survey by licensed land surveyor of all newly constructed facilities prior to issuance of a certificate of occupancy. have read and agree to the above: prINTNAME:Daw ABere signature: _D Soe Patt pate:3-7 7-2ZDZO sccesorStuture Application ese February 2019, OFQUEENSBURYaDEPARTMENTeiinationissceeaconionsSpiceweHecomposingCotes 5 oF =Neo Si."C S—2x/2-PF,greRLSineParibecwie YXY Pe fosts AST-0122-2029 /#u RL 1S 2%TOP W/20.4BrepidKendrick,Brian 22 Northwood Dr sphere RM 2XPteWheelchairRamp130s4.