AST-0004-2021 Office Use Only
ACCESSORY STRUCTURE
Permit#: P"�:)r•
PERMIT APPLICATION
Town ofQeensbury Permit Fee:$ 1)05'-
742 Bay Road,Queensbury,NY 12804
P:518-761-8256 www.gueensbury.net Invoice#:
Project Location: 175 Assembly Point Road
Tax Map ID#: 239.07-1-34 Subdivision Name: NIA
CONTACT INFORMATION:
e Applicant;
Name(s): Ic7 c`Q ftu%%E-6� 1(4-
Mailing Address, C/S/Z: J17< � ". �T,_._ --.-APV -
Cell Phone:(5/,A-7 )-'n"6 Land Line:
Email:
• Prima Owners :
Name(s): ' �✓'' _ �� �Z'� .�
Mailing Address, C/S/Z: a na e-
Cell Phone:_ -� �'f 4 f Land Line:
Email:
❑ Check if all work will be performed by homeowner only
e Contractor(s): Workers' Comp documentation must be submitted with this application
Contractor Name(s): AdironDock's of Lake George, LLC
Contractor Trade: Dock and boathouse builder
Mailing Address, C/S/Z: 136 Stone Schoolhouse Rd., Lake George, NY 12845
Cell Phone: 518 )339-7451 Land Line: 518 )668-3159
Email:adirondockslg@gmail.com _
"List all additional contractors on the back of this form
e Architect(s)/Engineer(s): q `�� JAN 6 2021 �; l
Business Name:
Contact Name(s): '� r•:,.,.--:?
Mailing Address, C/S/Z:
Cell Phone: �_) Land Line:
Email:
Contact Person for Building& Code Compliance:Devin Dickinson
Cell Phone: 518 )339-7451 Land Line: ( sig 668-3159
Email: adirondockslg@gmail.com
Accessory Structure Application Revised February 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
_Detached Garage X Boathouse(with or w/o sundecic) _3-Season Porch
Other(description: )
SQUARE FOOTAGE OF STRUCTURE: '
1st floor:
2nd floor:
Total square feet:
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction:$ 50,000
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 X NO
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. 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 atrue 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 I, or my agents, will obtain a certificate of
occupancy.
5. 1 also understand that 1/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:
eWeiPRINT NAME: r �/
SIGNATURE: DATE: ��,,
Revised February 2019
Accessary structure Application
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PLAN VIEW 17� J
Existing sundeck width including overhang. O �
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Proposed sundeck width/no overhang.
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REBUILD SUNDECK TO INCORPORATE �01
EXISTING ROOF OVERHANG. _ _ V
OVERALL HEIGHT, WIDTH AND LENGTH
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with our comments shall not be construed as T I ANDIN 4 ° d o
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Sheet 2 of 3
Proposed boathouse modification for 7MP#239.07-1-34 AdironDoak's, LLC
Peter & Maureen Steciuk d ro n D0C kl Boathouse �
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Queensbury — Warren County scale: t" = 4' S Lake
stone schoolhouse Road
Lake George, New York 12845
175 sse b Po" RoadDate: 31 December 2020 (518) 361-8624 EL-1
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REPLACE LANDING,STAIRS AND RAMP o .2 y acl
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ALL RAILS MUST BE MINIMUM W HEIGHT 0 y y C9
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• Structural members have been designed for 15 psf dead load, GO EXISTING CRIBS TO REMAIN a
psf ground snow load and 110 mph wind load. o
• All fasteners and hangers must be Installed according to o ;,
• manufacturers s eclfications k_,_3 k / Aol/) y i4 r0 zl r cJ��G y
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FINAL HEI HT AS NEEDED FOR MANUFACTURED POST SLEEVE
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Sheet 3 of 3
Proposed boathouse modification for 1MP#239.07-1-34 AdironDoWs, LLC
Peter & Maureen Steciuk d i ro n DO� 1 Dock&Boathouse Bugdan
Queensbury - Warren County Scale: 1" ' 8' oad
Lake 136 SGeorge,tone cNew York hoouse�2845
5 s e b i oa Date: 31 December 2020 (518)361-8624 P-1
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TOWN OF QUEENSBURY
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