AST-0223-2021 Office Use Only
ACCESSORY STRUCTURE Permit#: `
PERMIT APPLICATION �j
Permit Fee:_$ ,
742 Bay Road,Queensbury,NY 12804 Invoice#: 5�'2"
P:518-761-8256 www.gueensbury.net Flood Zone? Y Reviewed By:
Project Location:
l �
Tax Map ID#: ����3� �( 5 Subdivision Name:
PROJECT INFORMATION:
TYPE: 'Cr Residential ❑ Commercial, Proposed Use:
STRUCTURE:
❑ Boathouse(with or w/o sundeck) ❑ Canopy ❑ Carport ❑ Cell Tower ❑ Deck
❑ Detached Garage (>300 s.f.) ❑ Dock ❑ Gazebo ❑ Pavilion ❑ Pole Barn ❑ Porch ❑ Ramp
Shed (<300.s.f.) 0 Solar Panels(w/o rafter upgrades) ❑ 3-Season Porch ❑ Other:
SQUARE FOOTAGE OF STRUCTURE:
1st floor:
2"d floor:
Total square feet: �2_
Brief description of scope of project: I�QW Wk 5 2 o a-a (r'L S'k'Gr I neu)
DEC Q E
APR 13 2vi
TOWN OF QUEENSBURY
BUILDING& CODES
Accessory Structure Application Revised January 2021
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction:$ I cz
2. Are there any structures not shown on the plot plan? DYES Z NO Explain:
3. Are there any easements on the property? ❑ YES ❑ NO
DECLARATION:
1. 1 acknowledge that no construction shall be commenced prior to the issuance of a valid permit and will be
completed within a 12 month period.Any changes to the approved plans prior to/during construction will require
the submittal of amended plans,additional reviews and re-approval.
2. If,for any reason,the building permit application is withdrawn,30%of the fee is retained by the Town of
Queensbury.After 1 year from the initial application date, 100%of the fee is retained.
3. If the work is not completed by the 1 year expiration date the permit.may be renewed, subject to fees
and department approval.
4. 1 certify that the application, plans and supporting materials are a true and a 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.
5. 1 acknowledge that prior to occupying the facilities. proposed I, or my-agents, will obtain a certificate of
occupancy.
6. 1 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:
� ,1
PRINT NAMEn I WC L( 44C) 1,
SIGNATURE: . G DATE: 1
Accessory.Structure Application Revised January 2021
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE,`PLEASE INCLUDE AN EMAIL
• A licant:
Name(s): gif1'I? l�ll'L A—' 1.01
Mailing Address, C/S/Z:
Cell Phone: i Land Line: —'
Email:�I Y nn hQ`t �� ���
• Primary Owner(s):
Mailing Address, C/S/Z: 1
Cell Phone: (::*Land Line:
Email:
❑ Check if all work will be performed by property owner only
• Contractor(s): (List all additional contractors n the back of this form)
Contractor Name(s): r, ff S
Contractor Trade:
Mailing Address, C/S/Z: C z) b o2 teo
Cell Phone: Land Line:
Email:
"Workers' Comp documentation must be submitted with this application"
• Architect(s)/Eneineer(s):
Business Name:
Contact Name(s): I
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email:
Contact Person for any questions regarding this project:
Cell Phone: Land Line:
Email:
Accessory Structure Application Revised January 2021
• Contractor(s): Workers' Comp documentation must be submitted with this application
Contractor Name(s):
Contractor Trade:
Mailing Address, C/S/Z:
Cell Phone: Land Line: 8D,?)-4q-/f a �35 �O
Email:
• Contractor(s): Workers' Comp documentation must be submitted with this application
Contractor Name(s):
Contractor Trade:
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email:
• Contractor(s): Workers' Comp documentation must be submitted with this application
Contractor Name(s):.
Contractor Trade:
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email:
• Contractor(s): Workers' Comp documentation must be submitted with this application
Contractor Name(s):
Contractor Trade:
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email:
• Contractor(s): Workers' Comp documentation must be submitted with this application.
Contractor Name(s):
Contractor Trade:
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email:
Accessory Structure Application Revised January 2021
Docu'-w4iiklope ID:1BEB5836-3E:AA-4FDB-9F6C-68B2AAC31087 Cindy Holt
TUFFSHER 3 Noble Way
Queensbury NY 12804
Q3257596-3250562
301.5-1-52 AST 0223-2021
Holt, Shane & Cindy
3 Noble Way
Shed 192 s.f.
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.a ,Popp—.,
TOWN OF QUEENSBURY
BUILDING & E:O S PT. wall D
Review By- �� E ILL9
Date:
APR 13
4d
TOWN OF QUEENSBURY
Wall A Wall C BUILDING& CODES
TOWN OF QUEENSBURY
BUILDING DEPARTMENT
Based on our limited examination,compliance
with our comments shall not be construed as
indicating the plans and specifications are in
full compliance with the Building Codes of
New York State. Wall B
Base Details Options Details Jobsite/Installer Details
Building Size&Style Doors Do you plan to insulate this building after Tuff Shed
TR-800-12'wide by 16'long 3'x 67'Double Shed Door(6%LowerX, installs it?
Paint Selection Drip Cap,Wood Ramp(pair)with No
Base:Sheffield Gray,Trim:Southern Special Sill Nose,4 extra ramps Is there a power outlet within 100 feet of installation
Breeze Windows location?
Customer to apply 2nd coat 2'x2'Insulated Horizontal Sliding Yes
Roof Selection Window The building location must be level to properly install the
Weathered Gray 3 Tab Roof building.How level is the Install location?
Drip Edge 233 Sq Ft Radiant Barrier Roof Decking Within 4"of level
White 24 Lin Ft 6"Gable EW Eave Upgrade Will there be 18"of unobstructed workspace around the
Floor and Foundation perimeter of all four walls?
192 Sq Ft 3/4"Treated Floor Decking Yes
Upgrade Can the Installers park their pickup truck&trailer within
Interior approximately 200'of your installation site?
12 Lin Ft 24"Workbench Yes
53 Sq Ft Pegboard Substrate Shed will be installed on?
Vents Dirt/Gravel
2 Ea 16"x8"Wall Vent-White
Workbench And Pegboard Locations
Workbench on Side C at 39".
Half Wall Pegboard on Side C at 39".
uocu. ;4%piope iu:1I3t68836-3EAA-4FDB-9F6C-68B2AAC31087
Sales Order
Location: QUEENSBURY 1#670 1(518)555-1234 Scheduled Date: Pending
Factory Location: Fairfield 1#670 1(973)315-8647 Created Date: 04/01/2021
Factory Address: 15 Industrial Road
Fairfield,NJ 07004 Cindy Holt
Customer p.(912)531-7452 1 c.
Prepared by: Stasi King 1(845)636-8773 cindyannholt@gmail.com
sking@tuffshed.com
SFSO 00552359
Special Instructions: HD Store#
Customer PO
JDESO 1650263
3 Noble Way
Serial Number: Ship to Address Queensbury,NY 12804
US
—'TR-80012 x 16 1.00
Upgrade-3'x 67'Double Shed Door(6') 1.00
PAINT TR-700,TR-80012'WIDE 1.00
6"Gable EW Eave Upgrade 24.00
Additional Heavy-Duty Ramp Plank 4.00
2'x2'Insulated Horizontal Sliding Window 1.00
Pair of Heavy-Duty 6'Wood Ramps and Sill Nosing 1.00
Radiant Barrier Roof Decking 233.00
3/4"Treated Floor Decking 192.00
Pegboard 53.00
24"Workbench 12.00
Door-Decorative Double Door Trim-Lower X 1.00
Door-Drip Cap(6') 1.00
16"x8"Wall Vent 2.00
Paint Discount,Customer To Apply 2nd Coat.Tuff Shed Supplies Paint,Roller& 1.00
Brush
Credit For Removal Of Default Door 1.00
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BUILDING& CODES
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