AST-0783-2020 Office Use Only
ACCESSORY STRUCTURE Permit#:
PERM_IT APPLICATION Permit Fee:$
Town of Quccnsbury
742 Bay Road,Queensbury,NY 12804 Invoice#:
P:518-761=8256 mmmqueensbury.net
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Project Location: Queenbury �— 0 %9 E
Tax Map ID#: 307-1-9 Subdivision Name: FDEC 14 2020-
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TOWN OF QUEJEN-381 IRY
CONTACT INFORMATION: BUILT?NG&CODES
• -Applicant:
Name(s): David La- Point-(LaPoint Comstruction)
Mailing Address, C/S/Z:."597 W. Valley Road Argyle, N.Y. 12839
Cell Phone: (518)232-9849 Land Line: _( )
Email: lapointconstruction@yahoo.com.
• Primary Owner(s):
Name(s): Brett Streeter
Mailing Address,'C/S/Z: 33 Tuthill Road Queensbury, N.Y. 12804
Cell Phone: (518)_206-7569 Land-Line: _( )
Email: strettbreeter@aol.com
❑ Check if all work will be performed by homeowner only
• CiDntractor(s): Workers' Comp documentation must be submitted with'this application
Contact Name(s): David LaPoint (LaPoint construction)
Contractor Trade: Carpentry
Mailing Address, C/S/Z: 597 W. Valley Road Argyle, N.Y. 12839 -
Cell Phone: (518) 232-9849 Land Line: _( )
Email: lapointconstruction@yahoo.com
"List all additional contractors on the back of this form
•* Architect(s)/Eneineer(s):
Business Name:
Contact Name(s):
Mailing Address, C/S/Z:.
Cell Phone:_( ) Land Line: _( )
Email:
Contact Person for Building & Code'Compliance: David LaPoint
Cell Phone: (518) 232-9849 Land Line: _( )
Email:_lapointconstruction@yahoo.com
Accessory Structure Application Revised,February 2019
i
PROJECT INFORMATION:
TYPE: Commercial X Residential
WORK CLASS:
x Deck,Open Porch ❑ Solar Panels(w/o rafter upgrades) ❑ Carport ❑ Cell Tower .
❑ Shed ❑ Pavilion, Pole,Barn,Canopy ❑ Dock ❑ Gazebo
❑ Detached Garage:. ❑ Boathouse (with or w/o sundeck) ❑ 3-Season Porch
❑ Other(description: )
SQUARE FOOTAGE OF STRUCTURE:
1st floor: 624
29d floor: NA
Total square feet: 624
ADDITIONAL PROJECT INFORMATION: .
1. Estimated Cost of Construction:$12,800
2. If Commercial project,what.is the proposed use:
3. Are there any'structures not shown on the plot plan? YES x NO Explain:
4. Are there any easements on.the property? ❑ YES x 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. 1 acknowledge that prior to occupying the facilities proposed I,- or my agents, will obtain a certificate of
occupancy.
5. 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:
PRINT NAME: D id L oint
SIGNATURE: --� DAT VE-
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Accessory Structure Application Revised February 2019
307.-1-9 AST-0783-2020
Streeter,, Brett
33 Tuthill Rd
Deck 624 s.f.
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