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AST-0724-2021 c Office Use Only ACCESSORY STRUCTURE Permit#: PF*-, -4k Town ofQueensbury PERMIT APPLICATION Permit Fee:$ 6rD' 742 Bay Road,Queensbury,NY 12804 Invoice#: P:518-761-8256 www.gueensbury.net Flood Zone? Y N Reviewed By: .S Project Location: 312 Glen Lake Road Lake George, NY 12845 Tax Map ID#: 523400 289.9-1-84 Subdivision Name: PROJECT INFORMATION: TYPE: X 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 OC Shed (<300 s.f.) ❑ Solar Panels(w/o rafter upgrades) ❑ 3-Season Porch ❑ Other: SQUARE FOOTAGE OF STRUCTUR . 1st floor: 188 sf end floor: Q�T 12021 Total square feet: 188 sf TOw eU OF G 8, CO Set) CO Set) Y Brief description of scope of project: new storage shed to replace.existing shed Accessory Structure Application Revised January 2021 ADDITIONAL PROJECT INFORMATION: 1. Estimated Cost of Construction:$ $1500.00 2. Are there any structures not shown on the plot plan? DYES 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 If,for any reason,the building permit application is withdrawn,30%of the fee is retained by the Town of Queensbury.After 1 year from the initial application date, 100%of the fee is retained. 3. Ifthework 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: PRINT NAME: SIGNATURE: DATE: Accessory Structure Application Revised January 2021 CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Applicant: Name(s): Jeff Godnick Mailing Address, C/S/Z: 312 Glen Lake Rd, Lake George, NY 12845 Cell Phone: (802)353-7102 Land Line: none Email: jeffggf@comcast.net Primary Owner(s): Name(s): Same as Applicant Mailing Address, C/S/Z: Cell Phone: Land Line: Email: ® Check if all work will be performed by property owner only • Contractor(s): (List all additional contractors on the back of this form) Contractor Name(s): Same as Applicant Contractor Trade: Mailing Address, C/S/Z: Cell Phone: Land Line: Email: "Workers' Comp documentation must be sAWtted with this application" • Architect(s)/Enaineer(s): Business Name: Same as Applicant Contact Name(s): Mailing Address, C/S/Z: Cell Phone: Land Line: Email: Contact Person for any questions regarding this project: Jeff Godnick Cell Phone: (802)353-7102 Land Line: Email: jeffggf@comcast.net Accessory Structure Application Revised January 2021 B ors'" glued&Screwed R oi:Metal QS d con eck Roof SheaXh4i s with Pl mosses n o plates U4 headers , -Trusses.2 s t all t {e&dbl t P e a Y a ' , Fl �"d.q.c �,t+y, ne clip toe 1 urr�ca sing)p + mnz,^�a+, _ :2X4 s�t6 oc 5 f f'.� luec�&nay � ; , ' �;«:r < r -{ {` °`�,4y Weal sto �'� �` 'r t n ch.�&n 9 Way 22!+" w "'° a• � ` .y,.�• „ °: '.s. va to Cu long _ �,_ «t` "' _'d• ? ,?�`yai i�Aa,,r a%" 314 - 4t >�' .1 •"f <= `i-,~ ", _ .tier paw t Iw Y Qerik' .� S ..i way X �� ,'� •:;.,.�,..�,,.i ��� F1oo � is�s: 4, ruri �,�' �'`A� :,,� .:fit' � �..� O• �C 1OQr 4X s 4�-+may ;. ,r>�:r' �,- "�rt � . • ., _ ,�� � � • p,,_•� s•:d ti��k �`��, t[� v�"'} 1 ,�. `,.i j ,+,may +{r. �.,, .. � Jr,,,.`. �'`,� +.'• i � �w� �F1y h- ,1t r y ,��y' , 19 - .. 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