AST-0100-2022 Office Use Only
\ 1 ACCESSORY STRUCTURE Permit#: flez>T- 0)00 - 2o7Z-
PERMIT APPLICATION
town ofQ Permit Fee:$ 0l
742 Bay Road,Queensbury,NY 12804 Invoice#: 46b!J
P:518-761-8256 www.ciueensbury.net Flood Zone? Y N Reviewed By:
Project Location: l(7P w-me mwid on 1
Tax Map ID#: �'S — 7—rP2.40 �Subdivision Name:—rOP of 1� NoiZLID
��11.ock1't�'� 1�1tA1. 12oac(
PROJECT INFORMATION:
TYPE: [Y/ Residential ❑ Commercial, Proposed Use:
STRUCTURE: �f
El Boathouse(with or w/o sundeck) ❑ Canopy El carport El cell Tower L(Deck
❑ Detached Garage (>300 s.f.) ❑ Dock ❑ Gazebo ❑ Pavilion ❑ Pole Barn ❑ Porch ❑ Ramp
❑ Shed (<300 s.f.) ❑ Solar Panels (w/o rafter upgrades) ❑ 3-Season Porch ❑ Other:
SQUARE FOOTAGE OF STRUCTURE: '1
1st floor: N I A
2nd floor: ?00? � 0� OU P"ASg URY
Total square feet:em
TOgU1I D1�1G O�E
Brief description of scope of project:
R�vwoval av �SPus4 l `�� �s��� �ecJc RvrLM' ed. Add -xe e�
1-0 -HA-0- S-h (31 Sur Y12X-4- 16) 4-0 Yk^kk ex4n-hen -6
S iced I n V0 vided s. I n s l ��w o-e-cka K5
�6 code.
Accessory Structure Application Revised January 2021
6 �
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Iv
Name(s): 00'�P'VIeYi� �U g
Mailing Address, C/S/Z: 33 ATNEtk- �� r`o�he� �� � S r
Cell Phone: 0r1r-lo(o�4 ! / Land Line: NIA-
Email: n(�Qm- noi@ nodherolvd.C61y)
• Primar Owners :
Name(s): �r /. r1J l• Q �1�71• �y /2��s� 1) -
Mailing Address, C/S/Z: T1
Cell Phone:=Cj�"1 ?0,57`�' 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): /vorm-Q.Y� U.►(��ri
Contractor Trade: �o NY 17S5-1
Mailing Address, C/S/Z:`3? A4-We-j 1&ad - h��s
Cell Phone: V11"I(C-cotfell, :Land Line: !°I —
Email: n01�,wl 0@ for i n b1�. cv�
"Workers' Comp documentation must be submitted with this application"
•-\ Arch itect(sVEngi nee r(s):
Business Name: 6,Ap4yContact Name(s): ,`eSQ�
C _
�,nc1�a
Mailing Addres , C/S/Z:-7V (/I/`ocAl►1lk A i ��V .�PY►n�.! �y �7 4'P .
Cell Phone: / 1, ' Land Line: �4J5';�7 /3 YO
Email: jiv
r- cri 2.)erkoo.6om
Contact Pers for any questions regarding this project: ' "` ® leg.
Cell Phone: Fl071LP Land Line: 111 A-
Email:nano Jj,0y,hernb1j, Coen)
Accessory Structure Application Revised January 2021
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction: $ x), oca OR
2. Are there any structures not shown on the plot plan? EES ❑NO Explain: I" kF bA Ft t. _
3. Are there any easements on the property? ❑ YES i 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.
M N
4. I 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.
g
I have read and agree to the above:
PRINT NAME:
SIGNATURE: DATE: /Z0ZZ_-
M,,ias bewuD
Accessory Structure Application Revised January 2021
- Deck and Roof Design checklist
Is deck freestanding or attached
�S Footing
Sobes sized for posts 44 8" 6x6 12"
Big foot or footing for roof load
Proper attachment to post and footing shown
Proper flashing or waterproofing to structure shown
—2�7 Attachment to structure shown on plans
Galvanized or stainless steel bolts shown NO ZINC COATED
Hex headed bolts NO CARRIAGE BOLTS
Diagonal bracing shown for deck over 24"
Floor joists parallel to carrying beams
qt/s- Deck post to beam attachment shown
Over 30" requires handrail
Over 30" requires guards
Over 30" requires guards @ 34" to 38" in height and handrails @ 34"-38"
Revised 4/15/2021
TOW HOA ARCHITECTURAL CONTROL FORM
Date Submitting: 10/20/2021 Estimated Start Date Spring 2022
Name Larry and Anne Reinstein Estimated Completion Date Spring 2022
TOW Address Unit 51 Email Address Larry.Reinstein@gmail.com
Phone# 516-456-2905- Alternate Phone#
DESCRIPTION OF MODIFICATION Please provide a brief description of modification, and
attach/include drawings, exterior elevations, floor plan, and detail of materials to be used,pictures,
catalog pictures; brochures and color samples.
C Existing upper deck removed and rebuilt according to attached plans.
Please submit a site plan showing the exact location of modification being requested in relation to your
home and property lines. Existing decks, walkways, driveways, etc., should also be indicated.A copy
of the land survey is acceptable.
I have discussed this modification with i4 neighbors wN will be directly impacted by the proposed
modification. ff Yes q
Signature of Owner._t?- _=_..r
Contractor's Infotmacion ._ i , '1 l `' �' i` 7 1<1 -V f .-
Contractor's Signature of Acknbwledgement o. Comments below:
Submit request either by emailing to the PM(propertymanager.tow@gmail.com)or mailing to Top of
the World Homeowners' Association, Attn: Architectural Committee,441 Lockhart Mtn. Rd., Site 2,
Box 47,Lake George,NY 12845
Date received by Architectural Committee. t0/.0/7-
Date of reply by Architectural Commit
Sign for Architectural Committee:,.
❑ - -
❑Approved Not Approved.�pproved with Conditions
COMMENTS:
All work is to be completed in a professional manner in compliance with all applicable building codes
and the TOWI-IOA published standards. All work shall be subject to inspection and coordination with
the TOWHOA Properly Manager and local building officials if applicable. If making exterior siding
repairs, the Property Manager shall be notified once the damaged wood is removed to inspect the
sheathing and framing before replacement of materials.
09/22/2021