AST-0334-2021 Office Use Only
ACCESSORY STRUCTURE Permit#: AS 0554- 20Z1
Town ofQuecl PERMIT APPLICATION Permit Fee:$
742 Bay Road,Queensbury,NY 12804 Invoice#: •Z�/
P:518-761-8256 www.gueensbury.net Flood Zone? Y N Reviewed By:
Project Location: �� % 6�& d X1
Tax Map ID#: Subdivision eE C E 0 v E
PROJECT INFORMATION: I MAY 07 2021
11
BURY
TYPE: [ Residential ❑ Commercial, Proposed Use: TOWN DI G&CODES
P BUILDING&CODES
-STRUCTURE:
❑ Boathouse(with or w/o sundeck) ❑ Canopy ❑ Carport ❑ Cell Tower ❑ Deck
Detached Garage (>300 s.f.) ❑ Dock ❑ Gazebo A Pavilion ❑ Pole Barn ❑ Porch El-Ramp
❑ Shed (<300 s.f.) ❑ Solar Panels(w/o rafter upgrades) ❑ 3-Season Porch ❑ Other:
SQUARE FOOTAGE OF STRUCTURE:
1st floor: 77,0
2nd floor: --
Total square feet: f
Brief description of scope of project:
CU .siRUc !
\ Accessory Structure Application Revised January 2021
1N
-ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction: $ 0,
��•
2. Are there any structures not shown on the plot plan? ❑YES ANO 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 If,for any reason,the building permit application is withdrawn, 30%of the fee is retained by the Town of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:
PRINT NAME:
SIGNATURE: d DATE:VJ /y z /
Accessory Structure Application Revised January 2021
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s): Ik r-
Mailing Address, C/S/Z: 52 FOX Rutd, C#&-,572-4 iow(J f !J / ZgJ
Cell Phone: -�19-17S-337-7 Land Line: 51g-g9Yr 7�6S
Email:
Primary Owner(s):
Name(s): oa U
Mailing Address, C/S/Z: ff ���� /�� AdlaJ ���, � ` �/ /�o
Cell Phone: ,Sly'-232—S9Sl ,^ Land Line:
Email: M -N619 PMP
❑ 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): L&r,J l5
Contractor Trade: ,�vlGJr� _
Mailing Address, C/S/Z: 50
7
Cell Phone: Land Line:
Email:
**Workers' Comp documentation must be submitted with this application**
• Arch itect(s)/Engineer(s):
Business Name: �m� ,q�Fnl ,10 Ti NJ�' 2r�m S
Contact Name(s):
Mailing Address, C/S/Z: /Q8/ jo-r,�`M Cl�v OC-g &J/
Cell Phone: Land Line: 19 7D — 76S 7z9,3
Email: y1q oml%l(dSe 7/M 2IMV&AlJ-o�/JomC,So Co
Contact Person for any questions regarding this project: /Mfi- to fS
Cell Phone: S/9-q7-0 232 7 Land Line: S& y9y- 7Z 6S
Email:
#1�-ffPO -%es Z66/�61t)&=s 6sO M
Accessory Structure Application Revised January 2021
Deck and Roof Design checklist
I VE
I%,detk freestanding attach
ki Footing ;-ZP M�Wo 5W-�3
,A'Sono tubes sized for posts 44 8" 6x612"
�1Big foot or footing for roof load 5-.4�
Proper attachment to post and footing shown
MU A- Proper flashing or waterproofing to structure shown
J6 Attachment to structure shown on plans
Galvanized or stainless steel bolts shown NO ZINC COATED
Hex headed bolts NO CARRIAGE BOLTS
NlA- Diagonal bracing shown for deck over 24"
& /�-Floor joists parallel to carrying beams
Nll�Deck post to beam attachment shown
Over 30" requires handrail
)J,—Over 30" requires guards
Over 30" requires guards @ 34" to 38" in height and handrails @ 34"-38"
f-A-1-101
Revised 4/15/2021
O i 1
a
.pans°si°v33n�Maims ol
307.4-8 AST 03342021
�ZOZ Bernard, Amanda
0 �ldW 11 Tuthill Rd
Pavilion 720 s.f.
TRUSS A
TRUSS C
TRUSS C
TRUSS C
N
.p TRUSS C
r
X
w TRUSS C
C
TRUSS B
b
D TRUSS C
z
m TRUSS C
TRUSS C
TRUSS C
TRUSS C
TRUSS A
i' 24!-Cr 4
o,
0
0
-t5
'R 6x8 12
O 0
0 0
0
0 0
0
0
0
24'-0"
TRUSS A - 2 REQ' D
I:r
0
0
sx8 �2
-�5
0
0
24'-Q"
TRUSS B - 1 REQD
0
0
48 12
t5
24'-0"
TRUSS C - 8 REQ' D