AST-0322-2022 Office Use Only
t /
ACCESSORY STRUCTURE Permit#:
Town ofQueensbury PER TIPT p rmit Fee:$ IV as
742 Bay Road,Queensbury,NY 12804 �/ 1 voice#: 7 v S
P:518-761-8256 www.gueensbury.net MAY 2 4 2022
ood Zone? Y N Reviewed By:
TOWN OF QUEENSBURY
BUILDING&CODES
Project Location: S 1't 00 �& kAf('-A&rQ
Tax Map ID M a 33 Subdivision Name: NIA
PROJECT INFORMATION:
TYPE: [9 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.) ❑ Solar Panels(w/o rafter upgrades) ❑ 3-Season Porch ❑ Other:
SQUARE FOOTAGE OF STRUCTURE:
1st floor:
2"d floor:
Total square feet:
Brief description of scope of project: 1 aC F 4 4e (
-3K--
e1 e V eC C !' CL
Accessory Structure Application Revised March 2022
ADDITONAL PROJECT INFORMATION:
1. Estimated Cost of Construction:$ .5-00 0 G
2. Are there any structures not shown on the plot plan? ❑ YES NO Explain:
3. Are there any easements on the property? KYES
1 e `lwr� rJ�T� kuJ
l� siine. o'� Gl r c a-e(( a of v e r--* s vM r U
P6o, e gtZ a �CkAwke � �s s�-� i s .50 �DEC TMN:
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 If,for any reason,the building permit application is withdrawn,30%of the fee is retained by the Town of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 atrue 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: (I
SIGNATURE: T DATE: d��
Accessory Structure Application Revised March 2022
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s):
Mailing Address, C/S/Z: 5� t�a�f .C��,rj-
Cell Phone: Land Line: IV IA /
Email: V,►m-� II
, ���e��Oo-4 C'uu xvle r. C�a�
• Primary Owner(s):
Name(s): V1 1 Vqn�e�;VJCAJ i CN1v,��ae ,,
Mailing Address, C/S/Z: ,�(Q h �,�„ �oLk,r-� eev►s�u &r Ut-�Zs0
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):
Contractor Trade:
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email
"Workers' Comp documentation must be submitted with this application"
• Architect(s)/Engineer(s):
Business Name:
Contact Name(s):
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 March 2022
Deck and Roof Design checklist
Is deck freestanding o attache
ootin.
!�- Sono tubes sized for posts 4 x 4 8" x6 12'
Big foot or footing for roof load
�161�proper attachment to post and footing shown
utj� Proper flashing or waterproofing to structure shown
-A Attachment to structure shown on plans
Galvanized or stainless steel bolts shown NO ZINC COATED
_15Hex headed bolts NO CARRIAGE BOLTS
Diagonal bracing shown for deck over 24"
01- Floor joists parallel to carrying beams
1�iDeck post to beam attachment shown
Over 30" requires handrail
t—
Over 30" requires guards
G�ver 30" requires guards @ 34" to 38" in height and handrails @ 34"-38"
Revised 4/15/2021
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