AST-0176-2023 J S
Office Use Only
ACCESSORY STRUCTURE Permit#: T\S\
Town ofQucensbuty PERMIT APPLICATION Permit Fee:$
742 Bay Road,Queensbury,NY 12804 Invoice#: LQ
P:518-761-8256 www.gueensbury.net
Flood Zone? Y bN Reviewed B�
Project Location: D3-1 Q DD-2(' S IP—(Cvl Lf) PWE
Tax Map ID#: �- l g' Z ^2 Subdivision Name: tPR
E
PROJECT INFORMATION: 202
;
TYPE: L Residential ❑ Commercial,Proposed Use: n\,1 IN of QU =�"SVLJ (
13UiLDI i _T CODES
STRUCTURE:
❑ Boathouse(with or w/o sundeck) ❑ Canopy ❑ Carport ❑ Cell Tower Ly'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: 31?N'4
2nd floor:
Total square feet: 328
Brief description of scope of project: L�U dec L c,-4o-� d Ac, a J- O'r
Accessory Structure Application Revised June 2022
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction:$ En"
'NO Are there any structures not shown on the plot plan? El YES EJ NO Explain:
3. Are there any easements on the property? ❑ YES E� 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 If,for any reason,the building permit application is withdrawn,30%of the fee is retained by the Town of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: IYIWrT
SIGNATURE: '/ -"' �/ \ DATE:
Accessory Structure Application Revised June 2022
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s):
Mailing Address, C/S/Z: a31 p -ec S�sa cmxcAn Orr L
Cell Phone: f-15%R-S3SS- 3R'FL4 Land Line:
Email: CED MA i 1 .CGrYI
Primary Owner(s):
IVame(s): `\Act-s-T c,,-AA�jrcr.'c�� �C7l�JhnA�)
Mailing Address, C/S/Z: a-3n y pip-e-C 5 htcA n ! ?
Cell Phone:S%2. 53�3 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 June 2022
Deck and Roof Design checklist
",
Is deck freestanding o attached
Footing
Sono tubes sized for posts 44 8"(6x6:1:2-)
4kffig foot or footing for roof load
Proper attachment to post and footing shown
Proper flashing or waterproofing to structure shown
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" i
Floor joists parallel to carrying beams
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"
l
Revised 4/1512021:,.,_
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TOWN OF QUEENSBURY
y0 BUILDING DEPARTMENT
Based on our limited examination,compli ce-T01J . ' C''-
cc�e with our comments shall not be construed as [";L}� _�r,'•��: 1.C4- -..�?; _,_,.
indicating the plans and specifications are4n—�� -
i full compliance with the Building Codes of
fl New York State. 0
10
TOWN OF QUEENSBURY
BUILDING & CODS EPT.
ReviewedBY:'
302.18-2-2.2 AST-0176-2023 Dates ?-
Bowman, Matt & Brandy
j 237 Sherman Ave
Deck 384 s.f. ;
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