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AST-0452-2022 2 Office Use Only ACCESSORY STRUCTURE Permit#: !A 'd� S-Z `ZD2Z PERMIT APPLICATION Town ofQucensbury Permit Fee:$ 742 Bay Road,Queensbury,NY 12 0 E 9 1/ 5Invoice#: P:518-761-8256 www. ueensbu � t JUL ' € `�l Flood Zone? Y U Reviewed By: U, -] LJ TOVVNI0 F QUEE,INgBURY BUILDING 8 Project Location: 80 Montray Roa -- ------- Tax Map ID#: 296.14-1-8 Subdivision Name: PROJECT INFORMATION: TYPE: IN 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: 12 Ft.X 12 Ft. 2nd floor: Total square feet: 144 Ft. Brief description of scope of project: To build a 12 ft X 12 ft Gazebo, as a permanent structure with a roof and open sides. Accessory Structure Application Revised March 2022 ADDITIONAL PROJECT INFORMATION: 1. Estimated Cost of Construction:$ 2200.00 2. Are there any structures not shown on the plot plan? ❑ YES IN 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 If,for any reason,the building permit application is withdrawn,30%of the fee is retained by the Town of Queensbury.After 1 year from the initial application date, 100%of the fee is retained. 3. 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: Debbie Lamoy SIGNATURE: / o DATE: j3 �— Accessory Structure Application Revised March 2022 CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Applicant: Name(s): Debbie Lamoy Mailing Address, C/S/Z: 80 Montray Road, Queensbury NY 12804 Cell Phone: 518-903-5829 Land Line: None Email: adk142@yahoo.com Primary Owner(s): Name(s): Keith Davis,Debbie Lamoy Mailing Address, C/S/Z: 80 Montray Road, Queensbury NY 12804 Cell Phone: 518-903-5829 Land Line: None Email: adkl42@yahoo.com ® 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** • Arch itect(s)/Engi nee r(s): Business Name: Contact Name(s): Mailing Address, C/S/Z: Cell Phone: Land Line: Email Contact Person for any questions regarding this project: Keith Davis Cell Phone: 518-335-9342 Land Line: Email Kadsl967@yahoo.com Accessory Structure Application Revised March 2022 Deck and Roof Design checklist Is deck freestanding or attached 4�� Footing USono tubes sized for posts 4x4 8" 6x6 12" AA Big foot or footing for roof load WProper attachment to post and footing shown OA 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" �J fa Floor joists parallel to carrying beams V Deck post to beam attachment shown r-J 6 Over 30" requires handrail *1 Over 30" requires guards AOver 30" requires guards @ 34" to 38" in height and handrails @ 34"-38" Revised 4/15/2021 z ' H TM SUPPLY AND SERVICE ............... . . ........ .......... .......... m7/4 i/)!., c.................. . . ................ .............. 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Gazebo http://www.vertex42-com/WordTemplates/printable-graph-paper.html ©2014 Vertex42 LLC s JUL 18 2022 � TOWN OF QUEENSLJRY BUILDING&CODES � a s 296.14-1-8 AST-0452-2022 Debbie Lamoy/Keith Davis 80 Montray Road 144 sq. ft. Gazebo