AST-0311-2023 r
.,. Office Use Only
J ACCESSORY STRUCTURE Permit#: AST— 0
Town of(Queens bu PERMIT APPLICATION
ry Permit Fee: $ ��`•
742 Bay Road,Queensbury,NY 12804 Invoice#:
P:518-761-8256 www.gueensbury.net
Flood Zone? Y N Reviewed By:
Project Location: SAR3 VAC\ -kQ Q
Tax Map ID#: A Subdivision Name:
PROJECT INFORMATION:
TYPE: 'piResidential ❑ Commercial, Proposed Use:
STRUCTURE:
❑ Boathouse (with or w/o sundeck) ❑ Canopy ❑ Carport ❑ Cell Tower .2rDeck
❑ 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: .
2nd floor:
Total square feet:
Brief description of scope of project: r 4 ' n
Accessory Structure Application Revised June 2022
r
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction:
2. Are there any structures not shown on the plot plan? ❑ YES ❑ 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 If,for any reason,the building permit application is withdrawn, 30%of the fee is retained by the Town of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. 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:
SIGNATURE: DATE:
Accessory Structure Application Revised June 2022
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s): / CS itr
Mailing Address, C/S/Z: 1, ER x 0'ar
Cell Phone: Land. L'ne:
Email:
• Primary Owner(s):
Name(s):
Mailing Address, C/S/Z: lam' �R� cav�d �
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): c
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:
Cell Phone: —6c Land Line:
Email• _ inn , r. v
Accessory Structure Application Revised June 2022
f
Deck and Roof Desig, n c heck) ist
Is deck freestanding or attached
Footing
Sono tubes sized for posts 4x4 8" 6x612"
Big foot or footing for roof-load
' Proper attachment to post and footing shown
c - -
Proper flashing or waterproofing to structure shown
I Attachment to structure shown on plans
��Galvanized.or stainless steel bolts shown NO ZINC COATED
Hex headed bolts NO CARRIAGE BOLTS
nJ Diagonal bracing shown for deck over 24"
Floor joists parallel to carrying beams
r�l.) Deck post to beam attachment shown
Over 30" requires handrail
Qf-0Over 30" requires guards
Over 30" requires guards-@ 34" to 38" in height and handrails @ 34"-38"
Revised 4115!207.1
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