AST-0204-2022 ate . Office Use Only
' 3 l ACCESSORY STRUCTURE Permit#: PO O 2'Lf_
PERMIT APPLICATION C) O
Town of Queensbury Permit Fee:$
742 Bay Road,Queensbury,NY 12804� ,;,, ��] Invoice#: 1�2 I /�
P:518-761-8256 www.queensbury. e n !/ lood Zone? Y Reviewed By: II
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APR 20 2022 j
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Project Location: la .s all5 C/TOUR " t,,r� 12..goq
Tax Map ID#: Sc2-3 Li" 302—.8-2_—111 Subdivision Name:
PROJECT INFORMATION:� /
•
TYPE:. LIB' Residential ❑ Commercial, Proposed Use:
STRUCTURE:
❑ Boathouse (with or w/o sundeck) ❑ Canopy ❑ Carport ❑ Cell Tower IIKteck
❑ 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: 2-5 2
2nd floor: 24— i,
Total square feet: 2.S
2.
Brief description of scope of project: 1 9 Px 1 g r D'te ck a vec co/ic-r Tc rd
Accessory Structure Application Revised March 2022
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s):Mailing Address,Address, C/S/Z: J 2. So g,,,i cr. • Q,- ..sb-un ,+V Y 12Pay
Cell Phone: sib' 338'7721 Land Line: -c c — 1?93-2.8 23—
Email: LJssae
• Primary Owner(s):
Name(s): tilt rEco-w sf e _ _ i286
MailingAddress, C/S/Z: 12_ 5044�e,..z ti7
Cell Phone: 5 cP 73e'-9`72y Land Line: S'8 79Y-2 y s—
Email: to .-r-e sr-e @ roe-�lrv„w , e.o
.: 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
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction:$ 11000d 00
2. Are there any structures not shown on the plot plan? ❑ YES k NO Explain:
3. Are there any easements on the property? ❑ YES IV 1
DECLARATION:
1. I 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. I 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. I acknowledge that prior to occupying the facilities proposed I, or my agents, will obtain a certificate of
occupancy.
6. I 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:
X, :::
// c — DATE:
ul2 Z
Accessory Structure Application Revised March 2022
Deck and Roof Design checklist.
9eJ Is deck freestanding or attached
(j-C/S Footing
C r5Sono tubes sized for posts 4x4 8" 6xx6612---
/✓,// Big foot or footing for roof load
VS Proper attachment to post and footing shown
C1OProper flashing or waterproofing to structure shown
9{SAttachment to structure shown on plans
Galvanized or stainless steel bolts shown NO ZINC COATED
iteJHex headed bolts NO CARRIAGE BOLTS
avA Diagonal bracing shown for deck over 24"
Floor joists parallel to carrying beams
tIkj. Deck post to beam attachment shown
n//4 Over 30" requires handrail
N/i� Over 30" requires guards
t fiver 30" requires guards @ 34" to 38" in height and handrails @ 34"-38"
Revised 4/15/2021
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