AST-0108-2023 z Office Use Only ^
ACCESSORY STRUCTURE Permit#: S►— 0 IQ8 20 2-2,
PERMIT APPLICATION Permit Fee: $
742 Bay Road,Queensbury,NY 12804 Invoice#:
P:518-761-8256 www.queensbury.net Flood Zone? Y Reviewed
Project Location: R-,C (0 z s t t
Tax Map ID#: - 3 - 1 — Subdivision Name: IA14
PROJECT INFORMATION: jECEOVIE
TYPE: L Residential El Commercial, Proposed Use:
MAR 15 2023
STRUCTURE: TOWN OF QUEENSBURY
BUILDING& CODES
▪ Boathouse(with or w/o sundeck) ❑ Canopy ❑ Carport ❑ Cell Tower 0 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:
2nd floor: l Z
Total square feet:
Brief description of scope of project: Re.10 4ck 0-2-0 L /C.-
4.,1( A_c_c Gaesre.r Lt
o re 4- U
Accessory Structure Application Revised June 2022
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction: $ /' / I S 1
2. Are there any structures not shown on the plot plan? 0 YES NO Explain:
3. Are there any easements on the property? ❑ YES NO
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 If,for any reason,the building permit application is withdrawn, 30%of the fee is retained by the Town of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 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. I acknowledge that prior to occupying the facilities proposed I, or my agents, will obtain a certificate of
occOpancyd'n
Vkk
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:
PRINT NAME: ?'k r3cv.
SIGNATURE: DATE: 3 / 9/
Accessory Structure Application Revised June 2022
( ! ---{ I I ---_ I —I 1r —I----1 - - -1 1 1 I I I 1 I_ I_-�
1
- �__ _ -0108-2023 _ -�--�-i
+ -1
-i
- -
I �I fJr�
� 1 - p Ca , { chard & Lisa
2962 State Rte 9L (
1
i L'e'v- 432 s.f. ( _ ( r
- - - -,'-- , (9Wry OuEEkS3 I R-Y -- __ sundeck
Boathouse &' ' - '''.1'" cl:--2
— - —! ' I _ 1 tatc. I
'. I i v-' 'III , ,r
...›,gi- 2.-1-- . ____ ___
.-i- i .,/ , ,
' I I I Fir -:z- l# _ , ,
---e) j. V Jew G _— — ,_ , Y
77 __ _ 1 1 1 1 MiligillailliP gill I I " P' . ,
= It 1 I
.
'�dr��I SDrt �I � , _. I I , "' ler ( �c _� =c i-S '_ - � , —
�T ' �, fL__1 —
I Ii . ' I
L,i , .. / A -
• - .11111 ® DE. '
_ _ + �'- a� N�sa
I' .,r ��■ w �m :as d our mit d e o ,co7• ce
� I FA, .af+rs ar-'in 111 -s�i 1I-
-
WI.-! 4 1 / 11111 Ail i ' 11111
16
®� I Ell ® YO
p ,
' 4 III" 1.)( INiniiiiffiii MINIMONIMIIPMITAI /I . i' .
- � I it♦�����1♦ 7• 'r
. ' -\ 4' v;i,-;-\T I ' 1 . i --I owasomme _Fimmison 'WE _ / 0 .. ___ ______2 L
i I , I ' -I : -. FIElatilimum edroxime _ii . a Al_
, .._. , ,
0.4mins ----7:. (if i 1,, 6. ,
ra ,4,.. 1
m �- 11/-� �) , ---
1, 1 . 1 1
5
aiI En i - iftillenh
i _ ` ,- i
‘ ill--. 1„.../._ , ri b..._r-- ---.IIISAatiOir, 6 c):_.
._Ve.GC4s__L
F (3) * ›' _ir..:[-L__------cr-__)--C::).-ci,,A 11.._1: i_._,ri“.7.___r__r..,_. __J\ ___\_Ii*-'7.--17-4.---i---T.. 7.______..,...._.„_.__y_ii!
ill
•
--r -- i--- . - -- ----i- - --------i- .1 ---k--7----- - - 7'- ,
�' 4 HH- i'ui ----I---
I1 IIILi -
/ 0 1 c(
\,:- ,P---
, ,,F\
-5 A
Ql-
,. r.
\-•2 1:
, ..
. .,3. :.
. [ , „ ;
..4; I D .0 J.4r
---td Pi- i u:‘
V
1 i,se, ,
i
1,
1
—•_.--,L-:_.: ,..,ft-c-1;). i
• ,
J
...V14 r h vmil ,
____ i
7 0
F----_, 5-\_,e.p
' 1
. ,
, \ '
-- ,
N.Y, 511:17-4: 1-/hati-Av.iiy 7- L
___ ______
!
, Schedule A -
'Permit#DWM22-00012
_ :Page 4 of 6
-----_ _-__ ___ _ __ __. . _
10/14/22, 10:52 AM Permit List I Citizenserve
YNE Lake George
STATE Park Commission
KENNETH W. PARKER DAVE WICK
Chairman Executive Director
10/14/2022
Cadena, Richard&Lisa
2962 State Rte 9L
Lake George NY 12845
Permit#: DWM22-000123 dock mod, cribs
Parcel#: 239.20-1-9,Town of Queensbury
Dear Mr. & Ms. Cadena,
Enclosed is your permit which was issued in accordance with the applicable provisions of the Park Commission's rules
and regulations(6 NYCRR 645&646)and the Environmental Conservation Law. Please review the general and special
conditions included in the permit;these are intended to minimize any environmental disturbance associated with the
authorized activity.
Please note that it is the responsibility of the permittee and the permittee's agent to comply with all permit conditions.
Further,the permit is valid only for the activity expressly authorized.Work beyond the scope of the permit shall be
considered as work without a permit.The notice enclosed with the permit must be displayed in a conspicuous place near
the project site during the entire period of construction and must be suitable protected from the elements.Any failure to
comply with the terms of the permit may be treated as a violation of the Environmental Conservation Law. Questions
regarding this permit should be directed to the undersigned.
Should your plans change,you must contact this office to determine whether a modification to the permit is required
prior to initiating construction. Please note the expiration date of the permit. If further time is required to complete the
project,you must request renewal of the permit prior to this date.Your interest in maintaining the environmental quality of
Lake George is greatly appreciated by the Commission.
Sincerely,
Joe Thouin
Deputy Permit Administrator
cc: Town of Queensbury, Morgan Gazetos
75 Fort George Road,RO.Box 749,Lake George,NY 12845 1518.668.9347 Fax:518.668.5001 I www.lgpc.state.ny.us info@Igpc.state.ny.us
httpsJ/www4.citizenserve.com/Admin/PermitController?Action=ListPermits&WorkOrder ID=860720598,ciDisplay=null&getPrint=true
1/7
LGPC Permit Number NEW Lake George Issue Date
DWM22-000123 r STTATE Park Commission 10/14/2022
Type of Permit PERMIT Expiration Date
Modification Under the Environmental Conservation 10/14/2023
Law
U Article 43,Title 1, 6NYCRR 646-1.1 1:1
Article 15,Title 5, 6NYCRR 608.5 Excavation and
Construction and Modification of Wharfs Placement of Fill in Navigable Waters
❑ Article 43,Title 1, 6NYCRR 646-1.1 ❑ Article 43,Title 1, 6NYCRR 646-1.2
Placement of Moorings Operation/Modification of Class A Marina
EiArticle 43,Title 1, 6NYCRR 646-1.4 ❑ Article 43, Title 1, 6NYCRR 646-1.4
Recreational Use- New Recreational Use- Parasail
❑ Article 43, Title 1, 6NYCRR 646-1.4 ❑ Article 43, Title 1, 6NYCRR 646-1.4
Recreational Use-Seaplanes Recreational Use-Tour Boat
ElArticle 43,Title 1,43-0117 Operation of ferries and Article 43,Title 1, 6NYCRR 646-4 Stormwater
certain other boats, barges and vessels restricted. Management
U6 NYCRR Part 608
Water Quality Certification
Permit Issued To Telephone Number
Cadena, Richard& Lisa 512-280-0384
Address of Permiftee Email Address
2962 State Rte 9L richard-
Lake George NY 12845 cadena@att.net
Contact Person (if not permittee) Telephone Number
Facility Name Facility Address
Private Lakefront 2962 State Route 9L
County Town Parcel#
Warren County Queensbury 239.20-1-9
AUTHORIZED ACTIVITY
In kind replacement of dock and boathouse, including cribs, in accordance with plans attached.
By the acceptance of this permit,the permittee agrees that the permit is contingent upon strict compliance with the
Environmental Conservation Law,the Navigation law, all applicable regulations,and the General and Special Conditions
included as part of this permit.
Joe Thouin
Deputy Permit Administrator
Lake George Park Commission, P.O. Box 749, Lake George, NY 12845 1518.668.9347
Authorized Signature Date
Page 1 of 6
October 14, 2022
https://www4.citizenserve.com/Admin/PermitController?Action=ListPermits&WorkOrder ID=86072059&ciDisplay=null&getPrint=true 2/7
i;ric�i i�.ac ruw remit LIs I uszenserve
NEW YORK
STATE OF
OPPORTUNITY_
LAKE GEORGE PARK COMMISSION
NOTICE: A permit has been issued for wharf repair,
modification or construction at this site. For further
information, contact the Lake George Park Commission at
PO Box 749, Lake George NY, 12845, 518-668-9347
Permit ID: DWM22-000123
Permittee: Cadena, Richard & Lisa
Expiration Date of Authorization: 10/14/2023
This notice must be posted in a conspicuous place &protected from the elements during the period of construction.
httpsJ/www4.citizenserve.com/Admin/PermitController?Action=ListPermits&WorkOrder ID=86072059&ciDisplay=null&getPrint--true 5/7