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AST-0777-2023 . .Office Use Only ..' � ACCESSORY STRUCTURE Permit#: Ttc77—OO V -2K02_ `� PERMIT APPLICATION Town ofQeensbury Permit Fee: $ 1�,'D 742 Bay Road,Queensbury,NY 12804 Invoice#: (0` Z P:518-761-8256 www.cueensbury.net Flood Zone? Y Reviewed By Project Location: /v3 KjCt-1 7L 4cts C/ev ,'&t/P N Tax Map ID#: -� _ ' !/, ,'--- Subdivision Name: PROJECT INFORMATION: TYPE: Residential ❑ Commercial, Proposed Use: STRUCTURE: XX oathous with or w/o sundeck) ❑ Canopy ❑ Carport n Cell Tower ❑ Deck `_l lif In El Detached Garage (>300 s.f.) El Dock El Gazebo Gazebo ❑ Pavilion ❑ P a n `Li Porch E,R ' p ❑ 3-SeasonL8HRY / ion P�Go-ther:J� =° ❑ Shed <300 s.f. El Panels w/o rafter upgrades) �la�� o I ( ) ( pg ) TOWN ��, F C2i�z� �w��S�t,� IN t� ;D` SQUARE FOOTAGE OF STRUCTURE: - -- j 1st floor: � 2ndfloor: �7ui Total square feet: .. g Brief description of scope of project: 6046/Lk p�� eeie • Accessory Structure Application Revised June 2022 ADDITIONAL PROJECT INFORMATION: 1. Estimated Cost of Construction:$ v J�U.Uv 2. Are there any structures not shown on the plot plan? ❑ YES \NO Explain: 3. Are there any easements on the property? ❑ YES V10 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 If,for any reason,the building permit application is withdrawn, 30%of the fee is retained by the Town of Queensbury.After 1 year from the initial application date, 100%of the fee is retained. 3.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 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: PRINT NAME: SIGNATURE: DATE: /2-/6 e�di3 Accessory Structure Application Revised June 2022 , CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Applicant: , A / 1/('Ci�S ;516/1'4 'I Name(s): ' `-' IN I Mailing Address, S/ ,34 c2 4L/ rk✓e �° /o� � Z Cell Phone!. / %l.Q` L� n�L Land Line: .5L /#S��i i- Email:1,J�G� ,S'�� • Primary Owner(s): Name(s): 'CC' pp � ��, �,_� l / Mailing Address, /S/Z: �.� Jltil /alt fJ C /� 4 /� /v Cell Phone g/ g Land Line: Email: /�//mac l Gt ❑ 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): i � �1 y*E 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 fy5an4estions re arding this project: Cell Phone: Sl � � D3( an/d Lire: Email: L:WL Il1/11`q/ Accessory Structure Application Revised June 2022 • Contractor(s): Workers' Comp/ docyme tation must be submitted with this application Contractor Name(s): / S/� 7 ' Contractor Trade: )� - i°//G , f/ �S_ Mailing Address, C/S/Z: / ' 7�1//� ca- 1`TtVV-- V 2 /j Cell Phone: Land Line: —c���.- 7766 . Email: • Contractor(s): Wor ers' Corny doc mentation must be submitted with this application Contractor Name(s): /"�7-. i/Contractor Trade: er`A" Mailing Address, jS/Z / G / YJc Oee.,4,6 Cell Phone: .5 %) � Q �" . Land Line: Email: ----- • Contractor(s): Workers' Comp documentation must be submitted with this application Contractor Name(s): Z� ,/' 7 CC..�Contracor Trade: �/fitli �- Mailing Address, C/S/Z: ` _ - - /e0.-12 .r//s /c * . Cell Phone: / Land Line: .�/r'' 7? '-'7% ?% Email: J • Contractor(s): Workers' Comp documentation must be submitted with this,application Contractor Name(s): Contractor Trade: Mailing Address, C/S/Z: Cell Phone: Land Line: . Email: • Contractor(s): Workers' Comp documentation must be submitted with this application Contractor Name(s): Contractor Trade: Mailing Address, C/S/Z: Cell Phone: Land Line: Email: Accessory Structure Apoiication Revised lune 2022 10/10/23,1:10 PM Permit Details I Citizenserve YO FY—NEK Lake George STATE Park Commission KENNETH W. PARKER DAVE WICK Chairman Executive Director ��ll -�' 10/10/2023 Sinatra, Frank, Jr. &Laura ®Ec ®s 20;, 33 Sulgrave Rd 0 Scarsdale NY 10583 1�,� TOIL/ r Permit#: DWM23-000134 SAP �` !`(�'.t , !+„' I Parcel#: 227.9-1-4,Town of Queensbury """ _ Dear Mr. &Ms. Sinatra, 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, oe Thouin/ Deputy Permit Administrator cc: Town of Queensbury, Morgan Gazetos 227.9-1-4 AST-0777-2023 Sinatra 3r, Frank 105 Rockhurst Rd Boathouse w/sundeck 518 s.f. • 75 Fort George Road,P.O.Box 749,Lake George,NY 12845 1518.668.9347 Fax:518.217.2172 I www.lgpc.state.ny.us info@lgpc.state.ny.us https://www4.citizenserve.com/Admin/PermitController?Action=DisplayPermitDetail&SelectedTab=Permits&Permit ID=12244403&WorkOrder ID=876... 1/5 10/10/23,1:10 PM Permit Details I Citizenserve LGPC Permit Number YO K Lake George Issue Date DWM23-000134 STATE Park Commission 10/10/2023 Type of Permit PERMIT Expiration Date New Under the Environmental Conservation 10/10/2024 Law ElArticle 43, Title 1, 6NYCRR 646-1.1 © 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 El 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 El Article 43,Title 1, 6NYCRR 646-1.4 Recreational Use-New Recreational Use-Parasail ElArticle 43,Title 1, 6NYCRR 646-1.4 El Article 43,Title 1, 6NYCRR 646-1.4 Recreational Use-Seaplanes Recreational Use-Tour Boat EIArticle 43,Title 1, 43-0117 Operation of ferries and 111 Article 43,Title 1, 6NYCRR 646-4 Stormwater certain other boats, barges and vessels restricted. Management © 6 NYCRR Part 608 Water Quality Certification Permit Issued To Telephone Number Sinatra, Frank, Jr. &Laura Address of Permittee Email Address 33 Sulgrave Rd Scarsdale NY 10583 Contact Person (if not permittee) Telephone Number • Facility Name Facility Address Private Lakefront 105 Rockhurst Road County Town Parcel# Warren County Queensbury 227.9-1-4 AUTHORIZED ACTIVITY In-kind replacement of a pier and cribs on an existing U-shaped dock and construction of a new sundeck sized 37'x 14' x 15.5'(LxWxH)to be relocated outside of the setback 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 7 October 10, 2023 https://www4.citizenserve.com/Admin/PermitController?Action=DisplayPermitDetail&SelectedTab=Permits&Permit ID=12244403&WorkOrder ID=876... 2/5 10/10/23,1:10 PM Permit Details I Citizenserve 'i To the permittee: Please sign,fold,tape shut and return upon completion of the project. FOLD#2 Sinatra, Frank, Jr. &Laura 33 Sulgrave Rd Scarsdale NY 10583 Lake George Park Commission PO Box 749 Lake George NY 12845 • FOLD#1 Certification of Completion of Work Authorized by Permit#DWM23-000134 Issued on 10/10/2023 Parcel#227.9-1-4, ,Town of Queensbury Project: In-kind replacement of a pier and cribs on an existing U-shaped dock and construction of a new sundeck sized 37'x 14'x 15.5' (LxWxH)to be relocated outside of the setback in accordance with plans attached. The project authorized by the above referenced permit was completed on / / The dock was installed/constructed by X / / Owners Signature Date An inspection will be made once form is received.The permit must be kept active during construction. https://www4.citizenserve.com/Admin/PermitController?Action=DisplayPermitDetail&SelectedTab=Permits&Permit ID=12244403&WorkOrder ID=876... 5/5 LEGEND: z Ne CIRF denotes Capped Iron Rod Found PROJECT SITE SLOPES NOTE: CDti n EB denotes Electric Box THE ENTIRE PARCEL HAS SLOPES THAT w n FF denotes Finished Floor Elevation EXCEED 15%NTH THE EXCEPTION OF THE 0 J I- FP denotes Flog Pole UPPER 30 FT X 80 FT PARKING/SEPTIC • -.Asia: ' IPF denotes Iron Pipe Found AREA ALONG THE EASTERN PROPERTY LINE Z LIPF denotes Leaning Iron Pipe Found (FRONTAGE ALONG ROCKHURST ROAD) ,IQ-2 - N/F denotes Now or Formerly 2 N am NG denotes Notions) Grid Utility Pole w CCe NYT denotes New York Telephone Utility Pole - w g OHUL denotes Overhead Utility Pole ALO APPARENT Z u PIPF denotes Pinched Iron Pipe Found WASTEWATER ZO I- '� RP denotes Roof Peak Elevation SEEPAGE PR K RRSF denotes Roilrood Spike Found LANDS N/F OF '� Q �� UP denotes Utility Pole _ RONALD J. MILLER AND d. BENCHMARK; > - o. K KATHERINE F. MILLER DOCK SPIKE SET IN = ' BOOK 1226 OF DEEDS AT PAGE 88 uT¢1TY POLE NG 15/I w o (LOT 10 - MAP REFERENCE No. I) w.curs ELEYARON w 342.91 q‘a--,, N ALO 108 I:05 ROCKHURST Et gila CIRF w000 NG WW SYSTEM �- S=NF 10 0 6 (BARRAS51 (119.2 TO EDGE OF WATER) SHED a$ 15 /�\�'�11� LL ,..]N Bra S79'00'00"E - _ 108.60' , ,`RRSF�z�->+ B L,s' •rlC''`.'ST (n W Q=N LAKE 3•HIGN W000 NPE10 1 tir// .•�� 1 .1• P C W r ;A - I� . •1'1 I'/ LS'HI N •OD L:n '• • 2 n r ►�•.� ST(1CKA4E FE E ^ .-LI A w ..\•.•, G1 Z Q N I v' n�'3 r' / 1 , °- •MU y r I r, � I, 7''CZ :°.n�M O K RP�J65.11I F :Yr1.•t•. •�• /' wNew SunCeck GEORGE �� '. ---52 " I - IPIJ(5•HIG p; , t, _: ;:/� //J o3Tx14'x15.5' mn �� 1FP � T I I 1 _ �, < ., lO y /1rj W LLJ FQ 1 r L t�/ to (SANDY BAY) 4 W I i °� �o if,- A 03 1.1 �' ri Q °� 4„ \�fSSt uk' L T o o / / : 11'111x .\ ° r82'' ALO SHOE(T6N y2c REF(R N o; 1 Ig n ; III /SALO 102 c 1 I 1 "I A ; i PAR NG ROCKHURST G I.Y u 6rsu.2 U-slapea Do.(REW 1608) 8.71 •FT. T CI AREA I l' WW SYSTEM — 42.xa Ce o �e1a.P. � ('O TI -L N=) lI /IR'. IJ W Ov l^ �e , . I— y m oFr."_ 1 F CAlE�BTREf $ (n Q o}3 H • BOAT HOUSE `It 5•RICH i e . .�Y :j1 N 81 WITH DECK ROOF • I I$ r^ FENCE Q j .., 1 sA':.I I Q Ce O ro Z y r ..__ • �_' / / t \11~_`. . PT to=4 11-S54:73:'''til' 'M1r,�:.' ''''"1 W FZ 1.-- seioau -- -- .�- n �tI' I2�0 . ..�.'�;f{. - �' to ILO o rra WO ry") h '� (at5 H1cH) G.1". I< rn / ••..,. ) E h n I I n•n ,r- I TPI• O �''L'•`=z%r=`''.'-`''�'SOtI$ ANALYSISTEST PIT AND PERCOLATION 0 =OO 1a I.Fool Ov0OnnG 1 . a 20 ^ I I I I n' HE LOcrt • V1 TEST DATA a Y a Z 10.00 t 10.01 'INA EOL•.CK ' •NEE Ce SOIL TEST PITS WERE PERFORMED BY THE ENWRONMENTAL Z U o = n n n n n n 2.B l 1\ ,I' DESIGN PARTNERSHIP ON AUGUST 5,2021 THE RESULTS 0 f� O W o SwOacY Ea to E,000070Faa1 STIUON o,O ry TR h n n n 's s��j/ 'I PTII $ 0 Z 2' L •sp.con4Nan139 h 11 n \'('— ®' I n n r, O WERE AS FOLLOWS: a. ii5 N 3 Q„ llP� /, 5'tlG�1i�.CaO N.E IY/,\� n_° 1' ^� P1PF• MILL BE 0�3 c FL ,,.� `�� ° -b ° �. •• •. ° . ' 109.26' , o 0 3' TOPsoa w N79 OO'OO"W e s w 3'-24" LOAMY BROWN SAND REVISION DATE BY I (123't TO EDGE OF WATER) '1 24" TOP LAYER OF CRUSHED STONE. ASSUMED 01 RHIAO,Cola mW Pin IMlMC IF, .Ivb[H.la cpa.[xil 12/n/]pT1 tai (SEE MAP REFERENCE No.2. ALO APPARENT EXISTING SEEPAGE PIT LOCATION _ NOT FOUND IN 2021 BY EDP) NO SIGNS OF SEASONAL HIGH GROUNDWATER ONO.tc.aoo SEM nn°2/1e/2021 ri a 1 WASTEWATER TPY2 Iw.�P4xS To 1o.M /u/]o]l cw °O SEEPAGE PIT D-3' TOPSOIL L ENCHMARK.• 3'- 18' LOAMY BROWN SAND B DOUBLEHEO NAIL SET LANDS N/F OF 18' TOP LATER OF CRUSHED STONE. ASSUMED 1^ A EXISTING SEEPAGE PIT LOCATION i IN 24"HEMLOCK TREE PETER PAUL KRIHAK NO SIGNS OF SEASONAL HIGH GROUNDWATER SCALE: .. ELEVARON-337.7; BOOK 1121 OF DEEDS AT PAGE 229 MO. .1 _uo- r (LOT 8 - MAP REFERENCE No. 1) 0-5' TOPSOIL/ROOTS 1 —GO ° 5'- 18" LOAMY LIGHT BROWN SANG • .j. 18'-68'• DARK BROWN FINE SAND SHEET TITLE: ; NO SIGNS OF SEASONAL HIGH GROUNDWATER n GRAPHIC SCALE THE FOLLOWING INFILTRATION TESTS WERE PERFORMED BY EXISTING THE ENNkONMENTAI DESIGN PARTNERSHIP.: CONDITIONS m _ __— mimmonomommin _ — PTI11 - SOIL STABILIZATION RATE.5.5 MIN/INCH PTO-SOIL STABILIZATION RATE.6.2 MIN/INCH SHEET NO. K 20 15 10 5 0 20 40 00 (IN FEET) 2 1 INCH = 20 FT. ce Schedule A Permit#DWM23-000134 Page 5 of 7 thl• _`( fin^•,:n i Y� 0t 2 1J t a}, fl t p .1 , ; r--J 37 Roof y ,....:, _ hn i .. . ..c . : • ..,.. .. .•••••.„.: :. .,4....:0„sit.:::kl, s� � � II l'-')ti YJ 1.�-+ Roof Slip .„„ •... .. : : •••. •....: . . :.:• .,::: ::,,x.4,. ., _,Ea <y,t !,, + . . ,. .. . . ,. . • . . • • . , . .. ......„,,z?,..,,,, E... ...„.„......„.: ,,.. , ,,,•, •:.:,. :„..,:>,:.: . . . . „ • ,.,;.: :..::,;:%,,,.:.. . . ,___. ... a' . • • r,: i. Tom` e: • • • i I ,� _ ,ct____ I Ir°r o.; a dk. no. II.■t rrs r„cw►t 1 """"'c IMPERIAL PAPER&COLOR CORP. GLENS PALL*N.Y. Rec114...11•1.74 CeD1c./VP MULCT DRAWN Vi, APPROYED n. NO. TNACEIWI.,,Y ;✓m, DATE. ?..7-Ay PAONNIAL SCAL4 4.11... • NOr No. • Schedule A - Permit#DWM23-000134 Page 6 of 7 •:, • , 1....._____ . . . • ..t. _a . L . - ------- • - - • — - -' - ' - -..,- , , -•-:-.••••.., .....4-,..f — ----, ! 1 I . 1 : ! . ; t ; ! I ! 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