applicationPorch,Deck,Dock,or Boathouse Permit Application
Town of Queensbury ~Dept of Community Development,742 Bay Road,Queensbury,NY
(518)761-8256
A permit must be obtained before beginning construction.No Permit File No.
inspection will be made until applicant has received a valid Fee Paid §building permit.All applicants’spaces on this application must be :=>completed and must appear on the application form.Reviewed By:
Applicant:FRavk DeNagdo Owner:Lite)¢Delha Sel kow&<Address:Address:Phe FELD fueQRS2wySoyWETNy.Ay 1OFGY
Phone #(519)Cre -_3 22 Phone #(S45)Fi -_S2¢9
Email Address:Email Address:
Person Responsible for Supervision of Work as Regards to Building Codes:
NamefileK De Nao Address:£Y SviThec bt-Phone 5%$C2S~OPS hay
Property Location:Lot Number:/House Number (G0 /_Cayce Fapkes,
Subdivision Name:Tax Map Number:226 /S=/-5—
Estimated Market Value of Construction:$#/D.GC.
Q Porch
a Deck
Q Dock
PR Boathouse
Other work (describe
Size of structure tobe built FAG—square feet
Submit along with this applicatior
1.Two plot plans drawn to scale,preferably using a survey map.Indicate proposed
structure showing setback dimensions from all property lines.Show location of
water supply and location and configuration of septic disposal area.
2.Two sets of structural drawings.Indicate size of posts or studs,floor joists,
decking or flooring material to be used.Show howthe porch or deck will be
fastened to the building.If a roof will be constructed,indicate the size of posts or
studs,roof rafter spacing and span.Indicate type of roof:sloped,flat,shed,or
other.Indicate the type of material being used for the roof.
Declaration:please sign below after you have carefully read the statement:
To the best of my knowledge the statements contained in this application,together with the plans and
specifications submitted,are a true and complete statement of all proposed work to be done on the
described premises and that all provisions of the Building Code,the Zoning Ordinance and all other laws
pertaining to the proposed work shall be complied with,whether specified or noted,and that such work is
authorized by the owner.
Applicant's signature:Date:_[-3/1-S
LASuellemingway'Building Permit FORMSWPorch Porch Pemnitdoc 8/13/02 revised per DIL