Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
application
gir.@ ACCESSORY STRUCTURE IT APPI—_PERM LICAT 742 Bay Road,Queensbury,NY 12804 | P:518-761-8256 www.queensbury.net i Project Location:36!Clevendlale Raad yoCheverdaleNY.(SEPA oy NY Tax Map ID #:allo.[2 -/-5”4 Subdivision Name: _ CONTACT INFORMATION: icaAneah uke Willams -fa Wiltams Pet,Tne Mailing Address,C/S/Z:2)Ay 241,2 lererdale MV 12820 Cell Phone:(516 )_74/~2240 landline:(3/8)_GS@-3577 Email:WOWINSConstL hg thas |.Cor Prnan tees=Llacy Hathot, neal ees 444 Silum KE.)anbaste!”,A_/716 Cell Phone:j30/-DBL Land Line:DE \Gsb-94.89 Email:_¢.Aid rapt 9 tow) CO check if all work will be performed by homeowner only ©Contractor(s):Me documentation must be submitted with this application Contractor Name(s):Leeive[Mans 5Wo Williams Const.The Contractor Trade:anaesaam oP“ole AY 12827 Cell Phone:_(52 t-2/4 Land Line:_(57@_)450 ~ Email:_w Xm.‘cxskedab COM, **List all additional contractors on the back of this form .ArtiespenisBusinessName:Widhams_&Willams Desig ners Contact Name(s):Dan Wi/gon 2 Mailing Address,C/S/2:_509 Gea St,Ghas Zl Ie,NY 1286 Cell Phone:_()landline:_(<78 )778-4497 Email:_dan 6 wil//qmsandy)/fatsAesianers,C01. Contact Person for Building &Code Compliance:,Wane UY lams Cell Phone:(=f!Land Line:“(EH G50 -. Email:_LIG1J/N S6an3 1L.Com Accenor truce Aopieation Reve February 2019 *Contractors):Workers’Comp documentation must be submitted withthis applicationContractorName(s):_O06 Spring e/Contractor Trade:_Fayad a ato—(] Mailing Address,se losNop field Road Zale Lizcne My DEVOCellPhone:_(5/f")79/-FoGe2.Gand tine:(37?[Z Wo 2225Email;Spilelon cle fe Dyafoo,Ce ~*Contractor(s):Workers’Comp documentation must be submitted withthisapplicationContractorName(s):_Sahn Exh 3/'Q Contractor Trade:EieefYjcigr—7p Mailing Address,c/s/z:_70 Go SE Gina Zale WY JadaCellPhone:(S7F )7pm)land tine:{877 )2G7-05FEmails2.19€C772B inc Lia Com ©Contractor(s):Workers’mp documentation must be submitted with this applicationContractorName(s): Contractor Trade: Mailing Address,C/S/Z: Cell Phone:_()Land Line:_()Email: °Contractor(s):Workers’Comp documentation must be submitted with this applicationContractorName(s): Contractor Trade: Mailing Address,C/S/Z: Cell Phone:_()Land Line:_()Email: *Contractor(s):Workers’Comp documentation must be submitted with this applicationContractorName(s): Contractor Trade: Mailing Address,C/S/Z: CellPhone:(_)landline:_(_)Email: *Contractor(s):Workers’Comp documentation ‘must be submitted with this applicationContractorName(s): Contractor Trade: Mailing Address,C/s/z: CellPhone:(+)land Line:_()Email: ‘feewonysiracture Appetion joe PROJECT INFORMATION: TYPE:___Commercial _X_Residential WORK CLASS: __Deck,Open Porch __Solar Panels (w/o rafter upgrades)__Carport __Cell Tower ___Shed ___Pavilion,Pole Barn,Canopy ____Dock ___Gazebo _\ovetached Garage __Boathouse (with or w/o sundeck)__3-Season Porch ___Other (description: SQUARE FOOTAGE OF STRUCTURE: astfloor:_FZ2°floor: Total square feet:_570 ADDITIONALPROJECTINFORMATION:Estimated Cost of Construction:$,445 £00.001 2.If Commercial project,what is the proposed use: 3.Are there any structures not shown on the plot plan?YES (Explain: 4,Are there any easements on the property?ves =) DECLARATION: 1.1 acknowledge that no construction shall be commenced prior to issuance of a valid permit and will be completed within a 12 month period. 2.If thework is not completed by the 1 year expiration date the permit may be renewed,subject to fees and department approval. 3.\certify that the application,plans and supporting materials are a true and 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. 4.1 acknowledge that prior to occupying the facilities proposed |,or my agents,will obtain a certificate of ‘occupancy. 5.lalsounderstand that I/we are required to provide an as-built survey by alicensed land surveyor of allnewly constructed facilities prior to issuance of a certificate of occupancy. (have read and agree to the above: PRINT NAME:Ul A sianature:_//Jaane HM Lara — pate:2 J)!peane Accessory Strctre Appleton Revised Febery 2019,