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application207.15-/-}OFFICE TAX MAP NO. FEE PAID, onsen ACCESSOR Use this application for any structure other than the PrinciNotlimitedto:garage,shed,greenhouse,entitled Accessory Structures-Sheds/Fences. ‘A PERMIT MUST BE OBTAINED BEFORE WORKISSUANCEOFAVALIDPERMIT.NO INSPECTIO}RECEIVED A VALID BUILDING PERMIT. owner:TeEiy T.Dailey aAppress:14 WY,St Ext ECEIVEateStampOCT18200 TOWN OF QUEENSEAPPEFORTIONSETON ipal Structure (house)to include,butdock,deck,etc.Refer to Informational Brochure No.3 BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORENSWILLBEMADEUNTILTHEAPPLICANTHAS. wstaureneunoer:Je Grey V-Qai ky ADDRESS: prone nos,18)743-og9s°PHONE Nos. LOCATION OF PROPERTY:_S@nie_‘SUBDIVISION NAME: LOCATION OF PROPOSED CONSTRUCTION ANDIOR INSTALLATION:Gane- ESTIMATED COST OF CONSTRUCTION: IF YES,PLEASE LIST: $15,000 any OTHER ACCESSORY STRUCTURES ON PROPERTY? CONTACT PERSON FOR BUILDING &CODES COMPLIANCE:PHONE: PROPOSED CONSTRUCTION 1"FLOOR 80.FT. 2°FLOOR, 80.FT. PROPOSED HEIGHT FT.&IN. TOTAL, 8a.FT. OPEN PORCH DECK 3 SEASON,COVERED OR ENCLOSED PORCH? BOATHOUSE BOATHOUSE WITH SUNDECK Dock ‘SHED POLE BARN XC DETACHED GARAGE (NO.OF CARS:2-4 Bilo OTHER ACCESSORY STRUCTURE: “CONSIDERED FLOOR AREA &MUST COMPLY WITH FAR [FLOOR AREA RATIO]REQUIREMENTS IF THE‘STRUCTURE IS LOCATED IN THE WATERFRONT RESIDENTIAL ZONE, To the best of my knowled and specifications ige,the statements contained in the application,together with the planssubmitted,are a true and complete statement of all proposed work to be doneonthedescribedpremisesandthatallprovisionsoftheBuildingCodes,the Zoning Ordinance.and all other laws pertaining to the proposed work shall be complied with,whether specified ornoted,and that such work is authorized by the owner.Further,it is understood that lAve shallsubmitpriortoaCertificateofOccupaneyorCibytheZoningAdministratororDirectorofBuil surveyor,drawn to scale,showing actual location of all newconstruction. [have read any rove. Signed Dated: iding and Code ‘ertificate of Compliance being issued,as requesteds,an As-Built Survey by a licensed ‘QUESTIONS 7 CALL 761-8256 OR EMAIT des ensbury.net VISIT OUR WEBSITE FOR MORE INFORMATION, www.queensbury.net ee Town of Queensbury +Community Development Office +742 Bay Road,Queensbury,NY 12804 BILGL 11-05