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application
Office Use Only ACCESSORY STRUCTURE it #_AST --PERMIT APPLICATION Permit a_i She town Ogee tree.-742 Bay Road,Queensbury,NY 12804 Permit Fee:s45- P:518-761-8256 www.queensbury.net Invoice #:_2529 Project Location:733 Ridge aL TaxMapID#:__2-7 7.6 -/-96 20,Subdivision Hons CONTACT INFORMATION: ©Applicant: Name(s):San Le Benne Mailing Address,C/S/2:733 Elye Lf Buconsbawy $f.(260: Cell Phone:_($28_)77/-1708 Land Line:_()2¢le=10972— Email: +Primary Owner(s): Name(s):Dan ay Anel Ppmele Bona Tb Mailing Address,C/S/2:723 Bilge el Qucenshaey Wi,12607 Cell Phone:(578 _)74-7092 land line:(S7&)797/-4/728 Email:Beez 2e 2VSZ@OYHhvO Lam [Check if all work will be performed by homeowner only *Contractor(s):Workers’Comp documentation must be submitted with this application Contractor Name(s): Contractor Trade: Mailing Address,C/S/Z: Cell Phone:_()Land Line:_() Email: **List all additional contractors on the back of this form ©Architect(s)/Engineer(s): Business Name: Contact Name(s): Mailing Address,C/S/Z: Cell Phone:_().Land Line:_() Email: Contact Person for Building &Code Compliance: Danny Beame7CellPhone:(S7&_)29%~709z land Line:(S28)77/-/70€ Email:Aerne?iAsz@ yahoo.Con Accessory Structure Application ese Febraary 2019, PROJECT INFORMATION: TYPE:____Commercial residential WORK CLASS: _Deck,Open Porch ___Solar Panels (w/o rafter upgrades)__Carport __Cell Tower Shed ___Pavilion,Pole Barn,Canopy __Dock __Gazebo __Detached Garage __Boathouse (with or w/o sundeck)_3-Season Porch _Other (description:) SQUARE FOOTAGE OF STRUCTURE: 1st floor: 2"floor: Total square feet:_(72 59 fr ADDITIONAL PROJECT INFORMATION: 1.Estimated Cost of Construction:$ 2.If Commercial project,what is the proposed use: 3,Are there any structures not shown on the plot plan?YES Do Explain: 4.Are there any easements on the property?YES NOT DECLARATION: 1,Lacknowledge that no construction shall be commenced prior to issuance of a valid permit and will be completed within a 12 month period. 2.Ifthework is not completed by the 1 year expiration date the permit may be renewed,subject to fees and department approval 3.I 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.|acknowledge that prior to occupying the facilities proposed |,or my agents,will obtain a certificate of occupancy. lalso understand that I/we are required to provide an as-built survey by licensed land surveyor of all newly constructed facilities prior to issuance of acertificate of occupancy, Ihave read and agree to the above: pate:_Y43/2020 Accessory Structure Appiation aveedFetrury 2019,