Loading...
applicationOffice Use Only ACCESSORY STRUCTURE Permit :_AST-0245PERMITAPPLICATION Permit Fee:$_4>* d,Queensbury,NY 12804 518-761-8256 Invoice #:__2.9 Project Location:226 Queensbrny Ave. Tax Map ID#;323.6-l(-|3+\Subdivision Name: CONTACT INFORMATION:naeKen Sahel Mailing Address,C/S/2:204 Queensbury Ave Queenshury,WF 12 B09 Cell Phone:(S78)79)3651 Land Line:_(MZEmail:KenaetSchoi[(@Gnra:}-com «Primary Owner(s): Name(s):Same ns above Mailing Address,C/S/Z:RECEIVER Cell Phone:_()land Line:(1)1 I] Email:(UE SUN 03 onan TT]Ty CO Check if all work will be performed by homeowner ©Contractor(s):Workers’Comp documentation must be submitted with this application Contractor Name(s):__Garden Time Contractor Trade: Mailing Address,C/S/Z:_b5 2 Quaker RA Cell Phone:_()landline:(578 )293-8555 Email: *#List all additional contractors on the back of this form ©Architect(s)/Engineer(s): Business Name:__[Lobect R.Desmatais TR PE Contact Name(s): Mailing Address,C/S/Z:14/0 Wewton Yd,Lancaster PY /76Q3 Cell Phone:_()Land Line:_() Email: Contact Person for Building &Code Compliance: Cell Phone:_()Land Line: Email:, Accessry Structure Appleton evsed February 2019, otPROJECT INFORMATION: TYPE:Commercial X<_Residential WORK CLASS: __Deck,Open Porch __Solar Panels (w/o rafter upgrades)carport __cell Tower Ashea/rleed on level —__Pavilion,Pole Barn,Canopy __Dock __Gazebo Gearel sucthce __Detached Garage ___Boathouse (with or w/o sundeck)__3-Season Porch ___Other (description: SQUARE FOOTAGE OF STRUCTURE: Ast floor:_2*/O 2"floor: Total square feet:_2YO. ADDITIONALPROJECTINFORMATION:2600,2° 2.If Commercial project,what is the proposed u: 1.Estimated Cost of Constructior 3.Are there any structures not shown on the plot plan?YES CNO>Explain: 4,Are there any easements on the property?YES 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.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. 5.lalso understand that IAve are required to provide an as-built survey by alicensed land surveyor of all newly constructed facilities prior to issuance of acertificate of occupancy. have read and agree to the above: €Scholl SIGNATURE:ZA Y DAT PRINT NAME:shrbeeo Accessory Struct Appeation Reve February 2019,