AST-0400-2021 Office Use Only
ACCESSORY STRUCTURE Permit#: A.S.T. - O - 2-021
Town of"Queensbury PERMIT APPLICATION Permit Fee:$
742`Bay Road,Queensbury,NY 11804 Invoice#:
P:518-761-8256 www.aueensbury.net Flood Zone? Y N Reviewed By:
Project`Location:
Tax Map ID#: U r2 Z� J / Subdivision Name:
PROJECT INFORMATION:
TYPE: 91 Residential ❑ Commercial, Proposed Use:
STRUCTURE:
❑ Boathouse(with or w/o sundeck) ❑ Canopy ❑ Carport ❑ Cell Tower ❑ Deck
❑ Detached Garage(>300 s.f.) ❑ Dock ❑ Gazebo ❑ Pavilion ❑ Pole Barn ® Porch ❑ Ramp
El Shed(<300 s.f.) ❑ Solar Panels(w/o rafter upgrades) ❑ 3-Season Porch ❑ Other:
SQUARE FOOTAGE OF STRUCTURE: C VIE
1st"floor: 337.5 D
end floor: MAY 2 ] 2021
Total square feet: 337.5 TOWN OF QUEENSBURY
BUILDING& CODES
Brief description of scope of project:
Building a covered, screened porch 12.5' X 31' (eave to eave) attached to the rear of an existing
home.
Accessory Structure Application Revised January 2021
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction:$ 30,000
'2. Are there any structures not shown on the plot plan? DYES 2 NO Explain:
3. Are there any easements on the property? ❑ YES IR NO
DECLARATION:
1. 1 acknowledge that no construction shall be commenced prior to the issuance of a valid permit and will be
completed within a 12 month period.Any changes to the approved plans prior to/during construction will require
the submittal of amended plans,additional reviews and re-approval.
2. IfJo.r any reason;the building,permit application is withdrawn;30516of the-fee is retained-by the ToWn of
Queensbury.After 1 year from the initial application date, 100%of the fee is retained.
3. Ifthework is not completed by the 1 year expiration date the permit may be renewed, subject to fees
and department-approval.
4: I certifythat the application, plans and supporting materials-are atrue and-a complete statementand/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.
5. 1" acknowledge that,prior,-to occupying-the facilities.proposed I, or my agents, will obtain a certificate of
occupancy:
6. 1 also understand that lAve are required to provide an as-built survey by a licensed land surveyor of all newly
constructed facilities prior to issuance of certificate of occupancy.
I have read and agree to the above:
PRINT NAME: Michael West and Rebecca West
SIGNATURE: f'` `� '� ' 1-c�' C,(�/ — DATE::
Accessory Structure Application Revised January 2021
-CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s): Michael.West and Rebecca West
Mailing Address, C/S/Z: 7 Kimberly Ln/Queensbury /NY/12804
Cell Phone: (518)338-6430 Land Line: none
Email: beckyx3l @aol.com
• Primary Owner(s):
Name(s): Same as above
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email:
❑ Check if'all work will be performed by property owner only
• Contractor(s): (List all additional contractors on the back of this form)
Contractor Name(s): Kenneth Coons DBA KJC Construction
_Contractor Trade: General Contractor
Mailing Address, C/S/Z: 5 Cedar Run/Gansevoort/NY/12831
Cell Phone: (518)361-2997 Land Line: (518)745-5550
Email: kicconstr@aol.com
**Workers'Comp documentation must be submitted with this application**
• Architect(s)/Engineeds):
Business Name: Concepts&Designs/Building Design Consultants and reviewed by G. Peter Jensen
Contact.Name(s): -Mike'ManeyorG..Peter Jensen
Mailing Address, C/S/Z: P.Jensen 17 West Rd;South Glens Falls, NY 12803
Cell Phone: (518)744-8245 M Maney Land Line: (518)745-7612 M. Maney;
P.Jensen(519)798-3859
Email: maneymi@gmail.com
Contact Person for any questions regarding this project: Rebecca West
Cell Phone: (518)338-6430 Land Line: none
Email: beckyx3l@aol.com
Accessory Structure Application Revised January 2021
Deck and Roof Design checklist
T1�5 Is deck freestanding ((a-t�=tiached
Footing
_Sono tubes sized for posts 4x4 8" 6x612
Big foot or footing for roof load
19Proper attachment to post and footing shown
AProper flashing or waterproofing to structure shown
MAttachment to structure shown on plans
-LI-j Galvanized or stainless steel bolts shown NO ZINC COATED ��`�
Hex headed bolts NO CARRIAGE BOLTS
Diagonal bracing shown for deck over 24"
Floor joists parallel to carrying beams ~-Fk (7561 ram.
q►tG Deck post to beam attachment shown
Over 30" requires handrail
Over 30" requires guards _
MAOver 30" requires guards @ 34" to 38" in height and handrails @ 34"-38"
D
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MAY 2 7 2021
TOWN OF QUEENSBURY
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