AST-0170-2022 Office Use Only
ACCESSORY STRUCTURE Permit#:AST-0170-2022
Town ofQyeen b ry PERMIT APPLICATION permit Fee:$85.00
742 Bay Road,Queensbury,NY 12804 Invoice#: 4782
P:518-761-8256 www.aueensburV.net Flood Zone? Y N Reviewed By:
Project Location: 191 Farr Lane Queensbury, NY 12804
Tax Map ID#: 295.20-1 -4.17 Subdivision Name: Indian Ridge
PROJECT INFORMATION:
TYPE: ® 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
8 Shed (<300 s.f.) ❑ Solar Panels(w/o rafter upgrades) ❑ 3-Season Porch ❑ Other:
SQUARE FOOTAGE OF STRUCTURE:
1st floor: 140 J
end floor: 0 APR 0 8 2022
Total square feet: 140 TOWN CF QUEENSSURY
ILOING& COOLS
Brief description of scope of project: Replacement of existing shed structure,
in situ, with a new, prefabricated shed, from Garden Time
Accessory Structure Application Revised March 2022
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction: $
7500
Existing shed is not shown
2. Are there any structures not shown on the plot plan? ® YES ❑ NO Explain:
3. Are there any easements on the property? ❑ YES ® NO
DECLAMATION:
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. If,for any reason,the building permit application is withdrawn, 30%of the fee is retained by the Town of
Queensbury.After 1 year from the initial application date, 100%of the fee is retained.
3. If thework is not completed by the 1 year expiration date the permit may be renewed, subject to fees
and department approval.
4. 1 certify that the application, plans and supporting materials are a true and a 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.
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 I/we are required to provide an as-built survey by a licensed land surveyor of all newly
constructed facilities prior to issuance of a certificate of occupancy.
I have read and agree to the above:
Robert B. Schiavi Jr
PRINT NAME: Digitally signed by Robert Schiavi
Robert Schiavi Re cn=RobertSchiavitou=HUD /�/^^
Reason:I agree to the terms defined by the placement of my 4 I/ L L
SIGNATURE: Dais 2022.oao7d1zzs90-oa'oo' DATE:
Accessory Structure Application Revised March 2022
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s): Rob Schiavi
Mailing Address, C/S/Z: 191 Farr Lane, Queensburd
Cell Phone: 518-466-3297 Land Line: N/A
Email: rbs9413@gmail.com
• Primary Owner(s):
Name(s): Rob & Erica Schiavi
Mailing Address, C/S/Z: 191 Farr Lane, Queensbur6
Cell Phone: 518-466-3297 Land Line: N/A
Email: rbs9413@gmail.com
8 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):
Contractor Trade:
Mailing Address, C/S/Z: 191 Farr Lane, Queensburij
Cell Phone: 518-466-3297 Land Line: N/A
Email rbs9413@gmail.com
**Workers' Comp documentation must be submitted with this application**
• Architect(s)/Engineer(s):
Business Name:
Contact Name(s):
Mailing Address, C/S/Z: 191 Farr Lane, Queensburd
Cell Phone: 518-466-3297 Land Line: N/A
Email rbs9413@gmail.com
Contact Person for any questions regarding this project:
Cell Phone: 518-466-3297 Land Line: N/A
Email rbs9413@gmail.com
Accessory Structure Application Revised March 2022
CCEOWIE
APR U 8
List T„ it n-te_ $� F fi t
A , Sale Price: $6,582
�:,..--.::mow-., �.. �-'..�-^�'--,,.-•- ....,��,�.."""�,•: ''• 1 ,,'
Available. for Rnt- a-Own,
Location: QUeensbl-H-y
I
Product Specifications
I Stock IQ: 2110055
1.WE Size: 10' X 14'
• Style: i\Je Brookshire
' • Siring Type: Dui-atemp
Details
- s x • BUCkskin Duraternp Siding
- • Navajo White Trim
Black. Shingles
... - .r. Ustt mined Options
2 Transom Windows - $M