AST-0263-2022 ,�'`!�l�i• Office Use Only
ACCESSORY STRUCTURE Permit#: P6T— OZb'v- '2AZZ
Town ofQucensbury PERMIT APPLICATION Permit Fee: $ g�
742 Bay Road,Queensbury,NY 12804 Invoice#: -AID Z
P:518-761-8256 www.gueensbury.net Flood Zone? Y N Reviewed By:
Project Location: 'Q eC !s
Tax Map ID#: Subdivision Name:
--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
#Sed (<300 s.f.) ❑ Solar Panels (w/o rafter upgrades) ❑ 3-Season Porch ❑ Other:
SQUARE FOOTAGE OF STRUCTURE:
D1st floor: B n
nd {v�
2 floor:
�CJVtfN E7r C,�'_IEENSSURY Total square feet: ID X1 67
Brief description of scope of project: �nf
Accessary Structure Application Revised March 2022
i . 'i
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction: $ 4 b4l
2. Are there any structures not shown on the plot plan? ❑ YES NO Explain:
3. Are there any easements on the property? YES ❑ 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2._ _If,for any reason,the-building-permit application is withdrawn, 30%of the fee is retained-by-the-Town of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. Ifthework 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 1/
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. J
5. 1 acknowledge that prior to occupying the facilities proposed I, or my agents, will obtain a certificate of
occupancy. V
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. V
I have read and agree to the above:
PRINT NAME:
P
SIGNATURE: DATE: Z2-
Accessory Structure Application Revised March 2022
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s): N1��� ar�Mbe-Irrit'4
Mailing Address, C/S/Z:
Cell Phone: 316 703-078o Land Line: tf
Email: t-\'1 Co l42.M(D_X rc)CCa 2a g c�M 06 k -cayl
• Primary Owner(s): V
Name(s): t i Colt 6k.`rf0C.(.0
Mailing Address, C/S/Z: 11 k4 Lavin,
Cell Phone: N5-783-0`7490 Land Line: N �.
Email: 1Col2. Mo_V-rCCCO,�(; g Y�(l 6�,COYY1
-- -=0 Check-if-all work-w ll-be performed--by property owner only
• Contractor(s): (List all additional contractors on the back of this form)
Contractor Name(s): SV)e3 '5AI�)p
Contractor Trade: 5\f1*e a &;Ac' P CQ P
Mailing Address, C/S/Z: � g64 L q �rk Ann ,
Cell Phone: '4`A- Land Line:'" t"1
Email �`C)V �Vd�cumenvailon
m
**Workers om' C must be submitted wi h i **pt this application
• Arch itect(s)/Engineer(s):
Business Name:
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email
Contact Person for any questions regarding this project: �i c '"� �nc
Cell Phone: Nl Land Line: 51g-�3�1-3�5(0
Email
p LCor�
Accessory Structure Application Revised March 2022
20'and 24'wide 2x6"12"o/c rafters with 11 3/4"double LVL beam.
State Rte. 4, Fort Aim, NY
nd
struntud with these sidings. 2x4 Collar ties on 10x16 ' Double ''/z" Ply °od G°asets
and larger buildings 2x4 Rafters 1 V" on center �; Rafters are notched
)ouble 4 20'and 24'wide 2x6"12"a/c rafters with 113/4"double LVL beam. i out for more;strength-
Ridge beam with 2-d'return calls.
30 year architectural shingles Certified-1/2" Plywood,on Roof 'Vinyl.;
Board and Batten Our sid
Ridge Vent 15 lb. Tar Paper a l(n�itedl
,on request.
Gable ventso
mrationY41
. � rC� .ew u �• � �..-}.:_. ` \I% \ •\ /. y*0+'�
�ha
Drip Edge �: �• ,�` �?' -• ti�..�rr-�l� -�' %_."ecr.+is:�.�s.} �C'\1 `v`�
or base.
s n the size of our building.
ler door fu ction , , �-„ All Trim is =
t��.f'�i, F Qom: r_.�i IS URY covered with -
-
8 U,1mDHNI O DEPT, aluminum
1=tip�'€�ti�,�c coil stock .�.. _ — r '
1 ?Ro l3Z for low .: : : i�,
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maintt;nance = L__
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- •.-,- '•.^s'--ova;+" :�^•. - - �,�-r._! - - Yam•
I HI L E COPY Vinyl
. . Shutters
r •J —�E TOVVIV 0I- Wi :-� nnl , ---�fy_-�Y� -�� � it - - _ ,�J•
s BUILDING CEPgP '�cRY
cGsed on our limited e: A.
NT
"G, Our com�r,eris hY""'i aauon;comnGance
ndicatlr,.- the j sII no` be cor.sfrued as Aluminum Frame Window Double Fiberglass Doors
—s ufl con?(Iiance witi? ihe,�'e iflca j Cod re of with Grids with black.hardware 2X1
e'�'Yerl�Siafo. and keyed latch
(Brown ar White}
i
5/8" Pressure Treated Plywoo d 20 S1
Aluminum diamond plate in all 44 Pressure Treated Skids Single 2x4 Bottom Plate
12'wide and 10'wide ccef 5,
door openings B'and 6'wick 60 3
SALES INVOICE: E
SHED STOP
SHED
SOLD To:
KYLE MARROCCO jai(I)It Deliver to: Office use: Dates
11 KIMBERLY LN Sale: Apr130;,2022`
QUEENSBURY, NY Delivered:
Paid:
Phone: 518-955-1278 Sold By: WAYNE
Email: y STOCK# SS222241
DE C S ��RI List
,,.,,,.,t„..,.. r::u.'�:-.:.,•;:..ter�,4,..,..,v„^;'i;•:::n, ._;.:.:,
1OX16 BASIC COTTAGE $
DK GRAY SIDING WITH LT GRAY TRIM
lBI CR HWOOD SHINGLES
_.--.----___---- -__ -.- n
J#�r0&_OOn-
�_..__.. Thank you for this order. We will call you when it arrives._....__....;..---_---.- --._._-------___-.(
--- DELIVERY!- _.---______-----------_.—__-?
10,
SIT REP PRICE IS BASED ON NO MORE THAN — �}
6 INCHES OUT OF LEVEL. $
Full List Price $
I EAVE SIDE DISCI $
Make all checks payable to Shed Stop,Inc.
Delivery of shed may take 4 to 8 weeks,custom orders may take longer. Subtotal !'.-.�,..._.•.,', .,_,,.��
Building Permits and placement are the responsibility of the Customer as required. 3
Tax Rate I 7.00%i
Shed Stop Inc.,or its subcontractors,will not be held liable for any property damage -,-- 1
J.-
that includes,but is not limited to,ruts,damages to septic tanks or leach fields, !ants, : r':.' ' -`
:E
shrubs,!awns,walkways or driveways incurred during the delivery and set up process or ``
damage caused by your property. Total $
Site must be prepared and accessible at time of delivery.
Shed Stop will not be responsible for tie downs. Payment(w)
THANK Y FOR SS! Balance Due i - $
r
Obstacles:
Deposit
Cus o igrl re
Delivery
Customer Signature Loading lnstrucfions
Shed Stop,Inc. 6854 State Rt.4 Fort Ann,NY 12827 Phone:518-639-3055 Fax:518-639-3056 fortannshedstop.com