AST-0299-2021 �f ► Office Use Only
ACCESSORY STRUCTURE Permit#:
Town ofQuemsbury PERMIT APPLICATION permit Fee:$ 5 •��
742 Bay Road,Queensbury,NY 12804 [E C [E 0 V E
P:518-761-8256 www.gueensburv.net
D ice
APR 3 0 2021
d Zone? Yi / N) Reviewed By: (�S
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TOWN OF QUEENSBURY
Project Location: 5 W�1;5 C� c B I
Tax Map ID#: 301, 13--a-(0 ( Subdivision Name: -Ty ne5wc od1
PROJECT INFORMATION:
TYPE: �k 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
14 Shed (<300 s.f.) ❑ Solar Panels (w/o rafter upgrades) ❑ 3-Season Porch ❑ Other:
SQUARE FOOTAGE OF STRUCTURE:
1st floor:
2nd floor:
Total square feet: C21A/
Brief description of scope of project: /1 /).
Accessory Structure Application Revised January 2021
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction:$ 000
2. Are there any structures not shown on the plot plan? ❑YES bUO Explain:
3. Are there any easements on the property? ❑ YES $1 NO
DECLARATION:
1. I 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 If,for any reason,the building permit application is withdrawn,30%of the fee is retained by the Town of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 the work is not completed by the 1 year expiration date the permit may be renewed, subject to fees
and department approval.
4. 1 certifythat the application, plans and supporting materials are atrue 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 certificate of occupancy.
I have read and agree to the above:
PRINT NAME: leeh'16e13
SIGNATURE: DATE: `/ z/
Accessory Structure Application Revised January 2021
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant: D lal,6V AUaS& 4�
Name(s): s z aee," r /`I IaVY
Mailing Address, C/S/Z: � �i (�
Cell Phone: 5"/6 6JP0 0677 Land Line:
Email: pot---6uedc. P P'".
Name(s):Primary Owner(h6 r s :� L:,�m I 1 A ouej eko
C/S/Z:
Mailing Address, � i�hiS � n� � n2S �� /
Cell Phone: S IS ':H 10 Land Line:
Email: (a 0r"Vew M GL� �. Mrn
P g
❑ 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): � / y Aid '" "gyp
Contractor Trade:
Mailing Address, C/S/Z: 6 5Y OS--1f 6 44 a., 7
Cell Phone: Land Line: / 6,39 . 3OSS-
Email:
**Workers' Comp documentation must be submitted with this application**
• Arch itect(s)/Engi nee r(s):
Business Name:
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email:
Contact Person for any questions regarding this project:
Cell Phone: Land Line:
Email:
Accessory Structure Application Revised January 2021
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SALES /NKQ jiq NSAr
BUILDING DEPARTMENT ,S'HED STOP
Based on our limited examination,compliance
with our comments shall not be construed as
I indicating the plans and specifications are in
i SOLD To: full compliance with the Building Codes of
i New York State.
i RICHARD PORTUESE Deliver to: Office Use: Dates
5 WHISPERING PINES WAY Sale:
{ QUEENSBURY, NY 12804 Delivered:
Paid: a�
? Phone: 516-680-0677 Sold By: WAYNE
Email: STOCK#
! DESCRIPTION: -
3 12X24 VALUE NE CLASSIC A-FRAME
WHITE SIDING W/BLACK TRIM
BLACKSHINGLES
TOWN OF QUEENSBURY d
��� Copy BUILDING & CODES DEP
I Reviewed y: APR 3
Cute: z of QUEENS ES Y
I Thank you for this order. We will call you when it arri es.Og LDING&��� -
DELIVERY!
12' 3X6 RAMP
SITE PREP PRICE IS BASED ON NO MORE THAN
! 6 INCHES OUT OF LEVEL.
Full List Price
EAVE SIDE DISC
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. Tax Rate
Shed Stop Inc.,or its subcontractors,will not be held liable for any property damage
that includes,but is not limited to,ruts,damages to septic tanks or leach fields,plants, Sales Tax
shrubs,lawns,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(vu/)
I THANK YOU FOR YOUR BUSINESS! Balance Due
Ostacle"
Deposit
Customer Signature
Delivery
Customer Signature I Loadrng,lnsfructions
Shed Stop,Inc. 6854 State Rt.4 Fort Ann,NY 12827 Phone:518-639-3066 Fax:518-639-3056 fortannshedstop.com
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Speci ' ations
Double Plywood Gussets
i
-2X4 16"O.C.rafters
Double Top Plates � ,-- _,_-- �
1/2"4-ply CDX or OSB
Aw
Aluminum Soffit _ -y 30 Year
Facia&Drip Edge + �' ` Architectural Shingles
RL
![ ! 31 g
I" -Doubir Sour
D'!!t""zlir`Lap
Or
D4 Straight
� 6"Black Or
2X4 16"O.C.
Sidewalls �� -- -" - — 1/2"4-ply i Decorative Duraremp
14X4 5/8"Exterior Grade Plywood Hinges T1-11 Wood Siding
2X4 Pressure Treated Pressure 5-Plywood Or Raised Panel Or
Or Regular Floor Lt�;7OOF
on Or Smartsi
Treated Sid Floor Joists 8",12"or 16"O.C. Skids or
(� ! APR 3 0 2021
4 Jf&f l� t UEENSBURY
65 1/2" 6'W e S ed `
34"
34" 8,
241 2 341/4 341/4" 241 2" 10'
I
341/4 341/4" 341 4 341/4" I2'
361/2"ir 4.8" 48 361/2" 14,
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a
301.13-2-61 AST ® 2021
Portuese, Emily & Richard
5 Whispering Pines Way
Shed 264 s.f.
n E C E
U MAY 0 9 2021
Zy�}
T OWN OF QUEENSBURY
BUILDING&CODES
I-�a uSe THIS PLAN TO BE ON PRO, ECT
0
SITE Al ALL TI,�IES s Gr�'7Z THE
IP,ATICS Or CONISTRUC TICN
r�orclrl TOWN OF QUEENSBURY
BUILDING DEPARTMENT
Based on our limited examination,comp iance
with our comments shall not be cons tru d as
indicating the plans and specifications re in
full compliance with the Building Co es of
New York State.
TOWN OF QUEENSBUR`l at
BUILDING & CO ES DEPTo
Reviewed y: Warr
Date: �_�