AST-0501-2022 Office Use Only
ACCESSORY STRUCTURE Permit#: Jk T D50t • 202-2--
PERMIT APPLICATION G
Town of Queensbury Permit Fee: $ r
eJ
742 Bay Road,Queensbury,NY 12804 Invoice#: 2)60 /!� C1
P:518-761-8256 www.queensbury.net Flood Zone? Y Reviewed By: l." ' /
Project Location: �re. 01m9iA/K4-7e1 by
Tax Map ID#: Subdivision Name:
PROJECT INFORMATION:
TYPE: 7d�Residential ❑ Commercial, Proposed Use:
STRUCTURE:
❑ Boathouse (with or w/o sundeck) El Canopy El Carport El Cell Tower El Deck
❑ Detached Garage (>300 s.f.) ❑ Dock ❑ Gazebo ❑ Pavilion ❑ Pole Barn ❑ Porch ❑ Ramp
hed (<300 s.f.) ❑ Solar Panels(w/o rafter upgrades) ❑ 3-Season Porch ❑ Other:
SQUARE FOOTAGE OF STRUCTURE: E C LE I V E '
1st floor: '�►r 1 AUG t 2 2022
Y
2nd floor:
TOV1M OF QUEENSBUR�"� =UILDING& CODES
Total square feet:
Brief description of scope of project: .._RA, „3v e, et --n }\_ ((1 r4, ,-t-
Accessory Structure Application Revised June 2022
I
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction:$ ) Boa
2. Are there any structures not shown on the plot plan? ❑ YES 1NO Explain:
3. Are there any easements on the property? ❑ YES
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 If,for any reason,the building permit application is withdrawn, 30%of the fee is retained by the Town of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. I 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. I acknowledge that prior to occupying the facilities proposed I, or my agents, will obtain a certificate of
occupancy.
6. I 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:
PRINT NAME:
SIGNATURE: DATE: cl lz ,2
fff
Accessory Structure Application Revised June 2022
1
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s): 9 ever ,,
Mailing Address, C/S/Z: LA,,As-ei r
Cell Phone: . 5i -114 �t Land Line:
Email: S-4'e e '„-)elsC41-5d fvrreP 1 1G Gem
• Primary Owner(s):
Name(s):
Mailing Address, C/S/Z:
Cell Phone: ' and 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):
Contractor Trade:
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email:
**workers' Comp documentation must be submitted with this application**
• Architect(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: pli C,Q�r�
Cell Phone: Land Line: 1
Email:
Accessory Structure Application Revised June 2022
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EZ-Fit Riverside 12'W x 20'D Wood Storage Shed Kit (ez_riverside1220)
Designed to offer plenty of light and easy access, the EZ-fit 12x20 Riverside shed kit features a single
door flanked by two 24" x 36" windows, in addition to its convenient double doors. With optional
transom windows and other charming options, the Riverside Shed Kit is ideal as a backyard studio or
workshop. Made in the U.S.A.
Shed Kit Includes:
• Panelized wall sections with horizontal nailer and 24" oc wall studs TOWN OF QUEENSBURY
• Rafters, roof sheathing, pre-hung doors, trim, door hardware, fasten&ILDING DEPARTMENT
• Two 24"x 36" Windows with Shutters Included! Based on our limited examination,compliance
with our comments shall not be construed as
indicatifig the plans and soecincations are in
Features: lull compliance with the Building Codes of
New York State.
• U.S.A. Made Lock Sets
• Decorative Hinges
• Double Top Plate tiV• Horizontal NailerDECt
ED
• 6" Fascia Trim AUG 12 2022
• 60" Standard Door ;
Illi
Double Doors: 1 - Set of 60" Double Doors TOWN OF QUEENSBUR''
Single Door: 1 - 30 Single Door BUILDING 8 CODES
Windows: 2 - 24"x 36" Windows
Wall Height: 6'6"
Overall Height:10'9"
TOWN OF 0UEENSBUR`f
BUILDING & CO,DE �EP�'a
Reviewed By: C--_J
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Floor: 4x4x20 spaced 4' apart
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