AST-0464-2022 S
ROffice Use Only
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ACCESSORY STRUCTURE Permit#: PcS ' ��� 7fL
Town ofQ PERMIT APPLICATION Permit Fee:$ 'LSO
742 Bay Road,Queensbury,NY 12804 Invoice#: rZ>ZC)
P:518-761-8256 www.gueensbury.net
Flood Zone? Y eviewed By:N
Project Location: c e—���` 10fiL ( ,� j
Tax Map ID#: 5a 3 q d °G` p Subdivision Name: g� ---
u [
PROJECT INFORMATION:
2. 2l0F 2
TYPE: Residential ❑ Commercial, Proposed Use: _
L117WNFUEENSSUF;`t
CODES
STRUCTURE: ••,-• �
❑ Boathouse (with or w/o sundeck) ❑ Canopy ❑ Carport ❑ Cell Tower ❑ Deck
❑ Detached Garage (>300 s.f.) ❑ Dock ❑ Gazebo ❑ Pavilion ❑ Pole Barn ❑ Porch ❑ Ramp
❑ Shed (<300 s.f.) ❑ Solar.Panels(w/o rafter upgrades) ❑ 3-Season Porch I I Other: Wor)S}hc p do1'ic �a
SQUARE FOOTAGE OF STRUCTURE:
1st floor:
2"d floor:
Total square feet: 3
Brief description of scope of project: lipt^n\ -) , ,<,�n�X)il i J
Accessory Structure Application Revised June 2022
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction:$
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 If,for any reason,the building permit application is withdrawn, 30%of the fee is retained by the Town of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. 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 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:
PRINT NAME: ►
SIGNATURE: /'///L�ATE: 2 022—
Accessory Structure Application Revised June 2022
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant: �
Name(s): 9��yib.c. /`-rl � �- �C �V�"� Ir I- Al)`e-A
Mailing Address, C/S/Z: �G Gt.� � S q
Cell Phone: 5 i`R- `7 y S - 1 G 0 ,-1 2fKcc Land Line: W
Email %% (3('.- ' -r C�,rn� , s ��� yn Lro e-�c,r-,J )aine- t L- �a 0E- C�
T
• Primary Owner(s):
Name(s): CQ 4jLt� a- ?�-��c �� ! y l `
Mailing Address, C/S/Z: 1 z-&'ay
Cell Phone: S )s'- 33-9 I CDC---)_9 'JJgLand Line: A/A
Email: C.c v�l5 b'
❑ 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: b95Ll 'S e P-4 9 firm , &41 , .9,2 r7
Cell Phone: Land Line: al sz - 3g - 30
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: Jk?'? i C,&h
Cell Phone: Land Line:
Email:
Accessory Structure Application Revised June 2022
E C
a JUL 2 2 2022
SALES /NI/O/C TO UWN OFILD NAG&BCOpEgR f E
SHED STOP
SOLD To:
Deliver to: Office Use: Dates
ALLEN, BRUCE Sale: ,tune 24;2022.
25 RICHARDSON STREET Delivered: PROPOSAL
QUEENSBURY NY 12804 Paid:
Phone: 518-745-1904 Sold By: MICKEY
Email: STOCK#
DESCRIPTION:
List -
iSIZE - 12X26 NEWENGLAND A- FRAME SHED -- —$
!COLOR -SHED RED TRIM -GP ALMOND SHINGLE DUAL GRAY
j2 WINDOWS ALL WINDOWS IN BROWN $
i .26 —�
I UV tNI SSU R DELIVERY!
- FREE,
BUILDING & co
Reviewed! By,
1 RAMPI $
-6 INCHES OUT OF LEVEL.;
Full List Price! $
-- ---.--
Make all checks payable to 5hed Stop,Inc.
$
Delivery of shed may take 4 to 8 weeks,custom ord�r�may to a IoIY nger. Subtotal
Building Permits and placement are the responsibility of the Customer as required.
Tax Rafe _7.00%'
Shed Stop Inc.,or its subcontractors,will not be held liable for any property damage ;.. .• - -,I
that includes,but is not limited to,ruts,damages to septic tanks or!each fields,plants, Sales Tax
shrubs,lawns,walkways or driveways incurred during the delivery and set up process or
damage caused by your property. Total i _ $
Site must Shed Stop bwilpl notabed and res responsible for tie downs at time .
deliveryt-OWN OF QUEENSBURY payment(wQ I~ s
p BUILDING DEPARTMENT ------------- r
Based on our limited examination,compgS�i�e Due i $
THANK YOU FOR YOUR BUSY'l comments shall not be construed as --- � -�
full compliances withpthesZid'ngI Coder) in
New�RP199te. �Sftacles;
DOORS TOWARD TRUCK
309.10-2-41 :AST-0464-2022 lelivery
Allen, Bruce & Cathy Loading.instructlons
25 Richardson St
>.7 Phone:518.639-3055 Fax:518-639-3056 fortannshedstop.com
Work shop 312 s.f.
ilk ' 17? o m l
Double.Plywood Gussets
_ •-2X4 16"O.C.rafters
s Double Top Plate 1/2"4 ply CDX or OSB
L
�JK_s--'if JS t,tji+ ��i. r " ', \/••„M1,;,r
30 Year
Aluminum Sofitf ' ~ ,�. :s ` o s; ti a� g
!� •y "' Architectural Shingles
Facia&Drip Edge
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��,'SI�f 1 •3 r'.-_,3 ,' `{ I f•-�I1-•r ' I) IJ-r _ l
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—izittyl-Sid�ln9
_ ti `r I _ •'` :'r` �! �DoYililz our
�irttnor
a
D4 Straight
Li r
O �"�-:z - -— �• _ _ ,I_-4�-- `'' :J 6"Black Or
,r `�- �+r,• 1/2"4-ply 1 Decorative Duraremp
2X4 16"O.C.
Sidewalls `"f'� - Plywood i� Hinges T1-11 Wood Siding
,+ 4X4 5/8"Exterior Grade Or
2X4 Pressure Treated 5-Plywood Or Raised Panel
Pressure 1'`v Smarrside
OSB on Or
Or Regular Treated Floor Side Walls
Floor Joists 8",12"or 16"O.C. Skids Wood Doors
65�/z„ 6''wide shed
34 34" 8)
341/4„ 341/4„ �41/z„ 20'
34 1/4„ 34 1/4 34 1 4 34 1/4 12
361/2» 48„ 36 14
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