AST-0193-2022 ,
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> ' - Office Use Only.
ACCESSORY STRUCTURE'- Permit#:. . /4 5 C?i
Town&O—yeembury PER TI,'�P I'I TJ?.,°��f. l� r it Fee:.$ ✓. O.�
742 Bay Road,Queensbuty,NY 12804 � � [,PC ice#:
P:5]1B-76k-82SF www. ueehsbur .n APR 222 Joi idZ'onie?. Y 011eviewed By:
TOWN OF QUE "'SL�URY
BUILUNG CODES
Project Location: Pr—I=— 1L4
Taff Map.E®#: 5 Subdivision Name:. .- S%Ar_V_A�a A.
PROJECT Ol' FORMATFON:
TYPE: ff Residential . ❑ Commercial,Proposed Use.:
STRUCTURE:
❑ Boathouse(with or..w/o sundeck) ❑ Canopy l Carport - .: -:-0 Cell.Tower. ❑.Deck.
❑ Detached Garage(>300 s.f.) ❑ Dock ❑ Gazebo ❑ Pavilion ❑ Pole Barn 11 Porch ❑ Ramp
LJ Shed(<300 s.f.) El Solar Panels(w/o rafter upgrades) ❑ 3-Seasori Porch ❑ Other:
SQUARE FOOTAGE OF STRUCTURE:-
1st floor: �Z�t %a
2"d floor:
Total square feet:
Brief description of scope of project: �_T_C 5_? — .L,-�b �tm�d7S 2 Ce�`J5 9
S ioaF_ - L.C-9E=t_FD Deo,,-
t
2-1102-70
Accessory Structure Application Revised March 2022
ADDITIONAL-PROJECT INFORMATION:
1. Estimated Cost of Construction:$ i, c- ,
2. Are there any structures not shown on the plot plan? ❑ YES L- NO Explain:
3. Are there any easements.on the property? ❑YES 2-N-0
DECL.AF2AMN:
1. I acknowledge that no construction shall be commenced prior to the issuance of a valid permit and will b.e
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 if,for any reason,the building permit application-is withdrawn,30%of the:fee is retained by the Town of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 law_s .
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. I also understand that.1/we.are required to provide an as=builtsurvey by.a licensed land surveyor of all newly
constructed facilities prior to issuance of a certificate of occupancy.
have read and agree to the ab e:
PRINT NAME:
SIGNATURE: ' DATE: 4 I 1 2022
Accessory Structure Application Revised March 2022
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant
Name(s): <Aw2; CG S—, o€3Et_
Mailing Address,C/S/Z: xATRCE LiJ., JF1�53`>tz-1 ; ►�� ���'��
Cell Phone: Sib-3E>1 _oS33 Land-Line: .a Ilk
Email:
oc� .
• Primary Owner(s):
Name(s): L^,,j-zvzcL S—,RoEBEL
Mailing Address,C/S/Z: q cN,?�E �f e�����as3��-t ►�°0 �23c�4
Cell Phone: Sib-3�1-oS33 Land Line: .
Email: 5�coehe��
I� Check if all .work will:be performed by property cjwner only .
• Contractor(s): (List all additional conteactors on the back-of this form)
Contractor Name(s):
Contractor Trade:
Mailing Address, C/S/Z:
Cell Phone: Land Liner
Email
"Workers' Comp documentatiph must:be'submitted-with this application"
• Architec*)/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:
Cell Phone:. Land Line:
Email
Accessory Structure Application Revised March 2022
4/18/22,8:07 AM 12'X 16'Vinyl Canton at Garden Time Nursery and Garden Center in Clifton Park
( GARDEN .W) TIM12- x "Is, Vinyl). ca Won
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APR 1 2022.
TOWN Or QUEEi 1SBUFi'Y
:-:. . .! BUILDING & CODE%
i -
List
•
Sale Price: $8,493
Available for Rent-to-Own. Contact a
sales representative for details.
Location: Clifton Park
Product Specifications
Stock ID: 2110270
• Size:12'X 16'
Style: Canton
im Siding Type: Vinyl
hftps://www.gardentimeinc.com/sheds/vinyl-canton-2110270/ 1/2
4/18/22,8:07 AM 12'X 16'Vinyl Canton at Garden Time Nursery and Garden Center in Clifton Park
Details
• Pewter Vinyl Siding
• White Trim
• Charcoal Gray Shingles
Customized Options
• Additional 3' Door- $430
• Upgrade To 2436 Windows -
$170
https://www.gardentimeino.com/sheds/vinyl-canton-2110270/ 2/2
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shernoanPine 1-17,3-1
lJ. �J i 49A AssDciation
D12154
APR 1 5 ?-62?
TAX I D-301.17-3-5
€ Stroebel, Lawrence
TOWN OF OIUEFN`BUr--,`f � 9 Peachtree Ln
BULDING g:CODES c 0.24Ac
Se tic Roca Stomp shed L000uoo v n 22'-82
como�izxte
8'
TAX ID-301.17-3-4 T-4 1" .
Morse,Tyler
7 Peachtree Ln \ Qe JI
0.24Ac
5�g16
TAX ID-301.17-3-6
Lipinski, Bruce
j 3 Fawn Ln
. Town Road/Un61Y2 on 0.23Ace //
9
2.93
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achtree
Cane
Project: DWG—Details. Date—Drawn By:
12x16 Storage.Shed 9 Peachtree Lane, Proposed Shed Location 4.4.2022 L:-Stroebel -
- - -518.-36T.0533. . -_ ---- —=