AST-0528-2022 Office Use Only
ACCESSORY STRUCTURE Permit#: AST-0528-2022
Town ofQuc se PERMIT APPLICATION Permit Fee:$ 85.00
742 Bay Road,Queensbury,NY 12804 Invoice#:
P:518-761-8256 www.Queensburv.net Flood Zone? Y Reviewed B
Project Location: 14 Highview Road, Lake George, NY 12845
Tax Map ID#: 239.15.1.15 Subdivision Name: n/a
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
N Shed (<300 s.f.) ❑ Solar Panels(w/o rafter upgrades) ❑ 3-Season Porch ❑ Other:
SQUARE FOOTAGE OF STRUCTURE:
1st floor: 160
2"d floor: n/a
Total square feet: 160
Brief description of scope of project: Shed constructed by others previous to our involvement with the client.
We are documenting the construction of the shed after having already received a variance to allow the shed
stay in the current Iocation.The shed is a single story structure constructed per the submitted construction drawings
submitted on 8.24.22 with the same revision date shown on the submitted plan. Note there is no electrical in the shed.
Accessory Structure Application Revised June 2022
I
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction:$ 3,500
2. Are there any structures not shown on the plot plan? ❑ YES ® NO Explain:
3. Are there any easements on the property? ❑x 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 If,for any reason,the building permit application is withdrawn, 30%of the fee is retained by the Town of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
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: DATE: Z -
F(
Accessory Structure Application Revised June 2022
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s): Redbud Development, Inc- Geff Redick
Mailing Address, C/S/Z: 2 Commerce Park Drive, Wilton, NY 12831
Cell Phone: 518.321.8169 Land Line: 518.691.0428
Email: geff@redbuddevelopment.com
• Primary Owner(s):
Name(s): Alice &Jack Lynch
Mailing Address, C/S/Z: 14 Highview Road, Lake George, NY 12845
Cell Phone: 617.999.4684 Land Line: n/a
Email: aflynch5421 @gmail.corn
❑ 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:
Cell Phone: Land Line:
Email:
Accessory Structure Application Revised June 2022
F--- ----
---
---- ---- ---- ---
i
---- --
-
'I
O
O
8'-4 1 /2"