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AST-0286-2023 • Office Use Only C l ACCESSORY STRUCTURE Permit#: V1 0245(e - Z0'L6 Town ofQuc sne b ry PERMIT APPLICATION Permit Fee: $ � l• rD'a(4 la 742 Bay Road,Queensbury,NY 12804 Invoice#: AA P:518-761-8256 www.yueensbury.net Flood Zone? Y Reviewed By: ILO Project Location: 18 Crooked Tree Dr. 239.15-1 -9 N/A Tax Map ID#: Subdivision N/A L PROJECT INFORMATION: i MAY 3.0 2023 i �) TYPE: © Residential El Commercial, Proposed Use: TOWN OF CiU .NOS R`J . BUILDING uc CODES STRUCTURE: • 0 Boathouse (with or w/o sundeck) ❑ Canopy ❑ Carport ❑ Cell Tower El Deck ❑ Detached Garage (>300 s.f.) ❑ Dock ❑ Gazebo ❑ Pavilion ❑ Pole Barn ❑ Porch ❑ Ramp CI Shed (<300 s.f.) ❑ Solar Panels (w/o rafter upgrades) ❑ 3-Season Porch ❑ Other: SQUARE FOOTAGE OF STRUCTURE: • 1st floor: 1296 SQFT 2nd floor: N/A Total square feet: 1296 SQFT Brief description of scope of project: New construction boat house constructed on the existing dock space / cribbing. Building not to exceed origional foot-print. Accessory Structure Application Revised June 2022 ADDITIONAL PROJECT INFORMATION: 1. Estimated Cost of Construction: $1 50,000 2. Are there any structures not shown on the plot plan? ❑ YES I, NO Explain: 3. Are there any easements on the property? ❑ YES U 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 If,for any reason,the building permit application is withdrawn,30%of the fee is retained by the Town of Queensbury.After 1 year from the initial application date, 100%of the fee is retained. 3.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. 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: Nicholas Denno / Northern Builders SIGNATURE: DATE: 05/30/2023 Accessory Structure Application Revised June 2022 CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Applicant: Name(s): Northern Builders Mailing Address, C/S/Z: 33 Atwell Road Porter Corners NY 12859 Cell Phone: 518-796-6694 Land Line: N/A Email: ndenno@northernbld.com • Primary Owner(s): Name(s): David Cohen &Michelle Kaplan Mailing Address, C/S/Z: 18 Crooked Tree Dr. Cell Phone: 215-499-8827 Land Line: N/A Email: kaplancohen@gmail.com ❑ 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): -Pc? \\C 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: Saratoga Engineerting & Design Contact Name(s): Doug Adams, PE Mailing Address, C/S/Z: 74 Rolling Hills Drive Gansevoort NY 12831 Cell Phone: 518-683-6899 Land Line: Email: saratogaengndesign@nycapp.rr.com • Contact Person for any questions regarding this project: Nicholas Denno, Northern Builders Cell Phone: 518-796-6694 Land Line: N/A Email: ndenno@northernbld.com Accessory Structure Application Revised June 2022