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RC-000673-2017 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development-Building&Codes (518)761-8256 BUILDING PERMIT Permit Number: RC-000673-2017 Tax Map No: 309.9-1-87 Permission is hereby granted to: Clute Enterprises,Inc. For property located at: 50 Ohio AVE In the Town of Queensbury,to construct or place at the above location in accordance with application together with plot plans and other information hereto filed and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning Ordinance Type of Construction Owner Name: DKC Holding Single Family-New $50,000.00 Owner Address: 6 Holden AVE Total Value $50,000.00 Queensbury,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency Clute Enterprises,Inc. 6 Holden AVE Queensbury,NY 12804 Plans&Specifications Manufactured Home 27 ft.by 52 ft. Area Variance Z-AV-66-2017 Approval with conditions imposed by the Zoning Board of Appeals: a) The building should be no larger than the proposed 27 ft.by 52 ft. b) The building be located at the 20 foot setback requirement on Ohio Avenue c) Allowing a future garage to be built between 12 ft.and 14 ft.wide to the east without requiring a variance. d) That the six foot variance request is to the foundation and it does include the steps required to get to the front door. e) There will be no impermeable surface going to the front door. $168.48 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,November 7,2018 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the Town oues aer 7,2017 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement Office Use Only MANUFACTURED HOME Permit#"kO PERMIT APPLICATION Permit Fee: $ Town of Queensbury 742 Bay Road,Queensbury,NY 12804 Rec Fee: $moo,^akS P:518-761-8256 www.gueensbury.net Invoice#: o2�CP Project Location:, p Tax Map ID #: ��/ 7 Name of Park: ` Proposed Date of Placement: l`7 DECE VE CONTACT INFORMATION: () OCT 2017 • Applicant: TOWN OF QUEENSBURY COMMUNITY DEVELOPMENT Mailing Address, C/S/Z: — C( Cell Phone: ( Land Line: ) X7 r Email: C�'J-�e • Primary Owner(s): Name(s): ��t �►r „ Mailing Address, C/S/Z: -) Cell Phone: _L ) A n land Lines Email: • Contractor(s): Business Name: Contact Name(s): Mailing Address, C/S/Z: Cell Phone: � _ Land Li.0e;, ) Email: --�� Contact Person for Building & Code Compliance: C r— Cell Phone: btu I, Land Line: Email: Town of Queensbury Building&Code Enforcement Manufactured Home Application Revised May 2017 MANUFACTURED HOME INFORMATION: (INFORMATION FOUND ON THE PLATE OR STICKER LOCATED IN THE HOME): Insignia serial #: makN Name of Manufacturer: Place approval #: Model or component designation (New Home Only): Date of manufacture: (� �. \`7 ADDITIONAL INFORMATION: 1. Approximate Value of Home: $ a�2 E 2. Is the home NEW '_>5/- ora REPLACEMENT ? 3. Single-wide or Double-wide ?'<"; Size: eft.X ft. 4. Foundation support(choose one): Size Depth Piers: Slab: x5� 5. Is the home being placed on a private lot? No Yes (if yes,you must provide stamped engineered drawings of the permanent foundation plan) 6. Total#of rooms (exclude bathrooms): ' ;#of bedrooms: _;#of bathrooms: 7. Additional heat source? No Yes Choose one, if yes: gas fp_ woodstove_ wood fp 8. Are there any other/existing buildings on the property? No�Yes ; Explain: 9. What is the water source? PUBLIC PRIVATE WELL 10. Is the parcel on SEWER a PRIVATE SEPTIC s ? 11. Do you need a septic permit application? No Yes DECLARATION: I swear that,to the best of my knowledge and belief,the statements contained in this application,together with the plans and specifications submitted, are a true and complete statement of all proposed work to be done on the described premises;and,that all provisions of the NYS Building Code,the Zoning Ordinance and all other laws pertaining to the proposed work shall be completed with . I have read and agree to the above;..-' ' PRINT NAME: SIGNATURE: , DATE: i C) -7 Town of Queensbury Building&Code Enforcement Manufactured Home Application Revised May 2017 SEPTIC DISPOSAL PERMIT APPLICATION Office Use Only 742 Bay Road,Queensbury,NY 12804 P: 518-761-8256 www.queensbury.net Permit#: E &a ` / Tax Map ID#: 3�525'7 ci– i—-r7 Permit Fee:$ ; Invoice#: Project Location CX',_—_' Septic Variance? Yes No f Primary Owner(s) Mailing Address -"Ck �� Phone & Email 7 7-7 Installer/Builder Mailing Address Phone & Email Engineer Mailing Address LPhone & Email TOWN OF QUEENSBUR NT Contact Person for Building&Code Compliance: t' Phone: Co RESIDENCE INFORMATION: Year Built #of bedrooms X gallons per bedroom =total daily flow Garbage Grinder Yes o y 1980 or older Installed? (circle one) 1981-1991 Spa or Hot Tub Yes< No 1992 Prest Installed? (circle one) PARCEL INFORMATION: Topography Flat Rolling Steep Slope %Slope Soil Nature Sand Loam Clay Other Groundwater At what depth? Bedrock/Impervious material At hat depth? Domestic Water Supply Municipal _Well (if well, water supply from any septic system absorption is_ft.) Percolation Test Rate: per minute per inch (test to be completed by licensed engineer/architect) PROPOSED SYSTEM FOR NEW CONSTRUCTION: Tank size ks-&-jlc� gallons (min.size 1,000 gallons, add 250 gallons for each garbage cylinder or spa/hot tub System Absorption field with#2 stone Total length :O ft.; Each Trench Seepage Pit with#3 stone How many: ;Size: Alternative System Bed or other type: Holding Tank System Total required capacity? ;tank size ;#of tanks NOTES: 1. Alarm system &associated electrical work must be inspected by a Town approved electrical inspection agency;2. We will no longer allow systems to be covered until such time as an as-built plan is received and approved. The installed system must match the septic layout on file—no exceptions. Declaration:Any permit or approval granted which is based upon or is granted in reliance upon any material representation or failure to make a material fact or circumstance known by or on behalf of an applicant,shall be void. I have read the regulations and gree to alaide'l y these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. PRINT NAME: -7DATE: l� SIGNATURE: DATE: Town of Queensbury Bui in Code Enforcement Revised February 2017 Town of Queensbury Thomas R. Van Ness Highway Superintendent Highway Home (518) 745-0929 Department 742 Bay Road—Queensbury, NY 12801 David Duell Phone: (5 18) 761-8211 Deputy Highway Superintendent Fax: (518) 745-4466 Home (518) 743-0938 DRIVEWAY PERMIT DATE: � i�-�, , 7 � � � a � l5 APPLICANT NAME: �_ ` . s , � ,�, , D TELEPHONE NO.: rf OCT 2 6 207 ADDRESS TO BE INSPECTED: RETURN ADDRESS: TOWN OF QUEENSBURY COMMUNITY DEVELOPMEN Applicant must show exact location and width of driveway(s) to be connected to the highway by placing stakes at the specified location. The Superintendent of Highways of the Town of Queensbury has reviewed this application. The following action has been taken: STEP 1: ( ) Preliminary Approval NEED: ( } Slight Swale ( } Deep swale ( } Level with the road ( } Level with the top of the paved wing Size culvert pipe to be used (if necessary) ( ) 12" ( ) 15" ( ) 18" ( ) 24" ( ) 36" Preliminary inspection completed by: Date: Approval by Highway Supt: (or) Deputy Supt: Upon completion, please resubmit this approved permit for a final approval. STEP 2: ( ) Final Approval ( ) Rejected Date: Thomas R. Van Ness, Highway Superintendent David Duell, Deputy Highway Superintendent MAP REFERENCES i � MAP OF A SURVEY OF THE LANDS OF EARL E. &MINNIE G. MAILLE 0 BY.-JOHN B. VAN DUSEN DATED:JULY Z 1965 0 Lands N/F of Staunches 0 2 WESTERN PARK o BY. E.H. WELLES, C.E. DATED:JULY 19274 " AS TRACED BY. LESLIE W. COULTER `'o---o__ JANUARY 15, 1944 _ 0_0 0- 0-�=— 8830 02 00"E 0 0 0 0 100.00. °---0---_U�_ 20.0':- Landing Z Area rT� 6,000±sq.ft. 0.14±Acres ` W peg z-7' � s� 1 o ,�✓ (0 co Q Z One-Story 1 __ Wood-Frame 5ervlce Pole O House wth Meter Lands N/F of Ricketts o) coo I N I I � Dec.Meter 27.5± �O ` +I CV) CIRS 3 (L ECEOVE LAND 100.00' N83020-00-W I FEB 2 7 2018 ., TBS OF G SY &CODE I IAF NOTES: I I LC-- I ZZ��'ZZ�"VVVV I I.) THE FIELD SURVEY WAS CONDUCTED DURING WINTER WEATHER I CONDITIONS WITH SIGNIFICANT SNOW AND ICE COVER. 2.) THI5 MAP WAS PREPARED FROM AN ACTUAL FIELD SURVEY MADE IN ACCORDANCE WITH THE EXISTING CODE OF PRACTICE ADOPTED BY THE NEW YORK STATE ASSOCIATION OF PROFESSIONAL LAND SURVEYORS. n 3.) THI5 MAP IS COPYRIGHT ©2018 VAN DU5EN t.5TEVE5 LAND �T I LEGEND CENTRAL SURVEYORS. UNAUTHORIZED ALTERATION OR ADDITION TO THIS L 1 � TRAL AVENUE DOCUMENT IS VIOLATION OF SECTION 7209,5UBDIV15ION 2, OF NEW IRSQ= IRON ROD SET TO BE SET / YORK STATE EDUCATION LAW. I NAL S U RVEY IPFQ= IRON PIPE FOUND 4,) DIMENSIONS BETWEEN STRUCTURES AND PROPERTY LINES ARE TO THE = UTILITY POLE NEAREST HALF FOOT AND ARE FOR THE SOLE PURPOSE OF INTERPRETING CONFORMANCE WITH ZONING AND NOT INTENDED TO AID IN THE ESTABLISHMENT 0-0-0= METAL FENCE LINE OR RETRACEMENT OF PROPERTY LINES. 5 = LOT NUMBERS AS PER MAP REF. No. 2 5.) UNDERGROUND UTILITIES, IF ANY, ARE NOT SHOWN HEREON. ate October 11, 2009 A ` ` D u 'UNAUTHORIZED ALTERATION OR ADDITION S A SURVEY Map of a Survey made for Scale 1'=10' V^— j•i MAP BEARING A C ON LAND SURVEYORS SEAL IS A VIOLATION OF SECTION EDUCATION SUB-DIVISION 2.OF THE NEW YORK STATE EDUCATION LAW.' S ONLY COPIES FROM THE OF THE OF ISIS SURVEY NARKED PATH AN ORIGINAL OF THE LAND SURVEYORS SEAL SHALL BE CONSIDERED T BE VALID TRUE COPIES." •CERTR EY WAS INDICATED HEREON SIGNIFY THAT D C Holding, Inc . THIS SURVEY WAS PREPARED 9i ACCORDANCE WITH THE Z Land Surveyors BY THE CODE OF PRACTICE FOR LAND SURVEYORS ADOPTED 3 02121118 HOUSE FINAL BY THE NEW YORK STATE ASSOCIATION OF SURVEYORS PROFESSIONAL LAND SURVEYORS.SND CERTInCATIONS SHALL RUN ONLY FOR TO THE PERSON R WHOM THE SURVEY IS PREPARED,AND 2 10/20/17 ZBA COMMENTS SHAT 1 OF 1 ON HIS BEHALF TO THE TITLE COMPANY.GOVERNMENTAL 169 Haviland Road Queensbury, New York 12804 T THE Y AND ofITHE�IDING INSTITUTIOSTED N AND Town of Queensbury, Warren County, New York 1 09/01/17 NAME CHANGE Balfour C2407 (518) 792-8474 New York Lic. No. 50135 NO. DATE DESCRIPTION DWG. NO. 09122