BP 2009-100 ~� TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-82fl1
Community Development- Building&Codes (518) 761-8256
E I FIrATE C}F OCCUPANry
Pernut Number. P20090100 Date Issued: Monday, June 15, 2009
This is to certify that work requested to be done as shown by Permit Number P20090100
has been completed,
Location: I HUMMINGBIRD Ln
Tax Map Number. 523400-295-014-0001-085-000-0000
Owner, KATHLEEN DALY
Applicant; JOSEPH MONSOUR
This structure maybe occupied as a:
Garage Attached By Order of Town Board
Single Family Dwelling TOVN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the 1
property owner of the responsibility for compliance with Site Plan, +
Variance, or other issues and conditions as a result of approvals by the Director of Building&Co a Enfo ement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20090100 Application Number. A20090100
Tax Map No: 523400-295-014-0001-085-000-0000
Permission is hereby granted to: JOSEPH MONSOUR
For property located at: WHIPPOORWILL Rd
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 Value
Owner Address: KATHLEEN DALY
36 WHIPPOORWILL Rd Garage Attached
QUEENSBURY,NY 12804-0000 Single Family Dwelling $120,000.00
Total Value $120,000.00
Contractor or Builders Name/Address Electrical Inspection Agency
Plans &Specifications
2009-100
1337 sq ft single family dwelling w/241 sq ft garage
$190.44 PERMIT FEE PAID- THIS PERMIT EXPIRES: Friday,April 16, 2010
(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 T�lwn of�eens ry;,, April 16, 2009
SIGNED BY `'�"�` ve l for the Town of Queensbury.
Director of Building&Code Enforcement
......r...................................r_....... ------- r..r . �..__.._.__.r..._r.._..�
OFFICE USE ONLY
TAX MAP NO. PERMIT NO. 7:�WERMIT FEE + ;
APPROVALS: ZONING TOWN CLERK_
____________r_.__.____.____...____
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT(
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID
PERMIT.
OWNER:e•/o l ,),hI�IO�fSOU /F/e2 /�/iVS INSTALLER: 1"1/,"C ��✓n/L�2+ST�.7i
ADDRESS: �-YIzSOADDRESS: ���✓� �+1y / ����
PHONE NOS. 71 3 Sa 13 7i4 76 61 Call PHONE NOS. X
LOCATION OF INSTALLATION: A41
..................................................
.............................i ...............................................................,.......................................:.................................. RESIDENCE INFORMATION:
.... ...... .....
YEAR BUILT BEDROOMS X COMPUTATION= _ TOTAL DAILY FLOW
„...............................................i.......................................,,.....}......,..................,....,....,............................................... ..................................................................................... GARBAGE
1980 or older , , X 150 allon er bedroom = NSALLEDaRIN _
I 9 p
.................................................1..........................................,..,....................................... ...........w.........................................................................:
1 1981 -1991 X 130 gallon per bedroom i = `
s-.............................................. F... ....h........................ ' I SPA OR HOT TUB
1992-present i X 110 gallon per bedroom 1 3 3 v INSTALLED?,�f o
......_....�..-..................-......1..................... ......_.............1.._..................................................................................,...........,....,........,....,..................,.........I..........................,
PARCEL INFORMATION:
✓ TOPOGRAPHY: FLAT ROLLING `l STEEP SLOPE %SLOPE
✓ SOIL NATURE: SAND LOAM CLAY OTHER
✓ GROUNDWATER: AT WHAT DEPTH? BE_DROCK/IMPERVIOUS MATERIAL: AT
WHAT DEPTH?
✓ DOMESTIC WATER SUPLY: MUNICIPAL WELL
(IF WELL: WATER SUPPLY FROM ANY SEPTIC-SYSTEM ABSORPTION IS FT. )
✓ PERCOLATION TEST: RATE IS PER MIINUTE PER INCH (TEST TO BE
COMPLETED BY A LICENSED PROFESSIONAL ENGINEER OR ARCHITECT)
PROPOSED SYSTEM FOR NEW CONSTRUCTION: All individual sewage disposal systems must be designed by
a licensed professional engineer or architect (unless installed in a Planning Board approved subdivision). Add 250
gallons to the size of the septic tank and leach field for each garbage grinder, spa or whirlpool tub.
✓ SEPTIC TANK: 1060 GALLON (MIN. SIZE IS 1,000 GAL.) TILE FIELD: EACH TRENCH sd FT.
✓ TOTAL SYSTEM LENGTH: /Sy FT. SEEPAGE PIT(S): HOW MANY?
✓ SIZE OF EACH FT. X FT.
✓ SIZE OF STONE TO BE USED: # /DEPTH OR THICKNESS FT.
✓ BED SYSTEM SIZE: X
✓ ALTERNATIVE SYSTEM: LENGTH ANDIOR SIZE
✓ HOLDING TANK SYSTEM:(If required) NO. OF TANKS: I SIZE OF EACH
✓ GALLONS.(TOTAL CAPACITY: GAL.
" NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN
I`
APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED.
,,,,,,,,,,,,,,,,,,,
For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Queensbury, any
permit or approval granted which is based upon or is granted in reliance upon any material misrepresentation 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 with respect to this application and
agree to abide by these and all requirements of the Town of QUESTIONS? CALL 761-8256 OR EMAIL
Qu ensbury Sanitary Sewage Disposal Ordinance. codes Caueensl2 irv.net
VISIT OUR WEBSITE FOR MORE INFORMATION
c www.aueensburv.net
gnature f Person Responsible bate/
1 Town of Queensbury - Community Development Office - 742 Bay Road, Queensbury, NY 12804
��' J 'f�. 11 ... OFFICE USE ONLY.......,..�....................% %
TAX MAP NO. _PERMIT NO. L1 1 V\J
FEES: PER MI ECREATION ENGINEERING ' 0 '
(If applicable) ;
PRINCIPAL STRUCTURE:
APPLICATION FOR ZONING APPROVAL & BUILDING PERMIT
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. APPLICATION IS SUBJECT TO
REVIEW BEFORE ISSUANCE OF A VALID PERMIT FOR CONSTRUCTION.
APPLICANT/BUILDER:;C&&,L)0-4V 4:f ,SD"/Z ,, 4- wJ<iwJ OWNER: -5-4pK'_
ADDRESS: // Ji /,r r c TY/moo/ ADDRESS:
PHONE NOS. 73 Sd �yG79/ 60�' PHONE NOS.
CONTACT PERSON FOR BUILDING & CODES COMPLIANCE: PHONE: -/-1�.7 6o /3
LOCATION OF PROPERTY: / Cl
SUBDIVISION NAME: ��'e� ,-, Z7 (Ai ezr�� P�1L .Si m► /a4;3 id 0"
T
PLEASE INDICATE MEASUREMENTS AS REQUIRED BELOW:
CHECK ALL THAT z
APPLY TO YOUR z � O a O w
PROJECT O O0 I..: O =I._ _
3r 2 w U- W u_ = H O O U
UJIZ ¢ Q d z d �- 1- O 1- W z
� cn N (!J Ou- 1— u- dSotS
SINGLE FAMILY 1', U f - 3 7
TWO-FAMILY
MULTI-FAMILY
(NO.of UNITS )
TOWNHOUSE
BUSINESS OFFICE
RETAIL-
MERCANTILE
FACTORY OR 0
INDUSTRIAL
ATTACHED
GARAGE(1,2,3)
OTHER
IF COMMERCIAL OR INDUSTRIAL-NAME OF BUSINESS:
ESTIMATED CONSTRUCTION COST: 42,0,t)00 FUEL TYPE: 2?� 6,41
HEAT TYPE: �te]�p�� `HOW MANY FIREPLACE(S): 0 AND/OR WOODSTOVES(S):�
ZONING CATEGORY: .S,0/c lA ARE THERE WETLANDS ON THIS SITE? �'La
IS THIS A HISTORIC SITE? -74-o
PROPOSED USE OF BUILDING OR ADDITION:
*Please complete a separate Application for"Fuel Burning Appliances&Chimneys"available in our office
B 3-LGL 11-05
; :: Town of Queensbury - Community Development Office - 742 Bay Road, Queensbury, NY 12804