2009-066 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20090066 Application Number. A20090066
Tax Map No: 523400-239-008-0001-053-000-0000
Permission is hereby granted to: STEVEN JACKOSI
For property located at: 8 ONONDAGA 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: STEVEN JACKOSI
LISA POTVIN-JACKOSI Demolition
113 BIRDSALL Rd Total value
QUEENSBURY, NY 12804-0000
Contractor or Builders Name/Address Electrical Inspection Agency
Plans &Specifications
2009-066
demolition of 24 x 32 residence
$20.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Saturday, March 20,2010
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury befo the expiratyX- -
Dated at the own4,, y, March 20, 2009
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Pernut Number. P20090066 Date Issued: Wednesday, August 04, 2010
This is to certify that work requested to be done as shown by Permit Number P20090066
has been completed.
Tax Map Number. 523400-239-008-0001-053-000-0000
Location: 8 ONONDAGA Rd
Owner. STEVEN JACKOSKI
Applicant: STEVEN JACKOSKI
This structure maybe occupied as a:
Demolition
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the
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&Code nforce ent
Planning Board or Zoning Board of Appeals.
`<_?� - OFFICE USEONI„ --... _____ _____+ -----f
[/��� f + +
+ TAX MAP O. PERMIT NO. FEE PAID +
+ + + +
Permission is hereby granted to the above named Applicant to demolish the building(s) ;
described herein as set forth in the Application below. ; 0 '
+ + ' +
Director of Building&Codes Date + ;
:------------------------------------------------------------------ - -----------------------
APPLICATION FOR DEMOLITION PERMIT:
Fill in applicable spaces and submit two(2) plot plans,drawn to scale,showing lot boundaries with
dimensions and adjacent roads/streets. Show all existing structures on the property and indicate which
are to be demolished. Indicate on the plot plan the location of all utilities.
APPLICANT/BUILDER::�S��y d cru Kr� OWNER .� `+L —JA C kCS kr
ADDRESS: N+ r').SA C L /�® C, f ADDRESS: s F�JJ�L t. I'd . (Z
PHONE NOS. —7 I? 3 7(v _ 33, �_ PHONE: S --3 7
PERSON RESPONSIBLE FOR WORK: 5AML: PHONE:
LOCATION OF DEMOLITION: S C�Ie,�Or.Js0AG 1�D-
WHERE WILL DEMOLITION MATERIAL BE DISPOSED? gJ /17 I)Em t: 14r TTa`�4 /) E9s('?CI Ac.rUTJ
ASBESTOS INFORMATION:
✓ Is there any asbestos within the building to be demolished? YES NO
✓ If YES, our office needs the following information:
o Name of firm removing the asbestos:
o License number of firm:
o Indicate where the asbestos material will be disposed:
NOTE:A copy of Asbestos Removal Report must be filed with our office before demolition begins.
STRUCTURE INFORMATION:
✓ Indicate which structure(s)will be demolished: RESIDENCE X GARAGE BUSINESS
STORAGE BLDG. OTHER
✓ Size of structure:�_X
✓ Number of stories: I
✓ Foundation type: FULL CELLAR CRAWL SPACE SLAB
✓ Foundation: WILL BE REPLACED WILL NOT BE REPLACED
✓ Structures(s): WILL BE REPLACED WILL NOT BE REPLACED
UTILITIES INFORMATION:
✓ Indicate utilities for this structure: GAS ELECTRIC PROPANE PUBLIC WATER
ONSITE WELL-WATER PUMP PUBLIC SEWER
comlhwi—ny W,47>A*jE'-j4Ek
Have you notified the Town Water Dept. for public water and public sewer disconnect? YES NO f"
Have all utilitie een discon cted: YES NO
QUESTIONS? CALL 761-8256 OR EMAIL
codesa_g ueensburv.net
SIGN TURE OF APPLICANT VISIT OUR WEBSITE FOR MORE INFORMATION
www.gueensburv.net
j 3--uV»4 tic tr- C Q Q)C- _ �� 'r+1 t7 i-> CL �1�' 4 i-1:4 [J $T(11x rs 10auc P-r-) L vN6c�c'04
QTown of Queensbury• Community Development Office - 742 gay Road, Queensburif, NY 12804
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+ APPROVALS: ZONING 0
' TOWN CLERK
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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:_
INSTALLER:
ADDRESS: ? ncas�p �! ADDRESS:
PHONE NOS.
PHONE NOS.
LOCATION OF INSTALLATION: f
I.......................................................................................................
.......................
I YEAR BUILT NO.OF l ..... : ................................................................... RESIDENCE
(............................... ,BEDROOMS X ! COMPUTATION= ! = TOTAL DAILY FLOW INFORMATION.
.....I........., i i
1980 or older }....................................................................I.............:;...........
i X i 150 gallon per bedroom E .............
i ...................................i.............................................I.............................. = f INSTAL
1981 -1991
...........i....................I..............................
X 130 gallon per bedroom """"
BINDER
I 1992 resent """""""""""
;...........M................. SPA OR HOT TUB
1...... X i 110 gallon per b — i ............................... INS _
............ .....
............................_.......... P bedroom I — INSTALLED?
t...........i................... ...... .................I......................t
PARCEL INFORMATION:
✓ TOPOGRAPHY: FLAT ROLLING
STEEP SLOPE %SLOPE
✓ SOIL NATURE: SAND LOAM
CLAY OTHER
✓ GROUNDWATER: AT WHAT DEPTH?J00
WHAT DEPTH? BEDROCK/IMPERVIOUS MATERIAL: AT
✓ DOMESTIC WATER SUPLY: MUNICIPAL WELL "
(IF WELL:WATER SUPPLY FROM ANY SEPTIC-SYSTEM ABSORPTION IS FT 1
✓ 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:A GALLON (MIN. SIZE IS 1,000 GAL.) TILE FIELD: EACH TRENCH
FT.
✓ TOTAL SYSTEM LENGTH: �1 FT. SEEPAGE PIT(S): HOW MANY?
✓ SIZE OF EACH FT. X FT.
SIZE OF STONE TO BE USED: #_o /DEPTH OR THICKNESS � FT.
✓ BED SYSTEM SIZE: X
✓ ALTERNATIVE SYSTEM: LENGTH AND/OR SIZE
✓ HOLDING TANK SYSTEM:(If required) NO. OF TANKS: /SIZE OF EACH
✓ GALLONS./TOTAL CAPACITY. GAL.
I NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN
I APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED. ii
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 (4i4tg
1-8256 OR EMAIL
Queensbury Sanitary Sewage Disposal Ordinance. b net
ORE INFORMATION
bury net
Signature of erson Responsible Date
1 .. Town of Queensbury - Community Development Office - 742 Bay Road, Queensbury, NY 12804
i---- ............... " OFFICE USE ONLY_.- ._._. -Zj 'A 0 %
TAX MAP NO.
-----------------
PERMIT NO. ,
o FEES: PERMIT ?
--�, RECREATION , . � ENGINEERING f ,
__- -„- (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 OFA VALID PERMIT FOR CONSTRUCTION.
APPLICANT/BUILDER: 1 4 8 f4 SS/�r�(L OWNER:
ADDRESS: }p n Viy�n �1 y ADDRESS:
�Zg3 I
PHONE NOS. PHONE NOS.
CONTACT PERSON FOR BUILDING & CODES COMPLIANCE: f 1/t PHONE:��g
LOCATION OF PROPERTY:
SUBDIVISION NAME:
v
PLEASE INDICATE MEASUREMENTS AS REQUIRED BELOW:
CHECK ALL THAT z
APPLY TO YOUR z d w
PROJECT 0 0 OO U) U) COw
o W .ju- U- uu-- W ¢ a0 = v
W o O - Z
C'1 Z C1 !- O 1- w —
z Q Q U) CV (1) O u_ F- u_ d 2 otS
SINGLE FAMILY
TWO-FAMILY
MULTI-FAMILY
(NO.of UNITS )
TOWNHOUSE
BUSINESS OFFICE
RETAIL-
MERCANTILE
FACTORY OR
INDUSTRIAL
ATTACHED v_
GARAGE(1103)
OTHER
IF COMMERCIAL OR INDUSTRIAL-NAME OF BUSINESS:
ESTIMATED CONSTRUCTION COST: SILgq,6n� - FUEL TYPE: LP
HEAT TYPE4rud ADt-,A-i2 *HOW MANY FIREPLACE(S):__AND/OR WOODSTOVES(S):
ZONING CATEGORY: ARE THERE WETLANDS ON THIS SITE?
IS THIS A HISTORIC SITE? k(®
PROPOSED USE OF BUILDING OR ADDITION: n131,0 YW ILJ
"Please complete a separate Application for"Fuel Burning Appliances&Chimne available in our office
B 3-LGL 11-05
* Town of Queensbury - Community Development Office - 742 Bay Road, Queensbury, NY 12804
ARE THERE STRUCTURES NOT SHOWN ON PLOT PLAN?
ARE THERE EASEMENTS ON PROPERTY? f 5
I acknowledge no construction activities shall be commenced prior to issuance of a valid
permit. I certify that the application, plans, and supporting materials are a true and
complete statement/description of the work proposed, that all work will be performed in
accordance with the NY State Building Codes, local building laws and ordinances, and in
conformance with local zoning regulations. I acknowledge that prior to occupying the
facilities proposed, I or my agents will obtain a certificate of occupancy. 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 nd agree to the above.
Y
Signed
Director of Buildinq & Codes: 761-8256 (for questions regarding Building Permits, construction
codes or septic systems)
Zoning Administrator: 761-8218 (for questions regarding required permits, the permit process,
application requirements or to schedule an appointment)
......................
I , , I
Permission is hereby granted to the above This application / proposed action described
Applicant to erect or alter the building herein is found to be in accordance with the10
o described herein in accordance with said zoning Laws of the Town of Queensbury. 01
00 Application:
0
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BUI N & CODES P OVAL ZONING APPROVAL
0 1
,
Dgri=
DATE
0
QUESTIONS? CALL 761-8256 OR EMAIL
codes(ftueensburv.net
Office Use Only
VISIT OUR WEBSITE FOR MORE INFORMATION
www.queensbury.net
Operating Permit Issued: Yes No
Occupancy Type: i�"--D Construction Classification:
Assembly Occupancy Limit: Special Conditions:
Town of Queensburyj - Community Development Office - 742 Bay Road, Queensburyy, NY 12804
Queensbury Building & Code Lnforcemen esi entlal Flnal Inspection
Office No. (518) 761-8256 Arrive: am/pm Depart: v l am/pm
Date Inspection request received: Inspector's Initials:
__-----=NAME: r PERMIT#:
LOCATION: DATE:
TYPE OF STRUCT E:
Comments:
Too No
M/A
4° Building Number Address visible from road / r4
Chimney Height/"B'Vent/Direct Vent Location
Fresh Air Intake c
3 inch Plumbing Vent through roof minimum 6 inches 140
Roof Complete/Exterior Finish Complete
Platform at all exterior doors _
Handrail 4 or more risers
Guards at stairs decks atios more than 30 inches above grade
Guard at stairwell at 34 inches or more
Guard at deck porches 36 inches or more
Handrail Termination at Newell Post or Wall
Interior/Exterior Railings 34 inches to 38 inches
Deck Bracing/Handicapp2d Ramp Compliant
Grade away from foundation 6 inches with 10 feet
6 inch clearance to sill plate
Gas Valve shut-off a sed/regulator 18 inches above grade
Interior privacy/trim/doors/maln entrance 36 inches
Bathroom/Kitchen watertight
Safety glazina/Window in stairwells safety glazing
Interior Smoke Detectors/Carbon Monoxide Detectors
Every level: Every Bedroom:
Outside every bedroom area:
Inter Connected: Battery backup:
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area
Crawl Spaces 18 inch x 24 inch access 1 .ft.-150 sq.ft.vents
Bathroom Fans,if no window
Plumbing fixtures
Foundation insulation/Insulation Certification
Floor truss draft stopping finished basement 1,000 sq.ft.
Emergency egress below grade
Gas Furnace shut-off within 30 feet or within line of site
Oil Furnace shut-off at entrance to furnace area
Fumace/Hot Water Heater operating
Low water shut-off boiler
Relief Valves installed/Heat Ira Water Temp 110
Enclosed Stairs Sheetrock Underside minimum'A'Gypsum
Basement stairs dosed rise>4 inches
Garage Floor Pitched
Gara a fireproofing/%hour fire door/door closer
Duct work Sealed propedy
Gas Logs in Sealed or Glass Enclosure
Final Electrical
Final Survey Plot Plan
Arc Fault Breaker in Bedrooms
Flex Gas Pipe Bonding
As Built Septic System/Sewer Dept. Inspection Sticker
Site Plan /Variance required
Flood Plain Certification,if required
Oka to issue C IC or C/O Tem ora /Permanent
LABuilding&Codes Forms\Building&Codes\Inspection FormsWesidential Final Inspection Forrn_revised_100405.doc;Revised
January 7,2008;Revised 8M08
ZONING INFORMATION
ZONE WR-1A - WATERFRONT RESIDEN71AL I-ACRE
SETBACKS - 50' SHORELINE, 30' FRONT, 20' SIDES
28' MAXIMUM BUILDING HEIGHT
22% FLOOR AREA RA 770
65% PERMEABILITY REQUIRED
VA PJA NCE SUM ARY
REAR SETBACK REQUIRED: 15'
EXISTING COTTAGE SETBACK: 9.75'
����-' 72'± ALONG SHORE Y�,
�oPROPOSED BUILDING SETBACK: 10' (TAKUNDEMDE REQUIREMENT)
•.A �_, PROPOSED STOOP SETBACK: 7
'(PORE j $3�` �a�� VARIANCE GRANTED 11/22/06: 5' OF RELIEF
/ �/ LOT 8 .�� ''k (BUILDING CORNER 10' FROM P.L.)
AREA
. LANDS N/F OF
4,932± sq. ft. / �6I HtLLMAN EAST SIDE REQUIRED: 15'
0. 11± acres / 20' SIDE EXIS77NG COTTAGE SETBACK: 3.82'
SETBACK PROPOSED HOUSE SETBACK: 4.53'
PROPOSED 4' SCH-40 PVC VARIANCE GRANTED 11122106. 11.18' OF RELIEF
& 114" PER 3�� - /o� � �r / �R MIN. SLOPE (BUILDING CORNER 3.82' FROM P.L)
PROPOSED 1000 GAL
PRECAST CONCRETE WEST SIDE REQUIRED: 15'
a+,
SEPTIC TANK EXISTING COTTAGE SETBACK: 13.11'
o / / 20' SIDE / '`� Z �o�,. PROPOSED HOUSE SETBACK: 13.00'
/ SETBACK 10' P.L. SETBACK VARIANCE GRANTED 11/22/06: 2'
LOT 7 / �e �6 0 (TAD SEPTIC TANK) (BUILDING CORNER 13' FROM P.L)
- / 5CRUNEo .2' �,�cP o ; 0 MAXIMUM FLOOR AREA RATIO ALLOWED: 22%
POD" 4932 SF LOT = 1085 SF ALLOWABLE FLOOR AREA
/ 3G EXISTING COTTAGE FLOOR AREA: 768 SF
PROPOSED HOUSE FLOOR AREA: 1496 SF = 30.33%
1 STORY WOOD 9 VARIANCE GRANTED 11/22/06. 411 SF OF RELIEF
/ FRAMED HOUSE \
(1496 NEW BUILDING FLOOR AREA)
1 10' HOU SETBACK PROPOSED 4" SCH-40 PVC
/ (TO TIC TANK) \ . EFFLUENT SEWN TO
COMMUNITY WASTEWATER 7 ITE ETBACKS
\ REA7MENT SYSTEM: S S
j" 118" PER FT. MIN. SLOPE
REQUIRED FOR EXIS71NG PROPOSED
WR-IA ZONE COTTAGE HOUSE
' LOT 6 � . . _ . Q�,�
MH-1 SHORELINE 50' 51.87' 50.76'
LANDS N/F OF
RIM 336�„ TAKUNDEWIDE /
1 STORY WOOD HOMEOWNER'S
/ FRAMED HOUSE ` ASSOCIATION / REAR 15' 9.75' 10'
5CPEENED / ,�- _ NOR TN SIDE 15' 3.82' 4.53'
PORCH
1 PC 0r `elle�rt? 9 'ICP
S '� ` DC2 of, SOU TH SIDE 15, 13.11' 13'
�rl Y :p
r.cc etc.
.`l (LOT MDTH = 55--60 FEEL)z ,
LANDS N/F OF
t
TAKUNDEWIDE _
HOMEOWNER'S / CRUSHED °�' �t33yu
ASSOCIATION LOT 5 STONE
/ PARKING
LANDS N/F OF /
MASON /
ALTERATION OF THIS DOCUMENT EXCEPT BY A LICENSED PROFESSIONAL
ENGINEER IS A VIOLATION OF NYS EDUCATION LAW.
SITE PLAN
SCALE: 1"=20'
1 REVISED HOUSE & COMMUNITY WASTEWATER SYSTEM 11/13/08
0 ISSUED TO TOWN OF QUEENSBURY 10/12/06
No. Revisions Date
MAP REFERENCE: SITE PLAN
FOR COMPLETE SURVEY INFORMATION, prepared for:
SEE "MAP OF A SURVEY MADE FOR Steve & Lisa Jackowsk!
STEVE & USA JACKOWSK1," DATED OCTOBER 5, 2006, PREPARED BY: Lot 8 - Takundewide - Cleverdale
-q 8rL Du S e�2 Town of Queensbury, WarTen County,New York
Steves Drawn: LWD Checked: GTH Scale: NOTED Date: 10/12/06
Land Surveyoro 169 Haviland Road
169 Haviland Road Quemobur,. New York 12801 Queensbury, NY 12804 29367-01
(518) 792-8474 New York Lie. No. 50135 Hutchins En ineerin (518) 745-0307 Phone
g 9 518 745-0308 Fax