The URL can be used to link to this page

applicationsBuilding Permit Application ‘Town of Queensbury Department of Community Development,742 Bay Rd.,Queensbury,NY 12804 3M.72 (618)761-8256 A permit must be obtained before beginning construction. No inspection will be made until applicant has received a valid building permit.Form must be completed.Rec.Fee Paid: Reviewed By 777-C_— [Apmis]Rater Ro Weidman [O™"|PAs Dube en Cons tusstn(cass le Amethyst Drive Address:|ae Ametlyst DriveeensbuyyWY12804(Qreensbuy WY 12Po4 Phone #:‘Phone #:12)273-264 (518743 269 Tax Map Number:ReccivED Subdivision Name:Couvthouse s war 9.4 2003 (if applicable):a Lot Number:£3 /House Number:__/Street Name_G bofer 6s iG eENSBURY Property Location: © &New Building:Residential /Commercial Estimated Market Value of Construction:_/GO,08©Addition;Residential /Commercial If an Addition,what will use of addition be? ©Alteration:Residential /CommercialNochangeto Exterior size:Residential /Commercial ©Other work:(describe ) Cheek Below Occupancy Info [1 foorsg i.|F*looreg.ft,|Other Aooreg|Total Sq.Fe x Sage Py ENSS|GOI 12.63 Zlol‘Two Family Dwelling ‘Townhouse “Multifamily Dwelling#of units Orfice ‘Mercantile Manufacturing T car detached garage Tear detached garage 3 ear detached garage T car attached garage xX car attached garage SIL 3 car attached garage Storage Bldg,Comm. ‘Storage Bidg.,Res. I ce Z ‘What is the proposed height of the structure:2 feet_(2 inches ‘Will any second-hand or ungraded lumber be used?If so,for what?__/V/© No.of Hireplaces to be installed: No.of Woodstoves to be installe List below the person(s)responsible for supervision of work in regards to Building Codes: Address Phone No. ‘Builder ; Plumber, Mason Sone Electrician Declaration:Please sign below after you have carefully read the statement:— To the best of my knowledge 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 Building Code,the Zoning Ordinance and all other laws pertaining to the proposed work shall be complied with,whether specified or noted,and that such work is authorized by the owner.Further,it is understood that Vive shall submit,prior to a Certificate of Occupancy or Certificate of Compliance being issued,as requested by the Zoning Administrator or Director of Building and Codes,an lt Survéy by a licensed surveyor;drawn to scale,showing actual location of all new construction. RL.Signature:(circle one:Gameszowner’s agent,architect,contractor ) Application for Permit —Septic Disposal System Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518)761-8256 1,OWNER INFORMATION:oi Lnestiot ofinetiaion py G3.Courknse Exfohe,|ong Use Let Glo,Lf)|File Permit NoQ03-O1DTaxMapNo.1 y } (B ©|vee Peia ‘Owner’s Name:ef e~icra ere Address:2¢4 metlgct Drive Queensbury WY (220% 2.INSTALLER’S NAME :Vlorri aszy's Constructres Cp PHONE NO.778-6 6/2 3.RESIDENCE INFORMATION:(circle year of dwelling,indicate #bedroom(s)and multiply #of bedrooms with applicable gallons per bedroom to equal total daily flow) ‘Year of House:No.of Bedrooms _x__Computation Total Daily Flow 1980 or older x 150 gaV/bdrm 1980-1991 x 130 gal/bdrm. 1991 —present 3 x 110 gal/bdrm Garbage Grinder Installed yes___/no_X Spa or Hot Tub Installed yes/no :4,PARCEL INFORMATION:(circle applicable information &indicate measurements) ious MaterialSoi]Nature __Ground Water__Bedrock or.y Domestic Water Suj Flat at what depth|at what depth ici Rolling loam LVAD feet NG feet Steep slope|clay if well,water supplyS%slope \(ther Gov from any septic-system depth:absorption is ft. other Percolation Test:(To be completed by licensed professional engineer or architect) Rate:minute per inch 5.PROPOSED SYSTEM:For New Construction:All individual sewage disposal systems must be designed bya 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:_/2@Ogalton (min.size 1,000 gal.) Tile Field:each trench_S ©fi,Total SystemLength:DOO fi. Seepage Pit(s):number of size of each:‘ft.by ft Size of Stone to be used:#_2L /depth or thickness__2,feet Bed System Size:ves pero Altemative System:length and/or size 6.HOLDING TANK SYSTEM:(if required) ‘Number of tanks:1 Size of each:gallons /TOTAL Capacity:gallons Note:Alarm System and associated electrical work must be inspected by a Town approved electrical inspection agency. 7.SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON (please read) 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 oris 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. Thave read the regulations with respect to this application and agree to abide by these and all Town of Queensbury Sanitary Sewage Disposal Ordinance. (uo_aes ignature of responsible person Date Fire Marshal's Office Town of Queensbury,742 Bay Road,Queensbury,NY (518)761-8205 Application for Fuel. Burning Appliances & Chimneys applicable to solid fuel& vented gas appliances Date nt,�, „- , 20 0 3 Permit No. . Application is hereby made to the Building'& Codes Office for the issuance of a Building and Use Permit pursuant to the New York State Fire Prevention and Building Code. The applicant or owner agrees to comply with all applicable laws, ordinances, regulations, and all conditions that are part of these requirements and also will allow all inspectors to enter premises to perform required inspections. NOTE to applicant: Rough-in and Final Inspections are required. Applicant Information Fuel Burning Appliance Information (circle appropriate words) Stove: wood coal pellet ,gts1 Name:. f--�=�.� �'� < l�f.�_ar�/.,,.�,�-,;. Fireplace insert ' Address: 2.(, ') Is , Wit= <,a Fireplace, factory-built: wood gas A.l �, r 4 Fireplace, masonry: wood gas 1 Furnace: wood gas oil Phone: r7, If non-masonary applicance,please provide Owner: Manufacturer Name: Address: Model Number: Chimney Information Phone: (circle appropriate words) Masonry block brick stone Flue tile steel size: inches Exact Address: L of construction or installation Factory-Built L -to is •cA_c..sk- Manufacturer name: To e Clef GI."1 °' Model Number: Note: Listed By: Number:. Construction/Installation must . Conform to NYS Fire Prevention &Building Indicate(circle) chimney material: Code. Consult available Town of Queensbury -" - Handouts regarding required inspections. Double wall / Triple wall / Insulated / Direct venting Chimney Liner ,CASal z-',8 Dep meat— of Qucmitiffrbury, 347-iew Vior i Fire Marshal Code# `( ` $Collected $Re ended . Received from (refunded to):V tn,(i )944-4:41 address: A 173 3389 (190) Public Safety a _ A 233 2655 (230)Minor Sales LSDATE: — � ti !r Ir .... _ _ - 7 . t 4. ram White(Applicant) / Green(Fire Marshal) / Yellow(Bldg.Dept.) / Pink&Goldenrod(Cashier's Dept.) ,