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Applications
‘4 PRINCIPLE STRUCTURE Office Use Onh PERMIT APPLICATION remmitt:_RC-DOL8-2020 Town of Permit Fee:$_!,AY,10 742 Bay Road,Queensbury,NY 12604 Rec,Fee:$_J50.00 P.518-764-8256 wwwqueensburynet invoice:AOAC Project Location:5 Whispering Pines Way Tax Map #:301.1261 Subdivision Name:Tyneswood Wooded Home Sites ; TOWN 80.RESOLUTION 86-2019:$850 recreation fee for new dweling units:single famiy,uplexes/two-famiy multpiefamily,apartments,condominiums townhouses andor manufactured &modular Homes,But not mobie homes This i in addition tothe permit fee(s), CONTACT INFORMATION: ©Applicant: Name(s);Caruso Home Builders LLC. Mailing Address,C/S/Z:19 Railroad Place,Suite 201,Saratoga Springs NY 12666 Cell Phone:_{).land Line:(518 )478-8596 Email:Anthony@carusohomebuilders.com +Primary Owner(s)|=—~ Name(s):Same as applicant | Mailing Address,C/S) Cell Phone:_( Email: O Check if all work will be performed by homeowner only ‘*Contractor(s):Workers’Comp documentation must be submitted with this application Contractor Name(s):Caruso Home Builders LLC. Contractor Trade: Mailing Address,C/S/Z:19 Railroad Place,Suite 201,Saratoga Springs NY 12866 Cell Phone:_()land Line:_(_518_)478-8596 Email:Anthony@carusohomebuilders.com **List all additional contractors on the back of this form +.Architect(syEngineer(s): Business Name: Contact Name(s):Bill Balough Mailing Address,C/S/Z: Cell Phone:_()Land Lini Emai (518 __)701-3280 Contact Person for Building &Code Compliance:_Same as applicant Cell Phone:_()land Line:_() Emait, Pipe Structure Packet Revised February 2018 PROJECT INFORMATION. TYPE:__Commercial Y Residential WORK CLASS Single-Family _Two-Family _Mutti-Family (of units ___) _Townhouse __Business Office _Retail _HotelMotet __IndustrialWarehouse __Garage(ifofcars_)___Other(describe > STRUCTURE SQUARE FOOTAGE:GARAGE SQUARE FOOTAGE: 4°floor:1,805 ¥floor;_5ST a2"floor:1,011 2 floor:3¥floon_Total square feet:_S>7] Basement (habitable space): Total square feet:2.747 ADDITIONAL PROJECT INFORMATION 1.Estimated Cost of Construction:$350,000 2.Proposed use of the building:Single Family Residental 3.If Commercial or Industrial,indicate the name of the business: 4.Source of Heat{Gas)Oil Propane Solar Other: (Fireplaces need a separate Fuel Burning Appliances &Chimney Application,one per appliance) 5.Are there any structures not shown on the plot plan?YES (IO)Explain: 6.Are there any easements on the property?ves (IO) 7.SITE INFORMATION: a,What is the dimensions or acreage of the parcel?5 acres b.s this a corner lot?ves GO) c.Will the grade be changed as a result of the construction?vs GD 4.What isthe water source?PRIVATE WELL e,Is the parcel on SEWER or a PRIVATE SEPTIC system?_Private Septic Pringle stucture Packet Rese Febrary 2019 DECLARATION: |.lacknowledge that no construction shall commence priorto issuance of a valid building permit and work will be completed within a 12 month period. 2.Ifthe work is not completed by the tyear expiration date the permit may be renewed, subject to fees and department approval 3.I certify that the application,plans and supporting materials are a true and 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 focal zoning regulations, 4,|acknowledge that prior to occupying the facilities proposed I,or my agents,will obtain a certificate of occupancy 5.|understand that live are required to provide anas-built survey bya licensed land surveyor of ail newly constructed facilities priorto issuance ofa certificate of occupancy. |have read and agree to the above: PRINT NAME:__Anthony Caruso SIGNATURE:55 2.DATE:_2/14/2020 _c= Pringle truce Packet Revised February 2018 Office Use Onl FUEL BURNING APPLIANCE &Permit #:LC,-DO to -2025 CHIMNEY APPLICATION Permit Fee:§ Invoice #: 742 Bay Road,Queensbury,NY 12804 P:518-761-8256 wwwqueensburynet >Project Location:5 Whispering Pines Way Tax Map ID:_301.42-2-61 Room of Install:Living Room Planned Install Date:5/1/2020 **ONE APPLICATION PER APPLIANCE* CONTACT INFORMATION: ©Applicant: Name(s):Caruso Home Builders LLC. Mailing Address,C/S/Z:19RalroadPlace,Sulte201,SaratogaSpringsNY12866CellPh.:_()Land Line:__(_518_)478-8596 Email:Anthony@caruschomebuilders.com ©Primary Owner(s): Name(s);Same as applicant Mailing Address,C/SIZ ———__—CellPh:_(__)Land Line:_(___). Email Ci Check if all work will be performed by homeowner only +Installer/Builder:Workers’Comp documentation must be submitted with this application Contact Name(s):Same as applicant Contractor Trade Mailing Address,C/S/2: Cell Phone:_()Land Line:_{) Email Contact Person for Building &Code Compliance:Same as applicant Cell Ph.:__(__).Land Line:_(___).Email: Pringle structure Packet Revised February 2019 FUEL BURNING APPLIANCE INFORMATION: ‘TYPE OF DEVICE: __Stove ___Fireplace Insert,__Fireplace __Fuel Fired Equipment (Garage Only,18”clearance per IMC 304.3) _v.Fireplace,factory built** (**Manufacturer’s name:_Heat &GLo Model #:_SL: SOURCE OF HEA _Wood __Coal __Pellet Gas CHIMNEY INFORMATION: _—Masonry (require plans to be submitted): block __brick _stone __Flue: __tile steel ___size,in inches Material®: Zdouble-wall __triple-wall_4 insulated (*Manufacturer’s name:__Heat &GLo Model #:) ADDITIONAL INFORMATION: 1.Two inspections are required.A rough-in inspection,prior to installation andafinalinspection,after installation Manufacturer's installation manual must be available at the time of inspection. Masonry fireplaces &chimneys require plans to be submitted. Twenty-four (24)hour notification is required for inspections. Workers’Comp insurance information is required with this application. Declaration:Construction/installation must conform to NYS Fire Prevention &Building Code and/or manufacturer requirements.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 the inspector to enter the premises to perform the required inspections. Ihave read and agree to the above: PRINT NAME:Anthony Caruso. SIGNATURE:pare:2/14/2020oePringletrucePacketRevised February 2019, ‘Office Use Only Tome mitPC-0OES2070 i SEPTIC DISPOSAL PERMIT APPLICATION|Permit__#<00 o—20 Permit Fee:$Invoice # Septic Variance?Yes No 742 Bay Road,Queensbury,NY 12808 P:518-761-8256 www.queensbury.net ib Tax Map ID #:301.922-61 Project Location:5 Whispering Pines Way *Applicant: Name(s);Caruso Home Builders LLC Mailing Address,C/S/Z:19 Railroad Place,Suite 201,Saratoga Springs NY 12866 Cell Phone:_()Land Line:_(_518_)478-8596 Email:_Anthony@carusohomebuilders.com ©Primary Owner! Name(s):Same as applicant Mailing Address,C/S/2: Cell Phone:_(),Land Line:_() Email: O Check if all work will be performed by homeowner only *Contractor:Workers’Comp documentation must be submitted with this application Contact Name(s):Same as applicant Contractor Trade: Mailing Address,C/S/Z: Cell Phone:_().Land Line:) Email: ©Engineer(s) Name(s):Van Dusen &Steves Land Surveyors Mailing Address,C/S/Z:169 Haviland Road,Queensbury,NY 12804 Cell Phone:_{.)land Line:_(_518_)792-8474 Email: Contact Person for Building &Code Compliance:Same as applicant Cell Phone:_(__)land Line:Email Prnpe Stucure Packet eve Febraary 2019 RESIDENCE INFORMATION: Year Built [Gallons|#of bedrooms:|X gallons per|=total dally fow per day |bedroom |Garbage Grinder Yes |(No)| 1980 or older|150 |Installed?(circle one) josrien1|130 t [Spa or Hot Tub Yes (Wo) installed?(circle one) 1992-Present|110 4 L110 440 PARCEL INFORMATION: Topography T Flat Rolling Steep Slope %Slope Soil Nature [sZ Sand Loam Clay ____Other (explain:D Groundwater |At what depth?None Bedrock/impervious material |Atwhat depth?None Domestic Water Supply |Z Municipal __Well (if well,water supply from any septic system absorption is___ft.) Percolation Test |Rate:1:30 _per minute per inch (test to be completed by licensed engineer/architect) PROPOSED SYSTEM FOR NEW CONSTRUCTION: Tanksie |1,250 gallons (min,size 1,000 gallons,add 250 gallons foreach garbage cylinder or spa/hot tub System,[Absorption field with #2 stone|Total length_200 ft.Each Trench___50__ft |Seepage Pit with #3 stone How many:4;Size:_50 [alternative System Bed or other type:ae[Holding Tank System Total required capacity?tank size #of tanks NOTES:1.Alarm system and associated electrical work must be inspected by a Town approved electrical inspection agency;2.Wewillnolongerallowsystemstobecovereduntilsuchtimeasanas-built plan is received and approved.The installed system must match the septic layout on file—no exceptions.3.As-built drawings must be submitted prior to the inspection,if there has been a change to the submitted plans. 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.|have read the regulations and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance, PRINT NAME:__Anthony Caruso bare:_2/14/2020 ‘SIGNATURE:ie DATE:__2/14/2020we Prince Structure Packet Revised February 2019,