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RC-0743-2020 Office Use Only PRINCIPLE STRUCTURE PERMIT Permit#: 12.0 ^ 0+1. 202i0 APPLICATI ON Permit Fee:$ 1 081-� I,� Town of Queensbury *Rec. Fee:$ 1900 f 742 Bay Road, Queensbury, NV 2804 Zo Invoice#: 5 P: 518-761-8256 www .queensburynet 23 Pe, 25 D 5 o.3r1,VSP, Project Location: 15 Luzerne Road — B .ilding # /V Tax Map #: 309.10-1-97 Subdivision Name: TOWN BD.RESOLUTION 86-2013:$850 recreation fee for new dwelling units: single family, duplexes/two-family, multiplefamily, apartments,condominiums, townhouses,and/or manufactured &modular homes,but not mobile homes. This is in addition to the permit fee(s). CONTACT INFORMATION: • Applicant: Name(s): Hayes & Hayes LLC Mailing Address, C/S/Z: 297 Saratoga Road, South Glens Falls NY 12803 Cell Ph.: ( ) Land Line: 518-792-9142 Email:jamiehayes4@outlook.com • Primary Owner(s): Name(s): Hayes & Hayes, LLC Mailing Address, C/S/Z: 297 Saratoga Road, South Glens Falls NY 12803 Cell Ph.: ( ) Land Line: 518-792-9142 I --- Email:jamiehayes4©outlook.com (-' --- - ;, • Contractor(s): 4 : A. Name(s): Hayes & Hayes, LLC t --- Mailing Address, C/S/Z: 297 Saratoga Road, South Glens Falls NY 12803 Cell Ph.: ( ) Land Line: 518-792-9142 Email: jamiehayes4@outlook.com • Architect(s)/Engineer(s): Name(s): Ethan P. Hall — Rucinski Hall Architecture Mailing Address, C/S/Z: 134 Dix Ave, Glens Falls NY 12801 Cell Ph.: 518-260-2888 Land Line: 518-741-0268 Email: ephall@nycap.rr.com Contact Person for Building & Code Compliance: Ethan P. Hall Cell #.: 518-260-2888 Land Line: 518-741-0268 Email:ephall@nycap.rr.com Principle Structure Application Revised January 2019 PROJECT INFORMATION: TYPE: ❑ Commercial ►z Residential WORK CLASS: ❑ Single-family ►2 Two-family ❑ Multi-family (#of units: ❑ Townhouse ❑ Business Office ❑ Retail ❑ Hotel/Motel ❑ IndustrialNVarehouse ❑ Garage (#of cars ❑ Other(describe J STRUCTURE SQUARE FOOTAGE: GARAGE SQUARE FOOTAGE: 1sT floor:1,241 1sT floor: 2"d floor: 1,265 2nd floor: 3rd floor: Total square.feet: Basement(habitable space): 1,098 Total square feet: 3,604 ADDITIONAL PROJECT INFORMATION: 1. Estimated Cost of Construction: $_$500,000 2. Proposed use of the building:Two family Residence 3. If Commercial or Industrial, indicate the name of the business: 4. Source of Heat: ©Gas ElOil ❑Propane ElSolar ElOther: (Fireplaces need a separate Fuel Burning Appliances&Chimney Application,one per appliance) 5. Are there any structures not shown on the plot plan? DYES ®NO Explain: 6. Are there any easements on the property? DYES ®NO 7. SITE INFORMATION: a. What is the dimensions or acreage of the parcel? 3.47 acres b. Is this a corner lot? DYES r NO c. Will the grade be changed as a result of the construction? 1_1YES ENO d. What is the water source? ®PUBLIC CI PRIVATE DWELL e. Is the parcel on SEWER or a PRIVATE SEPTIC system? Sewer Principle Structure Application Revised January 2019 DECLARATION: I. lacknowledge that no construction shall commence prior to issuance of avalid building permit and work will be completed within a 12 month period. 2. If the work is not completed by the 1year expiration date the permit may be renewed, subject to fees and department approva I. 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 local zoning regulations. 4. I acknowledge that prior to occupying the facilities proposed I, or my agents, will obtain a certificate of occupancy. 5. I 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 and agree to the above: PRINT NAME: Ethan P. Hall —Architect\Agent for the Applicant SIGNATURE: cTiaw.A DATE: 27 Nov 2020 Principle Structure Application Revised January 2019 CHECKLIST-SINGLE FAMILY Project Location : 15 Luzerne Road — Building # /0 REQUIRED -2 SETS YES NO N/A 1. Building Permit application, completed o ❑ ❑ 2. Energy Code inspector's report from REScheck, completed & signed ® ❑ ❑ 3. Septic alteration application, if applicable 0 ❑ ®. 4. Solid Fuel Burning or Gas Appliance form completed, if applicable ❑ ❑ 5. Driveway Permit, if applicable ❑ ❑ ►= 6. Structural Drawings: ❑ ❑ a. Floor plans b. Foundation plans c. Cross Sections d. Elevations e. Window & Door Schedule f. Natural Light,Ventilation & Emergency Egress 7. Plot Plan: Show proposed structure(s) with setback dimensions o ❑ ❑ from all surveyed property lines 8. Electrical inspection agency selected ❑ ❑ ❑ CHECKLIST- MULTI-DWELLING/COMMERCIAL Project Location: 15 Luzerne Road REQUIRED -2 SETS YES NO N/A 1. Building Permit application, completed ❑ ❑ ❑ 2. Energy Code inspector's report from COMcheck, completed & ❑ ❑ ❑ signed 3. Septic alteration application, if applicable ❑ ❑ 0 4. Solid Fuel Burning or Gas Applia nce form completed, if applicable ❑ ❑ ❑ 5. Driveway Permit, if applicable ❑ ❑ ❑ 6. Structural Drawings: ❑ ❑ ❑ a. Floor plans b. Foundation plans c. Cross Sections d. Elevations e. Design loads including floor, snow&wind load f. Seismicdesign g. Plans signed & sea led by registered architect or engineer h. Window & Door schedule 7. Plot Plan: Show proposed structure(s}with setback dimensions 0 ❑ ❑ from all surveyed property lines 8. Electrical inspection agency selected ❑ ❑ ❑ 9. FINALAS-BUILT PLANS SUBMITTED ELECTRICONICALLY ❑ ❑ ❑ Principle Structure Application Revised January 2019 L U Z E R N E R D 11A ST JAMES PL 28B ST JAMES PL 31B ST JAMES PL 20A ST JAMES PL 27A ST JAMES PL 32A ST JAMES PL 12B ST JAMES PL 24A ST JAMES PL 19A ST JAMES PL 35B ST JAMES PL 16A ST JAMES PL 15A ST JAMES PL 28A ST JAMES PL 20B ST JAMES PL 23B ST JAMES PL 12A ST JAMES PL 24B ST JAMES PL 11B ST JAMES PL 19B ST JAMES PL 31A ST JAMES PL 16B ST JAMES PL 15B ST JAMES PL 27B ST JAMES PL 32B ST JAMES PL 23A ST JAMES PL 35A ST JAMES PL St. James PlaceAddress Map µ 0 50 100 150Feet Map Produced by TOQGIS: 12/2020DRAFT Service Layer Cred its: NYS ITS GIS ProgramOffice i IPF IPF IPF IfAaKETIC m 00 mw' � �tl 11�0 two W11 fortpsi _i 0 LANDS OF FIRE FIGHTERS OF WEST GLENS FALLS ASSOCIATION 4'0 x 4' DEEP DRYWELL AS PER DETAIL ON S-3/ TOP OF GRATE = 364.5 1 C8 GRASSED WEIRS OND 4 WEIR ELEV.= 359.5 LANDS OF POND 3 WEIR ELEV. = 360.75 THOMAS SPRING Lei VATION = 359.5 LANDS OF CS M=363.14 GRASSED WEIR EDWARD MURRAY GV WEIR ELEV.= 36475 ASPHALT LANDS OF WEST GLENS FALLS VOLUNTEER FIRE COMPANY NO. 1 KIM=3G8.98 GQ -Q� Eel cf) in IL REVISIONS 309.10-1-97 RC-0743-2020 Hayes & Hayes LLC 15 Luzerne Rd, Bldg. 10 2-family dwelling 3604 s.f. fl , 4( 20 0 10 20 m GRAPHiC SCALE '. = 40'-0"