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RC-0742-2020 • - = Office Use Only PRINCIPLE ST-UCTURE PERMIT �-t Permit#: eC. 0 �2 • 2 OZo APPLICATION Permit Fee:$ I Oil•20 $2'1-81 2 Town of Queensbury *Rec. Fee:$ ��OD 742 Bay Road,Queensbury, NV 12804 Invoice#: � P: 518-761-8256 www .queensburynet ets 2:;" .N3CoOrykk, Project Location: 15 Luzerne Road — Building # Tax Map #: 309.10-1-97 Subdivision Name: TOWN BD.RESOLUTION 86-2013:$850 recreation fee for new dwelling units: single family, duplexes/two-family, multiplefamily, apartments,condominiums, townhouses,and/or manufactured & modular homes,but not mobile homes. This is in addition to the permit fee(s). CONTACT INFORMATI ON: • Applicant: Name(s): Hayes & Hayes LLC Mailing Address, C/S/Z: 297 Saratoga Road, South Glens Falls NY 12803 Cell Ph.: ( ) Land Line: 518-792-9142 Email:jamiehayes4©outlook.com • Primary Owner(s): Name(s): Hayes & Hayes, LLC Mailing Address, C/S/Z: 297 Saratoga Road, South Glens Falls NY 12803 Cell Phi: ( ) Land Line: 518-792-9142 Email: jamiehayes4@outlook.com �- ','.A• §; • Contractor(s): Name(s): Hayes & Hayes, LLC " Mailing Address, C/S/Z: 297 Saratoga Road, South Glens Falls. NY 12803 Cell Ph.: ( ) Land Line: 518-792-9142 r Email:jamiehayes4@outlook.com r`;- ' • Architect(s)/Enclineer(s): i -:= " t, Name(s): Ethan P. Hall— Rucinski Hall Architecture Mailing Address, C/S/Z: 134 Dix Ave, Glens Falls NY 12801 Cell Ph.: 518-260-2888 Land Line: 518-741-0268 Email: ephall@nycap.rr.com • Contact Person for Building & Code Compliance: Ethan P. Hall Cell #.: 518-260-2888 Land Line: 518-741-0268 Email:ephal l@nycap.rr.com Principle,Structure Application Revised January 2019 `' PROJECT INFORMATION: TYPE: 0 Commercial N Residential WORK CLASS: O Single-family ►2 Two-family 0 Multi-family (#of units: ❑ Townhouse ❑ Business Office 0 Retail ❑ Hotel/Motel O IndustrialNVarehouse El Garage (#of cars ) ❑ Other(describe STRUCTURE SQUARE FOOTAGE: GARAGE SQUARE FOOTAGE: 1ST floor: 1,241 1ST floor: 2nd floor: 1,265 2nd floor: 3rd floor: Total square feet: Basement(habitable space): 1,098 Total square feet: 3,604 ADDITIONAL PROJECT INFORMATION: 1. Estimated Cost of Construction:$_$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 ❑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? OYES ®NO Explain: 6. Are there any easements on the property? OYES 0 NO 7. SITE INFORMATION: a.What is the dimensions or acreage of the parcel? 3.47 acres b. Is this a corner lot? OYES F2 NO c.Will the grade be changed as a result of the construction? OYES ONO d. What is the water source? ®PUBLIC El PRIVATE DWELL e. Is the parcel on SEWER or a PRIVATE SEPTIC system? Sewer Principle Structure Application Revised January 2019 DECLARATION: I. !acknowledge that no construction shall commence priorto issuance of a valid 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-bui It survey by a licensed land surveyor of a II newly constructed facilities priorto 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: CF/zaiy.A 7Vail DATE: 27 Nov 2020 Principle Structure Application Revised January 2019 CHECKLIST-SINGLE FAMILY Project Location : 15 Luzerne Road — Building # REQUIRED -2 SETS YES NO N/A 1. Building Permit application, completed ® 0 ❑ 2. Energy Code inspector's report from REScheck, completed & signed M ❑ ❑ 3. Septic alteration application, if applicable ❑ ❑ El 4. Solid Fuel Burning or Gas Appliance form completed, if applicable El El 5. Driveway Permit, if applicable ❑ ❑ ►� 6. Structural Drawings: c.1 ❑ 0 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 f= ❑ ❑ 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 ❑ 0 ❑ 2. Energy Code inspector's report from COMcheck, completed & ❑ ❑ ❑ signed 3. Septic alteration application, if applicable ❑ ❑ ❑ 4. Solid Fuel Burning orGasApplianceform completed, if applicable El El ❑ 5. Driveway Permit, if applicable ❑ ❑ ❑ 6. Structural Drawings: ❑ 0 0 a. Floor plans b. Foundation plans c. Cross Sections d. Elevations e. Design loads including floor, snow&wind load f. Seismic design g. Plans signed & sea led by registered architect or engineer h. Window & Door schedule 7. Plot Plan: Show proposed structure(s}with setback dimensions ❑ ❑ ❑ from all surveyed property lines 8. Electrical inspection agency selected ❑ ❑ ❑ S. FINALAS-BUILT PLANS SUBMITTED ELECTr llCONICALLY ❑ ❑ ❑ 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 MALLORY AVENUI IPF IPF IPF 4'0 x 4' DEEP DRYWELL TALL IPF AS PER DETAIL ON S— TOP OF GRATE = 358.5 2' W X 2' D STONE DIAPHRAG AS PER DETAIL ON SP-5 4'0 x 4' DEEP DRYWELL /AS PER DETAIL ON S-3 TOP OF GRATE = 360.5 N4 Am lk S. f O ' � ED 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 CRUSHED STONE ASPHALT 1 VATION = 359.5 LANDS OF GRASSED WEIR EDWARD MURRAY Gv WEIR ELEV.= 364.75 LANDS OF WEST GLENS FALLS VOLUNTEER FIRE COMPANY NO. 1 "d I NOV 0 2020 1709C .5ulliamp 41!wej-z 611PIS , PH aujaznl 9T 3,11 sqAeH IV SaAeH ozoz-zl7zo-3u 16-T-OT'60S THE SEAL BELOW IS AN ORIGINAL SEAL AND IS IN RED INK. ONLY SEALS IN RED INK SHALL BE CONSIDERED TRUE ORIGINALS 40 20 0 1.0 20-- 40 GRAPHIC SCALE 1. = 40p— 0 U) a. Asa era CD N o.,l E S C Rl.-P Tl 0 N! DATE REVISIONS c� C. 4- C, F- -w (D uj Ln Z) a- >- 1 0 z vca 0 < 0 E 0 6 00 oov F- Z c c' Q- LL- 17) Ln Q) LLJ ode :3 75 vi C o 41 �:' x 'o 6 E Ld Q > U- W