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2000-604 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building & Codes (518) 761-8256 I FI 10".A.'I'E 3F OCCUP-A-N. CY Pen-nit Number. P20000604 Date Issued: Tuesday, December 12, 2000 This is to certify that work requested to be done as shown by Permit Number P20000604 has been completed. Tax Map Number: 523400-074-000-0002-088-000-0000 Location; 64 SARA-JEN Dr Owner. GUIDO PASSARELLI This structure may be occupied as a; Fireplace Garage - 2 Cars Attached By Order of Town Board Single Family Dwelling TOWN OF QUEENSBURY Director of Building&Code Enfonement TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development- Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20000604 Application Number: A20000604 Tax Map No: 523400-074-000-0002-088-000-0000 Permission is hereby granted to: MICHAELS GROUP Owner of property located at: SARA-JEN Dr in the Town of Queensbury, to construct or place a Single Family Dwelling 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. Owner Address: GUIDO PASSARELLI 2569 LAKE Ave LAKE LUZERNE,NY 12846 Contractor or Builder's Name/ Address Electrical Inspection Agency MICHAELS GROUP NEW YORK BOARD 10 BLACKSMITH DRIVE QUEENSBURY.NY Type of Construc6ion: Single Family Dwelling Value : $ 178,900.00 Plans & Specifications 2400 SQ FT SINGLE FAMILY DWELLING WITH 2-CAR ATTACHED GARAGE AS PER PLOT PLAN SPECIFICATION $296.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Friday,August 16,2002 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the Town o1rQuee bu �d;otst 16,2000 SIGNED BY for the Town of Queensbury. Director of Building& Code Enforcement BuildingPermit Application Town of Queensbury - Dept. of Cony»turily Development, 742 Day Road, Queensbuty, NY 12804 1761-32S6/ BUILDING & CODE ENFORCEMENT NOTICE Requirements prior to issuance A permit must be obtained before of this permit: PERMIT FILE NO.p?�0 - (off beginning construction. No inspections rl will be made until applicant has received Zoning Board Action PERMIT FEE PAID $ __Cy a VALID BUILDING PERMIT. All Area /Use RECRL itT/ON FEE PAID$, applicants' spaces on this application MUST be completed arid-the signature [] Planning Board Action REVIEWED BY. . JA= of the applicant-must appear on the SPR / Subdivision /Other lJiiik/ink G«Ixnnr •t plication form. nn,c Recreation Fee Payment Applicant: TqEfltt�c'lt✓�S 1�t,2L�l�p Owner: Si�'mE Address: Mtt. ,�.„_,_T �2d Address: Phone # (5_� ) a - " _ Pltone # ( ) Property Location: '_ `I2r-6 1GZSL �!��Ct'RS Cl� ) �uD Tax Map Number Subdivision Namc: 2+K� , -- '�— _ Section Block l nt NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE _ New Building: CONSTRUCTION: $_ 1-1�3�oypc� residence / commercial Addition to Building: residence / commercial OCCUPANCY INFORMATION: Alteration to Building: Primary Building - residence / commercial X Single Family Dwelling Residence / Commercial Two Family Dwelling no change to exterior size Family Dwelling Office Other Work (describe below) Mercantile Manufacturing Other GROSS AREA OF PROPOSED STRUCTURE: 1st Floor. . . . . . . . sq. ft. /� If ADDITION, what will use 2nd .Floor. . . . . . . . 13131_ sq. ft. Iof knew addition be? : Other Floors . . = sq. f t. /i —`-'�'� (not unfinished•cellar or basement) ACCESSORY BUILDINGS: Detached Garage 1, 2 car TOTAL FLOOR AREA: 2,_-`�00 SQ. FT. Attached Garage 1 , 2 car Private Storage Bu SIZE OF NEW STRUCTURE: Commercial Storage Building FEET X _ FEET Other Foundation Type: ?�ao:!> Y, C3 Will any second-hand or ungraded Number of Stories : _�_ lumber be used? If so, for what? (habitable space only) �Ap Height (grade to ridge) : ZS feet TYPE OF HEATING SYSTEM: Number of fireplaces and/or woo3stove (circle all which a plies ) to be installed: �_ Electric / Oil / as / Wood Forced Hot Air / Baseboard / Other Person respg sible for supervision of work as regards to building codes i s : L,` �mlue. OR 2YU2n Ut-Elvcm Nd. e A dre s Phone Builder: 0 ` O - \k Plumber: 2 0 - _A&r Mason: 1 1 Electrician: Z DECLARATION- Please sign below (?er you Dave carefully read the state»tetrr. To the best of my knowledge the statements contained in this application, together witl1 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 I/we shall submit prior to a Certificate of Occupaney'or Certificate of Compliance being issued, an AS BUILT PLOT PLAN by a licensed surveyor; dr to sc le, o ng actual location of project on premises. Signature: (own r, owner's agent, architect, contractor) Application for Permit- Septic Disposal System 7owtt of Quounshttty 74211aylluncl Queensbury, NY 12304 (518) 761-82.56 1. OWNER INFORMATION: .............................................................................................................................: �,,11 o lee Use � i"Location of installation: ( �fc, / (1� ( File Peniiit No. Tax Map No. '/ Z 4 Fee Paid Owner's Name: 3 Q A!Q�,P _ Address: kQ 2. INSTALLER'S NAME PHONE NO. CvZ3- 1Cflj 3. RESIDENCE INFORMATION: (circle year of dwelling, indicate #bedroom(y) and multiply It of* bedrooms with applicable gallons her bedroom to equal total dailyJlow) Year of House: No of Bedrooms x Computation = Total Daily Flow 1980 or older x 150 gal/bdrm = 1980 - 1991 x 130 gal/bdrm = _ 1991 -present x 110 gal/bdrm = G� D Garbage Grinder Installed yes _ / no Spa or Whirlpool Installed yes— / no 4. PARCEL INFORMATION: (circle applicable information & indicate measure►nents) To ovraDliv Soil Nature Ground Water Bedrock or Impervious Material Domestic Water SuQpty (Ite sat at what depth at what depth /t/rulicipa� Rolling loam Q feel feet t--'"- Steep slope clay ij'wcll; water supply �%slope other jrolll anv septic-s)we'ln depth: absolption is other Percolation Test: (1'o be colnpletecl by licensed pl•(?%ssiolrcll etigirleer ill•arcltitec•t) - Rate __ � ___ minrrtcperinch 5. 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 sirs or the septic tank and leach field for each Garbage Grinder, Spa or Whirlpool Tub. Septic Tank: I- gallon (min. size 1,000 gal) Tile Field: each trench �o ,ft. Total System Length: 2 l 0 Jt. Seepage Pit(s): number of size oj'each: Size of Stone to be used: it / depth or thickness Bed System Size: x Alternative System: _ length ancUvr size ___ -_ _- --__---_---_..__._-_-.-_• 6. HOLDING TANK SYSTEM: (if required) Number of tanks:. ! Size of each: gallons !TOTAL Capacity: gallons Ala-r-ni-Sys"tem-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 or is granted in reliance upon any material misrepresentation or failure to wake 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 requireme:S1 Xnature n of Queens Sanitary Sewage Disposal Ordinance. C� o respo sable person Dat©