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applications. Office Use Only PRINCIPLE STRUCTURE PERMIT=|Permit #:be =O04;=2020 APPLICATION Permit Fee:$F450742BayRoad,Queensbury,NV 2804 *recFer:$@EQFP:518-761-8266 ners sisoar |Invoice #: Project Location:i Hill ‘De: Tax Map #:_308.7-1-1715 Subdivision Name:Pascinger HeightsTOWNBD.RESOLUTION 86-2013:$850 recreation fee for new dwelling units:single family.duplexes/two-family,multiplefamily,apartments,condominiums townhouses,and/or manuifactured&modlilar hy jot mobilehomes.This is in addition to the permit foe(s).pec kiwis+ ITA‘‘ORI JON:va}|),|JAN 40 2020 ©Applicant: 'TOWN OF QUEENSBURYName(s):_Hodneroski HrmeS BUILDING &CODES Mailing Address,C/SIZ:“A Burdeck St Schenectarly /220% Cell Ph.:__(Land Line:__(5/8 ).356-/435 Email:Paul@Inedbemaskigcnupfalwaat «Primary Owner(s): Name(s):__Mission Builders Maling Address,C/SIZ:Tle Puedeck St Schenectady NY /230¢ Cell Ph.:__(»)Land Line:_(S/&_)356 -/435 Emai:_Powd@ lnodocowasiiacoug.com *Contractor(s): Name(s):_Hodocoskti Homes Mailing Address,C/S/Z:196 Burdeck St Schenectady NY 12306 Cell Ph.:__()Land Line:__(_578 )3 -/436Email:PO@hnoclorouoskigcoup:com «Architect(s)/Engineer(s): Name(s):Nocdthetac Home De:LL mi. Mailing Address,C/S/Z:_35 Checru,“Tree bn Wilton NY 1480S Cell Ph:_(__)Land Line:.(518 )306-595 [ Email:_SKo7 \9&@ Ourop.Ce toa Contact Person for Building &Code Compliance: Cell Ph:_(5/8 )365-R808 Land Line:__() Email Neoa\S @ nodocowsk raroup:Com, PROJECT INFORMATION: TYPE:Commercial Residential WORK CLASS: “Single-Family ___Two-Family __Multi-Family Gof ) Townhouse Business Office __Retail __Hotel/Motel —Industria/Warehouse ___Garage(#ofcars__)___Other(describe. STRUCTURE SQUARE FOOTAGE:GARAGE SQUARE FOOTAGE: foo load Ptioor_BO5I2"floor:__l0g5 +/-2 floor: 3c .‘tH-3 floor: Total square feet:O05 *7/ Basement (habitable space): Total square feet:ANS 4/- ADDITIONAL PROJECT INFORMATION: Estimated Cost of Construction:$__6200 000) 2.Proposed use ofthe building:Sin.gle Lorni 44 duel og. 3.If Commercial or Industrial,indicate the name of the business: te 4.Source of Heat (circle one):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 (Wo Botain: 6.Are there any easements on the property?YES. 7.SITE INFORMATION: a.What is the dimensions or acreage of the parcel?2 Ho te b.Is this a corner lot?ves (Ko).Will the grade be changed as a resu[efthe construction?YES d.What is the water source?PUBLIO PRIVATE WELL e.Is the parcel on SEWER or @ PRIVATESEPTIC system?) DECLARATION: |.lacknowledge that no construction shall commence priorto issuance of a valid buildingpermandworkwillbecompletedwithina12monthperiod 2.Ifthe work is not completed by the 1year expiration date the permit may be renewedsubjecttofeesanddepartmentapproval. 3.I certify that the application,plans and supporting materials are a true and complete statementand/or description of the work proposed,that all work will be performed in accordance with theNYSBulidingCodes,local building laws and ordinances,and in conformance with local zoningregulations. 4.|acknowledge that prior to occupying the facilities proposed |,or my agents,willobtain acertificateofoccupancy. 5.|understand that lve are required to provide an as-built survey bya licensed land surveyor ofallnewlyconstructedfacilitiespriortoissuanceofacertificateofoccupancy. |have read and agree to the above:CPRINTNAME: SIGNATURE:Toul Hodacowsk pare:_]8/aa10 Office Use Only FUEL BURNING APPLIANCE &Permit #:£2 -001\4 -20210 CHIMNEY APPLICATION Permit Fee:$ =Invoice #:of Queensbu 742 Bay Road,Queensbury,NY 2804 P: 518-761-8256 www quec’bury net Project Location:98 Richmond Hill DeTax Map 1D:308,9-|-75 Room of Install:Family Room Planned Install Date: “ONE APPLICATION PER APPLIANCE** CONTACT INFORMATION: ©Applicant: Name(s):_Hodpceuosky Heme: Malling Address,GISIZ:“Te Bucdeck St Schenectady NY /230lCellPh:_(__)Land Line:_(Sig_)”356-435Email:_Qou @ Nedecossiing 120-1, ©Primary Owner(s): Name(s):_MisSion Buildec. Mailing Address,C/SIZ:_19lp Pucdeck St Schenectady NY 12306CellPh.:_()Land Line:__(5/€)45%-/435Email:Modoc ows kicrroug:cnaSaat©Installer/Builder: Name(s):_ndocvoski Homes Malling Address,C/S/Z:_14 Burdeck St Schenectady NY [A306 Cell Ph:_(__). Land Line:__(5/@ )356 ~/435 Email:au W@ \odoroussky Qro4p.Corry Contact Person for Building &Code Compliance:N €a\SaunaCellPh.:__(5/8)365-890 Land Line:__(NI Email:Nea\S @ Yond cows ix acnu0.Coo FUEL BURNING APPLIANCE INFORMATION: ‘TYPE OF DEVICE: Stove ___Fireplace Insert v Fireplace ___Fue!Fired Equipment (Garage Only,8 clearance per IMC304.3) __-Fireplace,factory built**ne"Manufacturer's Name:Su gerciom Model#_DRY 2005 SOURCE OF HEAT: Wood Coal Pellet CHIMNEY INFORMATION; NlA Gas dicect vent__Masonry: block brick stone Flue: tie steel ___size,n inches Material": double-wall _triple-walll_insulated ("Manufacturer's za re :—________.Model #: ADDITIONAL INFORMATION: ‘1.Two inspections are required.A rough-in inspection,prior to installation and a final inspection,after installation. 2 Manufacturer's installation manual must be available at the time of inspection.3 Masonry fireplaces &chimneys require plans to be submitted. 4.Twenty-four (24)hour notification is required for inspections. 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 lws,ordinances,regulations and all conditions that are part ofthese requirements and also will allow the inspector to enter the premises to perform the requited inspections.. Ihave read and agree to the above: PRINTNAME:Pass)Bodor oasis - SIGNATURE :DATE:tfelec Fuel Burning Appliance &Chimney Application Permi#(2-05 \4-21072 SEPTIC DISPOSAL PERMIT APPLICATION 742 Bay Road,Queensbury,NY 12804 P.518-76 18256 f Tax Map ID#:308.7-1 15 Permit Fee:$Invoice Project Location:_9 Richmond Hi Deive,Septe Varianee?__Yes igPrimaryOwner(s)Nission BulldersiolloTeBurcleck9Sclhenectacuy,NY 1230Phone&Email 51 356-1495 Pawel @ hodacowsKiqcauQ.com,Installer/Buikier Hedorowski HomesCaeee16BurdeckStSchenectady,AY 1230Phone&Email SIE -356-1435 h Eronger NarDusen +Steve's Land Sucveyocs,Malling Address 169 Haviland Ra Queens buyALY /a8O4Phone&Email R-199-84 Contact Person for Buitiing &Code Com pliance-Neal v0 prone:518 -345-50S RESIDENCE NFORMATION: YearBuit|#of bedrooms_|X gallons perbedroom|=totaldaily flow Garbage Grinder Yes (No) B80 or older Installed?{circle one) DELO ‘Spa or Hot Tub YesC NoyInstalled?{circle one)[mary Beleng|187 £20 PARCEL_NFORMATION: “Topography >Fiat Roling Steep Slope ___%Slope ‘Soil Nature X_Sand —lLoam Clay _Other Groundwater Atwhatdepth?wylila @ 917 Bedrock/imperviousmaterial|Atwhat depth?as6DomesticWaterSupplyXMunicipalWell{if well,water supply from any septic system absorption s___fL) Percolation Test Rate:/7°perminute perinch (test to be completed by licensed engneer/arcitect) PROPOSED SYSTEM FOR NEW CONSTRUCTION: Tanksize |/Z¢O gallons {min.size 1000 galions,add 250 galions for each garbage cylinder or spa/hot tub System|Absorption fieldwith#2 stone |Totallength 507 fzEachTrench 4)So ft. Seepage Pitwith #3 stone How many:“Size: ‘Aitemative System Bed or other type: Holding Tank System [Total required capacity?+—tank size #of tanks NOTES:1Alarmsystem &associated electricalworkmust be inspected bya Town approved electricalinspection agency;2.We willno longer allow systems to be covered until such time as an as-built plan és received and approved. The installed system must match the septic layout on file-no exceptions. Declaration:Any permit or approval granted which is based uponor is granted in reliance upon any material representation or failure to make a material fact or circumstance known by oron behalf of an applicant,shall be void! have read the regulations and agree to abide by these and allrequirements ofthe Town of Queensbury Sanitary Sewage Disposal Ordinance. PRINT NAME:“uw!Hodorowski oare_1|8/2020 t SIGNATURE:Weee?\8, pare:/[efaran