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applicationsOffice Use On Permit#:(RC ~OOS 3—Wozo Permit Fee:$“70,20 *Rec,Fee:$,v/a Law va teeolee Invoices ZBLO Tax Map #:_298,/€-2-4 ‘Subdivision Name:“Joy CLEHDO®H)npdEr ESTATES TOWN BD RESOLUTION 86-2013 $850 recreation fee for new dwelling unitsmultiplefamily,apartments condominiums townhouses.and'or manufacturedhomes.This is in addition to the permit fee(s). CONTACT INFORMATION: ©Applicant: Name(s):FooTHitcs guwners (Soe Leuct)=Mailing Address,C/S/Z:4 MounTAINS IDE _DRive _Quecusquey WY leroy Cell Ph f (S18 )741-1933 Lendtine:|(1 )146-3520 (eu) Email;Foo Tys Bui LoeRs NY@ GmAL-com ©Primary Owner(s) Name(s):__Same AS APPLICANT. Mailing Address,C/S/Z: CellPh:(_)Land Line:_(___) Email: single family,dupiex2s'two-family, &modular homes but not mobile +Contractor(s): Name(s):SAME AS APPLICANT Mailing Address,C/S/Z: Cell Ph:_( Email: Land Line:_(___) +Architect(s)/Enaineer(s): Name(s):DAY RYAN,PE (vision Eneinee Re ) Mailing Address,C/S/Z:200 Glew <7 SuiTe Se GLers FAUS MY 1280) Cell Ph:_()Land Line:1(cr )192 -4264 Email:DRY AN@VISION ENG.EMAIL Contact Person for Building &Code Compliance:DE Leuct Cell Ph.s {(Sl)141-1433 band Line:i(St?_)19@-3520 Gen)Email:__Foo THILls Bui LOERSNIC GMAIL.Com Too Mine &Code Feforcement Prince Stenetate Rovinnd!Reh 7038, PROJECT INFORMATION; TYPE:Commercial K_Residential WORK CLASS: ke Single-Family ___Two-Family —Multi-Family(#of ____) Townhouse ____Business Office __Retail __Hotel/Motel ~_|ndustrial/Warehouse Garage (#ofcars )Other (describe.) STRUCTURE SQUARE FOOTAGE:GARAGE SQUARE FOOTAGE: 4 floor:S34 floor:FS2S2"floor:—2"floor: 3"floor: Basement (habitable space): Total square feet:_/5 3‘ Total square feet:_S_2-0 DITIONAL PR¢INF‘IATION: 1.Estimated Cost of Construction:$__|]S_,00 © 2.Proposed use of the building:___Res?DEN TAL 3.If Commercial or Industrial,indicate the name of the business:v [A 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 (no,Explain: 6.Are there any easements on the property?YES 7.SITE INFORMATION: a.What is the dimensions or acreag parcel?_O-8 ACRES b.isthisacornerlot?YES €.Will the grade be changed as a result.of the construction?YES.(NO) 4.What is the water source?PRIVATE = WELL e.Is the parcel on SEWER or a PRIVATE SEPTIC system?PRIVATE SEPTIC To tuiine &Cade Enforcement ence Strutt Revise March 20 DECLARATION: |.lacknowledge that no construction shall commence priorto issuance of a valid building perm 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 |,or my agents,willobtain acertificateofoccupancy. 5.|understand that live are required to provide an as-built survey by a licensed land surveyor ofallnewlyconstructedfacilitiespriorto |have read and agree to the above: PRINTNAME:JOSEP It Leu SIGNATURE: - ~~vate:2[s[z0 ‘ToC Building &Code Enforcement Psnrnka Stmictice Resend Marrh 200% Office Use Only FUEL BURNING APPLIANCE &Permit #: CHIMNEY APPLICATION Permit Fee:$Invoices742BayRoad,Queensbu,Ny 2804 P 518-761-8256,st Project Location:“13_Joan (lwo Tax Map ID:_245.18-2- Room of Install:_(-2€xy Planned Install Date:4/5 [20 “ONE APPLICATION PER APPLIANCE** CONTACT INFORMATION: ©Applicant: Name(s):_FooTHites Buiepers rec (Jee teucs) Mailing Address,C/S/Z:4_MovwTAIwsin€De Queensauet WY 12804 Cell Phe:1 (S18)191-1933 tend Line:((5/8)196-3520 (cou) Email:FooTH its huirdersiny ©EMAIL,com ©Primary Owner(s): Name(s):__S Ame AS APILIC ANT Mailing Address,C/S/Z: CellPh.:_(__)Land Line:_(__) Email: © Installer/Builder: Name(s):Same AS Apericant Mailing Address,C/S/Z: )Land Line:_(__), Contact Person for Building &Code Compliance:“Sve LEWC! Cell Phir (SUF)791-1433 band Line:|(sf WMWe-352e (cer)Email.feeputirs—te FooTHILSBUILDE RS NYO GMAIL,Com oun of Quvenstury Buln §Cos Entorserant FUEL BURNING APPLIANCE INFORMATION: ‘TYPE OF DEVICE: Stove ireplace Insert FireplaceHITEMountainmopec Dvp36FP30N TAHOE DELUXE ——Fue!Fired Equipment (Garage Only,B"clearance per!IMC304.3) —Fireplace,factory built** "*Manufacturer's Name:Mode! SOURCE OF HEAT: Wood Coal Pellet (easy ‘CHIMNEY INFORMATION: —Masonry: block brick stone Flue: tie !2.size,in inches Material": double-wall —__triple-waill_insulated (Manufacturer's mz <=:——________Model #: ADDITIONAL INFORMATION: ‘1 Two inspections are required.A rough-in inspection,prior to installation and a final inspection afterinstallation. 2 Manufacturer's installation manual must be available at the time of inspection. S_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 manufacturerfequiements,The applicant or owner agrees to comply with all applicable laws,ordinances,regulations and allConditionsthatarepartoftheserequirementsandalsowillallowtheinspectortoenterthepremisestoperform therequiredinspections. Ihave read and agree to the above: PRINTNAM:PH Leuct Ge.- ‘oOSIGNATURE:/N—DATE:2)s]z Fuel Buming Appliance &Chimney Application SEPTIC DISPOSAL PERMIT APPLICATION 742 Bay Road.Queensbury,NY 804 P 518-760-856 ste:Tax Map ID#|ProjectLocation:73 Sete CLEN PGW Primary Owner(s)|FooTH BWILDERS Mailing Address 4 iwsipe Bi|Phone &Email Gene(433.[Csi96-3526_ =“nstalier/Buikier |SAME AS APPLICANT“Maling Address “Phone &Email ;aeL =_|Tom Cepter P.E+aetincinnliesMelingAddress)Lei wavicana RD Queensourd NYProneEmail|(s1¢)146-2515 TeewTER30 ©YAHOO Com Contact Person for Building &Code Compliance:22£44 ppone:(S11)141G8)oRESIDENCENFORMATION:SIE “he:382 YeerBuilt__#of bedrooms|x gallons per bedroom|=totally fow|[Garbage Grinder[Yes(wo)BBO or older installed?{circle one)e88)Z ‘Spa or Hot Tub [Fee ‘poz-preseat]3]PARCEL _NFORMATION: ‘Topography x Fiat Rolling ‘Steep Slope %Slope Soll Nature KSana ~Leam chy OtherGroundwaterTAtwhatdepth?0 /ABedrock/mpervousmateral |Atwhatdepth?jv 7A 2DomesticWaterSupplyMunicipalWellffwellupplyfromany septic system absorption s__1.)|Percolation Test Rate:1S"per minute per inch {test to be completed by licensed engneer/arcitect)|PROPOSED SYSTEM FOR NEW CONSTRUCTION: Tanksize _/O0 ©gallons {min.size 1000 gallons,add 250 galions for each garbage cylinder or spa/hot tub System|Absorptionfieldwith#2 stone Totallength ;_fixEachTrench_Of.ie ‘Seepage Pitwith #3 stone How many,‘Size:ce Alternative System Bedor other type: Holding Tank System "Total required capacity?tank size oH of tanks: NOTES:1Alarmsystem &associated electrical workmust beinspected bya Townapproved electrical inspection agency :2.We willno longer allow systems to be covered untilsuch time as an as-built plans received and approved The installed system must match the septic layout on file-no exceptions. Declaration:Any permit or approval granted which is based upon ors 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.thavereadtheregulationsandagreetoabidebytheseandallrequirementsoftheTownofQueensburySanitarySewage Disposal Ordinance. PRNTNAME:__JPSEPA LeUCy oare_2/S|26_ Tous at Ousanaburs ©2038 Coas Enforcement ctor Febeusry 200 —pare ts [20 Town of Queensbury Thomas R.Van NessHighwayDepartmentHighwaySuperintendent742BayRoad,Queensbury,NY 12804 Home:518-745-0929Phone:518-761-8211 Fax:518-745-4466 David Dueit Deputy Highway Superintendent Home:518-745-0938 DRIVEWAY PERMIT Date:2s |26 Applicant Name:FooTHits puoers (we ccucy) Telephone No.:(s18)741-1933_/(619)796-3520 Address to be Inspected:23 Joan crewow gp Return Address:G_mountainsDE DA QueerSeury AY [264 Applicant must show exact location and width of driveway(s)to be connected to the highway by placing stakes at the specified location. ‘The Superintendent of Highways of the Town of Queensbury has reviewed this application.The followingactionhasbeentaken: STEP 1:()Preliminary approval NEED ()Slight Swale ()Deep Swale ()Level with the road()Level with the top of the paved wing Size culvert pipe to be used (if necessary) ees!()as”()18”()24"()36" Preliminary inspection completed by:Date: Approval by Highway Supt.:or Deputy Supt.: Upon completion please resubmit this approval permit for a final approval. STEP 2:()Final Approval ()Rejected Date: ‘Thomas R.Van Ness,Highway Superintendent David Duell,Deputy Highway Superintendent ‘Town of Queensbury Building &Code Enforcement Principal Structure Appiction Revised February 2017