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Office Use Only Permit:be —7224-2979 Permit Fee:$08.*0 *Rec.Fee:$Lund Invoice #: Project Location:32 Jous CUsrdve gn Tax Map #:_Z29S,|§=2-2 Subdivision Name:“JoHW _CLEND0W inde ESTATES TOWN BD RESOLUTION 86-2013 $850 recreation fee for new dwelling unis single family,duplexestwo-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):FooTHites guwners (Soe reuci) Mailing Address,C/S/Z:_4 MoUNTAINS IDOE DRiveE Queewsauey WY legoy Cell Ph:t (S18 )741-14 33 Land-tine:|(51 )296-3520 (eeu) Email:FooTyjeesBuiLoers NY@ Gmaje-cewr *Primary Owner(s) Name(s):SAME _AS APPLICANT PRINCIPLE STRUCTURE PERMIT APPLICATION 742 Bay Road Queensbury,NV 2804 P 518-761-8256 Mailing Address,C/S/Z:r CellPh:(___)Land Line:_{|)CEIVER Email:Nt tea 99 anon TET MAE 28-2883 Toy +Gontractor(s}:TOWN OF QUEENSBURYName(s):SAME AS APPLICANT BUILDING &CODES Mailing Address,C/S/Z: Cell Ph:_(___).Land Line:_(__) Email *Architect(s)/Engineer(s): Name(s)DAY RYAN,PE (vision Ewe ineeking ) Mailing Address,C/S/Z:200 _Gtew $7 SwiTE 5b GLEPS FALLS NY 1280 1 Cell Ph.:_()Land Line:1 (cry)292 -4264. Email:DRY AP @ VISION ENG.EMAIL Contact Person for Building &Code Compliance:J0E Lewci Cell Ph:{(SU¥_)141-1433 tand Line:|(St?)W4e-3S20 (eet)Email:FooT Hits guitoeesw71@ GmMAIL.com ‘TOO Ruling R Code Fnforeoment Princes Stctuer Rowse Rasch 7038 PROJECT INFORMATION: TYPE:=___——Commercial XL Residential WORK CLASS: AX.Single-Family __Two-Family __Multi-Family(#of ___) ___Townhouse ___Business Office _——Retail ___Hotel/Motei _Industrial/Warehouse Garage (#ofcars )Other (describe,) STRUCTURE SQUARE FOOTAGE:GARA\JARE FOOTAGE: 1"floor:_|0 @ 0 foo:482"floor:_F (o'2 floor;3?floor : Total square feet:(8%Basement (habitable space): Total square feet:2029 ADDITIONAL PROJECT INFORMATION: 1.Estimated Cost of Construction:$_2S "©,co 0 2.Proposed use of the building:_Res (DE wTLAL 3.If Commercial or industrial,indicate the name of the business: 4,Source of Heat (circle one):(Gas?Oil Propane _—Solar_Other: (Fireplaces need a separate Fuel Burning Appliances &Chimney Application,one per appliance) ”Are there any structures not shown on the plot plan?—_-YES (AO}ExpIain: 6.Are there any easements on the property?YES (xo 7.SITE INFORMATION: a.What is the dimensions or acreage atthe parcel?__(.t Aches b.Is this a corner lot?Yes ©.Will the grade be changed as a result ofthe construction?YES CNO> d.What is the water source?PUBLIC PRIVATE WELL e.Is the parcel on SEWER or a PRIVATE SEPTIC system?Riv AT “Tol Bulline A Cade Enforcement Prncinte Stuctien Reent March 2018 DECLARATION: |.lacknowledge that no construction shall commence prior to 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.|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 the NYS Building Codes,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 live are required to provide an as-built survey by a licensed land surveyor ofallnewlyconstructedfacilitiespriortoissuanceofacertificateofoccupancy. |have read and agree to the above: PRINTNAME;Jose?Leuc/ SIGNATURE:Cy.ta pate:_S ]2e/20 ‘Too Bulldine&Code Enforcement Piincinle niches Ranked March 709% Office Use Only FUEL BURNING APPLIANCE &Permits:PE -D2ZH-2920 CHIMNEY APPLICATION Permit Fee:§ Invoice #: y Road,Queensbury Ny 2804 P 2)Project Location:32 Jouw Cleroe “Tax Map ID:295 (8-2-2 |Room of Install:GREAT Room Planned Install Date:_A“GUST _2¢10 “ONE APPLICATION PER APPLIANCE** CONTACT INFORMATION: ©Applicant: Name(s):_FooTHines pueners tec (JE Leuci) Mailing Address,C/S/Z:4_MeveTAInsiDE De QueEensAus4 NY 1/2804 Cell Ph:1 (SE)791-1933 band Line:((518 )196-3520 (cou) Email:FeoTw its huinderiny @ EMAIL.com ©Primary Owner(s): Name(s):__SAme AS Arfeic AwT. Mailing Address,C/S/Z: Cell Ph:__()Land Line:_(). Email: © Installer/Builder: Name(s):Same AS Apericant Mailing Address,C/S/Z: Cell Ph._()Land Line:__(). Email: Contact Person for Building &Code Compliance:Jue LEWC! Cell Phi:L(SUP_)791-1433 tand Line:((518)196-3526 (céuc)Email:Seetitees—pe FooTHILLSBUILDE RSNY@ EMAIL,COm ‘Tow of Gueenseury Buln:8 Cos Ent-cement FUEL BURNING APPLIANCE INFORMATION: TYPE OF DEVICE: Stove XX Fireplace Insert __FireplaceHITEMOUNTAINmoner DvD36FP30N TAHOE DELUXE ___Fuel Fired Equipment:(Garage Only,B"clearance|perIMC304.3) Fireplace,factory built***Manufacturer's Name:Model #: SOURCE OF HEAT: Wood Coal Pellet (ee CHIMNEY INFORMATION: __Masonry: block brick stone Flue: tie !Z.size,in inches Material: doublewall __triple-wall_insulated (Manufacturer's name Model #: ADDITIONAL INFORMATION: 4.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.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 manufacturerfequrements.The applicant or owner agrees to comply with allapplicable lws,ordinances,regulations and allconditionsthatarepartoftheserequirementsandalsowillallowtheinspectortoenterthepremisestoperform therequiredinspections.. Ihave read and agree to the above:VW Leucy = SIGNATURE:VW AX pate S/2 [re Fuel Buming Appliance &Chimney Application SEPTIC DISPOSAL PERMIT APPLICATION 742 Bay Road,Queensbury,XY x04 P 518-76 1°56 ‘Tax Map ID#: Project Location: Primary Owner(s) “MailingAddress|Phone &Email “nstaller/Buikler 6 APPLICANT ||Maiing Address Phone Engineer Tom Ceptee p.€+ loi _wavicams RD Queensaurd wy 12g04 (sig)146-251 5 TeewTER36 @ YAHOO.Lem qContactPersonforBuilding&Code Compliance:2LEXPhone:(810)141-1433 RESIDENCE NFORMATION:oI,“ae 3520 i Mailing Address Phone &Email YearBut ot uceoms [gon parbecon [=ley tow| SatbageGinaar~[Va5(R) Installed?{circle one)—oh Spa or Hot Tub Yes (No) sacar a __||instatied?(circle one)_}‘wea-PreseAt]=ue 330 qePARCEL_NFORMATION: Topography ~_K___Fiat Rotting ‘Steep Slope %Slope ‘Soil Nature KSand _Loam __Clay__Other Groundwater Atwhat depth?7 /A —eatBedrock/mperviousmateral |Atwhat depth?/AComesticWaterSupplyKMunicipal‘Well {if well water supply from any septic system absorption is_Rh)|Percolation Test [Rate:|~er minute per inch {lest to be completed by licensed engheer/arcitect) PROPOSED SYSTEM FOR NEW CONSTRUCTION: Tanksize (000 gallons {min size 1000 gallons add 250 ga lions for each garbage cylinder or spa/hot tub|System,Absorption field with#2 stone Totallength (SO fi:EachTrench ¢O fi.-‘Seepage Pitwith #3 stone How many:‘Size: Alternative System Bed or other type: Holding Tank System "Total required capacity?tank size #of tanks: NOTES:1Alarmsystem &associated electricalwork must be inspected bya Townapproved electrical inspection agency:2.We willno longer allow systems to be covered until such time as an as-built plan's received and approved, ‘The installed system must match the septic layout on file-no exceptions. Declaration:Any permi or approval granted which is based upon oris 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.! have read the regulations and agree to abicle by these and allrequirements ofthe Town of Queensbury Sanitary Sewage Disposal Ordinance. PRINT NAME:__Jesé ?W dieiioune Oy tae Come Entorceront Lwc|ome [20/20 —pare.SLee/r Town of Queensbury ‘Thomas R.Van Ness Highway Department Highway Superintendent742BayRoad,Queensbury,NY 12804 Home:518-745-0929Phone:518-761-8211 Fax:518-745-4466 David Duett Deputy Highway Superintendent Home:518-745-0938 DRIVEWAY PERMIT Date:§(26/2 Applicant Name:Footwices puwoers (me euct) Telephone No.:(s18)741-1933_/($18)796-3520 Address to be inspected:Bz eur Crerdom ko Return Address:G_Mountains me DA QueerSbury WY 12804 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 following action has been taken: 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) {)12”()18”{)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 Bulking B Code Enforcement Principal Structure Application Revised February 2017