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TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
— - Community Development-Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: CC-000064-2016
Tax Map No: 302.5-1-92.2
Permission is hereby granted to: JC Penney Company Inc.
For property located at 578 Aviation RD
In the Town of Queensbury,to construct or place at the above location in accordance with application togelher
with plot plans and other information hereto Fled and approved and in compliance with the NYS Uniform
Building Codes and the Queenshury Zoning Ordinance
Tyne of Construction
Owner Name: AVIATION MALL NEWCO LLC Retail-Mercantile-Alteration $200,000.00
Owner Address: 578 Aviation RD Total Value $200,000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
Interior Commercial Alterations 3300 s.f.
JC Penney
$660.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,February 17,2017
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury beforetion date.)
ue
Dated at the Town of 6: S,
)Yd
httrs a ,F 8,2016
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
"PRINCIPAL STRUCTURE APPLICATION Office Use Only
Date: 07- o 2of,&
Permit No.
Tax Map ID Z- Permit Fee {iQ acv , 1r1vo pct.2
Zone Historic? _Yes No Rec Fee
Subdivision Name Lot#1 Site Plan 4
Subdivision#
Project Location AVIAT+oN MAi-t.., X78 AvfA-norr
TOWN BD.RESOLUTION 86-2013: $850 recreation fee for new dwelling units—single family,duplexes/two-family,multiple family,
apartments,condominiums,townhouses,and/or manufactured&modular homes,but not mobile homes. This is In addition to the
permit fee(s).
Primary Owner(s) IG �1r N rVlt'�1( CIO All PA N y( IIV.
AadressI Lc(-,Acy M FLAW Trx '7 570 2-4 FSB � I
Phone/Email472) 4 31 i 6 q �V.F_—,\S P.-o 0 J C I,- WM Y
Applicant S 13 L M A P,LAA-L i Crt S
Address 16a10 VAL01S PKWY I SI-t- '2-i6 i Don LLA s i TA- -7S149
Phone/Email (46Q) t �_If `-7774 / 9JRi`toN0 Ca) 'S LOM
Contractor
Address
Phone/Email
Contact Person for Building&Codes Compliance: kTC, AKD f'`E N4 Phone
TYPE OF CONSTRUCTION
,/Check all that apply New Addition Alteration I1 floor sf 2"d floor sf Total sf Height
Single Family
Two-Family
Multi-Family
(#t of units
To,Amhouse
Business Office
Retail-Mercantile V 31300 Z,t3 p o
Factory-Industrial
Attached Garage
(1, 2, 3, 4f)
Other
Town of Queensbury Building&Codes Principal Structure Application revised January 2016
,r
If commercial or industrial please indicate name of business C
Proposed use of building or addition e?MMMUAL
Source of Heat(circle one) Gas Oil Propane Solar Other
Fireplace: Complete a separate application for Fuel Burning
Appliances&Chimneys
Are there structures not shown on plot plan?
Are there easements on the property?
Site Information:
a. Dimensions or acreage of lot
b. Is this a corner lot? Yes No
c. Will the grade be changed as a result of construction Yes No
d. Public water or Private well(circle one) Public Private
e. Sewer or Private Septic System(circle one) Sewer Private
Value of all work to be performed(labor or materials) $ S001000
DECLARATION.-
1. I acknowledge no construction shall be commenced prior to issuance of a valid permit and will be
completed within a 12 month period.
2. If work is not complete by the 1 year 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 /
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 also understand that I/we are required to provide an as-built survey by a licensed land surveyor of
all newly constructed facilities prior to issuance of a certificate of occupancy.
I have read and agree to the above:
PRINT NAME: 4Z1C.444P'> a-pj—�-LA-ND DATE: 02- 0 '20 f b
SIGNATURE: DATE:
For office use only
Operating Permit Issued: Yes No
Occupancy Type
Construction Classification
Assembly Occupancy Limit
Special Conditions
Town of Queensbury Building&Codes Principal Structure Application Revised January 2016