CC-0030-2018 TOWN OF QUEENSBURY
742 Bay Road, Queensbury,NY 12804-5904 (518)761-8201
MW Community Development- Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: CC-0030-2018 Date Issued: Wednesday, February 28, 2018
This is to certify that work requested to be done as shown by Permit Number CC-0030-2018
has been completed.
Tax Map Number: 296.20-1-8
Location: 333 QUAKER RD
Owner: Midas Muffler
Applicant: Nicholas Newell
This structure may be occupied as a: Commercial Interior Alterations
(Lobby/Waiting Area) 320 s.£ By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the
property owner of the responsibility for compliance with Site Plan,
Variance, or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
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-0030-2018
Tax Map No: 296.20-1-8
Permission is hereby granted to: Midas Muffler
For property located at: 333 QUAKER RD
In the Town of Queensbury,to construct or place 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
Type of Construction
Owner Name: Midas Muffler Business Office-Alteration $7,500.00
Owner Address: Total Value $7,500.00
Contractor or Builder's Name/Address Electrical Inspection Agency
Nicholas Newell
8 4th ST
Hudson Falls,NY 12839
Plans&Specifications
Commercial Interior Alterations(Lobby/Waiting Area) 320 s.f.
$ 175.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Wednesday, January 30, 2019
(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 o uee ury; ire&30, 2018
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
t
Office Use Only
ADDITION/ALTERATION PERMIT Permit#: r_c- - 60,50 ' Z o
APPLICATION Permit Fee:$ 1�5
linen of Quecilsburt
742 Bay Road,Queensbury,NY 12804 Invoice#:
P:518-761-8256 www.ciueensbury.net
Project Location: 3��Jr�►hSZY
Tax Map ID .'ZO Subdivision Name:
CONTACT INFORMATION:
• Applicant:
Name(s): i C,1' Vk S tie-WQA,,
Mailing Address, C/S/Z: -04
Cell Phone: 71 ) Land Line: � )
Email: n1c ofas oeAJe-11 62 W
• Primary Owner(s):
Name(s): �NT SVY1 I1
Mailing Address, C/S/Z: 0GIICC—YZ- J2(), \j&yL&IjuQ(,ti
Cell Phone: ( )T/ -0-17-L Land Line: � )
Email:
• Contractor(s):
Business Name:
Contact Name(s):
Mailing Address, C/S/Z: _ LAM tA S;1 l/
Cell Phone: !�E�jtDjg� Land Line: � )
Email:
• Arch itect(s)/Engineer(s):
Business Name: JAN 2 9 20
Contact Name(s): Y
Mailing Address, C/S/Z: T� CODES
Cell Phone: Land Lin
Email:
Contact Person for Building & Code Compliance:
Cell Phone: ( �'�l�) �f � � �'Z/� Q Land Line: �)
Email: k7 I c. La L.- s—� e c,v e,L ( �2 C)
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017
i r
PROJECT INFORMATION:
TYPE: Commercial Residential
WORK CLASS:
Single-Family Two-Family _Multi-Family(#of units )
Townhouse Business Office _Retail
_ Industrial/Warehouse Garage (#of cars ) _Other(describe )
ADDITION SQUARE FOOTAGE: ALTERATION SQUARE FOOTAGE:
1st floor: � C 1st floor:
2nd floor: 2nd floor:
3rd floor: 3rd floor:
4th floor: 4th floor:
fj I� t
Total square feet: c7�y �� Total square feet:
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction: $
2. If Commercial project, what is the proposed use: Lobs tnl 64
3. Source of Heat (circle one): Gas Oil Propane Solar Other CL6��I C6-( n�
Fireplaces need a separate Fuel Burning Appliances &Chimney Application
4. Are there any structures not shown on the plot plan? YES xplain:
5. Are there any easements on the property? YES 40 )
6. SITE INFORMATION:
a. What is the dimensions or acreage of the parcel?
b. Is this a corner lot? YES NO
c. Will the grade be changed as a result of the construction? YES NO
d. What is the water source? PUBLIC PRIVATE WELL
e. Is the parcel on SEWER or a PRIVATE SEPTIC system?
Town ofQueensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017
,
DECLARATION:
1. 1 acknowledge that no construction shall be commenced prior to issuance of a valid permit and will be
completed within a 12 month period.
2. Ifthework is not completed by the 1 year expiration date the permit may be renewed, subject to
fees and department approval.
3. 1 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 local zoning regulations.
4. 1 acknowledge that prior to occupying the facilities proposed I, or my agents, will obtain a certificate
of occupancy.
5. 1 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: //4
SIGNATURE: DATE: 1 l
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017