application IEIIqn
tECEFVEn
Office Use Onllma
AUG 21 20 Permit#: CC-OS3?_Zv/
kt: INCI RE PERMIT
TOWN OF � k = "Y Permit Fee: $ : ((_� 'J-O_
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r a •1 A I t ` *Rec. Fee: $ ! A
742 Bay Road Queensbury, NV U804
P 518-761-8256 Invoice#: 7? S 01"c�t
Project Location: 59 WEST MOUNTAIN RD, QUEENSBURY NY 12804
Tax Map #: 307.-1-29 Subdivision Name: -
TOWN BD RESOLUTION 86-2013 $850 recreation fee for new dwelling un single family. dup two-family,
multiple family apartments condominiums townhouses and or manufactured ,t modular homes !' it not mobile
homes This is in addition to the permit fee(s).
CONTACT INFORMATION:
• Applicant:
Name(s): EAST SLOPE HOLDING, LP 9CONTACT: SPENCER MONTGOMERY)
Mailing Address, C/S/Z: 59 WEST MOUNTAIN ROAD, QUEENSBURY NY 12801
Cell Ph.: ( - ) - Land Line: 1 ( 518) 636-3699
Email: spencer@westmtn.net
• Primary Owner(s):
Name(s): - SEE ABOVE-
Mailing Address, C/S/Z:
Cell Ph.: ( ) Land Line: _( )
Email:
• Contractor(s):
Name(s): TBD
Mailing Address, C/S/Z:
Cell Ph.: _( ) Land Line: ( )
Email:
• Architect(s)/Engineer(s):
Name(s): ANDREW J ALLISON ARCHITECTS, dba AJA ARCHITECTURE & PLANNING
Mailing Address, CIS/Z: 9 BROAD STREET
Cell Ph.: ( - ) - Land Line: 1 ( 518 ) 792-1651
Email: aallison@ajaarchitecture.com
Contact Person for Building & Code Compliance: Andrew Allison / Chris Jones
Cell Ph.: ( - ) - Land Line: 1 ( 518) 792-1651
Email: aallison@ajaarchitecture.com / cjones@ajaarchitecture.com
Ton Rnildinc R Code Fanrrement Prinrinle Stnirtiire Revised March 701R
PROJECT INFORMATION:
TYPE: X Commercial Residential
WORK CLASS:
Single-Family Two-Family Multi-Family(#of )
Townhouse Business Office Retail Hotel/Motel
Industrial/Warehouse Garage(#of cars ) X Other(describe RECREATIONAL )
COMMERCIAL
STRUCTURE SQUARE FOOTAGE: GARAGE SQUARE FOOTAGE:
1sTfloor: 13,721 SF ALTERATIONS: 3,127 SF 1sTfloor•
ADDITION: 813 SF
2"d floor: 2nd floor:
3rd floor:
Total square feet:
Basement(habitable space):
Total square feet: 3,127 SF
PROPOSED
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction: $ 500,000
2. Proposed use of the building: RECREATIONAL COMMERCIAL
3. If Commercial or Industrial, indicate the name of the business: WEST MOUNTAIN SKI RESORT
4. Source of Heat(circle one): Gas Oil (ropane 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 NO
7. SITE INFORMATION:
a.What is the dimensions or acreage of the parcel? 365.43 ACRES
b. Is this a corner lot? YES NO
c. Will the grade be changed as a result of the construction? YES CO
d. What is the water source? PRIVATE WELL
e. Is the parcel on SEWER or a PRIVATE SEPTIC system? PRIVATE
Toff Buiklinc R Culp Enfnrrement Prinrinka St►urtura Rom/kiwi Marrh 7A1 R
DECLARATION:
I. I acknowledge that no construction shall commence prior to issuance of a valid building
perm and work will be completed within a 12 month period.
2. If the work is not completed 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 t rue and complete statement
and/or description of the work proposed, that all work will be performed in accordance with the
NYS Building Codes, bcal 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 understand that Ikve 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:
_.�_ r4-
SIGNATURE
PRINT NAME: �%4�
: �/
�/ DATE:
Too Building&Code Enforcement Prinrinle Stru irhire Reuicarl Marrh 7f11 R