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Office Use Only ADDITION/ALTERATION PERMITJpermite:CC ~O [e2-202OmeBERHCATIONPermitFee:${7.5.00TAAond,eerbry,NY 12808 onP:518-761-8256 www.aueensbury.net Invoices:_Z¢C{__Project Location:1172 State Route 9 I} Tax Map ID #:288.20-1-20 Subdivision Name: }||)MAR 09 2920 CONTACT INFORMATIO! ©Applicant: Name(s):Great Escape Theme Park,LLC (Rebecca Wood) Mailing Address,C/S/Z:PO Box 511,Lake George,NY 12845 Cell Phone:_{)Land Line:_(518)792-3500 Email: +Primary Owner(s): Name(s): Mailing Address,C/S/Z:Same as Above Cell Phone:_)landline:_(_)Email: O Checkifall work will be performed by homeowner only ©Contractor(s): Contact Name(s):Dean Hyatt Contractor Trade:Work to be completed by Great Escape Theme Park Mailing Address,C/S/Z:PO Box 511,Lake George,NY 12845 Cell Phone:(518)955-0865 Land Line:(518)792-3500 Email:dhyatt@sftp.com **List all additional contractors on the back of this form ©Architect(s)/Engineer(s): Business Name:JARRETT Engineers,PLLC Contact Name(s):Robert U.Holmes II,P.E. Mailing Address,C/S/Z:12 Bast Washington St.,Glens Falls,NY 12801 Cell Phone:(518)796-7381 Land Line:(518)792-2907 Email:bholmes@jarrettengineers.com Contact Person for Building &Code Compliance:Dean Hyatt Cell Phone:(518)955-0865 Land Line:(518)792-3500 Email:dhyatt@sftp.com ‘Addition/Aeration Aapiction Revised February 2019 PROJECT INFORMATION: TYPE:&Commercial C1 Residential WORK CLASS: Ci Single-Family Otwo-Family —— CiMulti-Family (#of units ) OTownhouse CiBusiness Office ORetail CO Industrial/Warehouse CO Garage (#of cars )X Other (describe)Amusement Park ADDITION SQUARE FOOTAGE:ALTERATION SQUARE FOOTAGE: Ast floor:Ast floor:50 sqft 2"floor:2"floor:3 floor:3"floor: Basement (habitable space):Basement (habitable space). Total square feet:Total squarefeet:50 sqft ADDITIONAL PROJECT INFORMATION: 1.Estimated Cost of Construction:$10,000.00 2.If Commercial project,what is the proposed use:Food service 3,Source of heat:L1GasCloilIPropane(_Isolar Other Forced Hot Air Fireplaces need a separate Fuel Burning Appliances &Chimney Application 4,Are there any structures not shown on the plot plan?XIYES LINO Explain:Located in the Great Escape Theme Park 5.Are there any easements on the property?Ces BNO 6.SITE INFORMATION: ‘a.What is the dimensions or acreage of the parcel?237.6 b.Is this a corner lot?Oyes no c.Will the grade be changed as a result of the construction?LIES BNO d.What is the water source?[RIPUBLIC COPRIVATE WELL e.Is the parcel on SEWER or a PRIVATE SEPTIC system?Sewer Aktion Alteration Aplication Revised February2019