2004-403 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040403 Application Number: A20040403
Tax Map No: 523400-288-008-0001-009-000-0000
Permission is hereby granted to: LEONARD K C;ATJ,T)PT T,ONMARDO
For property located at: 1587 STATE ROUTE 9
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 Value
Owner Address: LEONARD & CALLIOPI LOMBAR
1587 STATE ROUTE 9 Commercial Alteration $500.00
Total Value $500.00
LAKE GEORGE, NY 12845
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
BP 2004-403 Harvest Fields Baptist Church
Commercial Alteration
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday, June 08, 2005
(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 To of ensb T s dy, June 08, 2004
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Building Permit Application
Town of Queensbury—Dept of Community Development,742 Bay Road,Queensbury,NY
(518)761-8256
A permit must be obtained before beginning construction. permit File N' 4�
No inspection will be made until applicant has received a Poe Paid $
valid building permit. All applicants' spaces on this Rec.Fee Paid $
application must be completed and must appear on the Reviewed By:
application form.
Applicant: i /)s Owner:
Address: Address: X677X 7 -
`
Phone#(�gL) -M -1LS3 . Phone#(�)
Property Location; Lot Number: / House Number /
SubdivisionName: Tax Map Number: -
���
o New Bull ' cues /commercial Estimated Market Value of Construction:
0 Additi residence/ commercial an Addition,what will use of new addition be?
Alt t'on: residence/ commercial'
C change to exterior size: residence/com'1
o ther work(describe )
Check OccupancyInformation 1` Floor 2na Floor Other floor Total
Below sq.ft. sq.ft. sq.It. Square Feet
o Single family dwelling
v Two fitmdly dwellin
e Townhouse
to Multifamily dwelling
#of units VP 11
0 Office
v Mercantile 20
c ManufacturingN
o l car detached garage 1N WRY
o 2 car detached garage
® D 3 car detached prage
0 1 oar attached garage
0 2 oar attached Sara e
e 3 car attached garage
o Storage building-
commereial
0 Storage building-
residential
pj Other ,1r
What is the proposed h t of the structare feet inches
Will any seco d or un ber be used? If so,for what?
Type of Heating System: electric/ oil / gas/wood /forced hot air/ baseboard/other:
Number of Fir-eylaces to be installed . Number of oWo dstoves to be installed
List below the person(s)responsible for supervision of work as regards to building codes:
Name Address- Phone Number
Builder
Plumber
Mason
Electrician
Declaration please sign below after you have carefully read the statement:
To the best of my knowledge the statements contained in this application,together with the plans and specifications
submitted,are a true and complete statement of all proposed work to be done on the described premises and that all
provisions of the Building Code,the Zoning Ordinance and all other laws pertaining to the proposed work shall be.complied
with,whether specified or noted,and that such work is authorized by the owner. Further,it is understood that Uwe shall
submit,prior to a Certificate of Occupancy or Certificate of Compliance being issued,as requested by the Zoning
Administrator or Director of Building and Codes,an As Butlt Survey by a licensed surveyor;drawn to scale,showing actual
location of all new construction.
Signature: owner,owner's agent,architect,contractor
Commercial Final Inspection Deport Q
Office No.: (518) 761-8256 Date Inspe do request received:
Queensbury Building&Code Enforcement Arrive: / ! am/pm Depart: am/pm
742 Bay Road, Queensbury,NY 12804 Inspector's Initials: (/
1�
NAME: 1 ( " �PERMIT#:
LOCATION: DATE: --—C�3-0
COMMENTS:
Y N IAA
Chimney/"B"Vent/Direct Vent Location
Plumbing Vent Through Roof 6"/Roof Complete
Exterior Finish/Grade Complete 6" in 10' or Equivalent
Interior/Exterior Guardrails 42 in. Platform/Decks
Interior/Exterior Ballisters 4 in. Spacing Platform/Decks
Stair Handrail 34 in.—38 in. /Step Risers 7"/Treads 11"
Vestibules For Exit doors>3000 s . ft.
All Doors 36 in.w/Lever Handles/Panic Hardware,if required
Exits At Grade Or Platform 36(w)x 44"(1)/Canopy or Equiv.
Gas Valve Shut-off Exposed&Regulator 18")Above Grade
Floor Bathroom Watertight/Other Floors Oka
Relief Valve,Heat Trap/Water Temp. 110 Degrees Maximum
Boiler/Furnace Enclosure 1 hr. or Fire Extinguishing System
Fresh Air Supply for Occupancy/Ventilation Combustion
Low Water Shut Off For Boilers
Gas Furnace Shut Off Within 30 ft. or Within Line Of Site
Oil Furnace Shut Off at Entrance to Furnace Area
Stockroom/Storage/Receiving/Shipping Room(2 hr.), 1 '/2 doors
> 10%> 1000 s .ft.
3/4 Hour Corridor Doors&Closers
Firewalls/Fire Separation,2 Hour, 3 Hour Complete/Fire
Dampers/Fire Doors
Ceiling Fire Stopping, 3,000 s . ft. Wood Frame
Attic Access 30"x 20"x 30"(h),Crawl Space Access 18"x 24"
Smoke Vents Or Fan, if required
Elevator Operation and Si is e/Shaft Sealed
Handicapped Bathroom Grab Bars/Sinks/Toilets
Handicapped Bath/Parking Lot Si na e
Public Toilet Room Handicapped Accessible
Handicapped Service Counters, 34 in., Checkout 36"
Handicapped Ramp/Handrails Continuous/12 in.Beyond [Both sides]
Active Listening System and Signage Assembly Space
Final Electrical
Site Plan/Variance required
ti� / G'�e"
Final Survey,New Structure/Flood Plain certification,if reg. ell
As-built Septic System La out Required or On File
Building Number or Tenant Address on Building or Driveway
Water Fountain or Cooler 1
Building.Access All Sides by 20' /Driveable Surface 20' wide �m
Okay To Issue Temp. or Permanent C/O
Okay To Issue C/C
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Commercial Final Inspection Report.doc
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9 Students 1 Teacher Utility Room/
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rear 36"Door
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Entrance/ 72"Door O Nursery O Kitchen
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