CC-0568-2021 Office Use Only p,
ADDITION/ALTERATION PERMIT Permit#: CC-i�
APPLICATION Permit Fee: $
Town of(ueensburn,
742 Bay Road,Queensbury,NY 12804 Invoice#: ztp?
P:518-761-8256 www.gueensbury.net
Flood Zone? Y N Reviewed By:
Project Location:
1,01
Tax Map ID #: „�<< c ,� � �15�5" Subdivision Name:
PROJECT INFORMATION:
TYPE: Residential 'X Commercial, Proposed Use:
_Single-Family _Two-Family _Multi-Family (#of units ) _Townhouse
_Business Office Retail _ Industrial/Warehouse —Garage (#of cars_)
_Other (describe
('�rrY7 i.Ltf79�i/ ��. _:�_r'Jl/�. lt. ,LtF�/L',l�R-� �;,�•��. +C��f/k- ."_{C't.�Y/l. -��4-C' <:l �/��,s. `.y�:rf'�-,-
L
ADDITION SQUARE FOOTAGE: ALTERATION SQUARE FOOTAGE:
1st floor: 1st floor:
2"d floor: 2nd floor:
3rd floor: 3rd floor:
Basement (habitable space): Basement (habitable space):
Total sq ft: Total sq ft:
Scope of work to be done:
! !�
Addition/Alteration Application Revised January 2021
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction: $
2. Source of Heat (circle one): _Gas _Oil _Propane _Solar_Other
Fireplaces/inserts need a separate Fuel Burning Appliances & Chimney Application
3. Are there any structures not shown on the plot plan? _YES NO Explain:
4. Are there any easements on the property? _YES �NO
SITE INFORMATION:
• Is this a corner lot? _YES NO
• Will the grade be changed as a result of the construction? _YES '&NO
• What is the water source? _ PUBLIC _PRIVATE WELL N;a
• What type of wastewater system is on the parcel? _SEWER _PRIVATE SEPTIC PT\
DECLARATION:
l. I acknowledge that no construction shall be commenced prior to the issuance of a valid permit and will be
completed within a 12 month period.Any changes to the approved plans prior to/during construction will require
the submittal of amended plans, additional reviews and re-approval.
2. If, for any reason,the building permit application is withdrawn, 30%of the fee is retained by the Town of
Queensbury.After 1 year from the initial application date, 100%of the fee is retained.
3. If thework is not completed by the 1 year expiration date the permit may be renewed, subject to fees
and department approval.
4. 1 certify that the application, plans and supporting materials are a true and a 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.
5. 1 acknowledge that prior to occupying the facilities proposed I, or my agents, will obtain a certificate of
occupancy.
6. 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: L�L1�If;�n� �:3nr'vti°F
SIGNATURE: �`t-'tC fir.- �__._ DATE:
Addition/Alteration Application Revised January 2021
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s): 'Uu. L_i-L
Mailing Address, C/S/Z: t ) A,�y we / �,, �,�,i y /j1�`5
Cell Phone: ( ) Land Line: 7 .2
Email: Lcj%x.,%o Q c�U
• Primary Owner(s):
Name(s): P,L�t1 : cc
Mailing Address, C/S/Z: 1,J
Cell Phone: ( _) Land Line:
Email:-
❑ Check if all work will be performed by property owner only
• Contractods): (List all additional contractors on the back of this form)
Contact Name(s):
Contractor Trade:
Mailing Address, C/S/Z:
Cell Phone:�_) Land Line:
Email:
**Workers' Comp documentation must be submitted with this application**
• Architect(s)/Engineeds):
Business Name:
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: �_) Land Line:
Email:
Contact Person for Compliance in regards to this project:
Cell Phone: �_) Land Line: A
Email:
Addition/Alteration Application Revised January 2021
COMcheck Software Version 4.1.5.1
Interior Lighting Compliance Certificate
� ECE0WE
Project Information AUG 0 2 2021
Energy Code: 90.1 (2016)Standard
Project Title: Ralph Lauren
Project Type: Alteration TOWN OF QUEENSBURY
BUILDING&CODES
Construction Site: Owner/Agent: Designer/Contractor:
The Outlets at Lake George Rulle Chou Nicholas Tricarico
1424 State Route 9,Suite 3 Ralph Lauren Tricarico Architecture and Design
Lake George, NY 12845 601 West 26th Street PC
5th Floor 502 Valley Road
New York,NY 10001 Wayne,NJ 07470
917-453-2989 973-692-0222
rulle.chou@ralphiauren.com njt@tricarico.com
Ailowed Interior Lighting Power
A B C D
Area Category Floor Area Allowed Allowed Watts
(ft2) Watts/M (B X C)
1-Sales-Main(Retaii:Sales Area):Exempt
2-Sales-Cashwrap(Retail:Sales Area):Exempt
3-Entry Vestibule(Common Space Types:Lobby-General):Exempt
4-Mechanical Room(Common Space Types:ElectricaVMechanical):Exempt " 5 F,_ " T
HIS PLAN TC Big "�., PF....,iE t
5-Storage Room#1 (Common Space Types:Storage<50 sq.ft.}:Exempt 9 '- " -a.`�' `��
6-Display Window#1 (Retail-Sales Area):Exempt v1 1 E AT ALL 1 3 i"li!.;J F 0' T'�-(�
7-Display Window#2(Rewi):Sales Area):Exempt DURAT I0;y! OF (.;ON
8-Men's Fitting Area(Retall:Dressing(Fitting Room):Exempt
9-Women's Fitting Area(Retaii:Dressing/Fitting Room):Exempt
10-Cosmair Room(Common Space Types:Storage>=50-<=1000 sq.R):Exempt
11-Storage Room#2(Common Space Types:Storage<50 sq.ft.):Exempt
12-Exit Vestibule(Common Space Types:Corridor/Transition<8 ft wide):Exempt
13-Main Stock Room(Warehouse:Smatter,Hand-Carried Material Storage):Exempt REVIEWED F 0 R
14-Storage Room#3(Common Space Types:Storage>=50-<=1000 scift):Exempt ENERGY CODE COMPLIANCE
15-Manager's Office(Common Space Types:Office-Enclosed):Exempt
16-Data Closet(Common Space Types:Storage<50 sq.ft.):Exempt
17-Break Room(Common Space Types:Lounge/Breakroom):Exempt
18-Toilet Room(Common Space Types:Restrooms):Exempt
Total Allowed Watts= NIA
Area Category Exemption Qualifications
Connected Watts Total#Watts
Activity Area
Pre-Alt. Repl.lAdded Pre-Alt. Post-Alt.
,Salt s-_Main(Retaail:Sales Area 5119 sa.ft.) 256 51 27002.000 4415.000
Exemption:Less than 20%connected lighting watts replacement.
Sales- sp hwrap(Retai(-.Sates Area 268 sq.ft.) 4 0 256.000 112.000
Exemption:Less than 20%connected lighting watts replacement.
EnD Vestibule(Common S a e Ines'Lobby-Q n .ral 2 0 128,000 56.000
117 sgft.)
Exemption:Less than 20%connected lighting watts replacement.
Project Title: Ralph Lauren Report date: 06/11/21
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Connected Watts Total#Watts
Activity Area pre-AIL Repl.lAdded Pre-Alt. Post-Alt.
Mechanical Room_(Common Space 1 0 17.000 10.500
1ypus•Electrical/Mechanical 37 sa ft)
Exemption:Less than 20%connected lighting watts replacement.
Storage Room#1 (Common Space Types-Storage<50 1 0 32.0D0 10.500
,gq.ft.37 ca.ft.l
Exemption:Less than 20%connected lighting watts replacement,
Display Window#1 (ReLil•Sales Area 43 sa 8 t 6 1 510.000 83.000
Exemption:Less than 20%connected lighting watts replacement.
Oisplay Window#2(Retail al s Area 54 sqJU 6 1 510.000 83.000
Exemption:Less than 20%connected lighting watts replacement.
Men's Fitting Area(Retail: Fitt' Raom 176 sq.ft.) 10 1 739.000 168.000
Exemption:Less than 20%connected lighting watts replacement.
Women's Fitting Area(Retail Dressing Fitting Room 263 11 2 603.000 196.000
Kja
Exemption:Less than 20%connected lighting watts replacement.
Cosmalr Room(Common Space TypesmStorage>=50- 1 0 64.000 64.000
<=1000 s .ft.65 sq ft.)
Exemption:Less than 20%connected lighting watts replacement.
Storage Room#2(Gammon Space JVeswStorage<50 1 0 64,000 64.000
sg.B.36 5a.ft._)
Exemption:Less than 20%connected lighting watts replacement.
Exit Vestibule(Common-Space Types: -o rid r/T an ition 1 0 96.000 32.000
<B ft wide 56 sa.ft.)
Exemption:Less than 20%connected lighting watts replacement.
Main Stock Room(W rehouse•Smaller.Hand-Carried 11 2 1056.000 346.500
Material Storage 92 s0 q ft.l
Exemption:Less than 20%connected lighting watts replacement.
StoraOe Room#3(Common SpaceTy - :(2es 5tora_ge>=50- 2 0 192.000 63.000
<=10005q ft.107 sa.ft.i
Exemption:Less than 20%connected lighting watts replacement.
Manager's Office(Common Space Types•Offi a Enclosed 2 0 192.000 63.000
139 sq.ftj
Exemption:Less than 20%connected lighting watts replacemenL
Data co<pt(Common Space Typ orage<50 sq.ft.2Z 1 0 32.000 32.000
Exemption:Less than 20%connected lighting watts replacement,
Break Room(Common. ace Typ- o r ge/Breakroom 51 1 0 96.000 32.000
541A
Exemption:Less than 20%connected lighting watts replacement.
Tgilet Room(Common Space Types:R troom 1 aqju 1 0 96.000 32.000
Exemption:Less than 20%connected lighting watts replacement.
Proposed Interior Lighting Power
q B C D E
Fixture ID:Description/Lamp 1 Wattage Per Lamp 1 Ballast Lamps/ #of Fixture (C X D)
Fixture Fixtures Watt.
Sales-Main(♦ etail•Sales Aroma 5119 sq.ft.)@ Exempt
LED 1:F1:2'x2'Envision LED Troffer:LED Other Fixture Unit 28W: 1 61 28 1708
LED 2:F2:Hera Elite LED 34in.:LED Undercabinet Unit 15W: 1 63 12 756
LED 3:F3:Hera Elite LED 221n.:LED Undercabinet Unit 15W: 1 5 9 45
LED 4:F4:Hera Elite LED 11 in.:LED Undercabinet Unit 15W: 1 3 5 15
Track lighting:L1:Green Creative Par38: Wattage based on 214 feet of track 0 0 6420 6420
Sao -Cashwrap(R ail ales Area 268 aq.ft.)@ Exempt
LED 1:F1:2`x2'Envision LED Troffer:LED Other Fixture Unit 28W: 1 4 28 112
Entry Vestibule(Common SpaCe Typeslobby-General 117 sa.ft.): Exempt
Project Title: Ralph Lauren Report date: 06/11/21
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A B C D E
Fixture ID:Description/Lamp/Wattage Per Lamp/Ballast Lamps/ #of Fixture (C X D)
Fixture Fixtures Watt.
LED 1:F1:2'x2'Envision LED Troffer:LED Other Fixture Unit 28W: 1 2 28 56
Mechanical Room(Common SpaceTypes. l c ri al/Mec=hanical 37 sn,_ft.):Exempt
LED 6:L3:Existing 2'Fluorescent w/new L:LED Linear 10W: 1 1 10 10
_Storage lRopm#1 f Common Space Typgs:Storage<50 sq.ft. 37 sq.ft.): Ex_pt
LED 6:L3:Existing 4'Fluorescent w/new L:LED Linear 10W: 1 1 10 10
Display Window#1 (ReWil:Salgs Area 43 sg.ft)i Exempt
Track lighting:L1:Green Creative Par38: Wattage based on 8 feet of track 0 0 240 240
LED 5:L2:Green Creative Par38:LED PAR 15W: 1 2 16 31
jDisplayyVindow#2(Retailp5ales Area 54 sn.tli): Exempt
Track fighting:L1:Green Creative Par38: Wattage based on 8 feet of track 0 0 240 240
LED 5:1-2:Green Creative Par38:LED PAR 15W: 1 2 16 31
Men's f=i ' gArea(Retail;DressinglAtting Room 175 sq.ft.):Exempt
LED 5:1-2:Green Creative Par38:LED PAR 15W: 1 9 16 140
LED 1:F1:2'x2'Envision LED Troffer:LED Other Fixture Unit 28W; 1 1 28 28
Women's'Fitting Area(Retail.DressinUffi ing Room 263 sq.ft.): Exempt
LED 5:1-2:Green Creative Par38:LED PAR 15W: 1 9 16 140
LED 1:F1:2'x2'Envision LED Troffer:LED Other Fixture Unit 28W: 1 2 28 56
osmair Boom(Commgn 5pace TypeseStnrage>=50- r=1000 sq ft. 65 sq.11: Exempt
LED 6:1-3:Exist.4'Fluor.2-Imp w/new LE:LED Linear 10W: 2 1 10 10
Storage Room#2(Common mace T : torag .<P 50 sg.t1_ 36 sg.ft):Exempt
LED 6:1-3:Exist.4'Fluor.2-Imp w/new LE:LED Linear 10W: 2 1 10 10
Exit Vestibule(Common Space Types:CorridorMansition 4$ft wide 56 q.ft.): Exempt
LED 6:1-3:Existing 2'x4'Fixture w/new LE:LED Linear 10W: 3 1 10 10
Main Stock Room(Warehouse.5m ller. Hand-Carried Material Storage 920sq ft):Exempt
LED 6:1-3;Existing 2'x4'Fixture w/new LE:LED Linear LOW; 3 11 10 116
Storage Room#3(Common Space Tynes:Storage>=50-<1000 sq.ft. 107 sq,jtJ: Exempt
LED 6:1-3:Existing 2'x4'Flxture w/new LE:LED Linear 10W: 3 2 10 21
Manager's Office(Common Space Types: fftce- Enclosed 139 s .): Exempt
LED 6:1-1 Existing 2'x4'Fixture w/new LE:LED Linear 10W: 3 2 10 21
Data Closet(Common Space Types;Storage<50 sq,ft,22 sq.111 Exempt
LED 6:1-3:Existing 4'Fluorescent whew L:LED Linear 10W: 1 1 10 10
Break Rpom(Common Space Ty o ngelBreakroom 51 sq,ftJ: Exempi
LED 6:1-3:Existing 2'x4'Fixture whew LE:LED Linear 10W: 3 1 10 10
Toilet Room(Common Space Types:Restrooms 51 sa.ftJ: Exempt
LED 6:1-3:Existing 2'x4'Fixture w/new LE:LED Linear 10W: 3 1 10 10
Total Proposed Watts= N/A
Interior . • PASSES
Interior Lighting Compliance Statement
Compliance Statement: The proposed Interior lighting alter n p t represented In this document is consistent with the
building plans,specifications, and other calculations submi d w Is permit application.The proposed interior lighting
systems have been designed to meet the 90.1 (2016)Sta rd irements In check Version 4.1.5.1 and to comply with
any applicable mandatory requirements listed in the Ins ecklist.
Nicholas 1•Tricarico-President ll ems-,
Name-Title SlgnaTuW Date
Project Title: Ralph Lauren Report date: 06/11/21
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COMcheck Software Version 4.1.5.1
Inspection Checklist
Energy Code: 90.1 (2016) Standard
Requirements: 0.0%were addressed directly in the COMcheck software
Text in the"Comments/Assumptions" column is provided by the user in the COMcheck Requirements screen. For each
requirement,the user certifies that a code requirement will be met and how that is documented, or that an exception
Is being claimed. Where compliance is Itemized in a separate table,a reference to that table is provided.
Section
# plan Review complies? Comments/Assumptions
&Re .ID
4.2.2, :Plans,specifications,and/or ;IJComplies
9,4.3,9.7 ;calculations provide all Information PDoes Not
[PR4]1 :with which compliance can be []Not Observable'
determined for the Interior lighting ,
;and electrical systems and equipment ;E3Not Applicable
and document where exceptions to i
:the standard are claimed. Information
provided should include interior I
;lighting power calculations,wattage of;
bulbs and ballasts,transformers and
control devices.
Additional Comments/Assumptions.,
1THIgh impact(Tier 1) 2 (Medium Impact cTier 2) 1 3 TLow Impact(Tier 3)
Project Title: Ralph Lauren Report date; 06/11/21
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Section
# R)Ogh-In Electrical Inspection Complies? Comments/Assumptions
8.4.2 :At least 50%of all 125 volt 15-and ❑Complies
[EL10)2 :20-Amp receptacles are controlled by ;❑Does Not
an automatic control device.
:❑Not Observable;
;❑Not Applicable
9.4.1.1 ;Automatic control requirements �^ ;❑Complies
(ELI)Z �prescribed In Table 9.6.1,for the ;❑Does Not j
appropriate space type,are Installed.
Mandatory lighting controls(labeled ![]Not Observable
as'REQ')and optional choice controls :❑Not Applicable ;
;(labeled as'ADDV and'ADD2')are
implemented.
9.4.1.1 :Independent lighting controls installed 10complies
(EL2)2 per approved lighting plans and all UDoes Not
manual controls readily accessible and
:visible to occupants. :❑Not Observable
_ j❑Not Applicable
9.4,1.1f Daylight areas under skylights and ;ClComplies
[EL13]1 :roof monitors that have more than UDoes Not
j 150 W combined input power for ;❑Not Observable;
:general lighting are controlled by
�photocontrols. :[]Not Appilcable�
9.4.1.3 ;Separate lighting control devices for :❑Complies
(EL4]1 specific uses Installed per approved ❑Does Not
;lighting plans. ;C]Not Observable:
❑Not Applicable
9.6.2 `Additional Interior lighting power ;❑Complies ^�~
[EL8]1 !allowed for special functions per the UDoes Not
approved lighting plans and is
:automatically controlled and ;❑Not Observable!
separated from general lighting. :❑Not Applicable ;
Additional Comments/Assumptions:
�1 jHigh Impact(Tier 1) � 2 Medium Impact(Tier 2) � 3 jLow Impact(Tier 3)
Project Title: Ralph Lauren Report date: 06/11/21
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Section
# Final Inspection ]___ Complies? Comments/Assumptions
8.7.1 FumZhed as-bullt drawings for ;❑Complies
[91613 electric power systems within 30 days :❑Does Not
of system acceptance. ❑Not Observable
?❑Not Applicable
8.7.2 Furnished O&M Instructions for— ;❑Compiles ;
[FI1713 ;systems and equipment to the ❑Does Not
building owner or designated ;[]Not Observable
representative.
;❑Not Applicable
9.2.2.3 ;Interior Installed lamp and fixture ;❑Complies —See the Interior Lighting fixture schedule for values. _ —
[FI18]1 lighting power is consistent with what ❑Does Not 1
;is shown on the approved lighting :
:[]Not Observable;
:plans, demonstrating proposed watts
are less than or equal to allowed I❑Not Applicable
watts.
9.4,4 .At least 75%of all permanently ;❑Complies 1
[F12011 :Installed lighting fixtures in dwelling :❑Does Not
units have>=55 Im/W efficacy or a :[]Not Observable
>=45 Im/W total luminalre efficacy. ;❑Not Applicable
Additional Comments/Assumptions:
- -- -------
1 HI h Im act Ier 1 2 Medium Im a -__
g p (T ) p ct(Tier 2} 3 rLow Impact(Tier 3}
Project Title: Ralph Lauren Report date: 06/11/21
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C
Project Title: Ralph Lauren Report date: 06/11/21
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FIRE MARSHAL'S OFFICE
Toum of Queensbury
742 Bay Road, Queensbury, NY 12804
" Home of Natural Beauty ... A Good Place to Live "
PLAN REVIEW
Ralph Lauren 'T-H'1S PLC.;j T r` F.w ECT
.
1424 State Route 9 SITE AT AIL .i :�,s_.v� FOR t�
/r p �r �f .a� x- ram , t r,, r,
CC-0568-2021 l;' E l4J'�d f �i ..i' � d 1� ;<<,a ��:i°
7/29/2021
The following comments are based on a review of submittals:
• Verify location and operation of exit/ Emergency lighting and external
remote heads
Michael J Palmer
Fire Marshal
742 Bay Road
Queensbury NY 12804
firemarshal@queensbury.net
Fi r e M a r s h a l 's Off i c e • P It o n e: 518-761-8206 • F a x: 518-745-4437
irenuarshal@queensbun/net - wit7 n.queensbury net