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CC-0068-2022 Office Use Oniv -AD DITION/ALTE RATION PERMIT Permit#: C 0©b$• 2�02.Z APPLICATION � Town o£Ctieensbury Permit Fee: 742 Bay Road,Queensbury,NY 12804 Invoice#: P:518-761-8256 www.gueensbtirV.net Flood Zone? Y N Ziewe P ro jept Lob ion: q c� = o �cc�s6q iz Y© u Q � E.4 7i,., Map I #: Ja3�Q0 0? 7 •13- l" /� Subdivision Name: PROJECT INFORMATION: TYPE: Residential _zommercial, Proposed Use: .d \�d� Single-Farniiy _Two-Family Multi-Family (# of units ) —Townhouse Business Office ^Retail _Industrial/Warehouse Garage (# of cars_) _Other (describe } ADDITION SQUARE FOOTAGE: ALTERATION SQUARE FOOTAGE: 2 - 1st floor: 1st floor: 2nd floor: 2nd floor: 3rd floor: 3`d floor: Basement(habitable space)_: basement (habitable space): Total sq ft: Q Total sq ft: �. ¢A I Scope of work to be done` DECC0V FEB 2 3 2022 TOWN OF QUEENSBURY BUILDING&CODES :,ddidon/Alteration Application Revised January 2021 � . `x,. _ � c ,., e F C O V 4 '! ` . t 4' * � ' t S 1 ADDITIONAL PROJECT INFORMATION: 1. Estimated Cost of Construction: $ 11 0 0 D • ® D 0 �J0 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: a Is this a corner lot? YES VNO ® Will the grade be changed as a result of the construction? YES ke,"NO a What is the water source? PUBLIC _PRIVATE WELL � * What type of wastewater system is on the parcel? ZSEWER PRIVATE SEPTIC :DECLARATION, 1. 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 If, for any reason,the building permit application is withdrawn, 30%of the fee is retained by the Town of Queensbury.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€ram the initial application date, 100% of the fee is retained. 3. If the work 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 1, or my agents, will obtain a certificate of occupancy. 6. 1 also understand that I/we are rewired to provide an as-built survey by a licensed land surveyor of all newly constructed facilities prior to issuance ofa certificate of occupancy. I have read and agree to the above: PRINT NAME: —Z_e-��&ed SIGNATURE: DATE: 71 Addition/Alteration Application Revised January 2021 CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL o Apiicant: o Name(s): / Mailing Address, C/S/Z: Cell Phone: ( '!578 ) Land Line: -Lflg-_) 723 Email: ezz& t� O C6 Priniary Owner Name(s): f A.P ':9( Mailing Address, C/S/Z:.-1?3,- 2 `'/— ,61,E Cell Phone: Land Line: Email: __-�ll �D ,5?'Check if 9-all Work will be performed by prop Pa ty owner oni Contractor(s): (List all additional contractors on the back of this form) Contact Name(s): Contractor Trade: N4aiIing Address, C/S/Z: Cell Phone:�_) Land Line: Email: "Workers" Comp documentation Must be submitted with this application" Q Arch Kect(s)IEngineer(s): Business Name: Contact Name(s): Mailing Address, C/S/Z: Cell Phone: � ) Land Line: Email: /• Contact Person for Compliance in regards to this project: _ as ��/�� _ Cell Phone: ��) _ 10,9q,4 Land Line: As,- ) Email: Addition/Alteration Application Revised January 20=I s; ._ � .. — .$ t ... � �, -. .. e J NQ ' t , °o FILEE CV %./e ( Ir \ TOWN OF QUEEN$BURY BUILDING DEPARTMENT Based on our limited examination,compliance v' with our comments shall not be construed as indicating the plans and specifications are in full compliance with the Building Co �c J O' New Yorlc State. E C \� C TOWN OF-QUE 22 ti o BUILDING & G D FEB 23 20 - � Reviewed By: OF OUBENSBURY Date: B ILDING&CODES 00 oo N ^' aCA � W 1 d N O Cn C d ICE 3 n KRAFT PAP INSULATION o MUST BE OVERT=D BY j NON-COMBU IBLE BARRIER / o N � O �, N r ®TICE FOAM INS LATI®N MUST BE C®VERE RY A 15 MMIK THEIR I AL BA f O,: f\1 / 6 (V cm N l9 (Ofv s OA .,o- ("fv vc °vl 'I RX Date/Time 04/20/2022 15:27 15182731202 P,003 Apr. 20, 20221 2,59PR MDIA No, 9147 P. 3/5 IDLE DEPARTMENT INSPECTION AGENcy, iNc. ( that the electrical wiring to the electrical equipment listed below has been examined and is approved as being in accord with the National Electrical Code, applicable governmental, utility and Agency rules in effect on the date noted below and is issued subject to the following conditions. Owner: Budget Inn Date: 04/11/2022 Occupant: Fire Repair Locatio rb32 Route 9 OccupancyNon-Residential Queensbury,Warren Co. NY Applicant F ......._ � I¢gj- 7A Z Spring Motor Inn CC» Old 2 215 Broadway Fort Edward NY Joseph A.Holmes No: 31i3014158212EL Equipment. 5-Switches; 11 -Receptacles; 7-Fb yes;2-Vent Fans; 1 -Smoke•Detector, 3-Are Fault Breakers This certificate applies to the electrical wiring to the electrical equipment listed Immediately null and void. This certificate applies only to the use,occupancy and above and the installation Inspected as of the above noted date based on a visual ownership as indicated herein, Upon a change in the use,occupancy or ownership inspection. No warranty Is e,-pressed or Implied as to the mechanical safety,effi• of the property indicated above,this certificate shall be immediately null and vold, cieney or fitness of the equipment for any particular purpose. This certifir ete shall In the event that this Certificate becomes invalid based upon the above conditions, he valid for a period of one year from the above noted date. Should the electrical this certificate may be revelidated upon reinspection by Middle'Department system to which this certificate applies be altered in any way,including but not limit- Inspection Agency,Inc,.An application for inspection must be submitted to Middle ed to,the introduction of additional electrical equipment and/or the replacement of Department Inspection Agency, Inc.to initiate the inspection and revalidation any of the components Installed as of the above noted date,this certificate shall be process. A fee will be charged for this semce.