2000-757 TOWN OF Q►UEENSBURV
Et 742 Bay Road, Queensbury, NY 12804-5902 (518) 761 -8201
Community Development - Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number. P20000757t•j�a C6 .Application Number: A20000757
Tax Map No: 523400-033-000-0001 -013-000-00 0
Permission is hereby granted to: LEO'S PIZZA TIME
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 & CA.LLIOPI LOMBARD Commercial Alteration 2,000.00
1587 STATE ROUTE 9 Total Value 29000,00
LAKE GEORGE, NY 12845
Contractor or Builder's Name / Address Electrical Inspection Agency
JOSEPH PORCO NEW YORK BOARD OF FIRE UNDER
251 -5421
1588 S. JOHNS13LIRG Rd
JOHNSBURG, NY
Plans & Specifications
2000-757
COMMERCIAL INTERIOR ALTERATION AS PER APPLICATION
$50.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Thursday, October 10, 2002
(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 Town PfX3UVvnsbuL-#VCTuesda , October 10, 2000
SIGNETS BY for the Town of Queensbury.
Director of Building & de orcement
�..-- Building Permit Application
TOwli of Queens bury - I?e1u. c,f� Cc�nreatuui!v Develcynneirt, 742 Ikiv Rmiel. Qdjee�t5'1.I NY 12804 1761-82561
BUILDING & CODE ENF0RCEM"ENT
NOTICE
Requirements prior to issuance
rbogI
rutit must be obtained before of this permit: `� 04ERMIT FILE NO.
construction, No inspectiems t� —� .
re made until applicarxt has received t -f 24lltirilg 8ozrd ACf`JOrt PERMIT FLEE !'Ali) $ ,JOW BUILDING PERMIT. All n:ca 1Use
rut#s' spaces on thin application 1?ECREATION FELL P.iJi7 $
MUST be compsatcKs the signature Q .p,P � Board �crt
Of the applicant must appear un the REVIEWED BY*
licat'ion 'Form. rho k �n.. r' SPR / Subdivision Cr BxriGfinyq lns�rnar
Z t�n Fee Pay rtt f /
Applicant: 4e Z? 10 '1 /�'► nor: �s-"Gr/7dCiG1i7 •G ¢ r, y , iz2 �- p
Address: ( rc I A7E !
Phone # CI /A.) 7,3,q - V, ,2 i5, Phone # ( } 73 2 h
Property Location: /SS7sylk - ,� 3
Subdivision Na'114; �' �!J S / 2 Z 1'ax Map !Number 1_ 1 ,43
�'i 1 "' Section )ll(vk left
NATURE OF PROPOSED WORK :
New Building : M I3 ESTIATE MARKET VALUE OF THE
r '- --
residence / commercial CONSTRUCTION : $- zryb
'�---- ----
Addition to Building :
residence / commercial OCCUPANCY INFORMATION :
Alteration to Builrlinct ; Primary 'Building -
residence / omme cial Single Family Dwelling
Residence / Commercia Two Family Dw JJin
no change to exterior size -
FamilyDwellinc
Other Work ( describe below ) C cantile � r .- ` 2 Manufacturing "
Other
GROSS AREA OF PROPOSED STRUCTURE :
ISt F .toor . . . . . . . G,I-er sq . ft . If ADDITION , what will use
2nd .Froor . . ...!w4' . . . sq . ft * of new. addition be ? ,
. Other Fluurs . . . . , sq . ft .
( not unfinished cellar or basement ) ACCESSORY BUILDINGS :
Detached Garage 1 , 2 car
TOTAL FLOOR AREA : Detached
FT , Attached Garage 11 2 car
Private - Storage Building
SIZE OF NEW STRUCTURE : Commercial Storage Building
FEET X ,FEET Other
Foundation Type : will any second- hand or ungraded
Number of Stories : lumber be used ? If so , for what ?
( habitable space onlly )
Height (grade to ridge ) : feet TYPE OF HEATING SYSTEM :
Number of flreplaceIi,o and/or woodstove ( circle all which plies )
to be installed :_ Electric / Oil / C� / Wood
Forced !lot Air / Baseboard / Other
Person responsible for supervision of work as regards to building
codes is :
/ Name A r ssa ,r hone
Builder :: h r v S. $y wr trd �vr f lcf' S/ S" 2 t'
Plumber : 4/ ,rrz ' w n
Mason :
Electrician : , �
DECL ARA77ON Please sign below after you have carefully read the stasenrent.
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 I/we shall submit prior to a
Certificate of Occupancy-'or Certificate of Compliance being issued , an AS BUILT PLOT PLAN by
a Licensers surveyor; drawn to scale, showing actual location of project on premises.
Signature: �- ,c.I,
(owner, owner's agent, architect, contractor)
(�'ENEgAL V SPECTION REPQR.T"
( 518 ) 761 - 8256
Town of Queensbury
DateDept. of Community Development Date inspection request received:
Building & Code Enforcement
742 Bay Road
Queenshury, NY 12804 Arrive 3r`/�am/pIn Depart a�Fm
Q� Inspector's initials r r
NAME: s u=4:?ztz-4 r - t: DATEPERM .
#
LOCATION: DATE '
SYPE OF STRUCTURE:
'T -
RECHECK
NIA 'YES NO COMMENTS
Footings/Piers
�!
Monolithic Pour Form
Reinforcement in Place
The contractor is respansi r
providing protection fram ng
for 48 hours following th p ent
of the concrete.
Materials for this Purpose site
Foundation/Wallpour
Reinforcement in Place
Foundatiotu�Datn
Backflll Approval
Plumbing Linder Slab /
Plumbing Vent/V in
U.
Healing u -Ind L' �� rr a, /cr � �!
Insulation Sf F
Foundation Walls or R
Foundation Walls erior R-
Floors R-
Walls R
Ceiling R-
Duct work or 'piPt g to
unheated R-
Proper 'Went, Attic V nt
Frami
Jack St rs
Bracing/Bridgin
joist Mangers
Jack Seam --
Air Infiltration Bernier
Fire Separation 1, 2, 3, hour
Penetration Sealed
Fire Wall 2, 3, 4 hour
Firestoppin
urS
GENERAL I1'V S�'ECTII 1N REF2RT
( 518 ) 7 +61 - 8256
Town of Queensbury
Date inspection request received:
Dept. of Community Development CJ c� GrffZ�
Building & Code Enforcement
742 Bay Road Arrive �� �' am/pin
Depart atnlpm
Queensbury, NY I281}4 Inspectoes Initials
LOCATION:/ yt7 A O cu
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
FootingslPiers ,._.�...i
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for
providing protection from Freezing,
for 48 hours following the placement
of the concrete.
Materials for this purpose on site
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofin
Back ill Approval
Plumbing Under Slab
Plumbing Vent(Vents in Place
Rough Plumbin c�
Heating Rough-ln ¢ b( fef�r�c��r,✓
insulation
Foundation Walls Interior R- _
Foundation Walls Exterior R- _
Floors R' —
Walls R-
Ceiling R-
Duct work or pilling in
unheated spaces R-
proper Vent, Attic Vent
Fran-Lin
Jack Stue�^rs
Bracing/Bridging
Joist Ha gers
Jack PostslMain 'Beam
Air lxrf"iltration Barrier
Fire Separation 1, 2, 3, hour
Penetration 'Sealed
Fire Wall 2, 3, 4 hour
FiresUipping_, . .
ROBS TAT E OF NEW 'YO R K
DEPARTMENT OF HEALTH
Glens Falls District Office, 77 Mohican Street, Glens Falls, New York 12801 (518) 793-3893 Fax (518) 793-0427
Antonia C. Novelle, M. D., M.P.H. Dennis F. Whalen
Commissioner Executive Deputy Commissioner
September 28, 2000
Leonardo Lombardo
1587 State Road Rte 9
Lake George, NY 12845
Re: Leo' s Pizza Time
Proposed Food Service Establishment
(T) Queensbury, Warren County
Dear Mr. Lombardo,
I have looked at the preliminary plans that were brought to our office by your associate. Please be advised
that we need plans for both the Sewage Disposal System and Water Supply, drawn by a Licensed
Professional Engineer.
These plans are for our review and approval. We also need a layout of the equipment and menu. You are
advised against any construction or modification to the existing structure until this office approves these
plans-
If you have any questions, call me at 793-3893 .
Sincerely,
Joseph Curatolo
Principal Sanitarian
Cc: Ms. Mann
Cc: Ms. Sayer
Cc: Glenn Bruso P.E.
Cc. Codes Enforcement Officer
(T) Queensbury
cc