CC-0064-2022 Office Use Only
ADDITION/ALTERATION PERMIT Permit#: a_- az(04- zbZ2
APPLICATION Permit Fee: $ Zoo
Town ofQueensbury
742 Bay Road,Queensbury,NY 12804 Invoice#: Lod
P:518-761-8256 www.gueensbury.net
Flood Zone? Y 4kReviewe B
Project Location: li..,A ���
Tax Map ID #: Z �Z,t� .. ZZ Subdivision Name:
PROJECT INFORMATION:
TYPE: Residential Commercial, Proposed Use: (�-iQ,'S
Single-Family _Two-Family _ Multi-Family (#of units ) —Townhouse
Business Office _Retail _ Industrial/Warehouse _Garage (#of cars
Other(describe )
ADDITION SQUARE FOOTAGE: ALTERATION SQUARE FOOTAGE:
1st floor: 1st floor:
2nd 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:
ir42+t
Addition/Alteration Application Revised January 2021
SWIAW= :,
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL h=
• Applicant•
Name(s):
Mailing Address, C/S/Z:
Cell Phone: ( Si 6r ) ��o - �601 Land Line:
Email:
•e(s): GLA PrimaryOwners :
Nam �AL /n `C L L
Mailing Address, C/S/Z:
Cell Phone: ( 3 Land Line:
Email: Jo7Y a k IS a,a) , LovL-L
❑ Check if all work will be performed by property owner only
Contractor(s): (List all additional contractors on the back of this form)
Contact Name(s): A-n!wkca At
Contractor Trade:
Mailing Address, C/S/Z: .�
Cell Phone: Land Line: � )
Email:
**Workers' Comp documentation must be submitted with this application**�
• Arch itect(s)/Eneineer(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: kc&A
Cell Phone: Land Line. _�) . .
Email:
Addition/Alteration Application Revised January 2021
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction: $ � .
2. Source of Heat (circle one): Ga _Oil _Propane _Solar_Other ,.0
Fireplaces/inserts need a separate Fuel Burning Appliances & Chimney Application
3. Are there any structures not shown on the plot plan? _YES ENO Explain:
4. Are there any easements on the property? _YES IS NO f-
for
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 ~"y
• What type of wastewater system is on the parcel? _SEWER _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 requirq-e,::
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. Y0
3. Ifthework 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 sup
porting materials are atrue and a complete statement and/or descripi:(00 .
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 certificate of occupancy. _•
I have read and gree to the above:
PRINT NAME: I61
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SIGNATURE: W 1 DATE:
.a w'MRi"
Addition/Alteration Application Revised January 2021
® ICE
KRAFT PAPER INSULATION
NONUST BE-COVERED,BY
COMBUSTIBLE BARRIER
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NOTICE
7Q
FOAL INSULATION MUST BE j
COVERED BY A 15 MINUTE
THERMAL BARRIER
TOWN OF QUEENSBURY
BUILDING DEPARTMENT
Based on our limited examination,compliance
with our comments shah nO be construed as
indicating the plans and s ecifications are in
full compliance with the Building Codes of
New York State.
288.12-1-22 CC-0064-2022
Artie's Outfitters TOWN OF O U F
1444 State Rte 9 BUILDING &
Commercial Interior Alterations Reviewed By.
Date:
FEB 2 2 2022
1 TOWN OF QUEENSBURy J BUILDING 8,(,
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FEB , g 2022
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288.12-1-22 CC-0064-2022
Artie's Outfitters
j 1444 State Rte 9
Commercial Interior Alterations
�pvt .
FIRE MARSHAL'S OFFICE
Town of Queensbttry.
742 Bay Road, Queensbury, NY 12804
"Home of Natural Beauty ... A Good Place to Live "
PLAN REVIEW
Artie's Outfitters
1444 Route 9
CC- 0064-2022
2/25/2022
The following comments are based on a review of submittals:
• Verify fire extinguisher, location and inspection
• Verify location of exit/Emergency lighting. Function test will be required
• Lock/ latches shall comply with Chapter 10 of 2020 IFC.
• Verify paths of egress
• Verify storage
• Verify clearances to electrical'service panels
• CO detection is required, if source is present
• Knox Box key is required
• Full detailed layout of the space is required, prior to any inspections
NOTE: It also appears that a new exit door has been added and new title displace
at the Artie's Camping and More. My office has no records of a review or
inspections for the work or the new business. It appears a CO application is also
required for this business. This needs to be completed in conjunction with this
application.
Michael J Palmer
Fire Marshal
742 Bay Road
Queensbury NY 12804
firemarshal@queensbury.net
Fire. Marshal 's Office • Photte: 518-761-8206 Fax: 518-745-4437
firentarshal@gtteensbttnl.net n mmu.queensburt1.net