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RC-0184-2022 Office Use Only j ADDITION/ALTERATION PERMIT Permit#: YZ -01 7_0�-�2 APPLICATION Permit Fee:$ 3 ` 40 Town of Qcensbury 742 Bay Road,Queensbury,NY 12804 � Invoice#: P:518-761-8256 www.gueensbury.net Flood Zone? Y Reviewed By.6y 1 Project Location: 4/ U l�y+s d 2 D a . a l e t7 t�5 ?,la 2�( Tax Map ID#: "30,1 , I a Subdivision Name: PROJECT INFORMATION: TYPE: ❑ Residential ❑ Commercial, Proposed Use: ❑ Single-Family ❑ Two-Family ❑ Multi-Family(#of units—) ❑ Townhouse ❑ Business Office ❑ Retail ❑ Industrial/Warehouse ❑ Garage (#of cars ) Q Other(describe t'3a,cn — WofL5'b® 1SfiwJly QeC5 0V1C1 cAs,Q 0��it�!) 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: �230 c..l Scope of work to be done: r �-e 9 ® `Yl5 lA afi�2 -4 ® i'\eV3 ►ont, fiLA vie �oa r ��n 1=O'St LA V00AI WoUv\.t �(Ck5 bie4;ee- 1 v� �cu.L� LAJO Addition/Alteration Application Revised March 2022 ADDITIONAL PROJECT INFORMATION: 1. Estimated Cost of Construction:$ 01) �)py 2. Source of Heat (circle one): �C�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 941<0 Explain: 4. Are there any easements on the property? ❑ YES ENO SITE INFORMATION: • Is this a corner lot? ❑ YES LAO • Will the grade be changed as a�revuu t of the construction? El YES I1NO • What is the water source? B�' UBLIC ❑ PRIVATE WELL �v � Cav�ne�c�J • What type of wastewater system is on the parcel? Cp-�5EWER ❑ PRIVATE SEPTIC DECLARATION: 1. 1 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 If,for any reason,the building permit application is withdrawn, 30%of the fee is retained by the Town of Queensbury.After 1 year from the initial application date, 100%of the fee is retained. 3.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 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 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: SIGNATURE: DATE: 41,q Lkad- Addition/Alteration Application Revised March 2022 e f CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Applicant: Name(s): v Mailing Address, C/S/Z: t. 11it1 T -e s -., 5 �J 6 Cell Phone: ( Lk-) - — Land Line: Email: Ie tA A a UK c.i c0 vcn • Primary Owner(s): Name(s): 'ri m a(L a- vt k-,e 12�-c-J Mailing Address, C/S/Z: J-y-- Cell Phone:�_) Land Line: � ) Email: F,b Check if all work will be performed by property owner only • Contractor.(s): (List all additional contractors on the back of this form) Contact Namd(s): �3 Contractor Trade: Mailing Address, C/S/Z: Cell Phone:�_) Land Line: Email: "Workers' Comp documentation must be submitted with this application" • Arch itect(s)/Engineer(s): Business Name: Contact Name(s): F—d u>a r-ef k_ � '- Mailing Address, C/S/Z: i-1 C ym ,o;rP V2 LwS 7 a f o Cell Phone: Land Line: s i ) 7yZq- L-l4/ Email: , Contact Person for Compliance in regards to this project: -- wi )24IU4e� Cell Phone: ! i ) 79i -�Lo�S' Land Line: Email: i tG g&vt10 Addition/Alteration Application Revised March 2022 Edward K. LaPoint, PE Geo-technical & Structural Engineer 14 Empire Ave.Glens Falls,NY 12801 518-744-4411/eklapointpe@gmail.eom April 9, 2022 ���•T•C�J n� `�:a;. 'y-,x. :.,�#'..,•,..-. .,.ex-+•. -sasni�ile Tim Reed (owner) 74 Webster Ave. Glens Falls, NY 12801 RE: Basis of desiqn report BODR, Acceptable change in use and occupancy. Existing barn structure at 4 Windsor court Glens falls NY Dear Tim, The owner has retained the engineer to inspect, evaluate, and provide recommendations for the above referenced site. Specifically. 1. The owner intends to renovate the above reference site to a Low-Hazard Storage, Group S-2 '2. Additionally,the owner is proposing slab type perimeter concrete footings which are acceptable for the unconditioned space. 3. Attached please find signed and sealed layout and specifications Please contact this Engineer for any additional information and /or c c F- CEOWE s:w --•-.-�--. Since APR 14 2022 r . _ TOIIINOFQtE 4° S � Y c pF NEby'y. 8U�' ENT �� PPD KEITi/�d �,A�• Based on our limited i;�riina:ion,compliance o� with our comments zl,:: not be construed as indicating the plans and suacifications are in Edward K. LaPoint PE full compliance with the �iuilding Codes of m ` . a w , New York State. 1 of 1 6IbIM0 NW'EAI.Tfi•I ELE,C RICAL.INSPECTI&N SERVICE.JNC. M. Malit 001 cc 176 ifo©Ilan Ropd-Menheim,PA.l7545 NdlfNICIPAL CEkTIFJCA'rE - -ELIECTRICAL APPROVAL Cert. 5 014 5 CuC-in tIatd N................. I r , 4 Pennit No.„ N 2 ...... .... i Owner.....................l..f..r..k.. ... . .. .f.L................................................., .... ................................... Location..,..,.,. ..'...,.y.......... i.ra.la.S.u� .....: ':.....................................:.........................................I :r"4 Installation Consisting c,i......7?.�.4!!�.LSJ......: f.lt.+n..G.,,-...... ' ............ ........ _..................................... .......... ............................. ...........,.................,............... .,. .. ....,.. - ..................................................... • ................. ... �• •`,: w InsCttllccl By.. .,�:H.....•.;... ..'Lie.No.. .. .. •,�:•, ��`� •�• The eotidi[iom Ibtlttwing govCmW the issuance o(lbis ccrtifcatC,andany ecrtificnla pi-Lviovsly issued is I• ��:� This cerlificow only ctyvci,,, the ulc;cirical equipment and installation conditions as of daic. Upon cite 1, introduction of.Wditioual equipmenf'or Itherations,application shell be promptly made for inspection. Inspectors of div, Company sball have the privilege of making inspeelions at tiny time. and if its rules are violated.►he Company tih.,ll have the rWrt to revoke this certificate. I `•s`' Date...........5 '..�-. .3.............. iNSI'IECTOR...�.3..r ` ..... :`• : [Member NI RA,I.A.6.1. Z0 3E)Cd msvinW NOd b89186L ZE:EZ EZ0Z/Z0/90