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RC-0121-2022 Office Use Only ADDITION/ALTERATION PERMIT Permit#: -• 0+2k-202,2. To APPLICATION permit Fee:$ 22©— wn of Quc ensbur}• 742 Bay Road,Queensbury,NY 12804 Invoice#: P:518-761-8Z56 www.gueensburv.net Flood Zone? Y (S;1,,4eviewe Project Location: I �/h!r��rjR� I�incS' �/a� I Tax Map ID#:_ 7,n J_ Subdivision Name;-- - PROJECT INFORMATION: APR 13 2022 I I TYPE: Residential ❑ Commercial, Proposed Use: TOWN Or QUEENSBURY btji a.,�'e a eea my 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: 77 Scope of work to be done: TC, 1(e a er-t -/-4t 11_�krcc" p,;fk C, �l�S�,� /cam F� �.�p'�j e�'P>rIPY , ew'•d J �P Ci/1 eJ,-C1•.E e4 c13Z (Jr 841, he,9-0® 1"sfell C, c-, dfl� J p l aa a Rewak a °t itsr► r ":� r J�r, i�� t .gait L ( r X beJY->Ned bed c_^ er�,_e,,pC Y Addition/Alteration Application Revised March 2022 f CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Applicant: Name(s): � P vPf 6c , S �vr/��- ��r[it G*S` 1 L- 4— Mailing Address, C/S/Z: M�r;.� ,:'� , ��: � , ��-°' n� f A/y Cell Phone: (.!E 11171 Land Line: Email:..Tfeve , • Primary Owner(s): Name(s): Mc i y e- ,&( P&C,5 !fie ri' r ff Mailing Address, C/S/Z: // P"lc-r L_/e1, , � , /UK )2_? 0L1 Cell Phone: 51( 6 ) ')6( Land Line: Email: m4h��, ❑ 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): S MvrrG S Srriln rs- L-L c— Contractor Trade: -n15;d1-_ Mailing Address, C/S/Z: 1/ Mr,,,+e_e=_4 L,ec-/ -I).- . Fc,+ A', a V� 1 71 2 Cell Phone: Ole,e ) 60 q 11171 Land Line: � ) E m a i c-. "Workers' Comp documentation must be submitted with this application" • Architect(s)/Enaineer(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: Cell Phone: Land Line: �) Email: Addition/Alteration Application Revised March 2022 i . , 4 ADDITIONAL PROJECT INFORMATION: 1. Estimated Cost of Construction:$ I t 5610 2. Source of Heat(circle one): E�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? d YES ❑ NO Explain: Rr' CAC 4. Are there any easements on the property? ❑ YES CZ NO SITE INFORMATION: • Is this a corner lot? ❑ YES 6f NO • Will the grade be changed as a result of the construction? ❑ YES 51 NO • What is the water source? 59 PUBLIC ❑ PRIVATE WELL • What type of wastewater system is on the parcel? ❑ SEWER W(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 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: ) SIGNATURE: DATE: �•?•- Addition/Alteration Application Revised March 2022 4126/22,7.'19 AM f j Whisper Choice,Ceiling Mount Ventilation Fan,130 or 150 CFM I Panasonic North America- United States eili Whisper Choice C ' • i 13 ng Mount Ventilat 0 or 150 CFM on Fang FV-1315RQ1 I —FILE Copy CONTACT SALES Q xffW'} r1 .V f _ �s. i:/$gin JYn¢. ,a1{Yr`A'3'tF n •'° t .'' !x.� ✓�Phi ;:.r. ':�;l.i, hops://na.panasonic.com/us/home-and-building-solutions/ventilation-indoor-air-quality/retail-fa ns/whisper-choice-ceiling-mount ventilation-fan_130-or-1... 1/6 4126/22,7:19 AM Whisper Choice,Ceiling Mount Ventilation Fan,130 or 150 CFM I Panasonic North America-United States f, PRODUCT DETAILS Designed for healthy living, this quiet, high-powered workhorse provides effective moisture and mildew control for clean indoor air in almost any room. Flex-Z-FastTM installation bracket enables fast, easy ceiling-mount installation. Pick-A-Flow airflow selector lets you choose the desired CFM level at 130 or 150 CFM to deliver precision ventilation and meet building codes. Ideal for new construction and remodeling projects. KEY FEATURES • Pick-A-FLowTm airflow selector lets you choose desired airflow at 130 or 150 CFM • Flex-Z FastTM bracket enables fast, flexible and easy installation from below the ceiling • Whisper quiet at <0.3/0.3 sones • Fits 2x8 joists and includes a 6" duct adapter for added installation flexibility a UL Listed for tub and shower enclosures ® View Product Support PRODUCT SPECIFICATIONS + RESOURCES + Whisper Choice ceiling -mount ventilation fan, 130 or 150 CFM https://na.pa nasonic.comfus/home-and-bu ild ing-solutions/venti lation4ndoor-air-q uality/retail-fans/whisper-choice-ceil ing-mou nt-ventilation-fan-130-or-1... 2/6 7-Day Programmable SPECIFICATIONS MODEL RPLS730B Timer Unit _ Qty. 1 FOR SECURITY, CONVENIENCE Dim.WxHxD(in.) 6.7x9.1x1.9 AND ENERGY SAVINGS Carton Wt.Q ) 0.77 Cu.Ft 0.07 I r I :.: :,.,, j �� •,,,,+ MODEL RPLS731 B = Unit I ; l Qty. 1 RPLS730B(white) RPLS731 B(light almond Dim.WXHxD(in.) 6.7 x 9.1 x 1.9 KEY FEATURES Carton Wt.(lbs.) 0.77 • For use with lights and motors up to 2400 W, 1 HP on 120VKs1.+ • No minimum wattage required • 7-day programming (up to 7 on and 7 off times per week) • Hidden programming buttons • Sleek design mounts flush with wall plate • Single pole installation(requires neutral wire) • Manual override enables load to be turned on/off Retail Package without affecting programming Qty. 5 • Built-in rechargeable battery • Programming protected during power outages Dim.WxHxD(in.) 8.7 x 14.6 x 9.8 • Can also be used like a conventional on/off switch Carton Wt(lbs.) 3.86 Does not include wallplate Cu.Ft 0.72 ®�r CFL compatible Single pole RPLS730B1000 RPLS73161009 Designed in Canada. Made in China. Automation and Control Solutions o 85267 5s072 s o 1 5267 59189 $ Honeywell 1985 Douglas Drive North Golden Valley, MN 55422-3992 800-468-1502 CB March 1 11 Honeywell ell March 2011 �iv�/��i yourhome.honeywell.com 0 2011 Honeywell Intematonai Inc. ,- 012.1 - Z02-2-- t`.O MMONNNTALTH ELECTRICAL INSPECTION SERV1CIF,INC. A. M19041 C>'iticr 176 Doe Rpn Road-Mallhcl'pt,,PA 17545 cd Ddi UNJQ1PAL CERTIFICATE ELECTRWAL APPROVAL •.' Permit Nor.......................................Cert. 0 5.01.19 C•ut in Card No..............,.......... ?`ate t .............:.•....... .......--...............,..r..r.,..,...........................---....................... >v Location. ......... ... ...................................................... 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Upoo the i 1,)w� introduction uFuddition!il•c�luiplrlCltl or sltcration5,application be promptly mode for inspection. lnspeclori ur imp (:ompany shall have the priviloge or making iuspuct;ons at any timc, and if it* 3! •;5.� +.:?•i. � at rglrs arc violed,Me t`ompany shall.havc the right to revcko'•this certiYit:act. -' D:tte- `t✓.° a.2,.3...'........... INSPECfO)<t, .. ....................................... .... ,Member h,F.P.A.,I.A.E.1. < ' 60 39dd oiawnW NMI b85186L ZZ:6Z 6Z0Z/LT/V0 • J ® E .'.."R 13 2022 TOW'.' '.3=OUBBi,-,ISBURY ti 1 BUI..�;ING&GOOFS t_�� 3 ka p t � L. A' J o Ko 150 '. 7 � i 4 0` (0S It d ,� 1 � z r s....fir' - 1 e pI-CIC ri L,Ihi3'Q7lrfn� 1����1e,s" j"�C(o V GC. / � = 10 vtc� S hv��� Al Y