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CC-0193-2023 / Office Use Only J ADDITION/ALTERATION PERMIT Permit#: cL -O XG 5- Z©23 Town ofQ�en ry APPLICATION Permit Fee:$ IZDb,50 742 Bay Road,Queensbury,NY 12804 P:518-761-8256 www.gueensbury.net Invoice#: Flood Zone? Y N Reviewed By: Project Location: — 1 Tax Map ID#: � 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 ) ❑ 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: uef APR 27 BUILDING 3 s COPES Addition/Alteration Application Revised June 2022- ADDITIONAL PROJECT INFORMATION: 1. Estimated Cost of Construction: $ 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 A NO Explain: . 4. Are there any easements on the property? ❑ YES 7 NO 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 • What type of wastewater system is on the parcel? IVSEWER ❑ 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 If,for any.reason,the building permit application is withdrawn, 30%of the fee is retained by the Town of Queensbury.After 1 year from the initial application date, 100%of the fee is retained. 3. 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 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: �p SIGNATURE: DATE: L� ZAP Addition/Alteration Application Revised June 2022 CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE-INCLUDE AN EMAIL • Applicant: Name(s): Mailing Address, C/S/Z: Cell Phone: (51V ) (_A"�) ©`? Z0 Land Line: Email: `; M.m pfe, 4— Q • Primary Owners : Name(s): �-1 MOO(- Mailing Address, C/S/Z: % Z- PIC,C Cell Phone: Land Line: �) Email: .e ©ore L(D 0 0"h(V n. C0 P ACheck 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): Contractor Trade: Mailing Address, C/S/Z: Cell Phone: _ ( ) Land Line: Email: "Workers' Comp documentation must be submitted with this application" • Architects En ineer s : l n Business.Name: to 8rC"p 1 r1 LLG QUT I -e V e��C4(Jr- C e5 Contact Name(s): C�(ern rev C r"mn Mailing Address, C/S/Z: - Z ® 'F,. C er\�,r ml P (C ,JCA\.f) S L4 O(9 Cell Phone: G 0) &V5 Z ZZi Land Line: Email: Q R Fla, MIDI) ( 1 G . C©►� Contact Person for Compliance in regards to this project: IBC I ' o o( � Cell Phone: ( � I� ) (�956� - � 7 d Land Line: �) Email: Addition/Alteration Application Revised June 2022 f FIRE MARSHAL'S OFFICE Town of Queensbury 742 Bay Road, Queensbunj, NY 12804 "Home of Natural Beauty ... A Good Place to Live " PLAN REVIEW Rack Room Shoes 1439 State Route 9 CC-0193-2022 6010sf • FE locations appear compliant 9 Need new hey for Knox Box, if locks are changed • FM will function test exit and emergency lighting fixtures • CO detection is required • Locks/Latches to be compliant with Chapter 10 of NYSFC. No key locks accepted • Verify all electrical switches and outlets are properly covered. Service panels shall have no openings and accurate legend cards installed. Michael J Palmer Fire Marshal 742 Bay Road Queensbury NY 12804 firemarshal@queensbury.net Fire Marshal 's Office Phone: 518-761-8206 Fat: 518-745-4437 ,firemarshal®gtieensbunl.net 7uzu7u.gyeensbyn1 net FINE FISSUREDTM � � CC. , cn IQ►3- 2O26 FINE FISSURED TM High NRC Te ular TOTAL SUSTAIN' g A C O U S T I CS' High Performance medium texture Sound Absorption(NBC) Sustainable +Sound Blocking (CAC) Ceiling Systems CAD/RevitO drawings at: armstrongceilings.com/cadrevit y. • -',`. 'I 00 Tw L Fine Fissured-Tegular panels with Prelude°XL®suspension system See more photos at armstrongceilings.con/photogallery Economical panels;Non-directional with standard or Total Acoustics®panel performance. KEY SELECTION ATTRIBUTES • Get total noise control and floor plank• Four new colors • Non-directional visual reduces scrap versatility with Total Acoustics®ceiling panels: Mold-and mildew-resistant surface and installation time NRC+CAC=Total Acoustics Performance . Options provide excellent combination of 30-Year Limited System Warranty y• Fine Fissured panels are part of the Sustain® acoustical performance NRC up to 0.75, against visible sag,mold,and mildew i portfolio,and meet the most stringent industry CAC up to 35,and Articulation Class 170 10-Year replacement =� sustainability,compliance standards today O• panel available for io-YEAR Fine Fissured'"School Zone' Items ��• CleanAssure"family of products— help comply with ANSI S12.60 items 1732,1734 REPUA.........4 r Uj C includes disinfectable panels,suspension Classroom Guidelines C -b systems,and trim t= z -� COLORS Due to printing limitations,shade may vary from actual product _ I t�N l' f a;. �^ °< Ste' � ' ,�•� ev e`.• �� •; Item 1732 is available in colors. NI other items are available in White only. Colored ceilings are dye-lotted and should becr, a _ E White Ivory Medium Taupe Light Grey Grey Stone Adobe segregated by dye lot.Do not mix. M'M PV) (Mn (LG) (Gs) (AD) DETAILS (Other Suspension Systems compatible.Refer to listing on next page.) 1.Fine Fissured"Beveled Tegular 0K 2.Fine Fissured'Angled Tegular 3.Fine Fissured"Tegular with Suprafine®9/16"suspension system .Tech Line 877 276-7876 �mstrong® armstrongceilings.com/finefissured CEILING tk WALL SOLUTIONS Q RECYCLED Calculate sustainability vdifh Green Genie" FINE FISSURED _7 /O CONTENT i armstrongceilings.corn/greengenie FINEFISSUREDTM High NRC SUSTAIN High Performance Sustainable Ceiling Systems Tegular GREENGUARDa= Gold Certified `y a o R =3 a a medium texture Declare• (details below) d E S� E i�� w . a s E, R % E_d E LOCATION DEPENDENG VISUAL SELECTION PERFORMANCE SELECTION Dots represent high level of performance. $$S S Bio- Humi- CleanAssure" 5 Block Guard+ 3... o Disinfectable Panels c c c U tU J N U v N E cc 03. Z mE m mE UL Classified 390 d m m vo o o 0 Acoustics 9¢ a� lT..a � ¢� rn¢ U� rL [a cc 2 0- ch armstrongceilings. Susp. Dimensions } _ com/suspdwgs Dwg. Rem No! (Inches) `aa! FINE FISSURED— 13 1756 24 x 24 x 7/8" ❑ 0.75 35 BETTER 170 Class 0.85 Std High NRC 47) A ' 15116" Angled Tegular 1757 24 x 48 x 7/8" 0.75 35 BETTER 170 Class 0.85 Std E�:] I)) ° A ° 9/16" 29,44, 1758 24 x 24 x 718" ❑ 0.75 35 BETTER 170 Class 0.85 Std Beveled Tegular 48,52, • ) • A 56 1759 24 x 48 x 7/8" 0.75 35 BETTER 170 Class 0.85 Std c0) A ° FINE FISSURED— 12 1732__ 24 x 24 x 5/8" ❑ 0.55 35 WA WA Class 0.82* • Std 15/16" • A Angled Tegular I� 1833 24 x 24 x 5/8" ❑ 0.55 35 N/A WA Fire 0.82 Std Sid �( Guard" 1733 24 x 48 x 5/8" 0.55 35 WA WA Class 0.82 • Std Std A MORE ITEMS► Red Numbers are Fire Guard items. t Total Acoustics®ceiling panels have an ideal combination of sound absorption and sound blocking in one product. GOOD(NRC 0.60-0.65;CAC 35+) BETTER(NRC 0.70-0.75;CAC 35+) BEST(NRC 0.80+;CAC 35+) .Add 2-letter color suffix to item number when specifying or ordering(e.g.,1732 flo *Light reflectance value for white panels only SUSPENSION SYSTEMS 15/16" 9/16" Prelude®XL® Silhouette- Silhouette Suprabne® Interlude® Preludem XL®Fire Guard' 1/4'Reveal 1/8"Reveal Suprafine®XL® Fire Guard'" PHYSICAL DATA Material VOC Emissions PHGOUCT CERTIFIED Cleaning and Disinfecting �■ Wet-formed mineral fiber GREENGUARD Gold Certified FOR LOW CHEMICAL DE Cleaning and CDC recommended disinfecting options EMMICINS Surface Finish Third-party certified compliant ULCOM/GG available on armstrangceilings.com/cleaning Factory-applied latex paint with California Department of Public UL2e18 30-Year Performance Guarantee&Warranty Fire Performance Health CDPH/EHLB/Standard Method GREENGUARD When installed with Armstrong°Suspension System. Version 1.2,2017.This standard is the Details at armstrongceilings.com/warranty Class A:ASTM E84 and CAN/ULC S102 surface guideline for low emissions in LEED®,WELL co D ®� Weight;Square Feet/Cartonburning characteristics.Flame Spread Index of 25 or Building Standard"',Living Building Challenge® less.Smoke Developed Index of 50 or less(UL labeled). (LBC),CalGreen Title 24,ANSI/ASHRAE/USGBC/IES 1732—0.70 Ibs/SF;64 SF/ctn ®® Fire Guard"':A fire-resistive ceiling when used Standard 189;ANSVGBI Green Building Assessment Protocol. 1733—0.70 Ibs/SF;80 SF/ctn In applicable UL assemblies.(Class A). Acoustical Performance 1833—1.05 Ibs/SF;48 SF/ctn 1756,1758—1.08 Its/SF;40 SF/ctn ASTM Ell 264 Classification CAC testing conducted using Prelude®suspension system for 1757,1759—1.08 ibs/SF;48 SF/ctn Type III,Form 2,Pattern C E 15/16"edge detail and Silhouette®suspension system for 9/16" Minimum Order Quantity Fire Class A edge detail. a Humidity/Sag Resistance High Recycled Content 1 carton HumiGuarda Plus ceiling panels are recommended Contains greater than 50%total recycled content. Metric Items Available for areas subject to high humidity,up to,but not Total recycled content based on product composition 1732M,1733M,1756M,1757M,1758M, including,standing water and outdoor applications. of post-consumer and pre-consumer(post-industrial) 1759M—Metric items subject to extended Anti-Mold/Mildew recycled content per FTC guidelines. lead times and minimum quantities. Ceiling tiles with BioBlock®performance resist the Insulation Value growth of mold and mildew on the tile surface. R Factor—1.5(BTU units);R Factor—0.26(Watts units) TechLine 877 276 7876 (Armstrong® armstrongceilings.com/finefissured CEILING&WALL SOLUTIONS o~ RECYCLEDI a■ ® Calculate sustainabili with Green Genie'" FINE FISSURED TM ® �,Q] IO CONTENT I annstrongceilings.com/greengenie FINE FISSUREDTM High NRC SUSTAIN' Hlgh Performance i Sustainable T Ceiling Systems =E m `o « Tegular GREENGUARD N E� Gold Certified Z5 =N m� c x o ad a g, - �o ma!a medium texture Declare: (detalsbelow) de �a �s �� daae m� y e=dl_E3I=QI LOCATION DEPENDENT VISUAL SELECTION PERFORMANCE SELECTION Dots represent high level of performance. Bio- Humi- CleanAssurr r Block Guard+ c Disinfectable Panels a a_"i w v LE ie E E m m E '--� m m r.. N UL Classified 'o " a�'�t '—a M,V5 r c) Acoustics 12 a a� t�a ¢ n w W> �E! a c 2 M armstrongceilings. Susp. Dimensions _ cam/suspdwgs Dwg. Rem No. (Inches) �g7 FINE FISSURED- 1 1834 24 x 48 x 5/8" 0 0.55 35 N/A N/A Fire 0.82 ° Std 15/16"Angled Tegular Guard- - 9/16" 29,44, 1734 24 x 24 x 5/8" 0.55 35 N/A WA Class A 0.82 Std Std ° Beveled Tegular 48,52, ° 56 1835 24 x 24 x 5/8" 0.55 35 N/A WA Fire 0.82 Std Stcl - • Guard 5/8"Thick-15/16"Angled Tegular,9/16"Beveled Tegular Made-to-Order ® ® Width Length N/A N/A WA WA Class A 0.82 • Std Std - Sizes 12"-30" 18"-72" FINE FISSURED" School Zane® 13 1717 24 x 24 x 3/4" ❑ 0.70 40 BETTER WA Class A 0.82 • Std FINE FISSURED ) 15/16"Angled Tegular 1820 24 x 24 x 3/4" 0.70 35 BETTER WA Fire 0.82 Stcl • (0) Guard 1824 24 x 48 x 3/4" 0 0.70 35 BETTER WA Fire 0.82 ° Std • ) Guard ® Red Numbers are Fire Guard items. r Total Acoustics®ceiling panels have an ideal combination of sound absorption and sound blocking in one product. s GOOD(NBC 0.60-0.65;CAC 35+) BETTER(NBC 0.70-0.75;CAC 35+) BEST(NBC 0.80+;CAC 35+) w TechLine 877 276-7876 ('mstrong armstrongcoilings.corn/finefissured CEILING&WALL SOLUTIONS RECYCLED ,® ~ ® Calculate sustainabdity with Green Genie"' FINE FISSURED TM_ = 0 CONTENT I armstrongceilings.com/greengenie FINE FISSURED High High NRC SUSTAIN' o o)0 r i0101 191010!High Performance f Suslaina6ia Ceiling Systems E Y 12 _12, m Tegular GREENGUARD H —g= N — U ! y Gold Certified y , y; g "x o o; `a a�o �- medium texture ®eclal12. (details below) d E 3 2 E I s E I E_ I—E I e LOCATION DEPENDENT _ VISUAL SELECTION PERFORMANCE SELECTION Dots represent high level of performance. BID- Humi- CleanAssure" Y e U Block Guard+ o'aDisinfectable Panels lR _ �crni 0 U 4M y O cc y N d W U A UL Classified —a o m t rn y r U rn y o 0 Acoustics r a a�, ri : co c � LEo a M armstrongceilings. Susp. Dimensions + _ 00 0com/suspdwgs Dwg. Rem No. (Inches) School Zone® 29,44, 1719 24 x 24 x 3/4" ❑ 0.70 40 BETTER WA Class 0.82 Std FINE FISSURED- 48,52, � A 56 9/16" Beveled Tegular 1821 24 x 24 x 3/4" ❑ 0.70 35 BETTER N/A Fire 0.82 • Stcl • �) Guard' 3/4"Thick—15/16"Angled Tegular,9/16"Beveled Tegular Made-to-Order ® ® Width Length WA WA WA WA Class A 0.82 Std Std • j Sizes 12"-30" 18"-72" School Zone® FINE FISSURED' Red Numbers are Fire Guard items. 1 Total Acoustics®ceiling panels have an ideal combination of sound absorption and sound blocking in one product. GOOD INK 0.60-0.65;CAC 35+) BETTER(NRC 0.70-0.75;CAC 35+) BEST INK 0.80+;CAC 35+) SUSPENSION SYSTEMS 15/16" 9/16" Prelude®XL® Silhouette® Silhouette Suprafine® Intedude° Prelude°XLe Fire Guard' 1/4"Reveal 1/8"Reveal Supratine0 XL® Fire Guard'" v PHYSICAL DATA Material VOC Emissions PRODUCT CERTIFIED Cleaning and Disinfecting �® Wet-formed mineral fiber GREENGUARD Gold Certified FOR LOW CHEMICAL � Cleaning and CDC recommended disinfecting options Surface Finish Third-party certified compliant EMISSIONS b available on armstrongceilings.com/cleaning ULCOFactory-applied latex paint with California Department of Public UL2818 30-Year Performance Guarantee&Warranty Fire Performance Health C.2,201 .This dardscan Method GREENGUARD When installed With Armstrong®Suspension System. Version 1.2,low e This standard is the Details at armstrongceilings.com/warranty ■® Class A:ASTM E84 and CAN/ULC S102 surface guideline for low emissions in LEED®,WELL taro burning characteristics.Flame Spread Index of 25 or Building Standard'",Living Building Challenge® Weight;Square FeeVCarton less.Smoke Developed Index of 50 or less(UL labeled). (LBC),CalGreen Title 24,ANSI/ASHRAEAISGBC/IES 1820,1821—1.31 Ibs/SF;48 SF/ctn ®® Fire Guard'":A fire-resistive ceiling when used Standard 189;ANSVGBI Green Building Assessment Protocol. 1717.1719—1.25 Ibs/SF;48 SF/ctn in applicable UL assemblies(Class A). Acoustical Performance 18352 1734 34——1..70 Ibs/SF;64 SF/ctn Ibs/SF;64 SF/ctn 1 ASTM E1264 Classification CAC testing conducted using Prelude°suspension system for —1.05 Type III,Form 2,Pattern C E;Fire Class A ' 15116"edge detail and Silhouette®suspension system for 9/16" Ibs/SF;48 SF/ctn 1824—1.20 Ibs/SF;64 SF/ctn Humidity/Sag Resistance edge detail. Minimum Order Quantity HumiGuard®Plus ceiling panels are recommended High Recycled Content 1 carton,excludes made-to-order panels far areas subject to high humidity,up to,but not Contains greater than 50%total recycled content.Total recycled including,standing water and outdoor applications. content based on product composition of post-consumer and Metric Items Available Anti-Mold/Mildew pre-consumer(post-industrial)recycled content per 1820M,1821 M,1717M,1719M,1834M, Ceiling tiles with BioBlock®performance resist the FTC guidelines. 1734M,1824M—Metric items are subject to s extended lead times and minimum quantities. growth of mold and mildew on the tile surface. Insulation Value Contact your representative for more details. R Factor—1.5(BTU units);R Factor—0.26(Watts units) Techl-ine/1 877 276-7876 LEED is a registered trademark of the U.S.Green Building Council;Declare"and Living Building Challenge"RBC) (rmstrong® armstrongceilings.corn/finefissured are registered trademarks of the International Living Future Instsdute'�;VVELL'"and WELL Building Standard are trademarks of the International WELL Building Insmute:UL and UL Cerafied are trademarks of UL LLC;all other BPCS-3026-323 trademarks used herein are the property of AWI Licensing LLC and/or its affiliates 0 2023 Awl Ucensing LLC CEILING&WALL SOLUTIONS