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CC-0278-2019 (2) TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development- Building & Codes (518) 761-8256 BUILDING PERMIT Permit Number: CC-0278-2019 Tax Map No: 302.5-1-92.11 Permission is hereby granted to: AVIATION MALL NEWCO LLC For property located at: 578 AVIATION RD 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 Owner Name: AVIATION MALL NEWCO LLC Retail-Mercantile-Alteration $15,000.00 Owner Address: 4 Clinton Square Total Value $15,000.00 Syracuse,NY 13202 Contractor or Builder's Name/Address Electrical Inspection Agency Plans& Specifications Repair to exterior utility door $ 175.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Tuesday, May 12, 2020 (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 of Queensbury; Monday, May 13, 2019 SIGNED BY: - for the Town of Queensbury. Director of Building&Code Enforcement ffi.. oA Office Use Only ADDITION/ALTERATION PERMIT Permit#: C�°-' ®� t 1 I —a APPLICATION Town of(ucensbury Permit Fee:$ 742 Bay Road,Queensbury,NY 12804 Invoice#: 1� P:518-761-8256 www.gueensbury.net �— Project Location: Space L09, 578 Aviation Rd, Queensbury,NY 12804 Tax Map ID #: 523400 302.05-1-92.11 Subdivision Name: CONTACT INFORMATION: I IU Y • Applicant: �15 "'i Name(s): Aviation Mall NEWCO LLC I Mailing Address, C/S/Z: 578 Aviation Rd Queensbury,NY 12804 W( Cell Phone: _( ) Land Line: (518)793-8818 L ° CCII � Email:jasontyler@pyramidmg.com 13 U ILDI N &C0D'Ei.1,1L • Primary Owner(s): Name(s): Aviation Mall NEWCO, LLC Mailing Address, C/S/Z: 578 Aviation Rd Queensbury,NY 12804 Cell Phone: _( ) Land Line: (518)793-8818 Email:jasontyler@pyramidmg.com ❑ Check if all work will be performed by homeowner only • Contractor(s): Contact Name(s): Contractor Trade: Mailing Address, C/S/Z: Cell Phone: _( ) Land Line: _( ) Email: "List all additional contractors on the back of this form • Arch itect(s)/Engi nee r(s): Business Name: St. Germain&Aupperle Contact Name(s): Shane Martin Mailing Address, C/S/Z: 5711 West Genesee St Cell Phone:_( ) Land Line: (315)-488-3550 Email: SMartin@sa-engineers.com Contact Person for Building & Code Compliance: Shane Martin Cell Phone: _( ) Land Line: (315)488-3550 Email: SMartin@sa-engineers.com Addition/Alteration Application Revised February 2019 PROJECT INFORMATION: TYPE: ❑X Commercial ❑ Residential WORK CLASS: ❑ Single-Family ❑Two-Family El Multi-Family (#of units ) ❑Townhouse El Business Office FX_1 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 square feet: Total square feet: 200 ADDITIONAL PROJECT INFORMATION: 1. Estimated Cost of Construction: $ VD,Opb 2. If Commercial project, what is the proposed use: Retail 3. Source of heat: ❑Gas❑Oil❑Propane❑Solar ❑Other Fireplaces need a separate Fuel Burning Appliances& Chimney Application 4. Are there any structures not shown on the plot plan? ❑YES ONO Explain: 5. Are there any easements on the property? ❑YES ❑X NO 6. SITE INFORMATION: a. What is the dimensions or acreage of the parcel? 10x20 panel b. Is this a corner lot? ❑YES ❑X NO c. Will the grade be changed as a result of the construction? ❑YES ❑X NO d. What is the water source? OPUBLIC El PRIVATE WELL e. Is the parcel on SEWER or a PRIVATE SEPTIC system? Sewer Addition/Alteration Application Revised February 2019 Si-- - I,� DECLARATION: 1. I acknowledge that no construction shall be commenced prior to issuance of a valid permit and will be completed within a 12 month period. 2. If the work is not completed by the 1 year expiration date the permit may be renewed, subject to fees and department approval. 3. 1 certify that the application, plans and supporting materials are a true and 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. 4. 1 acknowledge that prior to occupying the facilities proposed I, or my agents, will obtain a certificate of occupancy. 5. 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 February 2019