Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
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