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2024-0097 Office Use Only Permit#: 2D 2-1ft"OOci`k• / Permit Fee:$ 2.1r-D E vl2=J J I s C�,1 Town of Queensbury U FIRE MARSHALS' OFFICE FEB 2 2 2024 742 Bay Road,.Queensbury,NY 12804 _ _ -- 518.,761=8206 www.queensbury.net TOWN OF QUEENSBURY BUILDING c: CODES FIRE MARSHAL SPECIAL PERMIT APPLICATION Project.Location:�� " t e.c 24 \ kax Map ID #: 15 . 15 s1 Business Name, if applicable: WALMART Brief description of scope of project: • 1875KW GENERATION SYSTEM WITH SWITCHGEAR, APPLICABLE • WIRING, CONCRETE SLAB, TWO SUB BASE AST FUEL TANKS • THIS GENERATOR IS FOR OPTIONAL STANDBY USE ONLY; NOT A LIFE SAFETY GENERATOR * PLEASE MAKE SURE TO INCLUDE A SKETCH SHOWING THE LOCATION OF THE PROPOSED WORK OR PROJECT ON THE PARCEL'* FM Special Use Application Revised August 2022 CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Applicant: Name(s): POWERSECURE,INC. Mailing Address, C/S/Z: 4068 STIRRUP CREEK DR DURHAM NC 27703 Cell Phone: ( )4049982189 Land Line: ( Email:PERMITTING@POWERSECURE.COM • Primary Owner(s): Name(s): WALMART Mailing Address, C/S/Z: PO BOX 1500 BENTONVILLE AR 72716 Cell Phone: ( ) Land Line: ( Email:JHOUCHIN@WALMART.COM • Property Owner(s): Name(s): WALMART SAME AS ABOVE Mailing Address, C/S/Z: Cell Phone_: ( ) Land Line: ( Email: ❑ Check if all work will be performed by property owner only • Contractor(s): (List all additional contractors on the back of this form) Contractor Name(s): POWERSECURE, INC _ . Contractor Trade: GC Mailing Address, C/S/Z: 4068 STIRRUP CREEK bR DURHAM NC 27703 Cell Phone: ( )4049982189 Land Line: ( Email:PERMITTING@POWERSECURE.COM **workers' Comp documentation must be submitted with this application** DECLARATION: 1. I acknowledge that no work shall commence prior to approval of a complete building permit submission. 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 If, for any reason, the building permit application is withdrawn, 30% of the fee is retained by the Town of Queensbury.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. I have read and agree to the above: APPLICANT NAME: WES DEWEESE APPLICANT SIGNATURE: (�(� DATE: 2J22/24 PROPERTY OWNER NAME: WALMART(JEREMY HOUCHIN) PROPERTY OWNER SIGNATURE: DATE: 2/22/24 FM Special Use Application Revised August 2022 FIRE MARSHAL'S OFFICE Town of Queensbury 742 , NY 12804 Bay Road, Queensbury, "Home of Natural Beauty ... A Good Place to Live " PLAN REVIEW Wal Mart 4403 24.Quaker Ridge Blvd 2024-0097 • Provide complete specs. For both units for review • Need details for bollard spacing • Need secondary containment details • NFPA 704 labelling will be required on tanks • Indicate if either unit will pick up any emergency systems, ie. Fire alarm, exit lighting, emergency lighting Michael J Palmer Fire Marshal's Office 742 Bay Road Queensbury NY 12804 tysonc@queensbury.net Fire Marshal 's Office • Phone: 518-761-8206 ■ F a x: 518-745-4437 firemarshal©queensbury.net • www.queensbunj.net