CC-000251-2016 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-000251-2016 .8P2-
Tax Map No: 309.14-1-11
Permission is hereby granted to: Michael Ringer E VV l S E D
For property located at: 104 MAIN ST 1 v!
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
TTpe of Construction
Owner Name: M J RINGER PROPERTIES LLC Factory-Industrial-Alteration $7,000.00
Owner Address: 10 S WestemAVE Total Value $7,000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
'IENEWED
Plans&Specifications
Commercial Alterations
Convert warehouse into workout room
CONDITIONS OF BUILDING PERMIT:personal use only,not open to public,no customers,no signs
$ 0.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Saturday,July 29,2017
(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 ofr2115b ry; n I and y u 29,2013
SIGNED BY: �ylJf// for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
Town of Queensbury Building & Codes Received: 2013
PRINCIPAL STRUCTURE APPLICATION Tax Map ID: J _':3 09. lam/ —/- f L
Permit No.: �
A permit must be obtained before beginning construction permit Fee: $ d 3. —
Please read: 'TB resolution 86-2013(1-28-2013): $850 recreation fee for new dwelling 'Rec Fee: $ f?
units, including single-family dwellings, duplexes or two-family dwellings, multiple family Site Plan No.:
dwellings, apartments, condominiums, townhouses, and/or manufactured and modular Subdivision No.:
homes,but not including mobile homes. This is in addition to the permit fee.
Date Applicant /OS'o r r2l�
Tax Map ID 3 d , — / ' Address P. u
Zoning
Phone/E-mail
PropertyOwner1C.06�Pl 4r�Z ee�'_ Contractor/Agent
Address Address
Phone/E-mail Phone/E-mail (7f/ ,G l-6�S a
Building Street Address: /JAG n S S>i�
Subdivision Name: Lot 9. Historic Site: Yes No
Estimated cost of construction: $ 7 GGG. liC'�
Type of Construction:
Check all that apply Please indicate measurements as required below:
m v 1st Floor 2nd Floor Other Total Height
? a a
Single Family
Two-Family
Multi-Family(#of
units
Townhouse
Business Office
Retail-Mercantile
Factory-Industrial
Attached Garages(# )
Other
Town of Queensbury Building&Codes Principal Structure Packet 518-761-8256
If commercial or industrial indicate name of business
Proposed use of building or addition
Source of heat(circle one) Gas Oil Propane Solar Other
Fireplace-complete a separate application for"Fuel Burning Appliances&Chimneys' Yes _No
Are there structures not shown on plot plan?
Are their easements on the property?
Site Information
a. Dimensions or acreage of lot
b. Is this a comer lot?
c. Will the grade be changed as a result of construction: Yes —No
d. Public water or Private well
e. Sewer or Private Septic System
Value of all work to be performed(labor and materials) $
Declaration: I acknowledge no construction activities shall be commenced prior to issuance of a valid permit and will be completed
within a 12 month period. If work is not complete by the 1 year expiration date the permit may be renewed, subject to fees and
department approval. I certify that the application,plans, and supporting materials are a true and complete statement/description of the
work proposed,that all work will be performed in accordance with the NY State Building Codes, local building laws and ordinances, and
in conformance with local zoning regulations. I acknowledge that prior to occupying the facilities proposed, I or my agents will obtain a
certificate of occupancy. I 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 bove.
Signed 11 Date: /3
FOR OFFICE USE ONLY:
Operating Permit Issued: _Yes �N�
Occupancy Type:
Construction Classification:
Assembly Occupancy Limit: <SU
Special Conditions:
Town of Queensbury Building&Codes Principal Structure Packet 518-761-8256