application M!
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Office�/se Only
ADDITION/ALTERATION PERMIT Permit 4. C,-'
APPLICATION 5Q 0
Permit Fee:$ t(p.q
ket n..(t Liet•te,hun
742 Bay Road,Queen bury,NY 12804 Invoice q: 1Q83
P:518-761-8256 w-,v v.gueensburv.net
Project Location: Olive Garden#1428 (756 Glen Street Queensbury, NY12804
Tax Map ID#: 302.6-1-51.2 Subdivision Name:
CONTACT INFORMATION:
• Applicant:
Name(s): N and D Restaurants, LLC
Mailing Address, C/S/Z: 1000 Darden Center Drive Orlando, FL 32837
Cell Phone:_L_) Land Line: 4( 07 )245-4299
Email: BKendrick@darden.com
• Primary Owner(s):
Namc(s): Queensbury Plaza 1, LLC
Mailing Address, C/S/Z: 400 Andrews Street#500 Rochester, NY 14604
Cell Phone:. ( Land Line: _ 585 )546-4866
Email: mpalumbo@flaummgt.com
• Contractor(s): T.B.D.
Business Name:
Contact Name(s): -----
Mailing Address, C/5/Z: Linxi n-2—oni
Cell Phone: Land Line: )
Email:
BUILDING&CODES
• Architect ls)/Engineer(s):
Business Name: Hmd Group, PA
Contact Name(s): Wilfredo F. Perez
Mailing Address, C/S/Z: 10556 NW 26th Street Suite D-101 Doral, FL 33172
Cell Phone:_( Land Line: 3� 05 ) 594-2975
Email: hmdgroupta'Dbellsouth.net
Contact Person for Building & Code Compliance: Norma Medero
Cell Phone: ( Land Line: 305 ) 594-2975
Email: nmedero@hmdgrouparchitects.com
PROJECT INFORMATION;
TYPE: X Commercial Residential
WORK CLASS:
_Single-Family Two-Family _Multi-Family(4 of units )
_Townhouse —Business Office _Retail
Industrial/Warehouse GaraQe( of cars I X Other(describe Existing Restaurant }
ADDITION SQUARE FOOTAGE: No additional space being proposed ALTERATION SQUARE FOOTAGE:
1st floor: N/A 1st floor: 5,323 SQ FT
2"a floor: NIA 2"d floor: N/A
Yd floor: N/A Yd floor: N/A
4�"floor: N/A 41"floor: NIA
Total square feet: N/A Total square feet: 5,323
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction: $350,000.00
2. If Commercial project,what is the proposed use: Existing restaurant to remain.
3. Source of Heat (circle one): 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 NO Explain:
S. Are there any easements on the property? YES NO (Unknown)
6. SITE INFORMATION:
a. What is the dimensions or acreage of the parcel? 12.23 Existing- No Changes
b. Is this a corner lot? YES NO
c. Will the grade be changed as a result of the construction? YES NO
d. What is the water source? PUBLIC PRIVATE WELL
e. Is the parcel on SEWER or a PRIVATE SEPTIC system? Sewer
. ,
[}E-CLAR/\TION:
t»�� '`n constmmon sha| ua co-�n—noec phorto issuance o/a*U'J parrit a,d »;:| be
�o/np�eedm�hm o 12month period.
� If thevvo/( is vot cum�+ed by the 1 'es' e/pkadoo da\e (lie ppnsubsubjectit may be renewed. �� � co
,ca3 snddepe-trnenc approval.
l | ce/�i�v t|`a aPp|icaboo, p{an5 and suaporbng materials are o toe and como/ete oatementond/or
decr,'puon cfnhework Proposed, that o|| work will be pertonnaU in accordance ehth the MYS 8uibUnu
CuUes. /ocai hci/dino,/3vvs and o'dioxnces. and in coofoonance with local zomnQ regulations.
4. / acknoa|adz:e that prior to occupying the bcil beS pmpoed |, o/ my agents, *ill obtain a oardfico�e
mfoccuVancy�
j }also understand thac1/�xe are required toprovdeanas-built 5umeybya licensed land surveyor ofal!
nep/|v constructed lacUihes prior to issuance ofa certificate ofoccupancy.
/have read and agree to the above:
PRINT NAME:
SIGNATURE: DATE: