application Office Use Only
Permit#:
PRINCIPLE STRUCTURE PERMIT
APPLICATION
Permit Fee: $ IBJ �J •3
742 Bay Road,Queensbury,NY 12804 *Rec Fee: $
P:518-761-8256 www.gueensbury.net Invoice #: 4✓T
Project Location: 524 Aviation Road
Tax Map ID #: 302.5-1-96.1 Subdivision Name:
"TOWN BD. RESOLUTION 86-2013: $850 recreation fee for new dwelling units: single family,duplexes/two-family,
multiple family, apartments, condominiums,townhouses, and/or manufactured & modular homes, but not mobile
homes. This Is In addition to the permit fee(s).
CONTACT INFORMATION:
• Applicant:
Name(s): Bast Hatfield Construction, LLC
Mailing Address, C/S/Z: 1399 Crescent Vischer Ferry Rd., Clifton Park, NY 12065
Cell Phone: 518 ) 365-9997 Land Line: 518 ) 373-2000
Email:-ajlomnes@basthaffield.com
• Primary Owner(s):
Name(s): Aviation Hospitality, LLC
Mailing Address, C/S/Z: 636 Route 146A, Clifton Park, NY 12065 1) i 2 W
Cell Phone: 607 ) 308-0213 Land Line: � )
Emai1:-bjariwala@oakfieldhospitality.com
• Contractor(s):
Business Name: Bast Hatfield Construction, LLC
Contact Name(s): A.J. Lomnes
Mailing Address, C/S/Z: 1399 Crescent Vischer Ferry Rd., Clifton Park, NY 12065
Cell Phone: 518 ) 365-9997 Land Line: 518 ) 373-2000
Email:-ajlomnes@basthaffield.com
• Architect(s)/Engineer(s):
Business Name: Gerri A. Kielhofner, AIA Architect
Contact Name(s): Gerri Kielhofner
Mailing Address, C/S/Z: 319 N. Main, Suite 200 Springfield, M065806
Cell Phone: 417 ) 849-6794 Land Line: 417 ) 521-6107
Email: gkielhofner@brpae.com
Contact Person for Building & Code Compliance: Gerri Kielhofner
Cell Phone: 417 ) 849-6794 Land Line: 417 ) 521-6107
Email: gkielhofner@brpae.com
gown of Queensbury Building&Code Enforcement Principle Structure Application Revised February 2017
PROJECT INFORMATION:
TYPE: X Commercial id - .;;=:1
WORK CLASS:
_Single-Family _Two-Family viulti-Family(#of )
Townhouse Business Office Retail X Hotel/Motel
Industrial/Warehouse Garage(#ofcars i Other(describe
STRUCTURE SQUARE FOOTAGE: GARAGE SQUARE FOOTAGE:
1sT floor: 15,555 sf 11T floor:
2"d floor: 15,014 sf 2"d floor:
3`d floor: 15,014 sf
Total square feet:
4"floor: 15,014 sf
"Dotal square feet: 60,597 sf
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction: $ $6,913,664
2. Proposed use of the building: Hotel
3. If Commercial or Industrial, indicate the name of the business: Home2 Suites by Hilton
4. Source of Heat (circle one): Gas Oil Propane Solar Other: Electric on some units
(Fireplaces need a separate Fuel Burning Appliances & Chimney Application, one per appliance)
S. Are there any structures not shown on the plot plan? YES NO Explain:
6. Are there any easements on the property? YES NO
7. SITE INFORMATION:
a. What is the dimensions or acreage of the parcel? 2.50 Acres
b. Is this a corner lot? YES NO
c. Will the grade be changed as a result of the construction? FY—E-S-1 NO
d. What is the water source? PUBLIC PRIVATE WELL
e. Is the parcel on SEWER or a PRIVATE SEPTIC system? Sewer
s
DECLARATION:
I. 1 acknowledge that no construction shall commence prior to issuance of a valid building permit and
work 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. I 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: A.J. Lomnes
s-
SIGNATUR . DATE: 8-7-17
Town of Queensbury Building&Code Enforcement Principle Structure Application Revised February 2017