CC-0621-2021 i
Office Use Only
e' ADDITION/ALTERATION PERMIT Permit#: C c —0 tQ-2\—1011
APPLICATION Permit Fee: 7.7$ 06D tA�eS'
Tarn orQucens6ury
742 Bay Road,Queensbury,NY 12804
Invoice#• t�
P:518-761-8256 Www:gtieensbury.net
Flood Zone? Y �N�keviewed B .
Project Location:
Tax Map ID#: 9'L • b �� Subdivision Name:
PROJECT INFORMATION:
TYPE: Residential Commercial, Proposed Use:
—Single-Family _Two-Family _Multi-Family(#of units ) _Townhouse
Business Office _Retail _Industrial/Warehouse Garage(#of cars_)
Other(describe
ADDITION SQUARE FOOTAGE: ALTERATION SQUARE FOOTAGE:
1st floor: 1st floor:
2nd floor: 2nd floor:
3rd floor: 31d floor:
Basement(habitable space): Basement(habitable space):
Total sq fit: Total sq ft:
Scope of work to be done:
D GC E 0 V E
AUG 7 0 2021
TOWN OF QUEENSBURY
BUILDING& CODES
Addition/Alteration Application Revised January 2021
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s):
Mailing Address, C/S/Z: ► A,-e; %J bU CJ
Cell Phone: Land Line: -7 -Q'31(a
Email: r9g. q-T,61, ,,.jg,(reA-t ay.'
• Primary Owner(s):
Name`(s): R3beyr x,::fvt,,� 6L4ae)
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)
Contact-"Name(s): I, tr.
Contractor Trade: dvv-,t ke- 4 D4,0c,
Mailing Address,,C/S/Z: _ t4-w+ ✓/7 Ave
Cell Phone: ( 5'/-9 ) -rod, Land Line: )
Email:
"Workers' Comp documentation must be submitted with this application"
• Arch itect(s)/Engineer(s):
Business Name:
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email:
Contact Person for Compliance in regards to this project: R ben-
Cell Phone Land Line: �)
Email:
Addition/Alteration Application Revised January 2021
. ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction: $ ®1QD
2. Source of Heat (circle one): Gas _Oil _Propane _Solar_Other
Fireplaces/inserts need a separate Fuel Burning Appliances & Chimney Application
3. Are there any structures not shown on the plot plan? _YES NO Explain:
4. Are there any easements on the property? _YES NO
SITE INFORMATION:
• Is this a corner lot? _YES NO
• Will the grade be changed as a result of the construction? _YES _�<_N0
• What is the water source? _y,_ PUBLIC _PRIVATE WELL
• What type of wastewater system is on the parcel? _( SEWER _PRIVATE SEPTIC
DECLARATION:
l. I acknowledge that no construction shall be commenced prior to the issuance of a valid permit and will be
completed within a 12 month period. Any changes to the approved plans prior to/during construction will require
the submittal of amended plans, additional reviews and re-approval.
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.
3. If the work is not completed by the 1 year expiration date the permit may be renewed, subject to fees
and department approval.
4. 1 certify that the application, plans and supporting materials are a true and a 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.
5. 1 acknowledge that prior to occupying the facilities proposed I, or my agents, will obtain a certificate of
occupancy.
6. 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: �c1�P, Lj Kell g s
a
SIGNATURE: DATE: 2CIV
Addition/Alteration Application Revised January 2021
FIRE MARSHAL'S OFFICE
Town of Queensbury
742 Bay Road, Queensbury, NY 12804
"Home of Natural Beauty ... A Good Place to Live "
PLAN REVIEW
Warren Tire
14 Lafayette Street (18)
CC-0621-2021 -
8/23/21
The following comments based on review of the submitted plans:
1) Verify extisting Fire Extinguisher inspection & locations.
2) Verify existing Exit &Emergency lights.
3) Verify storage & aisles
4) Knox Box key recently verified 7/2021.
5) Have sprinkler contractor (Northest Fire Protection) evaluate the
sprinkler system in the space. May need 1 or 2 sprinkler heads dropped
below the new garage doors,so not to block heads in open position. AN
NFPA13 letter will be required.
4DiU:tCyZX arsha
Gary K. Stillman
742 Bay Road
Queensbury NY 12804
518 761 8205
garys@queensbury.net
Fire Marshal 's Office • Phone: 518-761-8206 Fax: 518-745-4437
firemarshal@queensbury.net • 'zvzvzu.queensbun/net
CG
P.O. BOX 508 BURNT HILLS, N.Y. 12027 (518)886-1115 FAX(518)885-0526
September 27,2021
Gary K.Stillman
Deputy Fire Marshal
Town of Queensbury
742 Bay Rd.
Queensbury,NY 12804
Project Address:Warren Tire
14 Lafayette St.
Queensbury,NY 12804
Re:Existing Sprinkler System Certification for System Modifications to provide fire protection
coverage as required due to building modifications.
i
I
To Whom It May Concern,
The existing active fire protection(sprinkler system)for the above-mentioned facility was modified in
accordance with the National Fire Protection Association's Guidelines for Sprinkler Systems(NFPA 13-
16)and New York State Fire Prevention and Building Codes.
If you have any questions,please do not hesitate to contact me.
Sincerely,
Chris Owens
5
Service Manager
North East Fire Protection Systems Inc.
North East Fire Protection Systems Inc. N-
318 Charlton Rd
Ballston Spa NY 12020
(518)885-1115
AEAST�`�Musireoi`
Service Report
Property: Service Date 09/27/2021
Warren Tire Center-Queensbury
14 Lafayette Street WO# 386
Queensbury NY 12804
Technician(s) Nick Smith
Problem Description
Installed 3 fire sprinkler heads under garage doors
Service Description
Add heads under garage doors
Work Performed on 09/27/2021
I added (3)mechanical tee outlets on the mains and dropped HSW heads under each garage door bay.
Service Items
Description Quantity
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Client Signature
state that the information on this form is correct at the time and place of this inspection and that all
equipment tested was left in operational condition upon completion of this inspection, unless
otherwise noted. I acknowledge the owner's responsibility to secure the building such that adequate
heat is provided, maintaining a temperature of 40F or higher, to prevent exposure of piping to
freezing conditions.
Client Name Signature Date Completed
Don Mallory 2021-09-27
Inspector Signature
I state that the information on this form is correct at the time and place of this inspection and that all
equipment tested was left in operational condition upon completion of this inspection, unless
otherwise noted. I acknowledge the.owner's responsibility to secure the building such that adequate
heat is provided, maintaining a temperature of 40F or higher, to prevent exposure of piping to
freezing conditions.
Inspector Name Signature Date Completed
Nick Smith 2021-09-27
August 20, 2021
John O'Brien
Code Enforcement Officer
Town of Queensbury— Buildings & Code Enforcement FILE COPY
742 Bay Road
Queensbury, NY 12804
Re: New Overhead Door Openings and Steel Header
Warren Tire Service Center— 14 Lafayette Street
Town of Queensbury, Warren County, New York
Dear Mr. O'Brien:
Please accept this letter as my formal response associated with construction
observations made relative to the two (2) new overhead door openings at Warren
Tire's Lafayette Street location.
Regarding the installation of the two steel door headers, the work is in general
conformity with the design drawings and applicable structural requirements.
If you have any comments, questions, or need additional information, please
contact me at (518) 376-7652.
Sincer
al,4 Va-1!0 0;
Chris A. Marchand, PE
cc: Bob Kellogg
File
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