RC-0588-2021 ,y
Office Use Only
ADDITION/ALTERATION PERMIT Permit#: ?G- D5b 5 - 202Q
APPLICATION Permit Fee:$ Zj
Town of Quccnsbury
742 Bay Road,Queensbury,NY 12804
Invoice#:
P:518-761-8256 www.gueensbury.net
Flood Zone? Y �j6viewed By��
Project Location: �� �
Tax Map ID#: '�pZ , _, 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: I ol L 1st floor: �' 5
2nd floor: 2nd floor:
3rd floor: 3rd floor:
Basement(habitable space): Basement (habitable space):
Total sq ft: Total sq ft:
Scope of work to be done: Re-^bJt 6L J i-.� lam� ►� 'ruC i>ram,
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Addition/Alteration Application Revised January 2021
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction:
2. Source of Heat(circle one): r1 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 vN0
• What is the water source? v/ PUBLIC _PRIVATES WELL
• What type of wastewater system is on the parcel? ,/SEWER _PRIVATE SEPTIC
DECLARATION:
1. 1 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 If,for any reason,the building permit application is withdrawn,30%of the fee is retained by the Town of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. Ifthework 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 area 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: LC'A C�t'�1 `
PRINT NAME: S�
SIGNATURE: DATE:
Addition/Alteration Application Revised January 2021
i
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant.,
Name(s): 05�\ T:�011
Mailing Address,C/S/Z: %y� ��� �• ( yct�tSbyr�• 1i��( I a$G�/
Cell Phone:_( N6 ) 2g5sl 65 S Land Line:
Email: ':r--S Co►•n
• Primary Owner(s):
Name(s):
Mailing Address C/S/Z• _�Q_ AN
Cell Phone: . (57Licl ) a Land Line:
Email: T05k G-,-\,i f o CoV
EdCheck if all work will be performed by property owner only
Contractor(s): (List all additional contractors on the back of this form)ontac Contact Name(s):
Contractor Trade:
MailingAddress, C/S/Z:
Cell Phone:�_) Land Line:
Email:
**Workers' Comp documentation must be submitted with this application**
• Architect(s)/Engineeds):
Business Name:
Contact Name(s):.
Mailing Address, C/S/Z:
Cell Phone:_�) Land Line: . ( )
Email:
Contact Person for Compliance in regards to this project:
Cell Phone: ( ) Land.Lihe: 1 )
Email:
Addition/Alteration Application Revised January 2021
Residential Plan Review: 1- and 2- Family Dwellings
Y/N/NA (1 of 2)
Two ( ) full sets of plans
Over 1,500 sq. ft. requires engineering stamp
� Design loads on plans: 115 Wind Floor Loads 40 psf
�IL7 (North of Rte. 149 60) 50 Ground Snow Load Sleeping Areas &Attics 30 psf
Calculations Decks 40 psf r04AI/
Wind design for lake front properties
Window schedule with glass size & main doors/Air leakage < .5 cfm for doors, < .3 cfm for
windows/Tempered glass in bathrooms
Door schedule/Main entrance 36" door 1Z -
Emergency Escape or Bedrooms & Habitable Space
Above-grade: 5.7 sq. ft.
Grade: 5.0 sq. ft.
24" (h) x 20" (w) minimum
44" maximum height above door
Window control devices 24" or less 2"d story or 72" above grade
Egress window from basement 5.0 sq. ft.
Floor system sizing per table 502.3.1
Residential check ERI or Prescriptive method
Driveway length: 300' or more-12' width required/500' or more, turnaround required
Foundation drainage on plans, if required
6" drop in 10' exterior grade
Framing cross section for each roof line, vertical fire stopping every 10' where
d required/joist spans pg. 127
Ice &snow shield -24"from exterior wall
Platforms at exterior doors
Stairway headroom 6'8"; all stairs 36" width
Stair run and rise
/VlPc Winder run and.rise
y� Spiral stairs meet requirements
Smoke detectors—battery backup & proper location, interconnected
Bathroom fixtures—proper clearance
Hall width-36" width
Handrails more than four risers on open sides
Railing &guards > 30"/basement stairs included/closed risers more than 4" in height
Safety glazing notes for required areas
Garage fire separation: %" gable end/5/8" under living space &%" on walls/20 min. door
and closer
Garage floor sloped
Attic access: gasket seal & R-value equal to roof insulation
Roof over 30"—22" x 30"/Crawl spaces 18" x 24" access
Residential Plan Review Revised March 2018
d
Residential Plan Review: 1- and 2- Family Dwellings
Y/N/NA (2 of 2)
Carbon Monoxide detector outside lowest sleeping area, on every level & interconnected
within 15' of sleeping area
Soil test results, if required
VC Septic to well or water line separation
All paperwork signed
Note on plans energy saving light bulbs 75%
ptl Blower door test agency paperwork
Floodplain Permit required —check map: 2 feet above flood elevation
Hurricane clips required
Floors less than 2 x 10 covered by%" gypsum or 5/8" wood panel
Manuals S &J required for heating system. Cold air return hard piped
A Separate room for draft HVAC or hot water heater with fresh air
HRV shown and calculations
Baffles at eaves for insulations and knee walls m a
Makeup air for range hood > 400 cfm
Continuous header for garage doors to end wall
Chimney rain cap shown for fireplaces
Deck hold down shown not less than 4 lags and bolts per table 507.2
Residential Plan Review Revised March 2018
t
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V TOWN OF QUEENSBURY BUILDING DE) .
Based on 0' limited examinati
comppliance with our comments shall
not be construed as indicating the
� N W. plans and specifications are In full
k �. t' compliance with the Building Codes Y
p y d \a of New York State. T -y
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