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CO-000199-2015 TOWN OF QUEENSBURY 742 Bay Road;Queensbury,NY 12804-5904 (518)761-8201 . Community Development-.Building&.Codes (518)761-8256 CERTIFICATE- OF..00-CUPANCY Permit Number: CO-000199-2015 Date Issued: Friday,November 6;2015 This is to certify that work requested to be done as shown by Permit Number . CO-000199-201'5 has been completed. Tax Map Number: 296:13-1=18 Location: 959 State Rte-9 Owner: Ray Hippele Applicant: Capital Area Physical Therapy,PLLC This structure may be occupied as:a:C/O only Capital Area Physical Therapy,PLLC By Order of Town Board Suite.ZZ TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the owner of the responsibility for compliance with Site Plan, property P t3' P Variance,or other issues and conditions as a result of approvals,by the' Director of Building&Code Enforcement Planning Board.or Zoning Board of Appeals. TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518),761-8201 Community Development-Building&Codes (518)-761-8256 BUILDING PERMIT Permit Number: CO-000199-2015 REVISED Tax Map No: 296.13-1-18 2' Permission is hereby granted to: Capital Area Physical Therapy,PLLC For property located.at: 959 State Rte 9 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 Tvpe of Construction Owner Name: Ray.Hippele Certificate of occupancy_ $0.00 Owner Address: 95.9 State Rte 9 Total Value $0.00 Queensbury,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications C/O only Capital Area Physical Therapy,PLLC Suite ZZ PERMIT FEE PAID-THIS PERMIT EXPIRES: (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 f Queen M y 26,2015 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement r, Office Use Only '°Town of Queensbury Fire Marshal Received: ESTABLISHMENT OF A NEW BUSINESS' Tax Map ID: 2.9 h • l)— I— I ?J) I :CERTIFICATE OF OCCUPANCY PERMIT APPLICATION Permit No.: Z1 I Permit Fee: I *Note: This application is for occupancy only,with no,work requiring'a-building permit. Name_of Business- ��A'P��tTNI- ARE� � �� I CA-�: � °�-1-t5/ r�'/ � P�LC, f i Address i11T, (fir)'YFl-t, PGA2A ? Type of Business Manager QwAirP-� or- 1(6 If,,PR- �S-. AP-.,S R T. ro S` 4 0 OR Person in charge Piz r`f ®tQ r.f GIZ AN r,�,-tJ L?A t=5 0 ^ a i Business Phone No. VAN d))rA4(-' „� . C1ll ,2,. V 15 " i Property Owner ,`�`�D �c� LR` 50. SO, 10 2015 Address I Phone I es- 9 r� TOWN OF UUEENSBURY BUIL"'DLNG & CODES, i ✓Provide an accurate layout of'your store showing all walls,exits,stockrooms, rest rooms,counters, and fixture layout"on a separate sheet of paper. Print Name: 55a 41 Signature: I Date: ' Notes 1 Comments: ' I P/,�movt A Pike C_�de f l " IMPORTANT: The-business owner' is responsible for keeping exits clear and maintaining exit signs and emergency lights. 'Fire l extinguishers,fire sprinkler systems, and fire alarm systems require annual inspections by an outside contractor and othe corresponding f documentation must be provided'tothe Fire Marshal's office. Fire extinguishing systems found1n kitchens and gas stations require ` s Pecti" ons. Any violations noted during an inspection,require immediate corrective action. emi-annual ins CONTACT NUMBERS: ° Director, Building and Codes-76178253 Zoning Administrator-761-8218 Zoning-761-8238 , Fire Marshal-761-8206 Planning-761-8220 3 • P,,P _ l k i Town°of Queensbury"Fire Marshal-,New Business Permit 518-761-8206 er _ D L CMG OWE ' EMERGENCY CONTACT UPDATE CEP 101, 2015 TOWN OF QUEENSBURY TO:, Warren County Sheriff's Department BUILDING & CODES 1 . - d 1. This form is used to assist Emergency Service personnel who maybe called to your business after hours. Please { be sure that the persons'listed on this form will be willing and available to respond during off-hours to assist Police and/or Fire personnel in gaining entry to your building. a 2. Please be advised that failure to respond to assist emergency service personnel may result in damage to your r building to'facilitate entry by police and/or fire personnel. P z PLEASE PRINT DATE: J BUSINESS NAME:, Ar� PkYs/cA( TLro/, reelt BUSINESS ADDRESS: r BUSINESS PHONE: ��( � CONTACT I: AC � HOME PHONE S7 ADDRESS: ('GP ( S . 6 CONTACT 2: �`� I� �� HOME PHONE . 1 ADDRESS: t . E a Town of Queensbury Fire Marshal—New Business Permit 518-761-8206 FIRE MARSHAL S OFFICE Town of Queensbury 74.2 any Road, Queensbury, .N)` 12804 Q ° " Hotae of Natitral heaitty ... A Good Place to Live " PLAN REVIEW Capital Area Physical Therapy 959 Route 99 Space ZZ 2600sf 2015 - 421 ® Verify location and function of all exit and emergency lighting All egress hardware to comply w/ Chapter 10 of NYSFC ® Fire extinguisher locations to be determined ® Verify aisles and storage ® Add carbon monoxide detection (see attached) o Any addition or relocation of walls may require an evaluation of the sprinkler system for compliance with.NFPA 13 ALL EGRESS DOOR F1WVNRE"LL COMPLY WITH CHAPTER'10 OF THE FIRE CODE OF NYS. NOTE., THE USE OF A KEY OPERATED OR THUht; TURN MVCE 4S NOT P'—=j0,4ITTED, Michael J Palmer Fire Marshal 742 Bay Road Queensbury NY 12804 firemarshal@queensbury.net Fi r e M a.r s h a I's Off i c e P It o it e: 518-761-8206 1'n.e: 518-745-4437 irerrrnrsluzl@cltreer7shr.trni.rret 7t?(UIU.l�lli'.errsl)ru�t Carbon Monoxide Detection in Existing Commercial Structures (1) Power source. (i) General rule. Carbon monoxide alarms shall receive their primary power from the building wiring where such wiring is served from a commercial source, and when primary power is interrupted, shall receive power from a battery. Wiring shall be permanent and without a disconnecting switch other than that required for overcurrent protection. (ii) Exception. Carbon monoxide alarms powered solely by a 10- year battery shall be permitted in (a) existing commercial buildings and (b) commercial buildings without commercial electric power. (2) Listing. Carbon monoxide alarms shall be listed in accordance with UL 2034. (3) Combination alarms. A combination carbon monoxide / smoke alarm shall not be deemed to satisfy the requirements of this section 1228.4. t is { f 'Yra� 0 -a� v000 vAAoo� vM o ate}. � ,— t�. G f� ittt [A a. r �I qr tpj ��S,�g v 1 � k not ZI s -IT rII Inspection Form Town of Queensbury Fire Marshal O Periodic Inspection Date: Time: 742 Bay Road,Queensbury NY 12804 Inspection /"jCl�^ 518 761 8206/518 761 8205 CO Inspection Permit#: & Fire Marshals Representative MJ Palmer Business Name: � � Jz� � pG Location: c�dl( Stillman Contact: Type of Inspection N/A Yes No EXITS: Exit Access FC 1014&FC1029 NOTES Exit Enclosure FC 1020&FC1029 Exit Discharge FC 1024&FC1029 Locks and latches FC1008& FC1029.2 Sign: Normal FC 1011 &FC1029 > l Sign: backup FC 1011.5.3&FC1029.7.5 AISLES: Main Aisle Width FC 1024/1025&FC1029.11 Secondary Aisle Width FC 1025&FC1029.11 _n� FIRE EXTINGUISHER: Hung FC 906 Inspection of extinguisher FC 906 EVAC Plan FC 404.2 TRUSS ID SIGNAGE FC 505.3 EMERGENCY LIGHTING: Interior FC 1006.3&FC1029.8 r� `ry. Exterior FC 1006.3 �. !r Clearance to Electrical FC 605.3 �i 6-lb �4y� Electric WiringEnclosed/Labelebeled FC 605.3.1 Combustibles in Equipment Rooms FC315.2.3 F.D.Si na e- FC 510 C 1 No SmokingSigns FC 310.3 Storage FC 315.2 Compressed Gas FC 3003 Vehicle Impact Protection FC 312.1 Interior Finishes FC 803-804 Smoke Detectors FC 907 CO detectors FC 610 Clearance to Sprinkler/Ceiling FC 315.2.1 18" / 24" Gi EVAC SIGNS IN Rooms FC 404.6(R1 &112) Tk (` Fuel Pump Warning Signs FC2205.6 _ Fuel Station Emer Procedures FC2204.3.5 l Exterior Storage FC 315.3 REWSPd-TIOATDUZ APPROXIMA Vacant Buildings FC 311 0 Emergency Disconnect FC 2203.2 21 DAYS 3rd Party Electrical SYSTEMS: FC 901.6 Insp OK NC DATE: OK NC Generator Annual FM Type Suppression Semi Annual DATE: OK NC Elevator Semi Annual FIRE ALARM Annual DATE: OK NC Paint Booth Suppression Semi Annual Sprinkler System Annual Sprinkler FDC d Kitchen Su ression Semi Annual60 //,�� Fuel Island Suppression Semi Annual Hood Cleaning 3-6-Annual Knox Box:installed/checked FC506 �/A) Operating Permit, if required will be issued after Completion of Inspection Inspection Form Town of Queensbury Fire Marshal O Periodic Inspection Date: Time 742 Bay Road,Queensbury NY 12804 o Re`°Inspection 518 761 8206/518 761 8205 5 NCO Inspection Permit#: Fire Marshals Representative MJ Palmer Business Name: a „�' Location: 4-?734 -t� � fl GK Stillman Contact: Type of Inspection N/A Yes No EXITS: Exit Access -FC 1014&FC1029 NOTES Exit Enclosure FC 1020&FC1029 ,o", Exit Discharge FC 1024&FC1029 , Locks and latches FC1008& FC1029.2 _ Sign:Normal FC 1011 &FC1029 Sign:backup FC 1011.5.3&FC1029.7.5 v.� ✓,, L f, Imo- -r / ..+.. 1 AISLES: �✓_�:rIP? ! f -tT;�f� I i'.,G �i 1•�l,�t�r" Main Aisle Width FC 1024/1025&FC1029.11 SecondaryAisle.Width FC 1025&FC1029.11 d Icy, FIRE EXTINGUISHER: Hung FC 906 `° Inspection of extinguisher FC 906 EVAC Plan FC 404.2 TRUSS ID SIGNAGE FC 505.3 EMERGENCY LIGHTING: .,Interior FC 1006.3&FC1029.8 Exterior FC 1006.3 !� Clearance to Electrical FC 605.3 _ �;, �� A��,• j,,�� ' Electric Wiring Enclosed/Labeled FC 605.3.1 r s l E 4 Combustibles in Equipment Rooms FC315.2.3 s" F.D.Si na e- FC 510 „sue No Smoking Signs FC 310.3 Storage FC 315.2 Compressed Gas FC 3003 Vehicle Impact Protection FC 312.1 Interior.Finishes FC 803-804 Smoke Detectors FC 907 A CO detectors FC 610 Clearance to Sprinkler/Ceiling FC 315.2.1 18" / 24" EVAC SIGNS IN Rooms FC 404.6 R1 &R2 Fuel Pump Warning Signs FC2205.6 Fuel Station Emer Procedures FC2204.3.5 Exterior Storage FC 315.3 REINSPECTION DUE APPROXIMATELY Vacant Buildings FC 311 4—/ Emergency Disconnect FC 2203.2 21 DAYS Insp OK NC DATE' OK NC SYSTEMS: FC 901.6 Date Generator Annual DATE: OK NC Hood Installation Elevator Semi Annual FIRE ALARM Annual DATE: OK NC HVAC Shutdown Sprinklers stem Annual Sprinkler FDC c Kitchen Suppression Semi Annual Fuel Island Suppression Semi Annual Hood Cleaning 3-6 -Annual Knox Box:installed/checked FC506 Operating Permit, if required will be issued after Completion of Inspection IiI _ i pH Cr AA 5 i b Mount Royal Plaza i 939 State Route 9 f — stairway to 2nd floor "Suites" is shown Tax Map No. 296.13-1-18 on layout between Store O and Store M Layout shows "Stores" 1 st floor. lor ground level