2012-443 " TOWN OF QUEENSBURY
742 Bay RoadQueensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20120443 Date Issued: Tuesday, January 20, 2015
This is to certify that work requested to be done as shown by Permit Number P20120443
has been completed.
Tax Map Number: 523400-295-006-0001-001-000-0000
Location: 1127 WEST MT. Rd
Owner: TOWN OF QUEENSBURY
Applicant: CELLCO DBA VERIZON WIRELESS
This structure may be occupied as a:
Miscellaneous Structure
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the1„..)6':N1
,4
propertyowner of the responsibility for compliance with Site Plan,
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
(EL 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20120443 Application Number: A20120443
Tax Map No: 523400-295-006-0001-001-000-0000
Permission is hereby granted to: CELLCO DBA VERIZON WIRELESS
For property located at: 1127 WEST MT. Rd
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. Tyne of Construction Value
Owner Address: TOWN OF QUEENSBURY
WATER DEPT. WATER TANK Miscellaneous Structure $100,000.00
742 BAY Rd Total Value $100,000.00
QUEENSBURY,NY 12804-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2012-443 VERIZON WIRELESS
Cell Tower Facility 360 sq ft [80'x 80] 120'high
$100.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday, October 03,2013
(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 of Queensbury; Wednesday,October 03,2012
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
OFFICE USE ONLY t� )
�! >
TAX MAP NO. A9 5 . Lp - I - ! PERMIT NO. I aa- ! 4! 3 t
/ do SEP (�
FEES: PERMIT /d� RECREATION ENGINEERING Stamp
,
(If applicable)
PRINCIPAL STRUCTURE:
APPLICATION FOR ZONING APPROVAL & BUILDING PERMIT
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. APPLICATION IS SUBJECT TO REVIEW
BEFORE ISSUANCE OF A VALID PERMIT FOR CONSTRUCTION.
ceAo 6\00
APPLICANT/BUILDER: Vei\j W\t\e c OWNER:
Own 0� �YNCIOtil
ADDRESS: D5(4)014nC�aac c��1�S�2rIJP 1 6a3 ADDRESS: 7MSSly NihveehC1)-kxy D,S0-1
PHONE NOS. Om) ‘-4t--%—os— PHONE NOS. \-A0)- ),S3
CONTACT PERSON FOR BUILDING & CODES COMPLIANCE: P`L.\1(le 1 Oct'rbX PHONE:��'1)`-Bci)S05'
LOCATION OF PROPERTY: 11),� }'(1'lovr��ta�� 10‘v ALN1 \ Jagd
HAS THERE BEEN A SITE PLAN REVIEW; VARIANCE OR SUBDIVISION APPROVAL? A YES 0 NO
IF SO, INDICATE APPLICATION NO. AND DATE OF APPROVAL: V5e1//,gnu-nce 1\Jo, y-)a). On aa��11-
540anNo,`)-dM cY\ LI )))-
PLEASE INDICATE MEASUREMENTS AS REQUIRED BELOW:
CHECK ALL THAT Z
OUJ LL
APPLY TO YOUR p O O • w
PROJECTco
}-
L11 O LL W J 0 = _
D � dL.72 _ o � V
z < a :- Na o
C/) oa. oLL Q ots
SINGLE FAMILY
TWO-FAMILY
MULTI-FAMILY
(NO.of UNITS )
TOWNHOUSE
BUSINESS OFFICE
RETAIL-
MERCANTILE
FACTORY OR
INDUSTRIAL
ATTACHED
GARAGE(1,2,3)
OTHER X 7 k1& YAW k Nt,',r N N,()sap- g0'X`�� ��Cl�i f
I? V . 10kkearea
IF COMMERCIAL OR INDUSTRIAL-NAME OF BUSINESS: �6(h n2AV` 1,`D1 Ver \vv '55
ESTIMATED CONSTRUCTION COST:'bi)tt OCO,G1) FUEL TYPE: dre5e\ A b( (ry\efo, 'jf
HEAT TYPE: J lA *HOW MANY FIREPLACE(S): �1A AND/OR WOODSTOVES(S):
ZONING CATEGORY:S&S}1 ARE THERE WETLANDS ON THIS SITE? �UU
IS THIS A HISTORIC SITE? 'Vo
PROPOSED USE OF BUILDING OR ADDITION: �`66\mmkivA\At . C�1\
*Please complete a separate Application for"Fuel Burning Appliances& Chimneys"available in our office
B 3-LGL 11-05
ARE THERE STRUCTURES NOT SHOWN ON PLOT PLAN? 0
ARE THERE EASEMENTS ON PROPERTY? `le'S ` U 4-1 1 e.Ct\erIe,1-
I acknowledge no construction activities shall be commenced prior to issuance of a valid
permit. I certify that the application, plans, and supporting materials are a true and
complete statement/description of the work proposed, that all work will be performed in
accordance with the NY State Building Codes, local building laws and ordinances, and in
conformance with local zoning regulations. I acknowledge that prior to occupying the
facilities proposed, I or my agents will obtain a certificate of occupancy. I 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 a ove.
Signed v - -YOU \iGn iy1QP_rin
�;- \fer1on\I \Qs 9 9
S
Director of Building & Codes: 761-8256 (for questions regarding Building Permits, construction codes
or septic systems)
Zoning Administrator: 761-8218 (for questions regarding required permits, the permit process,
application requirements or to schedule an appointment)
Permission is hereby granted to the above This application / proposed action described
Applicant to erect or alter the building herein is found to be in accordance with the
described herein in accordance with said zoning Laws of the Town of Queensbury.
Application:
Cz- \
Ail
BU DiG & CODES APPRO 'AL ZONING APPROVAL
7opi v
DATE DATE
J
J
QUESTIONS? CALL 761.8258 OR EMAIL
codes ueensburv.net
Office Use Only
VISIT OUR WEBSITE FOR MORE INFORMATION
Operating Permit Issued: Yes No W •queensburv.net
Occupancy Type: Construction Classification:
Assembly Occupancy Limit: Special Conditions:
Commercial Final Inspection Report
Office No.: (518) 761-8256 Date Inspection re. : - -i ed:
Queensbury Building & Code Enforcement Arrive: pe. r ,. • Depart: =' Dm
742 Bay Road, Queensbury, NY 12804 Inspector's Initia s:� .
NAME: /1\1 ,AIM of O ULA—!aZ ERMIT #: / —
l I _
LOCATION: l t Z� c�.��T �T'1J �� DATE: ,
COMMENTS:
Y N NA
Chimney/ "B"Vent/ Direct Vent Location
Plumbing Vent Through Roof 6"/ Roof Complete
Exterior Finish/ Grade Complete 6"in 10'or Equivalent
Interior/ Exterior Guardrails 42 inch Platform / Decks
Interior/ Exterior Balusters 4 inch Spacing Platform / Decks
Stair Handrail 34 inch— 38 inch / Step Risers 7"/Treads 11"
Vestibules For Exit doors > 3000 sq. ft.
All Doors 36 inch w/Lever Handles/ Panic Hardware, if required
Exits At Grade Or Platform 36"(w)x 44"(I)/ Canopy or Equiv.
Gas Valve Shut-off Exposed & Regulator(18")Above Grade
Floor Bathroom Watertight/ Other Floors Okay
Relief Valve, Heat Trap / Water Temperature 110 Degrees Maximum
Boiler/ Furnace Enclosure 1 hour or Fire Extinguishing System
Fresh Air Supply for Occupancy/Ventilation Combustion
Low Water Shut Off For Boilers
Gas Furnace Shut Off Within 30 ft. or Within Line Of Site
Oil Furnace Shut Off at Entrance to Furnace Area
Stockroom/Storage/Receiving/Shipping Room (2 hr.), 1 1/2 doors
> 10% > 1000 sq. ft.
3/4 Hour Corridor Doors &Closers
Firewalls/ Fire Separation, 2 Hour, 3 Hour Complete/ Fire Dampers
/ Fire Doors
Ceiling Fire Stopping, 3,000 sq. ft. Wood Frame
Attic Access 30"x 20"x 30"(h), Crawl Space Access 18"x 24"
Smoke Vents Or Fan, if required
Elevator Operation and Signage/ Shaft Sealed
Handicapped Bathroom Grab Bars/ Sinks/Toilets/ Mirrors
Handicapped Bath/ Parking Lot Signage
Public Toilet Room Handicapped Accessible
Handicapped Service Counters, 34 inch, Checkout 36 inch
Handicapped Ramp/ Handrails Continuous/12 inch Beyond [Both QC�'
sides]
Active Listening System and Signage Assembly Space Qc
Final Electrical/ Flex Gas Piping Bonded -\Si
Site Plan/Variance required
Final Survey, New Structure/ Flood Plain certification, if req. -;C")
As-built Septic System Layout Required or On File 1)�i
Building Number or Tenant Address on Building or Driveway 4" ..�
Water Fountain or Cooler / f
Building Access All Sides by 20'/ Drivable Surface 20'wide
Special Inspections/ Engineer or Architect ApprovalV//>-
Okay To Issue Temporary or Permanent C/O
Okay To Issue C/C
Commercial Final Inspection Report revised 11-27-2012
RX Date/Time 12/11/2012 12:38 518 273 1202 P.009
( .,-/t Dec, 11. 2 012-12:3 8 PN MD I A Wa t e r v I t e t N Y,.•,AVS 5A.'��.A45 ,\' 4,z;A•i•kv:v^4' N o. 1111 P. 9/9
t•,�
o MIDDLE DEPARTMENT INSPECTION AGENCY, INC. .
.4 that the electrical wiring to the electrical equipment listed below has been examined and is approved as Y/yt=
��i being in accord with the National Electrical Code, applicable governmental, utility and Agency rules in effect on the date
(0) noted below and is issued subject to the following conditions. . '<:
(.0 Owner: Verizon Date: 0.••
t�;) 0 1113012012 w•
tiOccupant: Same Location: tI
1127 West Mountain Road 3
1.*Sli)
Queensbury, Warren Co. NY
p Occupancy: Cell
Z Tower
A\ Applicant: John Coyne Elec. Contr. Inc. f�Y
P
? 43 Langenbach Road f
�� East Greenbush NYit
1206 f:'` 4
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10
^;Y>> Joseph A.Holmes
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���' No.
64
140136148688 L' L; .
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, Equipment: • • •
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1 -200 Amp Service Equipment; 2 - 100'Aini.ip Service Equipment;'500MCM Amp Service Conductors lis"
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