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2013-268 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development - Building & Codes (518) 761-8256 C ERT IF I C ATE OF OCCUPANCY Permit Number: P20130268 Date Issued: Tuesday, July 02, 2013 This is to certify that work requested to be done as shown by Permit Number P20130268 has been completed. Location: 959 STATE ROUTE 9 Tax Map Number: 523400-296-013-0001-018-000-0000 Owner: RAYMOND HIPPELE Applicant: QUEENSBURY FAMILY CHIROPRACTIC This structure may be occupied as a: Commercial Alteration By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the property owner of the responsibility for compliance with Site Plan, Variance, or other issues and conditions as a result of approvals by the Planning Board Director of Building&Code Enforcement or Zoning Board of Appeals. TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20130268 Application Number: a20130268 Tax Map No: 523400-296-013-0001-018-000-0000 Permission is hereby granted to: OUEENSBURY FAMILY CHIROPRACTIC For property located at: 959 STATE ROUTE 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. Type of Construction Value Owner Address: RAYMOND HIPPELE Commercial Alteration $2,000.00 50 ACORN Dr Total Value $2,000.00 DIAMOND POINT,NY 12824-0000 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications 2013-268 Queensbury Family Chiropractic Comm. Alteration 200 sq ft-Store "Z" ground level (former Well's Fargo) further division of Store "Z" $75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,June 25,2014 (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 o ue sbury; Tuesda ,June 25,2013 SIGNED BY for the Town of Queensbury. Director of Building&CoVE nfo ment Office Use Only Town of Queensbury Building & Codes f 3 Received: -. Tax Map 113� , 1 -, _ PRINCIPAL STRUCTURE APPLICATION Permit No.: A permit must be obtained before beginning construction Permit Fee: $ ?�S ' Please read: *TB resolution 86-2013(1-28-2013): $850 recreation fee for new dwelling *Rec Fee: $ A 2 L units,including single-family dwellings,duplexes or two-family dwellings,multiple family Site Plan No.: dwellings, apartments, condominiums,townhouses, and/or manufactured and modular Subdivision No.: homes,but not including 6 /1 -7111 mobile homes. This is in addition to the permit fee.til Date '1 T 111 Applicant r('liyi /1 ��.. Tax Map ID tit. , IS -1 -- ly Address Zoning "-nth C.��soc2 �� 6"Lt;. 11�1r3 Phone/E-mail '51 Property Owner 00?1-f r Ag� Z I IVI &L�4,YContractor/Agent ' Address )? Address b �j 'YZ Phone/E-mail Phone/E-mail ty� i .e?iwi . b3 M -7 Z--qllill Building Street Address: .T ,(U jY Subdivision Name: Lot Historic Site: Yes _10ro Estimated cost of construction: $ o o 0 . n �` ;'� , S r ;,�j R c � p / �j Type of Constructio .� �1 = 1t�(S re-1- Check e-1' ��v d' Check all that apply J C Please indicate measurements as required below: o � m 1st Floor 2nd Floor Other Total Height z ¢ a Single Family Two-Family Multi-Family(#of units_) Townhouse Business Office ✓ Ox Retail-Mercantile Factory-Industrial Attached Garages Other Town of Queensbury Building&Codes Principal Structure Packet 518-761-8256 If commercial or industrial indicate name of business �. Proposed use of building or addition Source of heat(circle one) Gas Oil Propane Solar Other Fireplace-complete a separate application for"Fuel Burning Appliances&Chimneys" —Yes _No Are there structures not shown on plot plan? Are their easements on the property? Site Information a. Dimensions or acreage of lot b. Is this a corner lot? c. Will the grade be changed as a result of construction: _Yes _No d. Public water or Private well e. Sewer or Private Septic System Value of all work to be performed(labor and materials) $ Declaration: I acknowledge no construction activities shall be commenced prior to issuance of a valid permit and will be completed within a 12 month period. If work is not complete by the 1 year expiration date the permit may be renewed, subject to fees and department approval. 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 ago above. Signed Date: _ 3 FOR OFFICE USE ONLY: Operating Permit Issued: Yes _No Occupancy Type: Construcfion Classification: Assembly Occupancy Limit: Special Conditions: Town of Queensbury Building&Codes Principal Structure Packet 518-761-8256 Inspection Form _ Town of Queensbury Fire Marshal O Periodic Inspection Date: 7�1'(�Time: —1 742 Bay Road,Queensbury NY 12804 o Re-Inspection p 518 7618206/518 761 8205 01'CO Inspection Permit#: 13 -aft, Fire arshals Representative MJ Palmer Business Name: Location: GK Stillman Contact: z- 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 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 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 Electric Wiring Enclosed/Labeled FC 605.3.1 Combustibles in Equipment Rooms FC315.2.3 F.D.Signage- FC 510 No Smoking Signs FC 310.3 Stora a 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" EVAC SIGNS IN Rooms FC 404.6 111 &112 Fuel Pump Warning Signs FC2205.6 Fuel Station Emer Procedures FC2204.3.5 Exterior Storage FC 315.3 REINSPECTIONDUE APPROXIMATELY Vacant Buildings FC 311 Emerqencv Disconnect FC 2203.2 21 DAYS SYSTEMS: FC 901.6 Insp OK NC DATE: OK NC Date Generator Annual DATE: OK NC Hood Installation Elevator Semi Annual FIRE ALARM Annual i' DATE: OK NC HVAC Shutdown Sprinkler System Annual Sprinkler FDC 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 Commercial Fina Report ( vim Office No.: (518) 761-8256 Date Inspection request received: ?JO Queensbury Building &Code Enforcement Arrive: am/ Depart:'_am/pm L 742 Bay Road, Queensbury, NY 12804 Inspector's Initials: _ �1` 01 - �, NAME: �,5)z �' r-1 I C6,i 1,C ra�Y( C PERMIT#: o� LOCATION: & S' I-C 2b(J r DATE: 7 77111 � v 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 in. Platform/Decks Interior I Exterior Ballisters 4 in. Spacing Platform I Decks Stair Handrail 34 in.—38 in./Step Risers 7"/Treads 11" Vestibules For Exit doors> 3000 sq.ft. All Doors 36 in.w/Lever Handles/Panic Hardware, if r uired Exits At Grade Or Platform 36 w x 44°(1)/Canopy or Equiv. Gas Valve Shut-off Exposed&Regulator 18° Above Grade Floor Bathroom Wateftht I Other Floors Oka Relief Valve,Heat Trap/Water Temp.110 Degrees Maximum Boiler/Furnace Enclosure 1 hr.or Fire Extinguishing System Fresh Air Supp 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 %doors > 10%> 1000 sq.ft. %Hour Corridor Doors&Closers Firewalls/Fire Separation,2 Hour, 3 Hour Complete/Fire Dampers/Fire Doors Ceiling Fire Stopping, 3,000 sq.fL 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 Si /Shaft Sealed Handica Bathroom Grab Bars/Sinks/Toilets Handicapped Bath/Parking Lot Signage Public Toilet Room Handicapped Accessible Handicapped Service Counters,34 in., Checkout 36" Handicapped Ramp I Handrails Continuous/12 in. Beyond[Both sides Active Listening System and Signage Assembly Space Final Electrical/Flex Gas Piping Bonded Site Plan/Variance required Final Survey, New Structure/Flood Plain certification,If As-built Septic System Layout Required or On File Building Number or Tenant Address on Building or Driveway 4' Water Fountain or Cooler Building Access All Sides 0'I riv Surface 20'wide Okay To Issue Tem Permanent CIO Okay To Issue C/C LABuilding&Codes Forms\Building&CodeMinspection Fomis\Commerc ial Final Inspection ReporLdoc Revised January 7,2008 Inspection Form m d� ('518 ensbury Fire Marshal Periodic Inspection Date: �" Time:__ 742 Bay Roa ,Queensbury NY 12804 Re-Inspection 13- 761 820 518 761 8205 CO Inspection Permit#: O Fire!�als Representative _---MJ Palmer Business Name: / Location: ZGK 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 Sign:backup FC 1011.5.3&FC1029.7.5 AISLES: Wf GUS cAii iSQL�rzo� Main Aisle Width FC 1024/1025&FC1029.11 A Secondary Aisle Width FC 1025&FC1029.11 a GIyS�' �s� G It tOt�f�LcG/ FIRE EXTINGUISHER: Hung FC 906 Inspection of extinguisher FC 906 EVAC Plan FC 404.6 TRUSS ID SIGNAGE FC 505.3 N ( yNtutJfi a �Gtt J E�w4�S EMERGENCY LIGHTING: L Interior FC 1006.3&FC1029.8 A'yy' $4 Exterior FC 1006.3 Clearance to Electrical FC 605.3 'j J� y N FP q 13 : Electric Wiring Enclosed/Labeled FC 605.3.1 Combustibles in E ui ment Rooms FC315.2.3 d 5. 4 i 0 Rita F.D.Signage- FC 510 No Smoking Signs FC 310.3 Storage FC 315.2 E"_ Y, Compressed Gas FC 3003 Vehicle Impact Protection FC 312.1 Interior Finishes FC 803-804 Smoke Detectors FC 907 t ti'f�K Cf Ltr t S h t4ClGrJ / CO detectors FC 610 Clearance to Sprinkler/Ceiling FC 315.2.1 Lit L�(Tf (: SGfi v1 L VJ6GV►� 18" / 24" EVAC SIGNS IN Rooms FC 404.6 R7 &R2 g y-I? k Fuel Pump Warning Signs FC2205.6 � f Fuel Station Emer Procedures FC2204.3.5 4 Exterior Storage FC 315.3 REINSPECTIONDUE APPROXIMATELY Vacant Buildings FC 311 21 DAYS SYSTEMS: FC 901.6 Insp OK NC DATE: OK NC Date Generator Annual DATE: OK NC Hood Installation Elevator Semi Annual FIRE ALARM Annual DATE: OK NC HVAC Shutdown Sprinkler System Annual Sprinkler FDC 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 :�'? Commercial Final Inspection C Pry Office No.: (518) 761-8256 Date Inspection request received: Queensbury Building &Code Enforcement Arrive: ''o am/F Depart: am/pm 742 Bay Road, Queensbury, NY 12804 Inspector's Initials: NAME: r` �' Gk '1 Z7 6 PERMIT#: 3 LOCATION: DATE: itt—/ 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 J 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"(1)/Canopy or Equiv. Gas Valve Shut-off Exposed &Regulator18'1 Above Grade Floor Bathroom Watertight/ Other Floors Oka 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 1h doors > 10% > 1000 sq. ft. 3/a 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 �y Handicapped Ramp/ Handrails Continuous/12 inch Beyond [Both sides Active Listening System and Signage Assembly Space Final Electrical/ Flex Gas Piping Bonded r� Site Plan/Variance required Final Survey, New Structure/ Flood Plain certification if reg. As-built Septic System Layout Required or On File Building Number or Tenant Address on Building or Drivewa 4" Water Fountain or Cooler Building Access All Sides by 20'/ Drivable Surface 20'wide Special Inspections Engineer or Architect Approval Okay To Issue Temporary or Permanent C/O '�,,t _„� = ✓j= �`�� Okay To Issue C/C Commercial Final Inspection Report revised 11-27-2012 2013 Queensbury Family 10 x 10 Chiropractic Build out at Mount Royal Plaza 959 State Route 9 Queensbury,NY 12804 (518)798-1111 o Attn: Jen Miner 0 0 a Closet I3' '7 777 20 z, 4' Office Utility/ _ Breakroom Office ri Batip WN OF QUEENSBURY Bath 2 WILDING & C(Pf T RevieIA/Pid Ry- Storage Closet: Date: 3'deep,with shelves at 2', X &4' . Louvred ors Office: build out 2nd office. Front entry halfway down north facing wall. 2nd entry into back of- fice in southeast corner. 10'x 20' TOWN OF QUEENSBURY Bathroom: move door to north wall BUILDING DEPARTMENT Based on our limited examination,compliance A " Back office: add door with our comments shall not be construed as rib indicating the plans and sr are in ;. , p Utility room: add door New York State. with the Building Codes of K p C-3 urr�uroRc asPER@En.a PaRe�cwo9sct 3 0-0 <8> 1 i \VIII E-EORu@PRwlER }�� L; 3309R KRISK WRN I,afi+A59RE NOIDEIi.Wp 2Y%]@' P9Sitl1 ON E.YSI @IDE NG p A%aAC uNE #1 7 i EC n MMM � — t^�C1 — N# r wxm cw nu u„ �C � �I r (' r+ '1� 42-P ` ACIERtt6iE L9G9--;(. " �� I 1 a41e• 0 E . - - 0 ,FURNITURE RNIT-U- RE. PLAN LEVER T ( LJ ItS REQUIRE 114. V_o. ON ALL PASSAGE DOORS f3'_9• SS-2' Y3•-2" 13'-9' WHETHER INTERIOR OR AR IEPOORS 30 A4 M _ 54 30 (��"��h1ARKETING DISPLAY FRAMES j ,vu �irAR%E1wC 96PIJ.Y iAAtlE.@0"%�@- i0'M!OFUicr`.i9aBURYBUiLDINGGPARiti&iT 30 e Ln> Based on odr limited examination, �. r-7 comppliance with our comments shall o u+Rxraw99iaurFluuE a'zsa not be construed as indicating the M e@x 9P��»E 25 plans and specifications are In full W erompllance with the Building Codes 84 of New York State. d> srAGEconcx AmwStgL� o •= . . �. , •• a , AW f Yt _ -�'" w .,..._ 4��t�'� (� Al 36 vwmu swE ex anwoacsa xsr j,_•1, �� a s9"r9P of enwe UILDING C- ��e '4„• AW REVIEWED 8�/�� (ry54 wms9ePEsnxm�n,nanv9Rz.ss-x@s- c�f � 0¢roPOErwuE DATE / y.�,,�,� WELLS PLAQUES «+ - 1 ,ucart,c sncxc9 a<rv.9uc o s-o'(em9u7 es.E. ON A9WSfICA1.WNL P1NFL (,\�}'(y/ .� . NLUWOY wEt--IS EIt2C0 P3UIXIN.EMit9'lKA99E \6b S= � �ea'-9.18tr1T9�+)FFF.M+EMKf 50E wNL AS SROWN. FXl�.S7stta 7 1 N4NwW—MEY PV.a•F !1 Raxxcem ansa,9anaecrae 6E :2CN N gN r4 AW "”" AW ARTWORK PLAN 54 36 P- py L i� E p - i<�;:•,.�x,' - - A� a p r1 o t R�'yal plaza traQun Route� 'ar,9 State -fax MaP is situ s Stes YdIa�to etv+e nista , ani stove O it be on iay �9 s...Store$ l-aY®u$�t,� .round l��el. AStIAoor or'9