2013-504 TOWN OF QUEENSBURY
742Bay Road,Qucensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20130504 Date Issued: Friday, November 15, 2013
This is to certify that work requested to be done as shown by Permit Number P20130504
has been completed.
Location: 797 STATE ROUTE 9
Tax Map Number: 523400-302-006-0001-043-000-0000
Owner: NORTHGATE ENTERPRISES INC
Applicant: BACK HOME, STYLES FOR LIVING, LLC
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.
00k4 TOWN OF QUEENSBURY
..1 . 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20130504 Application Number: A20130504
Tax Map No: 523400-302-006-0001-043-000-0000
Permission is hereby granted to: BACK HOME. STYLES FOR LIVING. LLC
For property located at: 797 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: NORTHGATE ENTERPRISES INC Commercial Alteration $300.00
PO BOX 4514 Total Value
QUEENSBURY,NY 12804-0000 $300.00
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
12013-504 Suite 1-B Back Home, Styles for Living
Comm. Alteration 30'wall partition
$75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday, October 29, 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 Towyt'ofensbt /1 /1-1 Tited.S , October 29,2013
SIGNED BY c.„4/tit j//" , for the Town of Queensbury.
Director of Building& Code Enforcement
IL4it I 3
Office Use Only
Town of Queensbury Fire Marshal
Received:
ESTABLISHMENT OF A NEW BUSINESS Tax Map ID:
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION Permit No,:
Permit Fee:
"Note: This application Is for occupancy only,with no work requiring a building permit,
Name of�iisiness (�ccc� Afre, ZI vihj L•L. C
Address 777 cJ/cele 4/ 7 Joie /-23 / ��i nshUy,/VY
Type of Business akin 17 (i' rP/ /'Pion/ 72110/51)/171/4.9 )mP c/ oY
Manager 774y ci(/ /`lAi (ew %�Pr7.Zicy
OR
?8F 9n in&ItaFp - - I - .P .
�ii'siness Phone No. J78- 7C/- 1/as.3
Property Owner :fir, f , 5 rn-ri i'n i i se 5 ,�n( Ind flec5(e2--
Address '7Ct'7 R-1-e q (4-k(Ice) (.6-y ;i. f 1c.2 �0�1
Phone _2922i
i 8 )
"Provide an loourate layout of your store showing all walls,smite, stookrooms,rest rooms,counters,and fixture layout on a
separate sheet of paper,
Print Name: /1/Rfrim.tv /7', ir,641y
Signature: t'i‘ G✓C�7
Date: /0/2 /3
JJ as 1 Ba�r�anile�
IMPORTANT: The business owner is responsible for keeping exits clear and maintaining exit signs and emergency lights. Fire
extinguishers,fire sprinkler systems, and fire alarm systems require annual inspections by an outside contractor and the corresponding
documentation must be provided to the Fire Marshal's office. Fire extinguishing systems found in kitchens and gas stations require
semi-annual inspections. Any violations noted during an inspection,require immediate corrective action.
CONTACT NUMBERS;
Director, Building and Codes-761.8253 Zoning Adrnini@trator.761-8218 Zoning-761.8238
Fire Marshal-761-6206 Planning-761-6220
Town of Queensbury Fire Marshal—New Business Permit 518-781-8208
EMERGENCY CONTACT UPDATE
6P13 - abq
TO: Warren County Sheriffs Department
1. This form is used to assist Emergency Service personnel who may be 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
angler Pii@ pFainn@l in pining @fltFy y®@F
2. Please be advised that failure to respond to assist emergency service personnel may result in damage to your
building to facilitate entry by police and/or fire personnel.
PLEASE PRINT
DAT /0/2 0 /3
BUSINESS NAME: A i/e, J y/PJ fog .Zw y /' Z, C
MINH§ ADDNE§& 7P 7c)-(4 M� c)-(4 /
6-JPnS6vr y /1/y
BUSINESS PHONE: (378) 7i" Y '3
CONTACT 1: //molly Wpm HOME PHONE s/8 7YJ-87?/• 222 -/0253--
ADDRESS:
25ADDRESS: /0 7k;'1-0/r iGne C1f '/2 5-4//(y A/V
CONTACT 2: NI# // n /a/ HOME PHONE 57e- 778-25;Y-
ADDREM 2 S/r)PAIrs1 oriv ,akat')arhu y IVY
Town of Queensbury Fire Marshal-New Business Permit 518-761-8206
Office Use Only
Town of Queensbury Building & Codes
Received: _<1-3
Tax Map ID: 3 I '2 5 21113
PRINCIPAL STRUCTURE APPLICATION Permit No.: , 17`)
A permit must be obtained before beginning construction Permit Fee: $ /3 --5 b
Please read: *TB resolution 86-2013(1-28-2013): $850 recreation fee for new dwelling *Rec Fee: $ //k
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 mobile homes. This is in addition to the permit fee.
Date Applicant Ma}t-Triemblc,. ,
Tax Map ID 3C' ; . ( � - M _L{ � Address 1S{1 �c�)P Kt-y
Zoning Sa,l.e i-j3
Phone/E-mail mca- . 1-11e.
Property Owner . . t _- „ . . Contractor/Agent -r-sr L'ansf rocl-run L&C
Address 777 .`,'+. R-9 ,5::,te i-i3 Address lU Cher() LA
C-Jueen5ly)ry NY C�1iPerub(,>y ky
Phone/E-mail t\.:;I d r--9,y c9 rOCId rt . cc.' Phone/E-mail rna4 G -1,e b,,Idr Sys• Co v
Contact Person for Building&Code Compliance: nil+i re�Alc./ Day Phone: Z60-5`/01
Building Street Address: '7 9-7 Si-. RI Q I't3 -OoeerisK;ry CNo r 1-h30le 01-0z(t)
Subdivision Name: 1 rR rj•rie btu 0, Lot#: i ' Historic Site: Yes No
Estimated cost of construction: $ 30C,
Type of Construction:
Check all that apply Please indicate measurements as required below:
0 0
�o 1st Floor 2nd Floor Other Total Height
F
a
Single Family
Two-Family
Multi-Family(#of
units )
Townhouse
Business Office
Retail Mercantile /\ iAM/ f Idrui
Factory-Industrial
Attached Garages(# )
Other
Town of Queensbury Building&Codes Principal Structure Packet 518-761-8256
If commercial or industrial indicate name of business ,QA C./16(6.0 z ithr 0�1.i v,, LLC
Proposed use of building or addition n / of -1,(cre, fvrn,lure t
Source of heat(circle one) Oil Propane Solar Other
Fireplace-complete a separate application for"Fuel Burning Appliances&Chimneys" _Yes / No
Are there structures not shown on plot plan? AC2
Are their easements on the property? ��
Site Information %✓or/App/e Picea_ f✓i k 1-6
a. Dimensions or acreage of lot pie-ex/Sin
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 A/die
e. Sewer or Private Septic System RAC
Value of all work to be performed(labor and materials) $ 3 7 cv
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 agree to the above.
Print Name: / M iti 7:-7:
Signature: j14 4-
� 7 Date: /41/27A
FOR OFFICE USE ONLY:
Operating Permit Issued: _Yes _No
Occupancy Type:
Construction Classification:
Assembly Occupancy Limit:
Special Conditions:
Town of Queensbury Building&Codes Principal Structure Packet 518-761-8256
Inspection Form
i, i ,Sji', 1,
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 .� u CO Inspection Permit#: 1 -3 -60 _!
Fire Marshals Representative
\MJ Palmer Business Name: ) ticiv^L Liv,J
Location: ,--)q 1 Rt)--1: 9
GK Stillman Contact: N\ ft ft
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 .ey
Sign:Normal FC 1011 &FC1029 !/
Sign:backup FC 1011.5.3&FC1029.7.5 /
•
AISLES:
Main Aisle Width FC 1024/1025&FC1029.11 .. _ Me
Secondary Aisle Width FC 1025&FC1029.11 -,k,•
FIRE EXTINGUISHER: Hung FC 906
Inspection of extinguisher FC 906
EVAC Plan FC 404.2 f II.
TRUSS ID SIGNAGE FCC 505.3 / 0
EMERGENCY LIGHTING:
MIL
Interior FC 1006.3&FC1029.8 / ,/ 1.`''
Exterior FC 1006.3 /
Clearance to Electrical FC 605.3 ` w"
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 / /
Storage FC 315.2 / _
Compressed Gas FC 3003 ,f,
Vehicle Impact Protection FC 312.1 /
Interior Finishes FC 803-804
Smoke Detectors FC 907 j
CO detectors FC 610
Clearance to Sprinkler/Ceiling FC 315.2.1
18" / 24" E
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
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
Sprinkler System Annual Y(�tre Marshal fnspectie ic'tTI �---
Sprinkler FDC _ CO may be;ssued ONL y t ith to
�,
Kitchen Suppression Semi Annual �i.illfiilg&Cedes app-oval
Fuel Island Suppression Semi Annual
Hood Cleaning 3-6-Annual \ i
Knox Box:installed/checked FC506 i si. r 1
Operating Permit, if required will be issued after I
Completion of Inspection r Fire (Marsha,
,.__.---..c�wn,_, or .f,Q'.laenshun' �.�.:
Commercial Final Inspection Report
eye
Office No.: (518) 761-8256 Date Inspection request received: it 1 Z//
Queensbury Building & Code Enforcement Arrive: 3, /1 am/pm Depart: am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: 1 ).-
NAME: / 1") CG� �`T G►`� y_ PERMIT #:
LOCATION: S7l3T 1 L ( DATE: i yi
/ Al�TN tLRZA
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 I 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/eMirrors /I
Handicapped Bath/ Parking Lot Signag , '
Public Toilet Room Handicapped Accessible r�
Handicapped Service Counters, 34 inch, Checkout 36 inch Ardl'cyar ,7iAl
Handicapped Ramp/ Handrails Continuous/12 inch Beyond [Both Y�
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 req.
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 by 20'/ Drivable Surface 20'wide
Special Inspections/ Engineer ojArchitec proval / }� /
Okay To Issue Temporary or�1 ermanent C/O • i''�3h�/r
Okay To Issue C/C
Commercial Final Inspection Report_revised 11-27-2012
N
,-D i,,„•,,,-..):72ay Re:49 ) \i/
/*ii,7w6;4•„4", AilNict, 16,? \/),-i OCT 2 5 2013
7?7 L,..V6.4, A?:/. 5?
4/,>'.1 -- — t, ,- i.._ ' ---4-- t 1°' .....+,+....-•-......**,.......••••••••,./1.,-......4.-....-.Y.....Al.
Joie /-8
1 i, .1:11,5712/4; ,:-.,-;4.‘0•?‹:;,,-:--
- . .
1 --- if3o•
em..hef.?
KADIO i 1
,
5PACK ItZ. Atifeti U14 I i 4:
i
,
1.1q
eigfy s.l• \ • I .
(1—\\, ,--L—. I ..,_,........:_ \ •ANIKROW ,1:,--\_t.)'` .
' * ' 1/ * " 1\4411Z1 1 PLA-TPOCM.4
- ' .. ..
- - ---".•-,--4".,---.7--.7-7------------ '-t;5 --_-___,._, ._ .
I :_tt.2.1t4 14.9)ACEctil • P.
i'..:(-- -,... ,'',1-:.,jjENT ruittit,,,A rs, '.."'N proposed
1-,•,c,;r1r.-. 21 f :,-;••'''';:,:.. .;(1. mnii
1"TiemQ61,;(0- P
, __ -. ;...•.i.It_ .9._ - mall SI\ -cv --- ' 1 o,,,.
,..•.,-,,, .
.:_,:. wi,:i try:: i3Jiiding Cod • ofex. ..„, Roac
1,;::: )•,...,,,,:::,ILI-3. . VI ... .'
3 0 talla I 41:'‘, 1 i 47415Vie Ild-o-o-a(
,;-:,1 3 71•`.1 Pg‘i,,‘i*Alk li / ---,........J.7....L.--:.--,...-----_--,------1----'------,L-.--
.•' " • 1, 1 0.,114' EPT i;Ni
\,,L
1;e. 'el:sVOCK 50d 101 CI!I Vi:-Pr-1 :3'(')
,..J
/--r") ,,
44.59J-11)," ,r-14e0CAtre IS kW/ ICOMed rai
Or C710/ vic
i
Jo/V an 01 /)-1 a sr at7 0 r/ /14.7114A A/041
ilisiii#1;) iri(-100f)Ciry v c.".•.f 1 ..,....... 1
•
A:bac I S W00041) lini.,c( Whil) /43,,,4 iclit)60,,,,i 46 eliki. ere)'
•
.
. PC9X.Serli CAC firye 6. 1911C141 tj 7 i r‘IV'gl9f G ril WC'1 di /0 feChKe
- i
• rehei/ -51)0e-e. 14:40 3c ' 44:2(Y
c: r.mSdruclian 4414A .:?. `114661. 'rncic't .
Ayisheof an reqw i ,:::Itie.
. ignif,10.61 hee.9411. r e" Jo eel - t'llie' s .
- .
- •
. .