CC-000810-2016 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
w- Community Development- Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: CC-000810-2016 Date Issued: Friday, January 5, 2018
This is to certify that work requested to be done as shown by Permit Number CC-000810-2016
has been completed.
Tax Map Number: 301.8-1-17
Location: 340 Aviation RD
Owner: DLS Enterprises
Applicant: Rejuvenations SPA Services
This structure may be occupied as a: Commercial Interior Alterations
500 sq. ft. By Order of Town Board
Business: Rejuvenations Spa Services TOWN OF QUEENSBURY
is adding 500 sq. ft. to their current business space.
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 Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
A 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
_ Community Development-Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: CC-000810-2016
Tax Map No: 301.8-1-17
Permission is hereby granted to: Rejuvenations SPA Services
For property located at: 340 Aviation 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
Type of Construction
Owner Name: DLS Enterprises Business Office-Alteration $6,000.00
Owner Address: 340 Aviation RD Total Value $6,000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Nick Vaughn
178 Dean RD
Hudson Falls,NY 12839
Plans&Specifications
Commercial Interior Alterations
500 sq.ft.
Business: Rejuvenations Spa Services
is adding 500 sq.ft.to their current business space.
$100.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday,December 5,2017
(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 Towtrjuebury;_/, I M �y, ecember 5,2016
SIGNED BY: f�'�'t for the Town of Queensbury.
Director of Building&Code Enforcement
PRINCIPAL ST UCTURE APPLI� ' ON OffceVse Only
Date: / CC 8/1
NOV ) 8 201 Permit No. /
i u i<
Tax Map ID 30(�ff— � — l� \ �� � Permit Fee w Lp' r V
0
Zone Htsto�Yes._ No Ree Fee /�q
Subdivision Name e 1 Lot# Site Plan
C
Project Location Subdivision 9 S C,`7�
TOWN BD.RESOLUTION 86-2013: $850 recreation fee for new dwelling units—single family,duplexes/two-family,multiple family,
apartments,condominiums,townhouses,and/or manufactured&modular homes,but not mobile homes. This is in addition to the
permit feels).
Primary Owner(s)
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Address ,3qo \/, '1 �'Ov! [�QI / x1Y /-z'8 �y
Phone/Email
Applicant n G i \k'
^h i ve
ia
Address
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Phone/Email 3a —ZI(�3
Contractor
Address
Phone/Email
Contact Person for Building&Codes Compliance: Phone —s}
TYPE OF CONSTRUCTION
✓Check all that apply New Alteration V floor sf 2nd floor sf Total sf Height
Single Family
Two-Family
Multi-Family IV
(#of units_)
Townhouse
Business Office
Retail-Mercantile
Factory-Industrial
Attached Garage
(1, 2, 3, 4+)
Other
Town of Queensbury Building&Codes Principal Structure Application revised January 2016
If commercial or industrial please indicate name of business
Proposed use of building or addition
Source of Heat(circle one) Gas Oil Propane Sol O er
Fireplace: Complete a separate application for Fuel Burning
Appliances&Chimneys
Are there structures not shown on plot plan?
Are there easements on the property?
Site Information:
a. Dimensions or acreage of lot
b. Is this a comer lot? _Yes —No
c. Will the grade be changed as a result of construction _Yes X No
d. Public water or Private well(circle one) ublic Private
e. Sewer or Private Septic System(circle one) Sewer Private
Value of all work to be performed(labor or materials) $ oualC00
DECLARATION.
1. I acknowledge no construction shall be commenced prior to issuance of a valid permit and will be
completed within a 12 month period.
2. If work is not complete by the 1 year expiration date the permit may be renewed, subject to fees and
department approval.
3. 1 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 NYS
Building Codes,local building laws and ordinances,and in conformance with local zoning regulations
4. 1 acknowledge that prior to occupying the facilities proposed, I or my agents will obtain a certificate
of occupancy.
5. 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:
PRINT NAME: fzrf4 �
yo ^ DATE:SIGNATURE: DATE:
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 Application Revised January 2016
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
Permit No. C�.....t.0 �o..Cert.N Q 44895 Cut-in Card No.....................................
Owner....... lr�..L� ...... .........../...............................................
Location...3..1V...ej..... Vl r,•,�� ......f..S.t ................................�..u:�.�.................
Installation Consisting of..'7....SOV/..� f...s...U. ...rm.............
....................................................................................................................................................................................
....................................................................................................................................................................................
InstalledBy............ ../ - .af' ....................................................Lic.No...................................................
The conditions following governed the issuance of this certificate,and any certificate previously issued is
cancelled:-
This certificate only covers the electrical equipment and installation conditions as of date. Upon the
introduction of additional equipment or alterations,application shall be promptly made for inspection.
Inspectors of this Company shall have the privilege of making ' ections at any time, and if its
rules are violated,the Company shall have the right t re e thi rtifi ate.
�Qi
Date... ........k.......f...F................... INSPECTOR................�.... ........
Member N.F.P.A.,I.A.E.1.