CC-000644-2017 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
- Community Development-Building& Codes (518)761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: CC-000644-2017 Date Issued: Thursday, December 14, 2017
This is to certify that work requested to be done as shown by Permit Number CC-000644-2017
has been completed.
Tax Map Number: 308.16-2-2.3
Location: 9 CAREY RD
Owner: Hudson Headwaters Health Network
Applicant: Richard E.Jones Associates
This structure may be occupied as a: Commercial Interior Alterations 1555 s.f.
(Administration Building) By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the 4
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
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
.� Community Development- Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: CC-000644-2017
Tax Map No: 308.16-2-2.3
Permission is hereby granted to: Hudson Headwaters Health Network
For property located at: 9 CAREY 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
Tvce of Construction
Owner Name: Hudson Headwaters Health Network Business Office-Alteration $130,387.00
Owner Address: 9 Carey RD Total Value $130,387.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
C.Raymond Davis&Sons
4591 Lakeshore DR
Bolton Landing,NY 12814
Plans&Specifications
Commercial Interior Alterations 1555 s.f.
(Administration Building)
$311.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday,October 16,2018
(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 To Quee bury; /f M ay 16,2017
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
ADDITION/ALTERATION PERMIT Permit#:
APPLICATION Permit Fee: $ X11
liritn ofQttccvshttn-
742 Bay Road,Queensbury,NY 12804 Invoice#: Z2:�)z�
P:518-761-8256 www.gueensbury.net
Project Location: 9 Carey Road, Queensbury, NY
Tax Map ID#: 308.16-2-2.3 Subdivision Name:
D ; U VY 11r;
CONTACT INFORMATION:
OCT 13 2011
• Applicant:
Name(s): Richard E. Jones,Architect TOWN OF QUEENSBURY
Mailing Address, C/S/Z: 339 Aviation Road, Queensbury, NY 12804
Cell Phone: 518 ) 791-1960 Land Line: 518 ) 793-1015
Email: info@rejaarchitects.com
Primary Owner(s):
Name(s): Hudson Headwaters Health Network(James McCormick)
Mailing Address, C/S/Z: 9 Carey Road, Queensbury, NY 12804
Cell Phone: 518 ) 812-1271 Land Line: 518 ) 824-8622
Email: jmccormick@hhhn.org
• Contractor(s):
Business Name: C. Raymond Davis&Sons
Contact Name(s): John Isaacs
Mailing Address, C/S/Z: 4591 Lakeshore Drive, Bolton Landing, NY 12814
Cell Phone: 518 ) 260-3864 Land Line: 518 ) 644-7046
Email:__ johnisaacs@craymonddavis.com
• Architect(WEngineer(s):
Business Name: Richard E. Jones Associates Architects
Contact Name(s): Richard E. Jones,Architect
Mailing Address, C/S/Z: 339 Aviation Road, Queensbury, NY 12804
Cell Phone: 518 ) 791-1960 Land Line: 518 ) 793-1015
Email: info(Wreiaarchitects.com
Contact Person for Building & Code Compliance: Richard E.Jones,Architect
Cell Phone: ( 18 ) 791-1960 Land Line: 518 ) 793-1015
Email: info@rejaarchitects.com
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017
PROJECT INFORMATION:
TYPE: x Commercial Residential
WORK CLASS:
Single-Family _Two-Family _Multi-Family(#of units )
Townhouse x Business Office Retail
Industrial/Warehouse _Garage (#of cars ) _Other(describe )
ADDITION SQUARE FOOTAGE: N/A ALTERATION SQUARE FOOTAGE:
1st floor: 1st floor: 1,555
2nd floor: 2nd floor: -
3rd floor: 3rd floor:
41h floor: 4t'floor: -
Total square feet: Total square feet: 1,555
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction: $ 130,387
2. If Commercial project, what is the proposed use: Offices
3. Source of Heat (circle one): Gas Oil Propane Solar Other
Fireplaces need a separate Fuel Burning Appliances&Chimney Application
4. Are there any structures not shown on the plot plan? YES NO Explain:
S. Are there any easements on the property? YES NO
6. SITE INFORMATION:
a. What is the dimensions or acreage of the parcel? 2.16 acres
b. Is this a corner lot? YES NO
c. Will the grade be changed as a result of the construction? YES NO
d. What is the water source? PUBLIC PRIVATE WELL
e. Is the parcel on SEWER or a PRIVATE SEPTIC system? septic
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017
DECLARATION:
1. 1 acknowledge that no construction shall be commenced prior to issuance of a valid permit and will be
completed within a 12 month period.
2. If the work is not completed 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 and/or
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: Richard E. Jones,Architect
SIGNATURE: DATE: 09/29/2017
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017
FIRE MARSHAL'S OFFICE
Toznn of Queensbury
742 Bay Road, Queensbury, NY 12804
"Home of Natural Beauty ... A Good Place to Live "
PLAN REVIEW
HHHN
9 Carey Road
CO-000644-2017
10/13/2017
Interior Alteration
The following comments are based on review of drawings:
• Provide NFPA 72 compliant letter
• Provide NFPA 13 compliant letter
• Verify operation of exit / Emergency lighting.
Michael J Palmer
Fire Marshal
742 Bay Road
Queensbury NY 12804
firemarshal@queensbury.net
Fire Marshal 's Office ■ Phone: 518-761-8206 - Fax: 518-745-4437
firemarshal@queensbuni.net - zvwzv.queensburU.net
e
Town of Queensbury-Building and Codes-Fire Marshal
742 Bay Road-(518)761-8256 Building(518)761-8206 Fire Marshal
Case Number: CC-000644-2017 Case Module: Permit
Inspection Date: 12/14/2017 Inspection Status: Passed
Inspector: Gary Stillman Inspection Type: OCC-Inspections
Job Address: 9 CAREY RD Parcel Number: 308.16-2-2.3
Queensbury,NY 12804
Contact Type Company Name Name
Granted Permission [Hudson Headwaters Health Network]
Applicant [Richard E.Jones Associates] Jones,Richard
Architect [Richard E.Jones Architects]
Contractor [C.Raymond Davis&Sons]
Primary Owner [Hudson Headwaters Health Network]
Checklist Item Passed Comments
Fire Marshal YES Clean up all Construction material
Exit Access FC1014&FC1029 YES
Exit Enclosure FC1020&FC1029 YES
Exit Discharge FC1024&FC1029 YES
Locks and Latches FC1008&FC1029.2 YES
Sign:Normal FC1011 &FC1029 YES
Sign:Backup FC1011.5.3&FC1029.7.5 YES
Main Aisle Width FC1024/1025&FC1029.11 YES
Secondary Aisle Width FC1025&FC1029.11 YES
Fire Extinguisher Hung FC906 YES
Inspection of Extinguisher FC906 YES
Emergency Lighting Interior FC1006.3&FC1029.8 YES
Clearance to Electrical FC 605.3 YES
Electrical Wiring Enclosed/Labeled FC605.3.1 YES
Combustibles in Equipment Rooms FC 315.2.3 YES
F.D.Signage-FC510 YES
Storage FC315.2 YES
Interior Finishes FC803-804 YES
CO Detectors FC610 YES Existing
Clearance to Sprinkler/Ceiling FC315.2.1 18"/24" YES
FIRE ALARM Annual YES PROVIDE NFPA 72 LETTER FROM FIRE ALARM CONTRACTOR
12/14/17 Received NFPA completion REPORT from Simplex/Grinnell
Sprinkler System Annual YES PROVIDE NFPA 13 LETTER FROM SPRINKLER CONTRACTOR
12/14/17 Received NFPA 13 letter dated 12/13/2017 from Northeast
Fire
Knox Box:installed/checked FC506 YES
Occupancy Cycle YES B
Stillman,Gary(Inspector)
Dec 14,2017 Page(1)
Town of Queensbury-Building and Codes-Fire Marshal
742 Bay Road-(518)761-8256 Building(518)761-8206 Fire Marshal
Case Number: CC-000644-2017 Case Module: Permit
Inspection Date: 12/12/2017 Inspection Status: Failed
Inspector: Gary Stillman Inspection Type: OCC-Inspections
Job Address: 9 CAREY RD Parcel Number: 308.16-2-2.3
Queensbury,NY 12804
Contact Type Company Name Name
Contractor [C.Raymond Davis&Sons]
Applicant [Richard E.Jones Associates] Jones,Richard
Primary Owner [Hudson Headwaters Health Network]
Architect [Richard E.Jones Architects]
Granted Permission [Hudson Headwaters Health Network]
Checklist Item Passed Comments
Fire Marshal YES Clean up all Construction material
Exit Access FC1014&FC1029 YES
Exit Enclosure FC1020&FC1029 YES
Exit Discharge FC1024&FC1029 YES
Locks and Latches FC1008&FC1029.2 YES
Sign:Normal FC1011 &FC1029 YES
Sign:Backup FC1011.5.3&FC1029.7.5 YES
Main Aisle Width FC1024/1025&FC1029.11 YES
Secondary Aisle Width FC1025&FC1029.11 YES
Fire Extinguisher Hung FC906 YES
Inspection of Extinguisher FC906 YES
Emergency Lighting Interior FC1006.3&FC1029.8 YES
Clearance to Electrical FC 605.3 YES
Electrical Wiring Enclosed/Labeled FC605.3.1 YES
Combustibles in Equipment Rooms FC 315.2.3 YES
F.D.Signage-FC510 YES
Storage FC315.2 YES
Interior Finishes FC803-804 YES
CO Detectors FC610 YES Existing
Clearance to Sprinkler/Ceiling FC315.2.1 18"/24" YES
FIRE ALARM Annual NO PROVIDE NFPA 72 LETTER FROM FIRE ALARM CONTRACTOR
Sprinkler System Annual NO PROVIDE NFPA 13 LETTER FROM SPRINKLER CONTRACTOR
Knox Box:installed/checked FC506 YES
Occupancy Cycle YES B
Stillman,Gary(Inspector)
Dec 12,2017 Page(3)
Nov, 20. 2017910 : 27AM MDIA No. '0�4 P.
.MIDDLE DEPARTMENT INSPECTION .AGENCYIIS r
C_
%-VIZ that the electrical wiring to the electrical equipment listed below has been examined and is approved as
being in accord with the National Electrical Code, applicable governmental, utility and Agency rules in effect on the date
noted below and is issued subject to the following conditions.
Owner: Hudson Headwaters Date:
11/02/2017
Occupant- 1 St FI/2 Rear Offices Location,
9 Carey Road
OccupancyNon-Residential Queensbury, Warren Co. NY
Applicant: �
Northeast Elec, Solutions LLCM - _'•-_..
151 Stone School '�� � - �` �•`
Rd.
Lake George, NY 1284.5...;64.
S.
J Joseph A.Holmes
No. - - - _ - - 14570$16J251EL
-• - - - - - - - - - - - - - - - - -
Fquipment: - ,
1 -Switch; 4 - Receptacles; 6 - Fixtures ---' — --" �—--- -
may"•• �r+ I',.— .. Yr��
' I
This certificate applies to the electrical wiring to the electrical equipment listed immediately null and void, This certificate applies only to the use,Occupancy and
above and the installation Inspected as of the above noted date based on a visual ownership as Indicated herein. Upon a change In the use,occupancy or ownership
inspection. No warranty is expressed or implied as to the mechanical safety,effl• of the property indicated above,iris certificate shall be immediately null and void.
ciericy or fitness of She equipment for any particular purpose. This certificate shall In the event that this certificate becomes Invalid bssed upon the above condAons, J
be valid for a peFod of one year from the above noted date. Should the electrical this certificate may be revalidated upon reinspection by Middle Department
System to which tniS cartif ate applies be altered in any way,including but not limit- Inspection Agency, Inc. An application for inspection must be submitted to Middle
ed to,the introduction of atltlitional electrical equipment and/or the replaxment of Department Inspection Agency, Inc, to initiate the Inspection and revalidation
any of the Components inslaJled as of the above notetl date,tri;certificate shall be process. A fee will he charged for alis service.
,
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_ I RICHARD E.JONES ASSOCIATES
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Education Law,Part 69 of the Regulations of the
Commissioner for the Practice of Architecture.
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