2004-052 ..011% TOWN OF QUEENSBURY
IFOS742 Ba Road ueensbu NY 12804-5902 518 761-8201Y Q rY, )
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20040052 Date Issued: Monday, April 05, 2004
This is to certify that work requested to be done as shown by Permit Number P20040052
has been completed.
Tax Map Number: 523400-296-019-0001-032-000-0000
Location: 375 BAY Rd
Owner: PROVIDENT DEVELOPMENT GROUP, LLC
Applicant: DR. YOVANOFF & DR. KARP
This structure may be occupied as a:
By Order of Town Board
Commercial Alteration TOWN OF QUEENSBURY
- 4
Director of Building&Code Enforcement
1
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
f
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040052 Application Number: A20040052
Tax Map No: 523400-296-019-0001-032-000-0000
Permission is hereby granted to: DR YOVANOFF & DR KARP
For property located at: 375 BAY 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 Value
Owner Address: PROVIDENT DEVELOPMENT GR
1656 STATE ROUTE 9 Commercial Alteration $75 000.00
Total Value $75,000.00
CLIFTON PARK, NY 12065-0000
Contractor or Builder's Name / Address Electrical Inspection Agency
Plans&Specifications
2004-052 Dr. Yovanoff& Dr. Karp
2000 SQ FT COMMERCIAL INTERIOR ALTERATION
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday, February 25, 2005
(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 f Que bu ; dnesday, February 25, 2004
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Building Permit Application
Town of Queensbury-Dept of Community Development,742 Bay Road,Queensbury,NY
•
(518)761-8256 � FEE
A permit must be obtained before beginning construction. Permit File No. 411. C
No inspection will be made until applicant has received a Fee Paid $
valid building permit. All applicants' spaces on this Rec.Fee Paid $ U
application must be completed and must appear on the Reviewed By:
application form.
Applicant: p •(0\fA tJ c)F" \' c& Owner: erou:ae-4 OFuF P L-k-
Address: a3A'2 Ro A D FST S Address:/6r4 TTrrE u c q
C�Ys�Ta AO-be-
Phone#(_) Phone#(, )31 1 - 36D-6
Property Location: Lot Number: / House Number 37.s I IAA
Subdivision Name: Tax Map NumberS.23 y-o o I b-oI1-o0.0 1-072
00v-vow
o New Building: residence /commercial Estimated Market Value of Construction: $ 7SS 000
O/Addition: residence/ co•• ial If an Addition,what will use of new addition be?
7 Alteration: residence/ . � ,►
/ No change to exterior size: - om'l
a Other work(describe
Check Occupancylnformation 1"Floor 2O0 Floor Other floor Total
Below sq.ft. sq.ft. sq.ft. Square Feet
o Single family dwelling
o Two family dwelling
a Townhouse
o Multifamily dwelling
/ #of units
a/ Office 2 000 -
o Mercantile
a Manufacturing
O 1 car detached garage
a 2 car detached garage
a 3 car detached garage
a 1 car attached garage
a 2 car attached garage
a 3 car attached garage
a Storage building-
commercial
o Storage building-
residential
a Other
What is the proposed height of the structure feet inches
Will any second-hand or ungraded lumber be used? If so,for what?
Type of Heating System: electric/ oil 4rg, wood /forced hot air/ baseboard/other:
Number of Fireplaces to be installed Number of Woodstoves to be installed
List below the person(s)responsible for supervision of work as regards to building codes:
Name Address Phone Number
Oevt P Builder flair-t-lA-t icra n ' f R� 373-2..ov
Plumber kWrKuo L Q '( -
t3Gak— Mason 13ArrA -rPsr 0 .Y_Nr. /t¢ C4 /-Pk ,3?1-2 00
,Qtre— Electrician ocerf . �„roCreic r oekot ;73 Cakt Pk 376- 953 6
Jc!�i
Declaratiow please sign below after you have carefully read the statement
To the best of my knowledge the statements contained in this application,together with the plans and specifications
submitted,are a true and complete statement of all proposed work to be done on the described premises and that all
provisions of the Building Code,the Zoning Ordinance and all other laws pertaining to the proposed work shall be complied
with,whether specified or noted,and that such work is authorized by the owner. Further,it is understood that Uwe shall
submit,prior to a Certificate of Occupancy or Certificate of Compliance being issued,as requested by the Zoning
Administrator or Director of Building and Codes,an As Built Survey by a licensed surveyor;drawn to scale,showing actual
location of all w constructio
6 Signatur , �` owner,owner's agent,architect,contractor
Tao,-
8
Commercial Final Inspection Report
P P
Office No.: (518) 761-8256 Date Inspection requ t eceiv
Queensbury Building&Code Enforcement Arrive: a p Depart: C
742 Bay Road, Queensbury,NY 12804 Inspector's Initia • <'
NAME: 1 D V' OF•F Cl l e t-" PERMIT 2 bt.4 -- Ot.5 Z
LOCATION: t k) iCAL DATE:
COMMENTS:
Y N NA
Chimney/"B"Vent/Direct Vent Location J
Plumbing Vent Through Roof 6"/Roof Complete f
Exterior Finish Grade Complete 6"in 10' or Equivalent
Interior/Exterior Guardrails 42 in.Platform/Decks
Interior/Exterior Ballisters 4 in. Spacing Platform/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 required I Exits At Grade Or Platform 36(w)x 44"(1)/Canopy or Equiv.
Gas Valve Shut-off Exposed&Regulator(18")Above Grade
Floor Bathroom Watertight/Other Floors Okay ✓/
Relief Valve,Heat Trap/Water Temp. 110 Degrees Maximum V
Boiler/Furnace Enclosure 1 hr. or Fire Extinguishing System
Fresh Air Supply for Occupancy t 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.
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
Handicapped Bath/Parking Lot Signage
Public Toilet Room Handicapped Accessible I
Handicapped Service Counters, 34 in., Checkout 36"
Handicapped Ramp/
Active Listening System and Signage Assembly Space
Final Electrical
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
Water Fountain or Cooler
Buil. __� ides b ►urface 20'wide )(/'
Oka AthiVVOIR 'ermanent C/O
Okay o su=
Last printed 6/3/2003 9:27 AML:\PamW\Building 86 Codes\Commercial Final Inspection Report.doc
. Town of Queensbury
lift
`lr Fire Marshal's Office
742 Bay Road
Queensbury, NY 12804
Phone (518)761-8205 Fax(518) 745-4437
Fire Marshal's Inspection Report
Request (;) SCHEDULE o
Received: Permit# 0 l -�Jo" INSPECTION ON: 4 5- 0
Name: 3141-k 1c-7 - Lc la ti /Hi- ci ,
AM PM ANYTIME
Location: CN \Ai't4 Mil.11 CL)
APPROVED
'! N/A YES NO COMMENTS
EXITS
AISLE WIDTHS
EXIT SIGNS-NORMAL
- BATTERY
EMERGENCY LIGHTING
FIRE EXTINGUISHERS '
FIRE ALARM SYSTEM F--) a Af\ittk,,,2ri\‘•JY7ec)In
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION , / /� k''Jt
INTERIOR FINISHES4-J &i
`G7 't ( ' 4
STORAGE
COMPRESSED GAS
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING
UNITS
CLEARANCE TO ELECTRICAL t (471:7cLe- 00
REQUIRED SIGNAGE
EMERGENCY PLAN
MAXIMUM OCCUPANCY SIGN �1
CHIMNEY i 1 v i
MASONRY ROUGH IN 1 , ))16kA l jU It '
FINAL
CHIMNEY 1
FACTORY BUILT ROUGH IN 5 t
-- I),1/'e?
FINAL ll Vica '
WOOD
STOVE ROUGH IN
FINAL
VENTED GAS
APPLIANCE ROUGH IN
FINAL
FIREPLACE
MASONRY ROUGH IN OK THIS DA OK FO CO ,:ToK .
__ -,FIREPLACE /
FACTORY BUILT ROUGH IN I SPECIE Y
_ FINAL
COMDEV/CHR1SJIWORDILETTERS2001/FIREMARSHALINSPECTIONREPORT11022001
YELLOW-OCCUPANT COPY
WHITE-BUILDING DEPARTMENT COPY
Commercial Final Inspection Report
Office No.: (518) 761-8256 Date Inspection req - ece o
Queensbury Building&Code Enforcement Arrive: • F p Depart:vii2any
742 Bay Road,Queensbury,NY 12804 Inspector's Initial : — t
NAME: (p‘)AtOF F 1)ARP PERMI . Znb4 —0. Z
LOCATION: a,)t 1,*) M F O tC' 1L_ DATE: y Z O`k-
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 Rot„
Interior/Exterior Guardrails 42 in. Platform/Decks
Interior/Exterior Ballisters 4 in. Spacing Platform/Decks ✓ U‘
Stair Handrail 34 in.—38 in./Step Risers 7"/Treads 11" N E
2/2
Vestibules For Exit doors>3000 sq. ft.
All Doors 36 in.w/Lever Handles/Panic Hardware,if required V` — VR� 2y4
Exits At Grade Or Platform 36(w)x 44"(1)/Canopy or Equiv. ✓/ �� ��Qto a
Gas Valve Shut-off Exposed&Regulator(18")Above Grade V tivk 6 •
Floor Bathroom Watertight/Other Floors Okay
Relief Valve,Heat Trap/Water Temp. 110 Degrees Maximum ✓ — \Q_S 1(W‘
Boiler/Furnace Enclosure 1 hr. or Fire Extinguishing System � �. M p^,
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 '/z 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. 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
Handiced Bathroom Grab Bars/Sinks/Toilets
andica ped Bat Parking Lot Signage
Pu lie oile boom Handicapped Accessible
Handicapped Service Counters, 34 in., Checkout 36"
Handicapped Ramp/Handrails Continuous/12 in.Beyond
Active Listening System and Signage Assembly Space /
Final Electrical
Site Plan/Variance required
Final Survey,New Structure I Flood Plain certification • es.
As-built Septic System Layout Required or On File 1:6F‘J
Building Number or Tenant Address on Building or ►'-
Water Fountain or Cooler
BuildinnAccess All Sides b 20' /Driveable Surface 20'wide
kay To Issue em . r Permanent CIO
kay o ssue
Last printed 6/3/2003 9:27 AML:\PamW\Building&Codes\Commercial Final Inspection Report.doc
Pill CD 0/31y __
Town of Queensbury ,
Fire Marshal's Office ' 07 4-- k
742 Bay Road
Queensbury, NY 12804 L gat/ 64Y'
Phone (518)761-8205 Fax(518) 745-4437 _ /
I15T i" (Obi
Fire Marshal's Inspection Report 5vo`1'-e 16,E
Request n SCHEDULE f 2 _ ,
Received: Permit# INSPECTION ON: 1 — +-
Name: Jj/J 1 tuliP\ IC AM PM ` ANYTIME
Location: 'i, ri, .
APPROVED
N/A YES NO COMMENTS
EXITS
AISLE WIDTHS •
EXIT SIGNS-NORMAL
-I
,9 ‘ft A.) Lt I , km-
BATTERY ,
EMERGENCY LIGHTING
FIRE EXTINGUISHERS /v AA- cl 1 ,6t() __,1
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM A FIRE SUPPRESSION SYSTEM r _ FUt �
�., Q I 4j IA, `�'YI i e
HOOD INSTALLATION
r , f L C,.�.!i
INTERIOR FINISHES X C�{ti.��,c�' J/V,,�� l t L n,
STORAGE X
COMPRESSED GAS X
CLEARANCE TO SPRINKLERS
Gr
CLEARANCE TO HEATING A �1 n
0-1-- s.
UNITS ! „
CLEARANCE TO ELECTRICAL S - l t C'l 1 i),'\ `-���if 1. /.1 -
REQUIRED SIGNAGE , 1 R
EMERGENCY PLAN - L ��ti� 1 l�f MAXIMUM OCCUPANCY SIGN )( J y71---.04,
CHIMNEY
MASONRY ROUGH IN K .= ti . 5 ,(fA)KI.I 5 km ( y )r-
FINAL
CHIMNEY - 44 j 0g 4'1?
FACTORY BUILT ROUGH IN 'FINAL
1 vttZ' ���� . y1It71fG2
WOOD
STOVE ROUGH IN / I
'` N L l . 7'O it 4i �l,'Z e vet-to
FINAL 11
VENTED GAS F�k -- `frj �r ,L)7�?
APPLIANCE ROUGH IN
-k..m .
FINAL
FIREPLACE -,
MASONRY ROUGH IN OK THIS D qNOT ATE OK FOR CO 0�.
FINAL
FIREPLACE (_S'�,L (, --/),
FACTORY BUILT ROUGH IN NSPECTED
FINAL • V
COMDEV/CHRISJ WORD/LETT ERS2001IFIREMARSHALINSPECTIONREPORTX1E0122001
LOW-OCCUPANT COPY
WHITE-BUILDING DEPARTMENT COPY