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2007-744 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number. P20070744 Date Issued: Tuesday, April 15, 2008 This is to certify that work requested to be done as shown by Permit Number P20070744 has been completed. Tax Map Number. 523400-309-014-0001-080-000-0000 Location: 110 MAIN St Owner. CUMBERLAND FARMS, INC. Applicant: CUMBERLAND FARMS, INC. This structure maybe occupied as a: Installation of Tank By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Compliance 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 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20070744 Application Number. A20070744 Tax Map No: 523400-309-014-0001-080-000-0000 Permission is hereby granted to: CUMBERLAND FARMS, INC. For property located at: 110 MAIN St 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: CUMBERLAND FARMS, INC. Installation of Tank 777 DEDHAM St CANTON, MA 02021-0000 Total value Contractor or Builder's Name/Address Electrical Inspection Agency THE TYREE COMPANY 125 COMMERCE Blvd BROOKFIELD, CT 06804-0000 Plans &Specifications 2007-744 INSTALLATION OF 4000 GALLON TANK, PIPING AND DISPENSER FOR E-85 $100.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Wednesday, December 10, 2008 (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 fD ndgy;"December 10, 2007 fl �/,�Q . a SIGNED BY ""f for the Town of Queensbury. 4' k Director of Building&Code Enforcement .. . ....... ........... ........ ............ ..... . .... �: t�� ................... / FICE USE ONLY G G , TAX MAP NO. PERMIT NO. ; FEES: PERMIT RECREATION ENGINEERING ° (if applicable) :.................... .. ..... ......: PRINCIPAL STRUCTURE: APPLICATION FOR ZONING APPROVAL &BUILDING PERMIT A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMIT FOR CONSTRUCTION. APPLICANT/BUILDER: ( (lam 7�� E cr c>AAl;/✓-1 OWNER: L'uM 6ez,4.4N.0 AA-4.as, c- ADDRESS: 12,C �'i I'r'1 n Cc- P L VL>. ADDRESS: `7 Ij.2G K'r�L"L%� C j 4lv�G� C°¢FA/iDN /VIA (aZd2! PHONE NOS. 7-4 3 740 '6 2,00 X r 271 PHONE NOS. 7 e, - g'�d �{y c x 33 f� ►_ to.51 - 2jr2' e617,1 Jo Pi q 40-,.1'2. CONTACT PERSON FOR BUILDING&CODES COMPLIANCE: A4 1644At L 0 LOCATION OF PROPERTY: L'ir rry�N Q `lAAI S% I c h SUBDIVISION NAME: PLEASE INDICATE MEASUREMENTt AS REQUIRIP BELOW: CHECK ALL THAT a a d a APPLY TO YOUR z ►-, Ix G�. m co PROJECT O .L LL� w a rOi NW o� o� airs SINGLE FAMILY TW0FAMiLY MULTI-f'AMiLY (NO.of UNITS_ TOWNHOUSE BUSINESS OFFICE RETAIL- MERCANTILE FACTORY OR INDUSTRIAL ATTACHED GARAGE(1.2.3) X �ltuV/o� lF•vd i��sN-u �t{L OTHER +vo; r e, 7-AW4- P/P /V4 A a o IF COMMERCIAL OR INDUSTRIAL-NAME OF BUSINESS: (' ✓ ��� z 4i 'd l��A2N 5 / -�r o Fviezi�t�t C�FFt /Lr�L`r ESTIMATED CONSTRUCTION COST:1�4-7.9 P,ta a FUEL TYPE: HEAT TYPE: -HOW MANS?FIREPLACE(S� AND/OR WOODSTOVES(S): ZONING CATEGORY: ARE THERE WETLANDS ON THIS SITE? /Vd IS THIS A HISTORIC SITE? Nd PROPOSED USE OF BUILDING OR ADDITION: 12-( %A rG 'Please complete a separate Application for"Fuel Burning Appliances&Chimneys'available in our office B 3-WL I,t-05 Tmon of Queensbury•Community'Development Office-742 Bay Road,Queensbury,NY 12804 ARE THERE STRUCTURES NOT SHOWN ON PLOT PLAN? f S ARE THERE EASEMENTS ON PROPERTY? {E S I acknowledge no construdion'aotivitles"shall be commenced prior to issuance of a valid permit. I certify that the application,plans,and supporting materials are,a true and complete statementldescription 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--tooccupying the facititles`proposed, I or my agents will obtain a certificate of occupancy. I also understand that,llwe are required to provide.an as-built survey-by a licensed land surveyor,of all nowly _constructed facilities prior to issuance of a certificate of occupancy. `I have read and=,agree to the ove.f- Signed Director of Buildingl&Codes 741.8266(for quesfion&regarding.Building Permits, construction COeS ar St;systiris) Zonina.iAdministrator: 761-8218(for questions regarding required permits,the permit process; applicaton requirements or to Schedule-.0h.appointmeht) ........ ................ ::.. Permission is hereby granted to the above ; This application/proposed action desallbeki Applicant to ered or alter the building ; herein Is found to be in=Ordattce with.-the- described hereinan.aocordanoe with said zoning Laws of the Town of Que"bury. Application: ; ;.BUIUDiNG.B.CODES APPROVAL ZONING APPROVAL DATA ... DATA auesrrorrS cau.761420 OR EMA L VISIT OUR Wr esITe FOR MOrA.INFORarnrM MAW--A riai net Town.of Queensbury--.Community Development 0ffice•742 Bay Road,Queensbury,MY 12804„ FIRE MARSHALS OFFICE Town of Queensbury 742 Bay Road, Queensbury, NY 12804 " Horne of Natural Beauty ... A Good Place to Live „ PLAN REVIEW Cumberland Farms Corinth Road 11/7/2007 I have reviewed the submitted drawings for the above project, and offer the following: (E85 tanks and pumps) 1) Complete permit application for FM special use permit required 2) FM office to witness tank install along with pump and all associated plumbing 3) Letter of compliance required form suppression company indicating no change necessary on application nozzles 4) FM to witness shutdown from heat detector and emergency disconnect, including activation of the fire alarm system 5) Dispensing permit from^FM office required upon completion. 6) Note: FM to advise WGF VFD of change Fire Marshal Michael J Palmer 742 Bay Road Queensbury NY 12804 518 761 8206 firemarshal@queensbury.net Fi r e M a r s h a I 's ©f f i e e • P h o n e: 518-761-8206 • F a x: 518-745-44 37 flrenzarshal@queensburu.net • zmw.queensbuEy.net MIDDLE DEPARTMENT INSPECTION AGENCY, INC. VeW 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: Cumberland Farms Date: 03/31/2008 Occupant: Unknown Location: 110 Main Street Occupancy: Queensbury, Warren Co. NY Non-Residential F Applicant: Tyrce 1 Northway Lane Latham,NY 12110 k L_ _J Raymond A. No k �' µ . 0 319 '_ 0 r Equipment: 1 - Pump; 1 Ethanol Dispe er; 1 `ol " J s _ ftov F 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,effi- of the property indicated above,this certificate shall be immediately null and void. ciency or fitness of the equipment for any particular purpose. This certificate shall in the event that this certificate becomes invalid based upon the above conditions, be valid for a period of one year from the above noted date. Should the electrical this certificate may be revalidated upon reinspection by Middle Department system to which this certificate 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 additional electrical equipment and/or the replacement of Department Inspection Agency, Inc. to initiate the inspection and revalidation any of the components installed as of the above noted date,this certificate shall be process. A fee will be charged for this service. Inspection for Permit to Occupy Fire Marshal's Office Request Rec'd Permit No. -7 f Town of Queensbury E 742 Bay Road C1h � Queensbury,NY 12804 Scheduled Inspection Date: -'C Time: Phone: (518)761-8206 Business Name: 4 Vq) Fax: (518) 745-4437 Location: T of Ins •coon N/A Yes No EXITS: Exit Access COMMENTS Exit Enclosure Exit Discharge AISLES: '' Main Aisle Width '�' Secondary Aisle Width �► `�� EXIT SIGNAGE is t� Sign—normal Sign-battery EVAC signs in rooms TRUSS ID SIGNAGE EMERGENCY LIGHTING FIRE EXTINGUISHER: Hun Inspection of extinguisher FIRE ALARM SYSTEM Fire Marsh�lp �10 GOm Fan Shutdown OK to Issue C,er xicate of OecupancY Fire Sprinkler System Fire Suppression-Vitchen q Fire Suppression-Gas Isian WR 1 ll Generator Hood Installation Elevator al ee _ Interior Finishes Fire MU SbU ora a TOWri 0f CbriiiLmsed Gas Clearanc*•to Sprinklers Clearance to Electrical Electric Wiring Enclosed/Labeled Combustible Waste Vehicle impact Protection Knox Box F.D.Si na e-Utility Rooms No Smoking Signs Maximum Occupancy Sin Emergency Evacuation Plan , . f,. Approved (if no other approvals apply,the B&C Office will issu 1 i8 C ificate of Q6cupancy) v Denied / call for Recheck Inspected by: P LAF1reMarshal\New Folder\permitto occupyform.doc 1 U to f= zUj W g 0 rr z D o U Z Lu SR-1A ZONING DISTRICT BOUNDRY RYAN STREET CR-15 ZONING DISTRICT BOUNDRY 0- a cn ® r o �' EXIST. EDGE OF PAVEMENT z LU S 060'40" E 141.00' cow EXIST, "I D" /� & "OUT" OUBLE rn EXIST. "IN" —�'a � 4 SIDED SIGN ' & "OUT" DOUBLE u SIDED SIGN g 44.4' 72.00' 1 24' ' ---------- -------- y I DECORATIVE I \� / / ( ' m LAMP(TYP I v �j .� . FOR 5) EMUING F000 STOFE Y I� 3 25 Q' I 3,816 SQUARE FEET(GFA) I • BLDG- A o ----------- h Q w EXIST. 1000 GAL. GREASE TRAP / � r BRICK PLANTER I O E) 3000 GAL. SEPTIC TANK/LIFT STATION \ < EXIS . 5' W K TO I MEET WK BY C THERS 1..— __ Q EXIST. 6' I.D. DRYWELL / T+TT \ — J ❑� EXIST. 4' DIA. SWER MH—— -- ——� EXIST. 6.5' CONC. WALK r r ®Ic 9'(TYP.) EXIST. 12'x22.5' CONC. PROPERTIES FRONTING ON RYAN STREET —� ❑ TRASH ENCLOSURE UTILIZE MUNICIPAL WATER SERVICE 2 5 R ( - " NG 1 (VERIFIED THROUGH R ARY TOWN 120 OF 02) QUEENSBURY C EXIST. HANDICAP RAMP (TYP.) ° 6' HT WOOD ST H.OCKADE I FENCER ATOP �° Lands N/F of EXIS . 15'R N EXIST. "OUT" SIGN EXIST. PAINTED STRIPING (TYN Clyde P. Benda 8 Elliott M. Qenadc c.> ST IPING �� L. 366 P. 646 O TAX MAP PARCEL 134-6-32 1 a ° EXIST. DISPENSER (8) o Lands N/F of Lands N/F of Louie Baltazar Cynthia J. Burgi James N. Murray 8 Charles 0. Sicard Lands Bal of Lands / of Lands P. of Willilm P. Bates ° PROPOSED E85 DISPENSER Aimee L. Murray L. 1170 P. 206 L. 886 P. 52 L. 1041 P. 64 L. 696 P. 550 EXIST. BOLLARD (8) EXIST, 4'x12' CONC. ISLAND (8) L. 1034 P. 106 TAX MAP PARCEL 34 34-6- TAX MAP PARCEL 134-6-37. 38. 39.1 TAX MAP PARCEL 134-6-36 Lands N/F of EXIST. COLLUN (8) TAX MAP PARCEL 134-6-33 Ronald P. Bombard b Susan 0. Bombard 23. PR(�OSED CONC. PAD TAX MAP PARCEL L. 626 P134--6-30.2. 40 21 + �.� 23 ° PROPOSED 4,000 GALLON z , . E85 U%G STORAGE TAW: EXIST. 6' HIGH k w� , o � � a PROPOSED 3" VENT RISER PRIVACY FENCE(TYP.) _ o Z 25 0' (PAINT TO MATC I G) 0 96.00' (CANOPY) - ® �' -o-- S 06d21 E EIc ❑ ❑ aA C ❑ ❑ o ❑ 25' • F o W- on ® 15 PROPOSED STAGE II VAPOR RECOVERY LINE 4� EXIST. AREA LIGHT(TYP. FOR 10) ID U; EXIST. EDGE OF WOODS (TYP.) APROX. LOCATION OF DOUBLE-WALL co 16 PT FIBERGLASS FLEXIBLE FUEL LINES EXIST. 44'x96' CONC. MAT # EXACT LOCATION UNKNOWN w/ POSITIVE LIMITING BARRIER PROPOSED DOUBLE-WALL FIBERGLASS FUEL LINES N e- #j 13 Q 171.d' EXIST. CONC. CURB 17 o � EXIST. "IN" SIGN — — — — — — — — — — _ —--EXt�T—_C�N�1#A -L_I 20'(TYP.) EXIST. 2 - 12,000 & 1 - 8,000 GALLON 40'00' 18 11M DOUBLE-WALL FIBERGLASS U/G STORAGE TANKS I I i /fir I 5'R INSTALLED 8-14-02 2 I CONC. RAMP t 19 " Total Area TP L 3 I `, NJ PT ljz _ {b °' 2,0 F. TH #j 20 I Q 1.95 Acres `� p� p\ o\ I� I�I�I 8�, I Q EXIST, N (o � (0� � o � 22' 21 1 I N 0&21' W SW O 0,01 � I � �I r Co . CURB I o I I I 4 hl I I 22 O o' I 5'R I— BASEMENT NTRANCE ( 3 5'R �' , ® # EXIST, "IN" SIGN f\ ) I O I I 91 ( I I 5 R i ,pc (TY .) �——— I 4°� '� W 14 1 0 �1 �1 10 9 8 7 N 6 5 all LASPH. VV ° °ING Br; r z z z Y a � W 0 EXIST. 12'x22.5' CCNC. ° 0 EXIST. 7'-9" x 15'-2" CONC. PAD ❑ TRASH ENCLOSURE �, w w/ TELE., AIR & VACUUM ❑p w 0 in w EXIST. FREESTANDING SIGN �G z Q z 3 w/ 4` x 10'-3" BRICK PLANTER / 3 a CD in z .................. �� v Z X w w REVISIONS 85,241.79 SQUARE FEET Main Street Corinth Road " � Ryan Street x w 14.0' 11.0' 14.0' DATE EV. BY;, `ESCRIP ` QUEENSBURY , NY : 1.95 ACRES _ Lands N/F of 10-29-07 J.C.M. ropose E85 (pump, tank & as lines "�� SCALE: 1" - 20'-0" Amerco Real Estate Company V* 1127 % DATE. October 26, 2007 L: 877 P: 076 # 16�8 Store FILE usr2/NY,pJ/V1127.db TAX MAP PARCEL 185-1-4.1.�{.2 DRAWN BY: J.C.M. Gas Station* 853187 777 Dedham street CAnton, Massachusetts 02021 CHECKED BY: 1596-1968 S I T E F> L_ .4-16% N