2004-706 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
FILE COPY
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20040706 Date Issued: Tuesday, November 02, 2004
This is to certify that work requested to be done as shown by Permit Number P20040706
has been completed.
Tax Map Number: 523400-288-012-0001-019-000-0000
Location: 1454 STATE ROUTE 9
Owner: KENNY-BROCK PARTNERSHIP
Applicant: EVERGREEN'S INDOOR GOLF CENTER
This structure may be occupied as a:
By Order of Town Board
Commercial Alteration TOWN OF QUEENSBURY
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040706 Application Number: A20040706
Tax Map No: 523400-288-012-0001-019-000-0000
Permission is hereby granted to: EVERGREEN'S INDOOR GOLF CENTER
For property located at: 1454 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. j Tvoe of Construction Value
Owner Address: KENNY-BROCK PARTNERSHIP
1454 STATE ROUTE 9 Commercial Alteration
Total Value
LAKE GEORGE, NY 12845
i
Contractor or Builders Name/Address; ;. Electrical.Inspection Agency
Plans&Specifications
2004-706 EVERGREEN INDOOR GOLF CENTER
CO1VllVIERCIAL INTERIOR ALTERATION:
$50.00 PERMIT FEE PAID-THIS PERMI'k EXPIRES: Wednesday, October 05, 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 TcGof eens ;A 4t� ay,, Oc�tober 05, 2004
3
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
A permit must be obtained before beginning construction. Permit File No.Q0Q Lr- 7�r- 70
No inspection will be made until applicant has received a Fee Paid $ ,::5jQ r g a
valid building permit. All applicants' spaces on this Roe.Fee Paid $
application must be completed and must appear on the
application form. Reviewed By:
Applicant:45M , and�Lbot 0", Va ,70wner: jf tpy I��lrt.DS
Address: 1�/6rY''S77PT� R7 T' S° - Address:, SY gf&,4 A2 AD
QQ&2 Z�y
Phone#( )aj!t- Phone.#(YA) - y.
-796 - 6691 rt3mAlas
Property Location: ,Lot Number: / House Number 4 6 /
Subdivision Name: Tax Map Number: � d' .I W-I- 9
0 Now Building. residence /commercial EsttmatedyMorkot Value of�Const-uctlon $a• A �
o Addition: residence/ co 1 Alteration: residence erei '
If an Addition what will use of new addition be ..
comm
0 No change to exterior size: res enee com'l
C) Other work(describe )
Check Occupancyluformation V Floor 284 Floor Other floor Total
Below sq.ft. sq.ft. sq.ft. Square Feet
o Single thmil dwelling
0 Two Aunfly dwellin
0 Townhouse
o Multifamily dwelling
#of units
o Office
0 Mercantile
o Maaufactutin
o ._1 car detached pmge U. -
e 2 car detached eme
(3. 3 car detached garage
ME)GE)BE
0 1 car Attached garage
0 2 car Attached game e
0 3 car attached garage
0 Storage building-
commercial
o Storage building-
residential
( Other �'O"r
What is the proposed height of the structure feet inches
Will any second-hand or ungraded lumber be used? If so,for what? /yo_
Type of Heating System: electric/ oil /(0/wood /forced hot air/ baseboard/other:
Number of Rrreytms to be installed 0Number of Rkodstovey to be installed
List below the person(s)responsible for supervision of work as regards to building codes:
Builder :
Name Address- Phone Number
Plumber - Gyv
Mason
Electrician
DeclarWow 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,anAs Built Survey by a licensed surveyor;drawn to scale,showing actual
location of all new consAraction.
Signature: owner,owner's agent,architect,contractor
flue 16 04 10: 14* Reliable Racing (6101 ivj-b-1U4 ,..�.
.•.sr.aw,...,..�_.a•r_aw......�....�W«o.s.... rw.•oe,a...era.A...rue.w--- n.+u '
Slle Flat) iZCy7�iN
Signature Page
This Page includes 113o Author:c:tti+Nt to •Act.As Agent Fetm. Engineering Pec Disrloswe. (➢tixr POMit
RespoWNlitics and Agreerrratt To Trovidt coct;Yterttat:on rey�ired.
Cctnplcte the fullowir.?if the cif rte property is not the ssir:e as the applicwlt
0wocr's Agent F'ottu
Owner:
Desigttat,�s, ��
AS regent regutdtng �. �'ariunse_� Si last _.._.as"ubclidnsior:
j For l•ax Map NO.: _ Section i§lnck i..ot
Deed Reference: ", look .3`� Pegs ii)ate
SIONA'11 t IM: _o ems..-- _------ — (C`wncr)
Complete the tclluaing it the Aj7L.1r.�P�T is Unable to attend the meeti.n,4 or wishes to be reprrsented
b'v another party,
Applicant's Agent kurim
Owner: .._.�....... _—....
As iigmre IMirg' Vanance Site Flair _-.• Subdivision
For 1'ux Map No: _ SC01,01, _ block Lot
..,... _.. Sli'rleA:['(.!RE.._..,... ..�_�t,Ownct}�!� ?'2 tc?..
Applieariuno rimy be r.tcrred to the Towa cv:rsulting engince.,for rcviea
q of w"gtic design, stoner, drainfAse, erc. as determined b the Zonin; or Plann:V Department, 1'crs for
1 engirmenng "vi(.,w smice, ,till lk: c!ta-ged directly to the applicant, Fees f'or ettgirteerirag xev r�}.
trot exceed S 1.000 wittWut notific.tio;t to the appbcant,
s t'v Othe3'ik'tpflS May he rayulred fir c moramior. or a,temdon activ;ty tub cy'acnt to ap iron al
tt tJy thr Zoning Borr3 or Planning Heard. It is the aWlicarivs tvpvnsiWiity to 66tain ar 1 add:tianal
Permits. ;
NEW Meeting Minutes D It is tits prttctict of the C:or wivi-t•Development Dept to have a
desigrinted stenographer taper record the proceedings of mw.ings r!sWv-ing tiotn aFplicatitJn, and first
minutea tr-anscriLivd from tImse tapes constitute the official record of all pramt-.tgs. If theme :s a
dr;crepency between such recoru and the handwritten rvinutes taker, by the desigmted sterogtapher, the
handmg1tr7 nttnutes almll he deemed the official record.
1,the undersigned, bane thoroughly read and understand the lastrm.ctiorss tar submbsiou, agree to
the oubmission reriuirersents and completed the checklist.
' _ /. AL
S,*N;kTVRE cal , .r' •I�:tta
Town of Queensbury
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
Received: Permit#� INSPECTI ON:
Name: _,� i'i��'Or 60 A PM ANYTIME
Location:
APPROVED
N/A, YES NO /Mi
COMMENTS
EXIT ACCESS
EXIT ENCLOSURE r
EXIT DISCHARGE MAIN AISLE WIDTHSECONDARY AISLE WIDTH
EXIT SIGN—NORMAL � J[Q EXIT SIGN-BATTERY /EMERGENCY LIGHTINGFIRE EXTINGUISHER HUNGFIRE EXTINGUISHERINSPECTIONm' Mv
FIRE EXTINGUISHER HYDRO G
FIRE ALARM SYSTEM '. d FIRE ALARM -FAN SHUTDOWN n A
FIRE SPRINKLER SYSTEM G►A I PiJ) J`�Ci I FYI
FIRE SUPPRESSION-KITCHEN r'
FIRE SUPPRESSION—GAS l A5 (ty , J00C
ISLAND , I I ���...
HOOD INSTALLATION"
INTERIOR FINISHES '
STORAGE �' e� '�. ` til�r/
COMPRESSED GAS
CLEARANCE TO SPRINKLERS A ku
/���,,� 04CLEARANCE TO ELECTRICAL I� l�tf/� v j
ELECTRIC WIRING ENCLOSED
COMBUSTIBLE WASTE
VEHICLE IMPACT PROTECTION
FIRE LANE
F.D.SIGNAGE—UTILITY ROO S
NO SMOKING SIGNS v
MAXIMUM OCCUPANCY SIGN
EMERGENCY EVAC PLAN
OK T IS DAT O O NOT OK
` ;PECTED BY
COMDEV/CHRISJ)WORDILETTERS2001/FIREMARSHALINSP C IONREPORT11022001
WHITE—BUILDING DEPARTMENT COPY YELLOW—OCCUPANT COPY
Town of Queensbury
Fire Marshal's Office
742 Bay Road
Queensbury, NY 12804
Phone (518)761-8205 Fax(518) 745-4437
Fire Marshal's Inspection Report ` 00
L
Request SCHEDULE
Received: Permit# D INSPECTION ON: O
Name: CAM PM ANYTIME
Location:
Aj S;2 Z
PPROVED
N/A. YES NO COMMENTS
EXIT ACCESS
EXIT ENCLOSURE
EXIT DISCHARGE •
MAIN AISLE WIDTH J
. 9 SECONDARY AISLE WIDTH
EXIT SIGN-NORMAL
EXIT SIGN-BATTERY
EMERGENCY LIGHTING
FIRE,EXTINGUISHER HUNG
FIRE EXTINGUISHER
INSPECTION
FIRE EXTINGUISHER HYDRO
FIRE ALARM SYSTEM
FIRE ALARM -FAN SHUTDOWN
FIRE SPRINKLER SYSTEM ek O� n � I �b�� .rn�u&t
FIRE SUPPRESSION-KITCHEN C
FIRE SUPPRESSION-GAS
ISLAND
HOOD INSTALLATION
INTERIOR FINISHES X. r
STORAGE �t �(
COMPRESSED GAS VVV
CLEARANCE TO SPRINKLERS
CLEARANCE TO ELECTRICAL M- &x1fAVMELECTRIC WIRING ENCLOSED oWuP,
N
COMBUSTIBLE WASTE 1
VEHICLE IMPACT PROTECTION
FIRE LANE X
F.D.SIGNAGE-UTILITY ROOMS
NO SMOKING SIGNS
MAXIMUM OCCUPANCY SIGN a5� �/V , Nam
EMERGENCY EVAC PLAN
a,6 �4
o 4D
OK THIS DATE K FOR_C NOT OK
IRSPEVTED BY
COMDEVICHRISJMIORDILETTERS20011FIREMARSHALINSPECTIONREP T 1022001
WHITE-BUILDING DEPARTMENT COPY ELLOW-OCCUPANT COPY
<� Commercial Final Inspection Report 0
Office No.: (518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: U, L5 am/pm Depart: am/pm
742 Bay Road,Queensbury,NY 12804 Inspector's Initials: Y/_
NAME: E �P Af C ( PERMIT M C—) w/7
LOCATION: ( I DATE: —
I COMMENTS:
Y N NA
Chimney/"B"Vent/Direct Vent Location
Plumbing Vent Through Roof 6"/Roof Com lete
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 s . ft.
All Doors 36 in. w/Lever Handles/Panic Hardware,if re u' ed --c X- -
Exits At Grade Or Platform 36 (w)x 44"(1)/Canopy or E iv.
Gas Valve Shut-off Exposed&Regulator(18" Above Gr de
Floor Bathroom Watertight/Other Floors Oka
Relief Valve,Heat Trap/Water Temp. 110 Degrees Maxin34M
Boiler/Furnace Enclosure 1 hr. or Fire Extinguishing Xystem
Fresh Air Supply for Occupancy/Ventilation Comb stion
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 Are
Stockroom/Storage/Receiving/Shipping Room(2 hr. 1 '/2 doors
> 10%> 1000 s . ft.
3/4 Hour Corridor Doors&Closers
Firewalls/Fire Separation, 2 Hour, 3 Hour omplete/Fire
Dampers/Fire Doors
Ceiling Fire Stopping, 3,000 s . ft.WoocJ rame
Attic Access 30"x 20"x 30"(h), Crawl Sp ce Access 18"x 24"
Smoke Vents Or Fan, if required
Elevator Operation and Si age/S aft Sealed
Handicapped Bathroom Grab Bar /Sinks/Toilets
Handicapped Bath/Parking Lo Si na e
Public Toilet Room Handica d Accessible
Handicapped Service Counte , 34 in., Checkout 36"
Handicapped Ramp/Handy6ils Continuous/12 in.Beyond
Active Listening System nd Signage Assembly Space
Final Electrical /
Site Plan/Variance re uired
Final Survey,New Structure/Flood Plain certification,if reg.
As-built Septic System Layout Required or On File
Building Number or Tenant Address on Buildin or Drivewa
Water Fountain or Cooler
Building Access All Sides by 20' /Driveable Surface 20' wide
flee
Okay To Issue Temp. or Permanent C/O
Okay To Issue C/Cjr�.`
Last printed 6/3/2003 9:27 AML:\PamW\Building&Codes\Commercial Final Inspection Report.doc/
Commercial Final Inspection Report
i
wc�[ K .
Office No.: (518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: 21 Sti am/pm�. Depart: am/pm
742 Bay Road, Queensbury,NY 12804 Inspector's Initials:
1
NAME: PERMIT#:
LOCATION: C QA
r �} DATE:
COMMENTS:
Y N NA
Chimney/"B"Vent/Direct Vent Location t
Plumbing Vent Through Roof 6"/Roof Complete
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 s . ft.
All Doors 36 in.w/Lever Dandles/Panic Hardware,if required !/ �y, � � �� �i3 ✓�
Exits At Grade Or Platform 36(w)x 44" (1)/Canopy or Equiv. Clujr
Gas Valve Shut-off Exposed&Regulator 18")Above Grade
Floor Bathroom Watertight/Other Floors Oka
Relief Valve,Heat Trap/Water Temp. 110 Degrees Maximum I�
Boiler/Furnace Enclosure 1 hr. 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
Stocicroom/Storage/Receiving/Shipping Room(2 hr.), 1 '/z doors
> 10%> 1000 s . ft.
3/a Hour Corridor Doors &Closers
Firewalls/Fire Separation, 2 Hour, 3 Hour Complete/Fire
Dampers/Fire Doors
'Ceiling Fire Stopping, 3,000 s . 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 Si a e/Shaft Sealed
Handicapped Bathroom Grab Bars/Sinks/Toilets / r
Handicapped Bath/Parkin Lot Si na e �]Ji�/� �C `�(, "`'y
Public Toilet Room Handicapped Accessible
Handicapped Service Counters, 34 in., Checkout 36"
Handicapped Ramp/Handrails Continuous/12 in.Beyond
Active Listening System and Signa e Assembly Space
Final Electrical
Site Plan/Variance required r !
Final Survey,New Structure/Flood Plain certification,if reg.
As-built Septic System Layout Required or On File
BuildingNumber or Tenant Address on Buildingor Drivewa
Water Fountain or Cooler
Building Access All Sides by 20' /Driveable Surface 20' wide
Okay To Issue Temp. or Permanent C/O
Okay To Issue C/C
Last printed 6/3/2003 9:27 AML:\PamW\Building&Codes\Commercial Final Inspection Report.doc
e-'
Existing Layout
6.0 j BATS, BATH 1 T
13.4 9.0
6.0 I 5.0 s.0 &4 EMPLOY. 66 9.0 FURN
�� 9.6 55 5S BATH -•4.5-__
4 4 I 43 BATH 133 10.7
i BATH B0 I 0F.5 �CITC`-H EN „3 ,2A �
OFFICE
----------------,235 - Scale
i 11.0
copy 0 I
29A 29.4 t
K:1: 1!:,atlon, 10.4
RECEIVED
com Ilr»,,•t....;11.��; c;c;:~��.its shall t
not s ,'•�c::c~vw.;? ;caL,Ming the
plans anu , .,,•.r;c:' c e in full 5.71
compliance ;a ra I,, , do:ig Codes 1 —
of New York S:ats;. a S E P 0 9
2004
1 Vx 42 TOWN OF QUEENSBURY
;ea;or al o er ea n Ar a
.• �`� '��.:-�' �`�:.. ... .. _. • n �,� .a, BUILDING AND CODE
�:'..CI 1 Y a..-�,�vergreens Indoor Golf Center
c� Gy Layout
Fire Fre
At Exit E,dt
6.0 - - -• 65 -6.5 13A 9.0 Gas-Wags
6.0 5.0 BAP{ _-:. -
55 55. Employee• b•b 9.0 hom
FURN 5.5 SS Pied Rare 8.4 BaMMPM Fum. TelepMim
BATH •-45--� verim
43 8. .. - \�,0.P
Storage Area '
Sink Area
12.8 Kitchen
1 _i_____ 79 __ ___ 713 12.4
Hood w/Class K Office
10.1
a0 �. 3((y�)x
`Y 6ra -Vv Cyr
F IN
tor
.4
Golf S
imulator
I I . . '�'r�^3'LL• sawn i
planters----- Mai�,rt(Fi
1 'x 2'
TOWN OF QUEENSRURY ea on I y r ati g e
1 (3 b es of p e) A
FIRE It�AR H `.ICJ OFFICE Evergreensln8o' or Golf Center
a, ) ` K Route 9 1468 State-Route 9 .
REVIEWED BY Queensbu
r L� plantersZ ry,NeW'York 12804
hanging baskets , company contact
Ken Reynolds
518-792-3419
a
Evergreens 2ndoor ' Center
Men's Restroom
26
i
i
4db0 1.2
i
10
� 3
v i
i
14.5
Box Wall Containing
Vent Pipe, -
36
i
® O 24
O
i
1
32"door
Evergreens Indoor o Center
Handicap Bathroom / Ladies Room
---------------------
42
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Book 613 of Deeds Page 492 EXISTING
8
IRON PIPE I
x\Sr`NG Right- of 'Way in common with others along this ores
Desicrated as' "Proposed Entrance Road on previous. surveys. i
I -o N. 840 16 W. 570 ! I
e, 1 lV
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lands now or formerly of Peter F Bailey ano. — RECENT FILL ENCROACHMENT 0993) �
Book 657 of Deeds Page 291 CONC.
EXISTING
MAP REFERENCES NOTES M IRON PIPE {`
1.MAP OF LANDS OF MOUNTAINVIEW REALTY TRUST 1. UNDERGROUND UTILITIES NOT LOCATED E h
BY COULTER B MCCORMACK OTD. APRIL 3, 1973. EXCEPT A3 SHOWN. O
1 0),
2. INFORMATION IN PARENTHESIS IS OF RECORD. �� `M
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EXISTING
t CONCRETE MONUMENT
F l
Ir CERTIFICATIONS SHALL RUN ONLY TO THE PERSONS FOR WHOM THE
W SURVEY IS PRrEPARED, ANO ON THEIR BEHALF TO THE TITLE COMPANY, - SURVEY 1'f0 F ANDS 0 F
O GOVERNMENTAL AGENCY AND LENDING INSTOFTIHE LISTED HEREON THE V E R M O N T V'V S T I NCORPORATION:
AND TO THE SUCCESSORS AND ASSIGNEES OF THE(ENDING INSTI-
TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL BOOK 638 OF.DEEDS PAGE 509 INSTITUTIONS OR SUBSEQUENT OWNERS. JOHN A. BROCK AND ON. HIS DATE
BEHALF TO FIRST AMERICAN BANK OF NEW YORK 3/22/90 SURVEY UPDATE PERFORMED. TO BE CONVEYED TO
I HEREBY CERTIFY TO AND AMERICAN TITLE INSURANCE COMPANY. ]G
ICOUNTY: s. _
Tht CERTIFICATION OF THIS THAT THIS MAP HAS BEEN PREPARED IN ACCORDANCE WITH THE 0 "•
` N UO MAP AND SURVEY IS NOT VALID UNLESS SIGNED EXISTING CODE OF PRACTICE FOR LAND SURVEYORS ADOPTED BY 3 ' WN _Or UEENSBURY WARREhL.
ICI Y
� AND SEALED WITH AN IMPRESSION SEAL. �yI tf�T QG
THE NEW PORK STATE ASSOCIATION OF PROFESSIONAL LAND - I.L. '
a UNAUTHORIZED ALTERATION OR ADDITION TO sCALt� 111 _ ^ OI DATE:DECEMBE� . I9 , 1983
m THIS SURVEY MAP IS A VIOLATION OF SECTION 7209 SURVEYORS. O V G `t
(2) OF THE NEW YORK STATE EDUCATION LAW. If a It attAarlafte
Q V Fl
W CL
LICl NtED LANE SURVEYOR-LAND PLA NNINei
O W
ONLY COPIES Of THIS MAP SIGNED WITH A RED PEN ONE EAST HIGH 8T 6AlLSTON S►A-NEW YORk-120I0
U � � wC. NO.: I
SHALL BE CONSIDERED TRUE AND VALID COPIES. ROSERT J.MecFAR r
m E P.L.S.44229
��ESE 4Afv,'.evt,� ROBERT .J. -MAC FARLAN.E .8�. . 44 2 2.9 JCS►. 83-.78...X
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