2011-084 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
CERTIFICATEF
� OCCUPANCY
Permit Number: P20110084 Date Issued: Friday, July 01, 2011
This is to certify that work requested to be done as shown by Permit-Number P20110084
has been completed.
Location: 375 BAY Rd
Tax Map Number: 523400-296-019-0001-032-000-0000
Owner: PROVIDENT BAY ROAD, LLC
Applicant: PROVIDENT BAY ROAD, LLC
This structure may be occupied as a:
Commercial Alteration By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the (Thc4.. ,,,,P
1
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: P20110084 Application Number: A20110084
Tax Map No: 523400-296-019-0001-032-000-0000
Permission is hereby granted to: PROVIDENT BAY ROAD, LLC
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 BAY ROAD, LLC
353 BROADWAY, 2ND FLR Commercial Alteration $55,000.00
SARATOGA SPRINGS, NY 128664 Total Value $55,000.00
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2011-084
1628 sq ft commercial alteration
$325.60 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,April 06, 2012
(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 a iration date.), ,. m
Dated at the Towrlfof Qu sbu ,pf 'JY day,April 06, 2011
av
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Z *6 ; N ._._ / _ OFFICE USE ONLY ii-
1 fTAX MAP NO./ PERMIT NO. L'" / '
� �FEES: PERMIT 3:2,(,67.9 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: PRov►pk.,4r P17 V4V14r OWNER: -Fp-- ..'►V i-"'r V' i mak ° L.L.L-
�-t R-1p
ADDRESS: ?)53 v.9A1' 2- p -ooh_ ADDRESS: _7 Bre a'rJ ,--'`C 2,u'4 Eta,
PHONE NOS. ?F5' —5100 04 T ?a" PHONE NOS. 'j�o - 5-1°0 txT- 3O6
CONTACT PERSON FOR BUILDING & CODES COMPLIANCE: I'L1'I4o -S PHONE: &C/ -51-17
LOCATION OF PROPERTY: 727'7 IPilk-r 12-0 WO Q U� S 13%./ + 1-iY 4200y
HAS THERE BEEN A SITE PLAN REVIEW; VARIANCE OR SUBDIVISION APPROVAL? )0 YES NO
IF SO, INDICATE APPLICATION NO. AND DATE OF APPROVAL:' -1-kX I n f.t- 51 - crie, 1 q
SL/2
PLEASE INDICATE MEASUREMENTS AS REQUIRED BELOW:
CHECK ALL THAT zz 0
APPLY TO YOUR z P rz O w O wLL, w
PROJECT i p 0 H: O = _
w a
U_ S2
w o wC! Z O I- 1- 0 � (Xwz
z < < - cn (NI ( Ow I- IL d = o6
SINGLE FAMILY
TWO-FAMILY
MULTI-FAMILY
(NO.of UNITS )
TOWNHOUSE 'i r4L .
t I_
BUSINESS OFFICE e-'-19.______
C� I ) VZ0 — t, L 247 to F-7-
RETAIL-
MERCANTILE
TRETAIL-
MERCANTILE
FACTORY OR
INDUSTRIAL
ATTACHED
GARAGE(1,2,3)
OTHER
Town of Queensbury* Community Development Office * 742 Bay Road, Queensbury NY 12804
Revised 4/14/2010
IF COMMERCIAL OR INDUSTRIAL-NAME OF BUSINESS: I 1,-t fILP-1-t 4,-- -, f J -—f (7w12-LtC--e
ESTIMATED CONSTRUCTION COST �-> ; C'C. — FUEL TYPE:
HEAT TYPE: NA-1 Otis *HOW MANY FIREPLACE(S): AND/OR WOODSTOVES(S): --
ZONING CATEGORY: ARE THERE WETLANDS ON THIS SITE? '-f0
IS THIS A HISTORIC SITE? NC
PROPOSED USE OF BUILDING OR ADDITION: 13 L,',/HI:5 OF1 rcr
ARE THERE STRUCTURES NOT SHOWN ON PLOT PLAN? i'10
ARE THERE EASEMENTS ON PROPERTY? M%
'Please complete a separate Application for"Fuel Burning Appliances&Chimneys"available in our office
I acknowledge no construction activities shall be commenced prior to issuance of a valid
permit. I 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 NY State Building Codes, local building laws and ordinances, and in
conformance with local zoning regulations. I acknowledge that prior to occupying the
facilities proposed, I or my agents will obtain a certificate of occupancy. I 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 a d agre 'to the above.
Signed // -7--2-1`/
`/ //i/
Director of Building & Codes: 761-8256 (for questions regarding Building Permits, construction codes
or septic systems)
Zoning Administrator: 761-8218 (for questions regarding required permits, the permit process,
application requirements or to schedule an appointment)
Town of Queensbury* Community Development Office * 742 Bay Road, Queensbury NY 12804
Revised 4/14/2010
Permission is hereby granted to the above This application / proposed action described
Applicant to erect or alter the building herein is found to be in accordance with the
described herein in accordance with said zoning Laws of the Town of Queensbury.
Application:
� c
BUI/: 8 CODEPROVAL ZONING APPROVAL
—
RATE •
DATE
QUESTIONS? CALL 761-8256 OR EMAIL
codes(a�queensburv.net
Office Use Only VISIT OUR WEBSITE FOR MORE INFORMATION
www.queensburv.net
Operating Permit Issued: Yes No
Occupancy Type: Construction Classification:
Assembly Occupancy Limit: Special Conditions:
Town of Queensbury * Community Development Office * 742 Bay Road, Queensbury NY 12804
2 -4.
Inspection for Permit to Occcu
Fire Marshal's Office Request Rec'd Permit No. 11-0,
Town of Queensbury � � � �
742 Bay Road �o
Queensbury,NY 12804 Scheduled inspection Date: nye: s____ ___z_c
Phone: (518)761-8206 Business Name: IZ'Ui -00 /?‘„/"----
Fax: (518)745-4437 Location: 7,5----
f
Type of Inspection N/A . Yes No
EXITS: `�
/ ,1 /A
Exit Access -�
Exit Enclosure � COMMENTS
Exit Discha,r9 a ./
C/PC-4-44firtv-&'
AISLES:
Main Aisle Width «/'
Secondary Aisle Width
EXIT SIGNAGE
Sign-normal
Sign-battery
EVAC signs in rooms
TRUSS ID SIGNAGE -..-0"
EMERGENCY LIGHTING ‘/
FIRE EXTINGUISHER:
Hung ✓'
Inspection of extinguisher .,,/
FIRE ALARM SYSTEM
Fan Shutdown
Fire Sprinkler System (FDC)
Fire Suppression-kitchen
Fire Suppression-Gas Islan
Generator
Hood Installation
Elevator
Interior Finishes 60
Storage -.--•". CA,
Compressed Gas
Clearance to Sprinklers
Clearance to Electrical -� �
Electric Wiring Enclosed/Labeled
Combustible Waste I
Vehicle Impact Protection •./
Knox Box
F.D.Signage-Utility Rooms �"
No Smoking Signs `�
Maximum Occupancy Sign `�
Emergency Evacuation Plan
pproved (If no other approvals apply,the B&C Office will issue the Certi' ate of Occupancy)
❑ Denied / call for Recheck ,
By:
Inspe -d ./s,/ / _ _�
Pr,
r
L:\FireMarshal\FM Forms Masters\permitto occupyform.doc
2 u
Commercial Final Inspection Report
Office No.: (518 761-8256 Date ins• =cl• • -• , •
*Queensbury Building&Code Enforcement Arrive: - • Depart:
e rt: a pm
742 Bay Road,Queensbury, NY 12804 Inspector's nitial :.
NAME: Pro tf PERMIT 1'01
LOCATION: DATE: / . ,
COMMENTS: .
Y N
Chimney I"B"Vent/Direct Vent Location
Plumbing Vent Through Roof 6°/Roof Complete
Exterior Finish/Grade Complete 6"in 10'or Equivalent
Interior I Exterior Guardrails 42 in.Platform/Decks F\ Agb\-\eLb
Interior I Exterior Banisters 4 in.Spacing Platform!Decks
Stair Handrail 34 in.—38 in.I Step Risers 7"/Treads 11" 11----Ob VI
Vestibules For Exit doors>3000 sq.ft.
All Doors 36 In.w1L.ever Handles/Panic Hardware,if required
Exits At Grade Or Platform 36(w)x 44"(l)/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
Boiler/Furnace Enclosure 1 hr.or Fire Extinguishing System
Fresh Nr 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 1/2 doors
10%>1000 sq.ft.
s Hour Corridor Doors&Closers
Firewalls I Fire Separation,2 Hour, 3 Hour Complete!Fire
Dampers/Fire Doors
CeilinaFire 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
Handicapped Service Counters,34 in.,Checkout 36"
Handicapped Ramp I Handrails Continuous/12 in.Beyond[Both
sides]
Active Listening System and Signage Assembly Space
Final Electrical/Flex Gas Piping Bonded
Site Plan/Variance required J�
Final Survey,New Structure/Flood Plain certification,if req. r-jh
As-built Septic System Layout Required or On File -C°Buildirj Number or Tenant Address on Building or Driveway 4' p�-
Water Fountain or Cooler 7
Building Access AIM. : • , :`,. : Surface 20'wide
F'Okay To Issue Temp. •ermanent CIO
Okay To Issue C/C )
L:1Buiding&Codes Formaknicfing&CodesVnspection FommssCommerclal Final Inspection Reportdoc Revised January 7,2008
Inspection Form
f
Town of Queensbury Fire Marshal C Periodic Inspection Date:( 0/ Time:3
742 Bay Road,Queensbury NY 12804 c Re-Inspection 4°:6518 761 8206/518 761 8205 "CO Inspection Permit#:20--ll
24arshals
Representative A'S
M almer Business Name: .2-
Location: 37.x3 9419'
GK Stillman Contact: i�� p-,/,/c__
Type of Inspection 'N/A Yes No
EXITS: Exit Access FC 1014&FC1029 NOTES
Exit Enclosure FC 1020&FC1029 .I
Exit Discharge FC 1024&FC1029 / ti\iN5i4.1 I
Locks and latches FC1008& FC1029.2 • ./ t g- /-4,a A cd'' kwit eia''2
Sign:Normal FC 1011&FC1029
Sign:backup FC 1011.5.3&FC1029.7.5
AISLES:
Main Aisle Width FC 1024/1025&FC1029.11 -.---' - , L
,1,-.4`
Secondary Aisle Width FC 1025&FC1029.11 '�-� PSCJ
FIRE EXTINGUISHER: Hung FC 906
Inspection of extinguisher FC 906 /
I
EVAC Plan FC 404.6 .., ''
TRUSS ID SIGNAGE FC 505.3 ./ V2e24-‘'e-� .. L .7!�1 =c>
EMERGENCY LIGHTING: 1.--��
Interior FC 1006.3&FC1029.8
Exterior FC 1006.3 ....
Clearance to Electrical FC 605.3 ./
Electric Wiring Enclosed/Labeled FC 605.3.1 ...0".
Combustibles in Equipment Rooms FC315.2.3 ,.J
F.D.Signage- FC 510
No Smoking Signs FC 310.3 ----"'
Storage FC 315.2 i
Compressed Gas FC 3003 ---c
Vehicle impact Protection FC 312.1 _
Interior Finishes FC 803-804 ./
Smoke Detectors FC 907 .,.--"--
CO detectors FC 610 -/
-777-— `--- Sr
Clearance to Sprinkler/Cel[ing FC 315.2.1 • !
EVAC SIGNS IN Rooms FC 404.6(R1&R2) •---•".
Fuel Pump Warning Signs FC2205.6 � . .M
Fuel Station Emer Procedures FC2204.3.5
Exterior Storage FC 315.3 REINSPECTION DUE APPROXIMATELY
Vacant Buildings FC 311 /
21 DAYS
SYSTEMS: FC 901.6 Insp OK NC DATE: OK NC
Date
Generator Annual DATE: OK NC
Hood Installation
Elevator Semi Annual
FIRE ALARM Annual / DATE: OK NC
HVAC Shutdown
Sprinkler System Annual
Sprinkler FDC 6j/ X
Kitchen Suppression Semi Annual
Fuel Island Suppression Semi Annual
Hood Cleaning 3-6-Annual
Knox Box:installed/checked FC506
Operating Permit,if required will be issued after
Completion of Inspection
HT—ieSdc
Commercial Final Inspedion eport
Offu, No.: (518) 761-8256 Date Insction ! ► ed:
Queensbury Building & Code Enforcement Arrive: a •►;/ Depart: '3,Zt= ar
742 Bay Road, Queensbu , NY 1 .:+ • Inspector's Initial+ /
NAME: }� 71‘c. f
;t /
/
17-
LOCATION: DATE:t 6) -_�
COMMENTS:
Y N NA
Chimney 1'B'Vent/Direct Vent Location
Plumbing Vent Through Roof 6"1 Roof Complete
Exterior Finish/Grade Complete 6" in 10' or Equivalent
Interior/Exterior Guardrails 42 in. Platform/Decks
Interior!Exterior Banisters 4 in. Spacing Platform 1 Decks
Stair Handrail 34 in.—38 in. /Step Risers 7"l Treads 11"
Vestibules For Exit doors> 3000 sq. ft. V'
All Doors 36 in. wlLever Handles/Panic Hardware, if required f �� t \ %\—\
Exits At Grade Or Platform 36(w) x 44' (I)/Canopy or Equiv. ✓ �/
Gas Valve Shut-off Exposed &Regulator(18")Above Grade
Floor Bathroom Watertight!Other Floors Okay
Relief Valve, Heat Trap 1 Water Temp. 110 Degrees Maximum
Boiler/Furnace Enclosure 1 hr. or Fire Extinguishing System -- i
Fresh Air Supply for Occupancy/Ventilation Combustion
Low Water Shut Off For Boilers 1 �
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.
'/. Hour Corridor Doors&Closers
Firewalls I Fire Separation, 2 Hour, 3 Hour Complete I 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, it required
Elevator Operation and Signage/Shaft Sealed
Handicapped Bathroom Grab Bars/Sinks I Toilets
Handicapped Bath/ Parking Lot Signage
Public Toilet Room Handicapped Accessible
Handicapped Service Counters, 34 in., Checkout 36"
Handicapped Ramp 1 Handrails Continuous/12 in. Beyond [Both
sides]
Active Listening System and Signage Assembly Space j
Final Electrical/Flex Gas Piping Bonded
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 4'
Water Fountain or Cooler
Building Access All Sides by 20'l Driveable Surface 20'wide
Okay To Issue Temp. or Permanent CIO
Okay To Issue C/C
L:1Building&Codes FamislBuilding&Codesllnspection Forms\Commercial Final Inspection Report_doc Revised January 7,2008
/fie
Framing / Firestopping Inspection Repot
Office No. (518) 761-8256 Date In n • • = •:' ed:
Queensbury Building &Code Enforcement Arrive: •� • ���.: •.rt: :L!{ya p
742 Bay Road, Queensbury, NY 12804 Inspector's Initi- s: - �
ry pe -
NAME: 6". fRMIT#:LOCATION: \ PECT ON:
TYPE OF STRUCTURE:
Y JN NSA
Framing COMMENTS:
fLILLL
Attic Access 22" x 30" minimum < \ \ �
Jack Studs/ Headers
Bracing 1 Bridging
Joist hangers
Jack Posts/Main Beams SSL s'- _
\�
Exterior sheeting nailed properly L�
12" O.C. \ ��i ;`1(-
Headroom 6 ft. 8 in.
Stairwells 36 in. or more -• •••—""*.um^
Exterior Deck Bracing
Headroom 6 ft. 8 in.
•
Notches/Holes 1 Bearing Walls
Metal Strapping for Notches Top Plate
1 (w) 16 gauge (8) 16D Halls each side �-' \
'
Draft stopping 1,000 sq. ft. floor trusses
Anchor Botts 6 ft. or less on center
Ice and water shield 24 inches from wall \ L � ,_‘\k‘5 v�s�LL-
Fire separation 1, 2, 3 hour tZ\ -� i��-'�� � �- \
Fire wall 2, 3, 4 hour
Firestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side 'A inch or 5/8 inch Type X
Garage side 518 inch Type X
Ceiling/wall
Windows Habitable Space/ Bedrooms
24 in. (H)
20 in. (W)
5.7 sf above / below grade
5.0 sf grade
L:\Buitding&Codes Forrns-OLD\Eui ding&Codes\Inspection FomvsFFraming Firestopping Inspection Reportdoc Revised January 7,2008
F.-/C7
Rough PlumbingI Insulation Inspection Report
Office No. (518) 761-8256 Date Ins•ection r- •nest received:
Queensbury Building & Code Enforcement Arrive: 41. 1 .W.01:- Depart: ' ro a =
742 Bay Road, Queensbury, NY 12804 Inspector's Ini a .:
NAME: ID- rota, ���;,� , PERMIT #: i�4
LOCATIO .$ ,C ge/� INSPECT ON: ADM'
TYPE OF STRUCTURE:
Y N
Rough Plumbing / Nail Plates
Plumbing Vent 1 Vents in Place
1 'A inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet I change of direction
Pressure Test
Drain /Vent
Air/Head
5 P.S.I. or 10 ft. above highest connection for 15 minutes
Pressure Test
star Supply Piping
\� Air mead
IN
r 15 e
llibinsulation
'esidenminuttial s Check/Commercial Check t
7-evrrrw imilar Exterior Sealant -- - z
-
Proper Vent, Attic Vent
Door/Window Sealed (No Insulation)
Duct/ Hot Water Piping Insulation
If required unheated spaces
ombustion Air Supply for Furnace
uct work sealed properly/ No duct tape
4/g
e
Q_I's41\,f� 11:- ...7_.: �- e`er /V
COMMENTS:
Rough Plumbing Insulation Report..revised Nov 17 2003, revised February 95,2005, revised January 7,2008
_3 of •
Rough Plumbing1 Insu ation Ins ion Report
r talon
Office No. (518)761-8258 Date Inspection - ►
Queensbury Building &Code Enforcement Arrive:\=L-1a .r—1 - '• . • . = '� a •
742 Bay Road, Queensbury, NY 12804 Inspector's Initia joir,ff
NAME: PO / jo
LOCATION: 3-75 ' _ ", I PELT ON:
TYPE OF STRUCTURE:
Y N N/AJ
Rough Plumbing/Nail Plates
Plumbing Vent/Vents in Place
114 inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet/change of direction
Pressure Test
Drain/Vent
Air/Head
5 P.S.I. or 10 ft. above highest connection for 15 minutes
Pressure Test
Water Supply Piping
�. ■ : :,•
54-'.S.I for • minutes
Insulation/ » •idential Check/Commercial Check
Tyvek or ' Oar Exterior Sealant
• T=r ent,Attic Vent
Door/Window Sealed (No Insulation) — Z
141 JWI-mF'
Duct I Hot Water Piping Insulation
If required unheated spaces ,
Combustion Air Supply for Furnace '
Itt--N
Duct work sealed properly I No duct tape e t i7t A-V vos
CORAM SI
Rough Plumbing insulation Report.revlsed Nov 17 2003,revised February 15,2005, revised January 7,2008
uki - 1'5 1301/e0 /0'- / 2 rc �.
Rough Plumbing I Ins lation Inspection Report
Office No. (518) 761-8256 Date Inspection r- • • ceiv.•:
Queensbury Building & Code Enforcement Arrive: `2cC a _ •�•-` ' =•art: . a�
742 Bay Road, Queensbury, NY 12804 Inspector's Inrtia INV
NAME: PrccL . P` " AlI1T#:
LOCATION: Pc) INSPECT ON: -2 -j/
TYPE OF STRUCTURE:
WPC-
NWRout h Plumbin• I Nail Plates ��
Plumbin• Vent/Vents in Place �'� vq.
1 % inch minimum Drain Size �■
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet/change of direction 1111��
Pressure Test
Drain /Vent
Air/Head
5 P.S.I. or 10 ft. above highest connection for 15 minutes
Pressure Test
%" water Supply Piping
( 1/ Air ead
_' � `
/ 0P:S, or 15 minutes ` �--11
, Insulation/Residential Check I Commercial Check
LT ek or milar Exterior Sealant
Proper ent, Attic Vent
Door/Window Sealed (No Insulation) Fa ‘ E,'?‘ R
Duct/Hot Water Piping Insulation vDte3V–t-tx.
If required unheated spaces
Combustion Air Supply for Furnace —
Duct work sealed properly/No duct tape AER-
COMMENTS. 17
Rough Plumbing Insulation Reportrevised Nov 17 2003, revised February 15,2005, revised January 7, 2008