2002-580 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
CE OFOCCUPANCY
HT IFICATE
Permit Number: P20020580' Date Issued: Thursday,August 15,2002
This is to certify that work requested to be done,as shown by Permit Number P20020580
has been completed.
Tax Map Number: 523400-297-008-0001-025-000.0000
Location: 551 Queensbury Ave'
Owner: ADIRONDACK IP,L.L.C.
Applicant:
DOMED CATHETER
This structure may be occupied as a:
By Order of Town Board
Commercial Alteration TOWN OF QUEENSBURY
97
Director of Building&Code Lforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20020580 Application Number: A20020580
Tax Map No: 200000-000-000-0000-035-000-0000
Permission is hereby granted to: (�(� CL 1 L►�L, /���
For property located at: 604 QUEENSBURY Ave
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: MEDI-DYNE
Commercial Alteration 6,500.00
QYLTEENSBURY Ave Total Value 6,500.00
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2002-580 Joined Catheter, Inc.
Construction of onunercial Interior Alterations as per plot plan and specifications.
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,July 18,2003
(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, of Q ensb r my 18,2002
SIGNED BY �d 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. # -ScP�
No inspection will be.made until applicant has received a Fee Paid $
valid building permit. All applicants' spaces on this Rec. Fee Paid $ .
application must be completed and must appear on the Reviewed By:
application form.
Applicant: � bM!;fp Owner: yct°
Address:. A /6 �::�vi�:r a c� r_ Address:
CRRPhone# ( / Qc,��_..�, T��� ,/!0� .
� �
Phone#( ) - ,
Email Address: Email Address:
Property Location: Lot Number: / House Numb S�0 6?u
Subdivision Name: Tax Map Number:
❑ New Building: residence /commercial Estimated Market Value of Construction: $
❑ Addition: residence/ commercial If an Addition,what will use of new addition be?
X. Alteration: - residence/ commercial
No change to exterior size: residence/com'1
❑ Other work(describe )
Check OMcupancyInformation 1"Floor 2"d Floor Other floor Total
Below sq.ft. sq,ft. sq.ft. Square Feet
❑ Single family dwelling
a Two family dwelling _
❑ Townhouse
❑ Multifamily dwelling
#of units
❑ Office
❑ Mercantile
j1s( Manufacturing ,
1 car detached garage
❑ 2 car detached garage
❑ 3 car detached garage %
❑ 1 car attached garage
❑. 2 car attached garage
❑ 3 car attached garage "
❑ Storage building-
commercial
❑ Storage building-
residential
❑ Other
What is the proposeWY fight of the structure feet inches
Will any second-hand or ungraded lumber be used? If so,for what?
Type of Heating System: electric/ oil gas wood / orced hot air baseboard t othet:
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 ,
Builder i hl" '3�o ,0M.4:
Plumber
Mason
Electrician
Declaration: 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 1/we shall
submit,prior to a Certificate of Occupancy or Certificate of Compliance being issued, as requested by the Zoning
Administrator or Director of Buil g and Codes,an As Built Survey by a licensed surveyor;drawn to scale,showing actual
location of all new struc 'on.
1 '
Signature: owner,owner's agent,architect,contractor.
FINAL - COMMERCIAL INSPECTION REPORT
Request received: , 9/3/02-
1 .
Office Use
Town of Queensbury (518) 761-8256 ARRIVE am/pm: DEPART anilynn
742 Bay Road Ready at time:
Queensbury, NY 12804 Inspector's Initials
4F6 C, 1s
NAME J-6 PERMIT# 2--
—0 ,S Meet: k r
At time-, i
LOCATION
TYPE OF STRUCTURECaa jw.r,LC c.9 Atkin&w INSPECT ON(date): D /3 Notes:
N/A YES NO
ChimneyP'B"Vent/Direct Vent location
Plumbing Vent
Roof Complete COMMENTS
Exterior finish grade complete
Interior/exterior guardrails 42 in.platform./decks
Interior/exterior balusters 4 in.spacing platform/decks
Stair handrail 34 in.-38 in.
Step risers 7 1/4in.
Main door 44 in.
All others 36 in.
Lover handles
Exits at grade or platform
Canopy to cover req. exit doors
Gas valve shut-off exposed®ulator(18 in.)above grade
Floorbathroom watertight
Other floors okay
Hot water relief valve
Boiler/furnace enclosure
<250,000 BTUN`1R
250,000 BTU to 1,000,000 BTU's(1 hour)___
>1,000,000 BTU's(2 hour)
Gas furnace shut off within 30 ft. or within line of site
Oil furnace shut off at entrance to furnace area
Stockroom enclosure(1 hour),%hour door
Storage/receiving/shipping room(2 hour), 1 V7,doors
I 1/2hour doors and closers
1/4hour corridor doors and closers
Firewalls/fire separation,2 hour,3-hour complete
Fire dampers,2-hour fire wall/separation or greater_
Fire door/shutters 1 Y2 hour,3 hour C6
Ceiling fire stopping 3,000/5,000 sq. ft.
Fan shutdown,smoke vents or fan
Exit door/panic bars assembly hardware
C4f-14 61
Elevators
Elevator signage,
Handicapped bathroom grab bars/sinks/toilets
.Handicapped batb/parking lot signage
Handicapped service counters 34 in.,checkout 36 in.
Handicapped ramp/handrails continuous/12 in.beyond
Active listening system and signage assembly space
Final Electrical
Site Plan/Variance required
Final Survey,new structures
As-built septic system layout required
Okay to issue TEMPORARY C/O—Certificate of Occupancy yes no
Okay to issue PERMANENT C/O—Certificate of Occupancy yes t-, no
Okay to issue C/C—Certificate of Compliance yes no
>VE,
FINAL - COMMERCIAL INSPECTION REPORT
Request received: V y&2
Office Use
Town of Queensbury (518) 761-8256 ARRIVE 7 q° am/pm: DEPART amlpin
742.Bay Road Ready at time:
Queensbury, .NY 12804 .Inspector's Initials
Meet: Nlry
NAME 4 PERMIT# - r At time:
LOCATION �-_ 1 v
C
11Y"tiS
TYPE OF STRUCT INSPECT ON(date):
N/A'YES NO `SD ,W',
.'A Chimney/"B"Vent/Direct Vent location ;L t .
{ Plumbing Vent {J
Roof Complete COMMENTS
Exterior finish grade complete
Interior/exterior guardrails 42 in.platform/decks
Interior/exterior balusters 4 in.spacing platform/decks
Stair handrail 34 in.-38 in.
Step risers 7 3/4 in.
Main door 44 in.
All others 36 in.
Lever handles rf
Exits at grade or platform
Canopy to cover req.exit doors
Gas valve shut-off exposed®ulator(18 in.)above grade
Floor bathroom watertight
Other floors okay
Hot water relief valve
Boiler/furnace enclosure
<250,000 BTU N/R
250,000 BTU to 1,000,000 BTU's(1 hour)
>1,000,000 BTU's(2 hour}
Gas furnace shut off within 30 ft.or within line of site
Oil furnace shut off at entrance to furnace area
Stockroom enclosure(1 hour),3/4 hour door f
Storage/receiving/shipping room(2 hour), 1 Iz doors
1 '/z hour doors and closers
3/4 hour corridor doors and closers
Firewalls/fire separation,2 hour,3-hour complete
Fire dampers,2-hour fire wall/separation or greater
Fire door/shutters 1 i/z hour,3 hour
Ceiling fire stopping 3,000/5,000 sq.ft.
Fan shutdown,smoke vents or fan
Exit door/panic bars assembly hardware
Elevators
Elevator signage �Handicapped bathroom grab bars/sinks/toilets /% �`b 1 u�n�i f- U jt
Handicapped bath/parking lot signage
Handicapped service counters 34 in.,checkout 36 in. �e�a�� �oor l✓ �r
Handicapped ramp/handrails continuous/12 in.beyond
Active listening system and signage assembly space
Final Electrical
Site P1anfVariance required
Final Survey,new structures
As-built septic system layout required
Okay to issue TEMPORARY C/O—Certificate of Occupancy yes no
Okay to issue PERMANENT C/O—Certificate of Occupancy yes no
Okay to issue C/C—Certificate of Compliance yes no
FINAL -- COMMERCIAL INSPECTION REPORT
Request received: 7 t`Z-----
Office Use
Town of Queensbury (518) 761-8256 ARRIVE3�� am/pm: "DEPART am/pm
742 Bay Road Ready at time: 3.a
Queensbury, NY 1280r4 Inspector's InitialsQk
NAME C3 me d PERMIT# a?O0 'S� Meet:
At time:
LOCATION b� Ue—,
TYPE OF STRUCTURE INSPECT ON(date): 7 r A07. Notes:
NIA YES NO
Chimney/"B"Vent/Direct Vent location
Plumbing Vent
Roof Complete COMMENTS
Exterior finish grade complete
Interior/exterior guardrails 42 in.platform/decks
Interior/exterior balusters 4 in.spacing platform/decks
Stair handrail 34 in.-38 in.
Step risers 7%in. Grey
Main door 44 in.
All others 36 in.
Lever handles
Exits at grade or platform r� , �j
Canopy to cover req.exit doors jl� ;r �/rx�r lry '~ /tl J1
Gas valve shut-off exposed®ulator(18 in.)above de r
Floor bathroom watertight
�"/ °Other floors okay, �`°�"re s`�''
Hot water relief valve
Boiler/furnace enclosure
<250,000 BTU N/R
250,000 BTU to 1,000,000 BTU's(1 hour)
>1,000,000 BTU's(2 hour}
Gas fiunace shut off within 30 ft.or within line of site
Oil furnace shut off at entrance to furnace area
Stockroom enclosure(1 hour),%hour door
Storage/receiving/shipping room(2 hour), 1 1z doors
1 'Yz hour doors and closers
3f hour corridor doors and closers -
Firewalls/fire separation,2 hour,3-hour complete
Fire dampers,2-hour fire wall/separation or greater
Fire door/shutters 1 '/z hour,3 hour
Ceiling fire stopping 3,000/5,000 sq. ft.
Fan shutdown,smoke vents or fan
Exit door/panic bars assembly hardware
Elevators
Elevator signage
Handicapped bathroom grab bars/sinks/toilets
.Handicapped bath/parking lot signage
Handicapped service counters 34 in.,checkout 36 in.
Handicapped ramp/handrails continuous/12 in.beyond
Active listening system and signage assembly space
Final Electrical
Site Plan/Variance required
Final Survey,new structures
As-built septic system layout required
Okay to issue TEMPORARY C/O—Certificate of Occupancy yes no
Okay to issue PERMANENT C/O—Certificate of Occupancy yes no
Okay to issue CIC—Certificate of Compliance yes no
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 t SCHEDULE
Received: V—/2-- �_ Permit# Q6a"-� d_. INSPECTION ON:M�r�R� _._.
Dame: row .�? � AM P ANYTIME
Location: — U P,�-
APPROVED
N to YES NO COMMENTS
EXITS
AISLE WIDTHS
EXIT SIGNS-NORMAL
- BATTERY A�-e2p.��`� /I
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM y�
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM l I E
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE r G�i CID 5V
I l
COMPRESSED GAS
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING �;� ,,J �{,���� DIA
UNITS t {
� � .RECLEARANCE TO ELECTRICAL � AT/C
QUIRED SIGNAGE fa.
EMERGENCY PLAN
MAXIMUM OCCUPANCY SIGN
CHIMNEY
MASONRY ROUGH IN
FINAL /y( � l I-/ d�✓
CHIMNEY
FACTORY BUILT ROUGH IN
FINAL
WOOD r
STOVE ROUGH IN jtV
{ f F 1 e `t t�(911�
FINAL �t' a
VENTED CAS
APPLIANCE ROUGH IN
FINAL
FIREPLACE
MASONRY ROUGH IN OK THIS DATE K'FOR CO NOT OK
FINAL �=
FIREPLACE
FACTORY BUILT ROUGH IN INSPECTEDZY
FINAL
COMDEVICHRISJIWORDILETTERS200WIREMARSHALINSPECTIONREPORT111E012L20 1W_OCCUPANT COPY
WHITE-BUILDING DEPARTMENT COPY
i
1
COMMONWEALTH ELECTRICAL INSPECTION SERVICE, INC,
Main Office 176 Doe Rua Road - Manheim, PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVALI
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The conditions following governed the issuance of this certificate, and any certificate previously issued is
cancelled: -
This certificate only covers the electrical equipment and installation conditions as of date. Upon the
introduction of additional equipment or alterations, application shall be promptly made for inspection.
Inspectors of this Company shall have the privilege of making i ections at any time, and if itl
rules are violated, the Company shall have the right to v e this c t' cate
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