2012-327 ..4111a TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20120327 Date Issued: Wednesday, August 22, 2012
This is to certify that work requested to be done as shown by Permit Number P20120327
has been completed.
Location: 110 MAIN St
Tax Map Number: 523400-309-014-0001-080-000-0000
Owner: CUMBERLAND FARMS, INC.
Applicant: CUMBERLAND FARMS, INC.
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 property 4
owner of the responsibility for compliance with Site Plan, Variance, or
other issues and conditions as a result of approvals by the Planning Board Director of Building&Code Enforcement
or Zoning Board of Appeals.
010k TOWN OF QUEENSBURY
=7.` 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20120327 Application Number: A20120327
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. Commercial Alteration $200,000.00
100 CROSSING Blvd Total Value
FRAMINGHAM, MA 01702-0000 $200,000.00
Contractor or Builder's Name/Address Electrical Inspection Agency
EMCO CONSTRUCTION
518-456-1853
2050 WESTERN Ave Suite 210
GUILDERLAND NY 12084-0000
Plans&Specifications
2012-327
Comm Interior Alterations 3,816 sq ft.
$763.20 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,August 03, 2013
(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 Town trTie sbury• 4Fril :.ugust< . , 03, 2012
% .
SIGNED BY ' for the Town of Queensbury.
Director of Building&Code Enforcement
A
i'1"1010
OFFICE USE ONLY
/ 3A
TAX MAP NO.3�, 14-WO PERMIT NO. 1
FEES: PERMIT -7V)• ATION ENGINEERING JUL b 2012 •
.
(If applicable) i
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: Emco Construction OWNER: Cumberland Farms
ADDRESS:2050 Western Ave Suite 210 Guilderland NY 12084 ADDRESS: 100 Crossing Blvd Frammingham MA
PHONE NOS. 518-456-1853 PHONE NOS. (508)270-4410
CONTACT PERSON FOR BUILDING &CODES COMPLIANCE: Kevin Huntington PHONE: 518-456-1853
LOCATION OF PROPERTY: 110 Main Street
HAS THERE BEEN A SITE PLAN REVIEW; VARIANCE OR SUBDIVISION APPROVAL? D YES IN NO
IF SO, INDICATE APPLICATION NO.AND DATE OF APPROVAL:
PLEASE INDICATE MEASUREMENTS AS REQUIRED BELOW:
CHECK ALL THAT ZD H
APPLY TO YOUR z o 0 O 0 w LL O v7 v7 w w
PROJECT O <
00 O �: O =
w iL` o � U
W 0 U Z C1 F- Of— wz
z < <
to Nu) Ow Hw OI s
SINGLE FAMILY
TWO-FAMILY
MULTI-FAMILY
(NO.of UNITS )
TOWNHOUSE
BUSINESS OFFICE
RETAIL- X 3,816
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: Cumberland Farms
ESTIMATED CONSTRUCTION COST: 200,000 FUEL TYPE: NG
HEAT TYPE: Hot Air RTU *HOW MANY FIREPLACE(S): AND/OR WOODSTOVES(S):
ZONING CATEGORY: ARE THERE WETLANDS ON THIS SITE?
IS THIS A HISTORIC SITE? No
PROPOSED USE OF BUILDING OR ADDITION: Convenience Store with Gasoline Sales
ARE THERE STRUCTURES NOT SHOWN ON PLOT PLAN? No
ARE THERE EASEMENTS ON PROPERTY? No
*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 and ._•
Signed P��
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:
%r,
BUILD! CODES APPROVAL ZONING APPROVAL
3L—
DAT DATE
QUESTIONS? CALL 761-8256 OR EMAIL
codes(a�queensbury.net
Office Use Only VISIT OUR WEBSITE FOR MORE INFORMATION
www.queensbury.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
Commercial Final Inspection Report
Office No.: (518) 761-8256 Date Inspection request received: g'(,)-(4/3-ti/ Z
Queensbury Building & Code Enforcement Arrive: am/pm Depart: am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:
NAME: ar)'` ' 4�¢��t d71 PERMIT#: i / cam' 7
LOCATION: uy ti &. r& DATE:
COMMENTS:
YN NA
Chimney/"B"Vent/Direct Vent Location m r
Plumbing Vent Through Roof 6"/Roof Complete
Exterior Finish/Grade Complete 6" in 10'or Equivalent
Interior/Exterior Guardrails 42 in. Platform/Decks
Interior I Exterior Ballisters 4 in. Spacing Platform/Decks
Stair Handrail 34 in.—38 in./Step Risers 7"I Treads 11"
Vestibules For Exit doors > 3000 sq. ft.
All Doors 36 in. wiLever Handles/Panic Hardware, if required N/
Exits At Grade Or Platform 36(w)x 44°(1)/Canopy or Equiv.
Gas Valve Shut-off Exposed &Regulator(18")Above Grade 4
Fkaor Bathroom Watertight I Other Floors Okay
Relief Valve, Heat Trap I Water Temp. 110 Degrees Maximum 4r
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 ^
Stockroom/Storage/Receiving/Shipping Room (2 hr.), 1 ''A doors
> 10% > 1000 sq. ft. A�� �l cTJM5
% Hour Corridor Doors&Closers Yr
Firewalls/Fire Separation, 2 Hour, 3 Hour Complete/ Fire -"(
Dampers/Fire Doors �' _
Ceiling Fire Stopping, 3,000 sq. ft.Wood Frame ' 23 ) j[ Z1
Attic Access 30" x 20"x 30" (h), Crawl Space Access 18"x 24" L
Smoke Vents Or Fan, if required
Elevator Operation and Signage/Shaft Sealed
Handicapped Bathroom Grab Bars/Sinks/Toilets 4
Handicapped Bath/ Parking Lot Signage
Public Toilet Room Handicapped Accessible
Handicapped Service Counters, 34 in., Checkout 36"
Handicapped Ramp/Handrails Continuous/12 in. Beyond [Both
sides]
Active Listening System and Signage Assembly Space /
Final Electrical/Flex Gas Piping Bonded b�
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' e"---
Water
Water Fountain or Cooler
Building Access All Sides by 20'!Driveable Surface 20'wide
Okay To Issue Temp. or Permanent CIO
Okay To Issue C/C
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Commercial Final Inspection Report.doc Revised January 7,2008
iJi4 at 'I 7
Inspection Form
Town of Queensbury Fire Marshal C> Periodic Inspection Date:' '' -e3-I) } lime: 1�35�
742 Bay Road,Queensbury NY 12804 o Re-Inspection l�
518 761 8206/518 761 8205 CO Inspection Permit#: / ,1� A /
Fire Marshals Representative
MJ Palmer Business Name: C-w.-tL A(?cct!
Location: / /D
GK Stillman Contact: kL11 i r\I 1
Type of Inspection N/A Yes No
EXITS: Exit Access FC 1014&FC1029 , NOTES
Exit Enclosure FC 1020&FC1029
Exit Discharge FC 1024& FC1029 / s
Locks and latches FC1008& FC1029.2 y ok CJ' N
Sign:Normal FC 1011 &FC1029 �` A*�G mU C.‘1< Ji-
Sign:backup FC 1011.5.3&FC1029.7.5
AISLES: r` 1.6,..1:, NI F P •-
Main Aisle Width FC 1024/1025&FC1029.11 /'
Secondary Aisle Width FC 1025&FC1029.11 // C GrcY\Q11 crtJ NP. � n r
FIRE EXTINGUISHER: Hung FC 906 l ( +11n-F 614,n.n
Inspection of extinguisher FC 906 j
EVAC Plan FC404.6 l Y -,7-3c \ Vr-/i1Gc--Y✓r Sh�IA.---r--
TRUSS ID SIGNAGE FC 505.3 /
r,i.e
EMERGENCY LIGHTING:
����4�
Interior FC 1006.3& FC1029.8 7 •
Exterior FC 1006.3 /
Clearance to Electrical FC 605.3 /
Electric Wiring Enclosed/Labeled FC 605.3.1 6'Combustibles in Equipment Rooms FC315.2.3 /
F.D.Signage- FC 510 / � �
No Smoking Signs FC 310.3 !i ,, 1
Storage FC 315.2 0
Compressed Gas FC 3003 .."- (---'k6 k
Vehicle Impact Protection FC 312.1
Interior Finishes FC 803-804
Smoke Detectors FC 907
CO detectors FC 610
Clearance to Sprinkler/Ceiling FC 315.2.1 /
18" / 24"
EVAC SIGNS IN Rooms FC 404.6(R1 &R2)
Fuel Pump Warning Signs FC2205.6 / /
Fuel Station Emer Procedures FC2204.3.5
Exterior Storage FC 315.3 /
Vacant Buildings FC 311 REINSPECTION DUE APPROXIMATELY
21 DAYS
Insp OK NC DATE: OK NC
SYSTEMS: FC 901.6 Date
Generator Annual DATE: OK NC
Hood Installation
Elevator Semi Annual
FIRE ALARM Annual DATE: OK NC
HVAC Shutdown
.efl—r
Sprinkler System Annual
Sprinkler FDC c:o til` t like "
�I4llli,j&Cetl�s : •
Kitchen Suppression Semi Annual ,
Fuel Island Suppression Semi Annual •
Hood Cleaning 3-6-Annual h'��
Knox Box:installed/checked FC506 � "
) *0
Operating Permit, if required will be issued afterFire 10 •
Turr V —i
Completion of Inspection
Jc 2-SdcL y -fo
Commercial Final Inspection Report
Office No.: (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: 7/)1P am/pm Depart: am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: <iT
NAME: lam' 7"-e•d2a,--y,(4) PERMIT#: / ' 3 ,;)
'7
LOCATION: l/c i Mo? , � DATE: 2 - ' 1.-i
COMMENTS:
Y N NA
Chimney/13"Vent I Direct Vent Location
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 sq. ft. /
All Doors 36 in. wllever Handles I Panic Hardware, if required �h/�`
Exits At Grade Or Platform 36(w)x 44° (1)/Canopy or Equiv. i�
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 �� ����e/•
Boiler/Furnace Enclosure 1 hr. or Fire Extinguishing Systemn
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 1/2 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
Handicapped Bathroom Grab Bars/Sinks/Toilets i,,/G 2 At
Handicapped Bath I Parking Lot Signage f GA.
Public Toilet Room Handicapped Accessible ' ✓ rfi� ,2/t. j r
Handicapped Service Counters, 34 in., Checkout 36" t/-
Handicapped Ramp I Handrails Continuous/12 in. Beyond [Both
sides]
Active Listenin_g System and Signage Assembly Space
Final Electrical I Flex Gas Piping Bonded ✓ .h ec . -�^f�
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° 4—pi, i
Water Fountain or Cooler
Building Access All Sides by 20'/Driveable Surface 20'wide
Okay To Issue Temp. or Permanent C/® iJ
Okay To Issue C/C
L:\Building&Codes Forms\Building&Codeslinspection Forms\Commercial Final inspection Report.doc Revised January 7,2008
Framing / Firestopping Inspection Report - ( C)
Office No. (518) 761-8256 Date Inspection request received: S 11-)/1-2--
Queensbury
Building &Code Enforcement Arrive: _amlp Depart: am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: ') `�
NAME: , C / F) ,v flThrL m PERMIT##: -5)-7
LOCATION: f IT11 ,� te; \T INSPECT ON:
TYPE OF STRUCTURE: bt/�
1� N NIA COMMENTS:
`Framing \ "
Attic Acce 2" x 30° min's,
Jack Studs/ Headers G
Bracing /BridgingS l -�. � ,� S1.k �\ I I Ch1
Joist hangers j
Jack Posts 1 Main Beams
Exterior sheeting nailed properly
12" O.C. c�-
Headroom 6 ft. 8 in. r�
Stairwells 36 in. or more
Exterior Deck Bracing
Headroom 6 ft. 8 in. •
Notches/ Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 %(w) 16 gauge (8) 16D nails each side
Draft stopping 1,000 sq. ft. floor trusses
Anchor Bolts 6 ft. or less on center
Ice and water shield 24 inches from wall
Fire separation 1, 2, 3 hour
Fire wall 2, 3, 4 hour
Firestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side %inch or 5/8 inch Type X
Garage side 5/8 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:\Building&Codes Forms-OLD1Building&Code;\Inspec#ion Forms'Framing Firestopping Inspection Report.dOC Revised January 7,2008
Foundation Inspection Report
Office No.(518)761-8256 Date tion, :•� ed:
Queensbury Building&Code Enforcement Arrive: i :�, : Depart:
742 Bay Rd.,Queensbury,NY 12804 Inspector's Intr: s:✓,I
NAME: P. I #: I '3 a7
LOCATION: I / O NW SPECT ON:
TYPE OF STRUCTURE:
Comments
N N/A
Footings
Piers
Monolithic Slab
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on site.
Foundation/Wallpour
Reinforcement in Place
Footing Dowels or Keyway in place
Foundation Dampproofmg
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone: Q �
12 inch width Js�
6 inches above footing
6 mil poly for wet areas under slab
ill
P - . rgU• .erSlab ylL/,
PV . ast/Copper `�� Q�
oundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
Rough PlumbingI Insulation Inspection R
Report
Office No. (518) 761-8256 Date Inspectio requ- «-iv r:
Queensbury Building & Code Enforcement Arrive: -V „yr1� �.: 'art: _I - �C artp1L,
742 Bay Road, Queensbury, NY 12804 Inspector's ini i. �
NAME: C- � �M (SER c (=0 ENi 3 -ERMIT #: 1 7----.3 Z.7
LOCATION: 1 t 0 M at t _ 61LE-=_ INSPECT ON: -9 - 1 Z
PE OF STRUCTURE:
_ Y NIA
Rough Plumbing / Nail Plates
Plumbin s Vent/Vents in Place
1 % 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.1. or 10 ft. above highest connection for 15 minutes
/
Pressure Testti/'ZI
Water Supply Piping
Air/ Head
50 P.S.I for 15 minutes
Insulation / Residential Check/ Commercial Check
Tyvek or Similar Exterior Sealant
Proper Vent, Attic Vent
Door/Window Sealed No Insulation)
Duct I Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace r
Duct work sealed properly/ No duct tape I
COMMENTS:
Rough Plumbing Insulation Report revised Nov 17 2003, revised February 15, 2005, revised January 7, 2008
Framing / Firestopping Inspection Report lit t(a tg 0
Office No. (518) 761-8256 Date •Ins
Queensbury Building &Code Enforcement Arrive: (3.- ton app: