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1987-751 j l a CERrnFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK i 'date December 22 , 19 87 This is to certify that work requested to be done as shown by Permit No.. 87- 751 has been compleftd. Th w structure may be occupied as a Medical €7 f f i c e r ,), ...n,p,q '--$9Q""Ll1212er Glen St ner Community Health Plan Ow l By Order Town Board ' 7OWN OF QUEENSBURY I f /T Building & Zoning Inspector BUILDING PERMIT � TOWN OF QUEENSBURY No- 87-751 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Community health Plan l N I OWNER of property located at 800 Upper Glen Street Street, Road or Ave. ~ in the Town of Queensbury, To Construct or place a Alterations at the above location in accordance to application together with plot plans and other information hereto filed and o approved and in compliance with the Town of Oueensbury Building and Zoning Ordinance. C n 1 . OWNER'S Address is John J . Nigro C . 0 Nigro Realty 63 Colvin Ave . 1� 2. CONTRACTOR or BUILDERS Name " Sano-Rubin Construction Co . , Inc , .y P . O . Box 9078 w 3. CONTRACTOR or BUILDER'S Address cc O 0 d. ARCHITECT'S Name b ~a m re S. ARCHITECTT"S Address to C rn rr 6_ TYPE of Construction — (Please indicate by X) [ 1 wood game ( 1 Masonry l ) Steel ( I 7_ PLANS and Specifications No- Alterations to retail store as per plot plan , specifications and applicatione 8. Proposed Use Alterations to store to become medical office o u5 5 . 00 C/o 300 . 00 June 1 , 88 $ PERMIT FEE PAID - THIS PERMIT EXPIRES 19 (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the town of Queensbury before the expiration date_) Dated at the Town of Queensbury this 6ttt Day of November 19 87 SIGNED BY - '� for the Town of Clueenshury Budding and Zomrg Inspector �Jou/I�! o u e►� 3 u►�t�t Application No. Permit Issued 19 BUILDING and ZONING DEPARTMENT permit Expires 19 Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation i� Queen ury, New York 12801 1 Variance No . 9ff f Site Plan Review No . i l LLL Approve S E P 2 5 1981 '-t d y : (APPLICATION FOR % r BUILDING AND ZONING PERMIT �7 1 " A PERMIT MUST BE OBTAINED BER E GI ING CONSTRUCTION . ANSWER ALL OF THE FOLLOWING * The undersigned hereby applies for a Building hermit to do the following work which will be done in accordance with the description , plans and specifications submitted , and such special conditions as may be indicated on the Permit . The owner of this property is : .Jph!►V ..J. 1V/GR© P. O. Address C. • C7 • "I& R& QC=A4jY - & 3 Goa:✓/+U ^VE . A/. Y. Tel . 4$9- 542 ! Property Location : _ Sao uPPg� 2 CaLAGI�j 57TZ4Se:T' Tax Map No . 99 / Z / ►" street number or building lot number Warne Cif applicable) C F'a7'Aa_ AgaA C,oA4A4y&jrir F eAiL-TH eLj wJ THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS . S0W0",2UadPN C4WUST. Cn , IaJG. P, d ' 01ax '7078 .ra1"SA"V A/. +/- ('51@) 4&Z. C647I Name P . O . Address Tel . No . Name of builder SEE #AeO✓+E Address '- Tel . Name of plumber A,007' Ifi1JOW10J Address Tel . -- Name of mason 4,F6 a3ute.DC.R _ Address Tel . 'MATURE OF PROPOSED WORK : * ZONING INFORMATION : Construction of a new building " A PLOT PLAN MUST BE PREPARED AND SUBMITTED , Addition to a building '" drawn reasonably to scale and attached hereto , Alteration to a building * showing clearly and distinctly all buildings , � (no change to exterior dimensions) * whether existing or proposed and indicate all Other work {describe} set-back dimensions from property lines . Give street and number or lot number and indicate * whether interior or corner lot . show location FOR DEMOLITION PERMIT , STATE SIZE AND * of water supply and location and configuration LOCATION OF STRUCTURES AFFECTED . * of septic disposal area . - * COMPLETE INFORMATION REQUIRED BELOW . wa PLA16i " size o-f property �3�2 5s Ff ft X * Existing buildings) Size. ft x zcac> ft . * A*I AO S{7 J 7` X IS Fpl = G7 l35C� SAr PROPOSED BUILDING AND USE : * Existing building s s ) Ue ��.wr - Size of new structure ft X -- ft �RETA#►L / �'.AS FU�A2�7�3N- e,AG+4ti+7" Foundation-pler/slab/crawl/partial/full " Proposed building, distance from property line (circle one ) No . of stories (habitable space ) j * Front yard 4z) 3 ft Rear yard 417 ft et Side yards t and ft Height ( grade to ridge ) /8'- O*y ft . * et fback from side street et ft If residential , no , of families * If on corner ' setback No . of rooms ( excluding baths ) ¢ " OCCUPANCY INFORMATION No . of bedrooms Noe of bathrooms PRIMARY BUILDING - Primary heating system $700F TOP' A4R ymil` * One family dwelling * Two family dwelling -Type of fuel Ei +rCM/C. Multiple dwelling / Number of units Na.. of fireplaces to be installed Permanent occupancy Will a wood stove be installed? Transient occupancy Central Air conditioning? 'rj ✓Business BUILDING STYLE, PRIMARY STRUCTURE * Industrial Ranch Contemporary Log cabin * Other 'raised ranch Mansion y ci Duplex * Ef , what will use be? slit Level Old style Bungalow f=QdFCA4L c>e Cod Cottage Other ACCESSORY BUILDING- onial Row Town House Detached garage/one car/ two car/ car ( CIRCLE ONE PLEASE ) * Attached garage/one car/ two car/ car Private storage building 'MATED MARKET VALUE OF Other TRUCTION $ � yt`s _ _ t _ _ _ _ _ _ _ TION ON BUILDING SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETEDI 1 4/86 and-vl BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATIONS : Type of construction , f-= _ _ _ ` _ . } " • nns45an�rxY $E�ki4i1�1Gr a"'aTtf 574 $I��4 dorST` Will any second--hand or ungraded lumber be used? If so , for what? Np Foundation wall material VK1577"& Thickness Depth of foundation below grade (to bottom of footing ) fx15'r1AJ& uAJ*4C1yQ10AJ Will there be a cellar?Heated or unheated? Floor sq. footage --- sq ft Will there be a basement? x10 Will any portion be used as living space? No ( If so , what portion? -- sq . ft . - - Type of use? Type of roof - slope la shed/other /G� Material. of roof BAR ddrst MJSrAt.. D,F.ICIc� s"^ 4rwt Size , wood studs — "X "" spacing = " o . c . length ft , ?R ' Joists ( floor beams ) 1st . floor --- "X spacing — "o . c . span ft . Joists ( floor beams ) 2nd . floor "X spacing.— "o , c . span ft . Overlays ( ceiling beams ) "X — spacing "o , c . span -- ft . Roof rafters "X " spacing.— o . c , span ft . Roof trusses (pre-engineered) spacing " o . c . span ft . Exterior wall finish_5_FGJT F �""r" Of what material? rAA-60AJdeY Interior wall finish cyligar ELOC44 if a garage is to be attached , describe materials to be used for FIRE SEPARATION : A.43 Is there to be an opening between garage ,and dwelling?_ Aj If so will a Fire-rated door , enclosure , and self- closing device be ,provided? /V . A . Will a flue-lined chimney be installed? ND Height above roof. N• A . ft . Depth of chimney foundation below grade h+• -A•' ft . Depth of fireplace hearth — ft . � in . Water supply - Municipal or private well M y&i c I PA [_ SEPTIC SYSTEM _ Distance from ANY private well ( including adjoining properties ft , (A separate application is necessary for any repair or new installation of septic system) aels'r 1V � ruYS1La�+l Town of Queensbury A F F I D A V I T STATE OF NEW YORK County of Warren I swear that to the best of my knowledge and belief 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 propose& work shall be complied with, whether specified or not , and that such work is authorized by the owner . SWORN TO BEFORE ME THIS Signature = - _._.ILI4 -[Owner , owner ' s agent , arcnirect . contractor day of 19 Notary Public , Warren County, N . Y . IT III It * * IT * * * * * _ * * It IT IT * * IT * * * * * * * * at * * , * * * * * * Yr * it IT * ,t SPECIAL CONDITIONS OF THE PERMIT : By------------- --- ........ -_-_-__-- - TOWN OF QUEENSSURY WARREN COUNTY , NEW YORK Application for : BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK STATE ENERGY CONSERVATION CODE A permit must be obtained before beginning work . ANSWER ALL of the following .* 20 1 . Gross floor area 2? 2? S� PidA 746' jZ""` FNA*9 Z 2 , Type of heat 0kid'577R.7Cx R X361•'r`YA4#44a }.SEA' IM pblC7WOPM 3 . Is the building mechanically cooled ? Y95 1JGa�DGS 4 , Percentage of area o £ windows and doors� Q �Cs Pf�RSEfQ PMAW 1 A . Over 16 % Only Y . Uo value of gross area of walls , roof / ceiling and floors exposed to ambient conditions 2 , Floor over heated spaces YES NO a . Are foundation walls insulated ? YES NO 1 . If YES , what is the R value ? 3 , Slab on grade YES NO a . If YES , what is the R value of insulation around perimeter of floor- ? 4 . Is basement heated ? YES NO a . R value of insulation S . Type of insulation B . Under 16 % Only 1 . R value of roof and floors exposed to ambient conditions _ jGaC 15771 JG - 9,Mt/X"6 wN 2 . R value of exterior walls &K/;577Ad& 41 3 , R value of glazed area �mm__ 4 , R value of doors �i 2 5 . R value of floors over unheated spaces • +q• ,�?GI' S7"/11jG 60 R value of slab edge insulation - unheated slab +L oV^^r* %NW 7 . R value of slab insulation - heated slab JV• A � 8 . R value of heated basement/ cellar walls ( above grade ) rra • 9 . R value of heated basement/ cellar walls ( below grade ) dtAs 10 , Type of i n s u l a t i o n WA6.L. - GATT C . Controls $ o 1 . Thermostat maximum heat setting D . Duct Systems 1 , Is duct system installed in unheated spaces ? YES NO a . If YES , R value of duct installation b , R value of duct in other areas E . Piping insulation 1 . Size of hot water or cooling carrying agent pipe *V* Aa 20 R value of pipe insulation F , Service Water Heating Co#vnp4 e$ J14O'R A&IJORCrY 1 , Performance e £ ficiencyF_ PX42P#4" '{ L*J147f A51dO1~ACE '9'odA � 19 !'a0 2 . Temperature control setting maximum G . For Swimming Pool Only 1 , Maximum heating 14* A o -- Telephone No . C678) A4oLA ( applicant ' s signature ) PRO JARIr AdAW A1GjF4K!, 5pfJ0 -R0431P^3 cv <^r4':P• 4000263 THE NEW YORK ,BOARD OF FIRE UNDERWRITERS [— to BUREAU OF ELECTRICITY I January 6 . 1988 41 STATE STREET. ALBANY NE WL7IZ1 4 2/ 7 Bate Application ,Vo. onfile x THIS CERTIFIES THAT anly the electrical eq�+ # se described befom and intradtsced by the appliewnt named on slue above sppfics[ion number is the premes is of C, f3. P . Rt i79 G. Square Shopping Center Queenebury, hTY " Medical offices in thefollowirtg location: ❑ Basement LJ lat F!. ❑ 2nd ,fy. oUtB3.dB i2-16- 87 Section Block Lot coos essrai►red on andfe""d to be in coTapliance with the requirements of this $card. FI%TLtRE FIXTURES OUTS FTAc1E5 SWITCME5 RANGES Ci7RiKIN4 DECKS bII S ENSN WASHERS EXHAUST FANS 8ry 2 r� IFiCANpt$CtNT FlW7ACEN7 V AMT. K. W- AMT. K. W, AMT. K.W. AMT. K, W. AMT, H, P- [7� 72 22 9 7.� DRYERS FURNACE MOTORS FUTURE APPLIANCE FUMES SPECIAL REC'FT TIME CLOCKS A BELL UNIT HEATERS tdLILTI pVTIET DIIMMM MT, K. W. OIL H. P, GAS H. P, AMT- ND. A. w_ G. AMT. AMP- AMT. AM►$. TRANS. AMT. H. P, SYSTEMS r' NO. OF FEeT M4T. wArrS SERVICE DISOONNECT METER of S E R V I C E.� AMT. AM►. TYPt EQUIP, X $N! 1 X 3W 9 X 3W 3 X AW NO- OF CC. COND- A. W, fa- !dl'7. OF Iti.eEG h. W. Cw, _ PER �r Of CC. CONE. OF HI-PEG. NO. iGF NEUTRA4S ii qF NW.tJft - I 200 panel ]C 2S10 At 250 1 I OTHER APPARATUS: J . A. Bradley & Sons , Inc . 9 P . O . Boat 304 Hoonlck FAlls , NY 12090 BRANCH AtwNAfsER 1 f Per ' This certificate must not be oitered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their, cradenlials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. 7.1 a/ Qu ee" i "r y BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 C}ueensbury, New Yo k 1280 dr /o BUILDING rrrs b re NAME LOCATION L3at / / ermit No . ✓ APPROVED - YES No FootingfPier Forms Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext . Porches finished Floors Interior Trim `stairs & Railings Cellar Drain "rile Concrete Floors Iilbg . Fixtures Gar . Fireproofing Door Closers Smoke Detectors Chimney INSULATION : Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION �1VEWAY APPROVAL,, nal Sull.ding Survey Next scheduled inspection ( call when ready ) Re/maayrks- /Ir/04w r Building Insp &tor 6/86 md -vl GA i f /� �e own o� �uteenshur� I II CUING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 f3ox 98 Queensbury, New York 12801 BUILDING INSPECTORS REPORT NAME L�l L0CATI4Nd .' ��, � [late 111le17 / Permit No . ✓ = - Footing/Pier Forms APPROVED YES NO Foundation Waterproofing Backfill C-F'raming Roofing Siding Ma.psonry Veneer Hugh Plumbing Relief Valves Ext . Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg . Fixtures Gar , Fireproofing Door Closers Smoke Detectors Chimney INSULATION : Foundation Floors Wa11s Ceiling FINAL ELECTR AL INSPECTION DRIVEWAY APPROVAL _ Final Building Survey � Next scheduled inspection ( call when ready ) Remarks- Building Inspector 6/86 and-vl �.,I'o wart v� �u ee ri s 6 u rt� BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. Q. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPO Tp NAME LOCATION e " Date /IyPermit No . � - ✓ = APPROVED - 'YES NO Footing/Pier Forms Foundation Waterproofing Backfill Framing Roofing Siding 1psonry Veneer Lo^Ough Plumbi Relief Valves Ext . Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg _ Fixtures Gar . Firepro ing Door Closer Smoke Dete ors Chimney INSULATI Foundat ' n Floors Walls Ceiling FINAL E TRSCAL INSPECTION DRIVEWAY APPROVAI�� Final Building Survey Next scheduled Inspection (call when ready ) Remarks- 5oL- l� 1'YZ /4"j .+os _ 02 ,p.ZA4-w's 6J86 and-vl Buil ing Inspector BUILDING KEPT. COPY OF APPLICATION FORM 46-EL, NEW YORK BOARD OF F1RE UNDERWRITERS. FILE THIS COPY WITH BUILDING DEPT. WHEN REQUIRED. TEMP, III DATE CITY dR VILLAGE f - _ . . /� . . . •- TOWNSHIP - •. . COUNTY STREET AND LE Nan o ROAD AHD POLE NO. � - i. = . ( e=.J BETWEEN WHAT TWO POLE N , CROSS STREETS IS _ PREMISE L TE } +' . :.r '�1= . • .---^. �; • :' { -: � ,/ OCCUPANT'S SECTION —BLOCK LOT e NAIRE r{ r. r++'J BUILDING ' "' . . .'. f !. !OCCUPANCY OWNERS NAME AND ADDRESS - .J : 1C.f , CURIVIEN Tell.. SUPPLIED BUILDING FROM THEIR ' y OFFICE IS NEW ❑ OLD f,� ARK D' DEFECTS IS NEW ADDITIONAL ❑ REMOVED ❑ LIST BELOW ,ALL EQUIPMENT WHIC" YOU INSTALLED Larne- NU1t"SER OF OUTLETS LLmnw FR,ecep MOTORS BRANCH .�' HEATERS CIRCUITS OFFICE USE tort t Slide Sa Axlaah't GYlrta Ytlell Raap'Ie SI"liaeh Pelrtlanx Bradiet No. TYpa Em Ma Eac No. AG«y' INSPECTION out- Sub- blow Hrae- lot 44. Inewt bd FI 8rd Fl- .r- REMARKS: LIST OTHER E*!CTR ICAL DEVICES NOT SET FORTH APOVE: DO NdT USE THIS SPACE, Ij This applii`*'N n is intended to Carat the abutla•Ilsted,awipment to be i You are autltorixed to make the ospecto but if at time of inspection there is found additional equipment not alaore listed, unpae+ion and adjasx The fee to corer the additional al equipment, as provided by the applicant. 512E OF .. MAINS 11 ECTR IC SIGN FEEDERS '/ - '-� n � TOTAL - } CHARACTER WATTS OF WORK '.� { f r EXPOSEDGAS TUBE SIGN -"'WORK TO BE COMCEALED TRANSFORMERS OF VA STARTED ` i f //L �fIJtUMBERI fCApAC17Y} COMPLETED ' SIZE OF SIGN -_ SERVICE {OVERHEAD UNDERGROUND ENTERS yf :r If i. , . BUILDING MAKEROF SIGN INSPECTFUN REQUESTED ON OR AS NEAR AS �--- POSSIBLE ' NEW ❑ OLD AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION" ALL SPACES MUST BE FILLED IN OR APPLICATION MAY RE RETURNED. DATE OF PRINT NAME AND ADDRESS APPLICATION ... { , .'"+ / f ,;f 7 NAME OF APPLICANT . - • ' >jSIGNATURE + - .- OF APPLICANT—STREET ADDRESS TELEPHONE POST OFFICE r / `s -1 ''.' j'.; , ;f- ZlP .. !• / e/ - �' I LICENSE NO, CODE .? L WHEN APPLICABLE ea.6L (REV. 1/86) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING _. _ --� _. L Aw- - ' *�:odwn f7 +G�l e+1 l2� Ca'GGI" 1 CLUEENSBUKY TOWN OFFICE 801LDtNG s.. i _. . 'BAY AT HAV: LAND ROAD QUEENSBURY, NEW YORK , 12801 TELEPHONE: (518) 792-5832 TO : The Building Department Town of Queensbury FROM : N . W . Bodenweiser , Fire Marshal - DATE : SUB : Certificate of Occupancy Name : Address : ' It is the opinion of this office that the above named premises has complied with all sections of the N . Y . S . Fire & Building Code regarding fire prevention No W . Bodenweiser Fire Marshal SETTLED 1763 . . . HOME OF NATURAL BEAUTY - . . A GOOD PLACE TO LIVE 500�own 4 ueeatj QUEENSBUKY TOWN OFFICE BUILDING k-qSzt4 , FIRE MARSHAL BAY AT HAVILAND ROAD QUEENSBURY, NEW YORK, 12801 TELEPHONE: (518) 792-5832 TO . The Building Department Town of Queensbury FROM : N . We Bodenwe:iser , Fire Marshal DATE : September 14 , 1987 SUB : Plan. Review Capital Area Community Health Pl an �? G'G`.+ J�C}7Ufl ' C 14. (" ',$ Phase # I .Details on fire related segments of plans are acceptable with notes as marred on drawings and as follows 1 . Smoke detectors should be installed in all examination rooms , service rooms and staff lounge . 2 . Two doors into storage area should be labeled " NO EXIT" . 3 , On site inspection Will determine location of fire extinguishers prior to issuance of C . O . 14 SETTLED 1763 . . . HOME OF NATURAL BEAUTY . . A GOOD PLACE TO LIVE r :+IA+r.v+�r*nIb•-.w......rirow.m- .M..+:wlx..,+. .., .,..wuw w.,-....-..a-•..,.,. .... �.r.+, AM.^rwawv., (/.ate+/+^.,aj.._.s.. wrw••..+.w.w s ......,. . ,.s,. � _y_.+....--,........-.,�,wr............._o jam( ��/ ,...,�.�. +-1,-,—_«+._ __. ...�f«�('J.. .. .�. �.. J_�_f.�,/_��.,Jy'..-,__-.....-�]-/�..F-j_•-- _—t/.'.'_'1f��,.._�. ___.._. .�`j{/��.�o �,,,.._.+.r 1/ �� V � � �,�j tip.. ..-.. .. .. 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