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2010-022 iA QUEENSBURY OF TOWN - - Fir742 Bay Road, NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20100022 Date Issued: Friday, March 01, 2013 This is to certify that work requested to be done as shown by Permit Number P20100022 has been completed. Location: 190 QUAKER Rd Tax Map Number: 523400-302-007-0001-041-000-0000 Owner: MB-NEW YORK INC. Applicant: HANNAFORD SUPERMARKET 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 (-DJ - owner of the responsibility for compliance with Site Plan, Variance, or 'V other issues and conditions as a result of approvals by the Planning Board ��\ Director of Building&Code Enforcement or Zoning Board of Appeals. ��` TOWN OF QUEENSBURY w's 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20100022 Application Number: A20100022 Tax Map No: 523400-302-007-0001-041-000-0000 Permission is hereby granted to: HANNAFORD SUPERMARKET For property located at: 190 QUAKER 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: MB-NEW YORK INC. Commercial Alteration $60,000.00 C/O HANNAFORD BROS. REAL ES Total Value PO BOX 1000 MS6000 $60,000.00 PORTLAND, ME 04104 Contractor or Builder's Name/Address Electrical Inspection Agency CLAY COUNTRY ENDEAVORS, LLC (802)877-2820 (802)870-1050FAX(802)31 1233 SATTERLY Rd FERRISBURG, VT 05456-0000 Plans &Specifications 2010-022 325 sq ft commercial alteration-bathrooms $50.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Wednesday, February 02, 2011 (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 o eensb sday, February 02, 2010 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement 2o2 e 7_/.... 4 `OFFICE USE ONLY TAX MAP NO. PERMIT NO. 0 4-Z I I E C E V 1E0 FEES: PERMIT /0 ---RECREATION ENGINEERING [^ �} �} _ ___EEBJ _2 2010 TOWN OF QUEENSBURY PRINCIPAL STRUCTURE: BUILDING& CODES APPLICATION FOR ZONING APPROVAL & BUILDING PE A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUAANCC�E�OF A VALID FOR CONSTRUCTION. caim APPLICANT/BUILDER: -IyQ VV02S iyL&.-C OWNER: HANINA�ro,,40 a,&S CO ADDRESS: 12.3 j SAc TEle t k 60 ADDRESS: 10 RAC WOO MF, FEwt•Is&, -c,A, VT- o-*S'‘c, PHONE NOS. SeQt-Cr)-Z8u7 PHONE NOS. - OL7a-44-Coal.. CONTACT PERSON FOR BUILDING&CODES COMPLIANCE:ALf 0 /f11(E1t3 PHONE: (i?O - 'fl-'-820 LOCATION OF PROPERTY: SUBDIVISION NAME: PLEASE INDICATE MEASUREMENTS AS REQUIRED BELOW: CHECK ALL THAT z APPLY TO YOUR 0 ty d o F PROJECT O < O 0 w w�-w O O �- w U-. LL LL W ¢ 0_0 W O . O S. o i O F,- F W Z < Q amu) NV) OU- HU 0_=06 SINGLE FAMILY TWO-FAMILY MULTI-FAMILY (NO. ) TOWNHOUSE BUSINESS OFFICE RETAIL- _/� „_/ MERCANTILE �CJj(�7 FACTORY OR INDUSTRIAL ATTACHED GARAGE(1,2,3) OTHER IF COMMERCIAL OR INDUSTRIAL-NAME nOF BUSINESS: HAWN ACcr'7ttO S jP(;� ✓11� Yl -e ESTIMATED CONSTRUCTION COST:4/16 WO FUEL TYPE: HEAT TYPE? *HOW MANY FIREPLACE(S) AND/OR WOODSTOVES(S): ZONING CATEGORY: ARE THERE WETLANDS ON THIS SITE? IS THIS A HISTORIC SITE? PROPOSED USE OF BUILDING OR ADDITION: Town of Queensbury•Community Development Office•742 Bay Road, Queensbury.NY 12804 ARE THERE STRUCTURES NOT SHOWN ON PLOT PLAN? ARE THERE EASEMENTS ON PROPERTY? `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 Builidng 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 livens:• land surveyor of all newly constructed facilities prior to issuance of a certificate of•ccupan I have r: d a,. :. e t• t • above. Signed:, . Director of Building&Codes: 761-8256(for questions QUESTIONS? CALL 761-8256 OR EMAIL regarding Building Permits,construction codes or septic codest'aaqueensbury.net systems) VISIT OUR WEBSITE FOR MORE INFORMATION Zoning Administrator: 761-8218(for questions regarding www.queensburv.net required permits,the permit process,application requirements or to schedule an appointment) r Permission is hereby granted to the above This application/proposed action described herein is Applicant to - or alter the building described found to be in accordance with the zoning Laws of herein i, :.,, .. -with said Application: the Town of Queensbury i_ Are • sIN &CODE PROVAL ZONING APPROVAL DA : DATE Office Use Only Operating Permit Issued: Yes No Occupancy Type: tkqdttnA Construction Classification: lr Assembly Occupancy limit: Special Conditions: Revised 9/22/09 Town of Queensbury•Community Development Office• 742 Bay Road, Queensbury,NY 12804 • STATE OF NEW YORK WORKERS'COMPENSATION BOARD . CERTIFICATE OF NYS'WORKERS'COMPENSATION INSURANCE COVERAGE in.Legal Nathe&Address of Insured(Use street address only) lb.Business Telephone Number of Insured . (802) 877-2820 CLAY COUNTRY ENDEAVORS LLC 1233 SATTERI,Y ROAD lc.NYS Unemployment Insurance Employer FERRISBURG VT 05456 Registration.Number of Insured Work Location of Insured(Only required if coverage is specifically Id.Federal Employer Identification Number of Insured limited to certain locations in New York State, ie., a Wrap-Up or Social Security Number Policy) 56-2487632 2.Name and Address of the Entity Requesting Proof of 3a. Name of Insurance Carrier • Coverage(Entity Being Listed as the Certificate Holder) EXCELSIOR INSURANCE COMPANY • 3b.Policy Number of entity listed in box"la" WC 199045' ' TOWN OF QUEENSBURY, NY 742 BAY ROAD 3c. Policy effective period QUEENSBURY, NY 12804 • 11/11/2009 to 11/08/2010 3d. The Proprietor,Partners or Executive Officers are • - . 0 included.in (Only cheek box If all partners/offxceis included) - • Lf all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"3" insures the business referenced above in box"la"for workers' compensation under the New York State Workers'Compensation Law.(To use this form,New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send - this Certificate of Insurance to the entity listed above as the certificate holder in box"2". • The Insurance Carrierwill also notify the above certificate holder within 10 days IF a policy is canceled due to nonpayment ofpremiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail) Otherwise,this Certificate is valid for one yeas after this form is approved by the insurance carrier or its licensed agen4 or until the policy expiration date listed in box"3c",whichever is earlier. Please Note: Upon the cancellation of the workers'compensation policy indicated on this form,if the business continues to be named on a permit,license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers'Compensation'Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. . •Approved by: ADRIENNE S DOMEY (Print name of wit h()• representative or licensed agent of insurance carrier) Approved by: i I/O • (si ) Title: COMMERCIAL LINES UNDERWRITER Telephone Number of authorized representative or licensed agent of insurance carrier. (603) 358-4556 Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-105.2.Insurance brokers are NOT authorized to issue it. vs- Commercial Final Inspection Report Office No.: (518) 761-8256 Date Inspection request =• Queensbury Building &Code Enforcement Arrive: V:1-10 am,r7rieW part: I -5O ami 742 Bay Road, Queensbury, NY 12804 Inspector's Initials NAME: PE 4` #: 16 o LOCATION: D�oZ � 'D �.R DATE: — I — t � � It E.1 Q� 3 COMMENTS: Y N NA Chimney/"B"Vent/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 f Exterior Banisters 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.w/Lever Handles/Panic Hardware,if required Exits At Grade Or Platform 36(w)x 44'(1)/Canopy or Equiv. Gas Valve Shut-off Exposed&Regulator(18")Above Grade Floor Bathroom Watertight/Other Floors Okay Relief Valve,Heat Trap I Water Temp.110 Degrees Maximum Boiler/Furnace Enclosure 1 hr.or Fire Extinguishing System Fresh Mr 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 %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 Handicapped Bath I Parking Lot Signage f Public Toilet Room Handicapped Accessible IN7 Handicapped Service Counters,34 in., Checkout 36" Handicapped Ramp/Handrails Continuous/12 in.Beyond(Both sides] Active Listening System and Signage Assembly Space Final Ell/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 Driveway4' Water Fountain or Cooler Building Access AN Sides by 20'I Driveable Surface 20'wide Okay To Issue Temp. or Permanent C/O Okay To Issue C/C L:\Building&Codes Forms%Building&CodesUnspection FonnsiCommercial Final Inspection Report.doc Revised January 7,2008 Rough Plumb' . ig 1 Insulation InspectiorrReport Office No. (518) 761-8256 Date Inspectio• r�• jr=A ed: -40111 Queensbury Building & Code Enforcement Arrive: ` = r- •art: • ='S.; a • 742 Bay Road, Queensbury, NY 12804 Inspector's In a s/57 NAME: n1C2/1PER #: LOCATI N: /70c 2 r- INSPECT ON: ;% — TYPE OF STRUCTURE: \ . . at. Y N N/A Rough Plumbing / ail Plates Plumbing Ven ents in Place 1 imum 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 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/Hot Water Piping Insulation If required unheated spaces Combustion Air Supply for Furnace Duct work sealed properly/No duct tape COMMENTS: Rough Plumbing Insulation Report.revised Nov 17 2003, revised February 15,2005, revised January 7,2008 -// /; Framing / Firestopping Inspection Re• , ' Office No. (518)761-8256 Date I vaes_ . • - - Queensbury Building &Code Enforcement Arrive: , ,�• �,� - -part: '�Lffa • 742 Bay Road, Queensbury, NY 12804 Inspector's In" r4„.. „� NAME: yI yI5 -� PERMIT#: LOCATI 0ei(' INSPECT ON: TYPE OF STRUCTURE: Y N N/A COMMENTS: Framing ' A 22" x 30" minimum Jack Studs/Headers Bracing/Bridging Joist hangers Jack Posts/Main Beams Exterior sheeting nailed properly 12"O.C. Headroom 6 ft. 8 in. 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 Forma-OLDDBuiiding&Codeslinspedion FormssFraming Furestopping Inspection Repoitdoc Revised January 7,2008 Rough Plumbing / Insulation In action Report Office No. (518) 761-8256 Date Ins ectt reque: - .: /► Queensbury Building & Code Enforcement Arrive. am/- • =• : ''�r�a • • 742 Bay Road, Queensbury, NY 12804 Insp is Initials• NAME: 4 PER T#: I -1012, LOCATION: /70 C ,kms INSCT ON:' �►��� TYPE OF STRUCTURE: 1/1, (tough Plumbing Nail Plates iumbin /Vents in Place 1 Y2 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 Air/Head 50 P.S.I for 15 minutes Insulation /Residential Check/Commercial Check �►vek or Similar Exterior Sealant Proper Vent, Attic Vent Door/Window Sealed (No Insulation) Duct/Hot Water Piping Insulation If required unheated spaces Combustion Air Supply for Furnace Duct work sealed properly/No duct tape COMMENTS: Rough Plumbing Insulation Report.revised Nov 17 2003, revised February 15,2005, revised January 7,2008