CO-000110-2016 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: CO-000110-2016
Tax Map No: 302.10-1-7
Permission is hereby granted to: UGI/AmeriGas Propane LP,Price Chopper
For property located at: 677 GLEN 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
Tyne of Construction
Owner Name: Price Chopper Certificate of occupancy $0.00
Owner Address. 677 Glen ST Total Value $0.00
Contractor or Builders Name/Address Electrical Inspection Agency
Plans&Specifications
Special Use Permit
AmeriGas Propane LP propane exchange at Price Chopper
$100.00 PERMIT FEE PAID-THIS PERMIT EXPIRES:
(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 Quee ury; F d y 2016
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
FIRE MARSHAL'S OFFICE
Town of Queensbury
742 Bay Road, Queensbury, NY 12804 C(D — 1 I(D `
"Horne of Nafurat Beauty ... A Good Place to Live "
FIRE MARSHAL SPECIAL PERMIT APPLICATION
APPLICATION TO BE SUBMITTED BEFORE BEGINNING WORK,FOR REVIEW BY THIS
OFFICE, AN OPERATING PERMIT WILL BE ISSUED UPON COMPLETION.
Business Name: PRICE CHOPPERS#40 677 GLEN STREET, QUEENSBURY, NY
Property Owner: GLEN STREET LLC
Mailing Address: PRICE CHOPPER SUPERMARKET 501 DUANESBURG RD. SCHENECTADY, NY 12306
Contact Number:
Tax map Number: Section 302.10 Block 1 Lot 7
Descri tion of scope of work: NEW VENDOR FOR EXISTING PROPANE CYLINDER EXCHANGE
CAGITS (2}. CHANGE EME
LOCATION OF PRICE CHOPPERS 677 GLEN STREET QUEENSBURY NY
PLEASE PROVIDE A SKETCH SHOWING LOCATION OF PROPOSED WORK ON THE PROPERTY
Provide Information Indicating person(s) responsible for the work:
Contractor Name: AMERIGAS PROPANE LP
Contact Number: 800-434-2323*1268
Foreman or Supervisor Name: EVAN ULSCHT
Contact Number: 518-943-3680
Owner 1 Contractor shall verify with the local Code Enforcement Official and 1 or
Fire Marshal any hold points required so proper inspections may be completed.
R E C E IV E ru""
Fi r e M a r s It a l 's Off i c e • P It o n e: 518-761-8206 • F a x: 518-745-4437
rt,)nrarsltriIQgtteerzsbtrn .riet • urrtrty. ueensbu .net
AnienGas
Anickii's Ffnpann Cnmpany
NEW INSTALLATION ACKNOWLEDGEMENT & SITE PLAN FORM
EASTERN/5598 Customer Name &
AG Area/Dist: CATSKILL, NY Store Number: PRICE CHOPPERS #40
Address, City, State, 577 UPPER GLEN STREET
Dist Phone/Fax: Zip: QUEENSBURY, NY 12804
Account#: Store Phone/Contact:
------Any questions with completing the survey,-contact-the-ACE Office at 1-800-434-2323
------------------------------------
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O �40' cart storage
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Existing (3) 18 Count propane
P
exchange cages with existing ;
jersey barriers for protection.
No electrical with in 5'of the cages,
No combustibles with in 10' of cages
18#FE with in 50' of cages,
Parking
RECEIVEru"
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INSTALL FOUNDATION: x Concrete Asphalt CAGES BOLTED DOWN: x YES NO
EXISTING VEHICLE_PROTECTION:
AUTHORITY HOLDING JURISDICTION REQUIREMENTS
Sidewalk Curb Height: Existing Curb Stop: Y N ONLY:
Other
COMPLETE ONLY IF ADDITIONAL PROTECTION REQUIRED Doors into Building:_5'_10' x 20'
13Y AHJ: To be installed if existing jersey barriers are removed Source of Ignition: x 5'_1 01 20'
Qty 4 Bollards: circle one Bolt Down oK ore Drilled Other:
(all Bollard orders must go through the ACE Off�c
Other Protection: Bollards cannot be installed until the Spring. NOTE: 36" minimum required for handicap access
FIRE EXTINGUISHER—18 [b B,C REQU[RED:
CAGE CAPACITY&QTY: 12CT 3 18CT NO x YES DISTANCE FROM CAGE: 50' FT
An 18 pound Dry Chemical BC rated extinguisher will be
supplied by AmeriGas if two or more cages are set and/or the
SURVEY DATE: Authority Holding Jurisdiction requires.
AMERICAS EMPLOYEE
STORE MANAGER SIGNATURE:
SIGNATURE: AM CODE:
n-Ga
America's Propasic Cnmpany
NEW INSTALLATION ACKNOWLEDGEMENT & SITE PLAN FORM
EASTERN/5598 Customer Name &
AG Area/Dist: CATSKILL, NY Store Number: PRICE CHOPPERS #40
Address, City, State, 677 UPPER GLEN STREET
Dist Phone/Fax: Zip: QUEENSBURY, NY 12804
Account#: Store Phone/Contact:
Any questions with completing the survey, contact the ACE Office at 1-800-434-2323
-------------------------------------------------------------------
D STOREFRONT
DOOR DOOM
0 4D' cart storage
R
walk way
a
Existing (3) 18 Count propane
exchange cages with existing
jersey barriers for protection.
No electrical with in 5'of the cages,
No combustibles with in 10' of cages
18#FE with in 50'of cages.
RECEIVED Parking
z a
INSTALL FOUNDATION: x Concrete As halt CAGES BOLTED DOWN: x YES NO
EXISTING VEHICLE PROTECTION:
AUTHORITY HOLDING JURISDICTION REQUIREMENTS
Sidewalk Curb Height: Existing Curb Stop: Y N ONLY:
Other
COMPLETE ONLY IF ADDITIONAL PROTECTION REQUIRED Doors into Building: 5101 x 20'
BY AHJ: To be installed if existing jersey barriers are removed Source of Ignition: x 5' 10' 20'
Qty 4 Bollards: circle one Bolt Down or are Drilled Other:
(all Bollard orders must go through the ACE Offic
Other Protection: Bollards cannot be installed until the Spring. NOTE: 36" minimum required for handicap access
FIRE EXTINGUISHER—18 Ib B,C REQUIRED:
CAGE CAPACITY& QTY: 12GT 3 18CT NO x YES DISTANCE FROM CAGE: 50' FT
An 18 pound Dry Chemical BC rated extinguisher will be
supplied by AmeriGas if two or more cages are set and/or the
SURVEY DATE: Authority Holding Jurisdiction requires.
AMERIGAS EMPLOYEE
STORE MANAGER SIGNATURE:
SIGNATURE: AM CODE:
AnienGw-
Americas Propene Gompaay
NEW INSTALLATION ACKNOWLEDGEMENT & SITE PLAN FORM
EASTERNI5598 Customer Name &
AG Area/Dist: CATSKILL, NY Store Number: PRICE CHOPPERS #40
Address, City, State, 677 UPPER GLEN STREET
Dist Phone/Fax: Zip: QUEENSBURY, NY 12804
Account#: Store Phone/Contact:
_Any questions with completing the survey, contact the ACE Office at 1-800-434-2323
-----------------------------------------------------------------------
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D STORE FRONT
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I
1 I
O 40' cart storage
1
R walk way `
1
1
Existing (3) 18 Count propane
exchange cages with existing
jersey barriers for protection.
No electrical with in 5'of the cages,
No combustibles with in 10' of cages
18#FE with in 50'of cages.
RECEIVE Parking '
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i e
i
Z
i
1
1
1
INSTALL FOUNDATION: x Concrete As halt CAGES BOLTED DOWN: x YES NO
EXISTING VEHICLE PROTECTION:
AUTHORITY HOLDING JURISDICTION REQUIREMENTS
Sidewalk Curb Height: Existing Curb Stop: Y N ONLY:
Other
COMPLETE ONLY IF ADDITIONAL PROTECTION REQUIRED Doors into Building:_5'_1 0' x 20'
BY AHJ: To be installed if existing jersey barriers are removed Source of Ignition: x 5'_1 0 20'
Qty 4 Bollards: circle one Bolt Down or ore Drilled Other:
(all Bollard orders roust go through the ACE OfFic
Other Protection: Bollards cannot be installed until the Spring. NOTE: 36" minimum required for handicap access
FIRE EXTINGUISHER—18 Ib B,C REQUIRED:
CAGE CAPACITY&QTY: 12CT 3 18CT NO x YES DISTANCE FROM CAGE: 50' FT
An 18 pound Dry Chemical BC rated extinguisher will be
supplied by AmeriGas if two or more cages are set and/or the
SURVEY DATE: Authority Holding Jurisdiction requires.
AMERIGAS EMPLOYEE
STORE MANAGER SIGNATURE:
SIGNATURE: AM CODE:
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GOO,SIC- earth feet 10 _
C7 meters
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RECEIVE ®
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