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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 ------------------------------------ 1 I , f 1 I I , I , D STOREFRONT I p I O �40' cart storage [ 1 R walk way 1 I � I I � I 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" I I I 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 ----------------------------------------------------------------------- 1 ! 1 , 1 9 1 1 1 ! I 1 1 1 ! I D STORE FRONT nQOR 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 ' �p 1 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: e ! .` GOO,SIC- earth feet 10 _ C7 meters S RECEIVE ® 3 ��