CC-000488-2016 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: CC-000488-2016 Date Issued: Tuesday, October 18, 2016
This is to certify that work requested to be done as shown by Permit Number CC-000488-2016
has been completed.
Tax Map Number: 302.6-1-64
Location: 54 QUAKER RD
Owner: TD Bank
Applicant: Bergmann Associates
This structure may be occupied as a:Commerical Interior Alterations 3000 s.f.
TD Bank By Order of Town Board
TOWN OF QUEENSJ
BURY
Issuance of this Certificate of Occupancy DOES NOT relieve the /�
property owner of the responsibility for compliance with Site Plan,
Variance,or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
r' 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development - Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: CC-000488-2016
Tax Map No: 302.6-1-64
Permission is hereby granted to: TD Bank
For property located at: 54 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
Owner Name: TD Bank Business Office_Alteration $250,000.00
Owner Address: 17000 Horizon Way Total Value $250,000.00
Mount Laurel,NJ 08054
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
Commerical Interior Alterations 3000 s.f..
$ 600.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Friday,July 28, 2017
(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 o ensbury; Th da 28, 2016
4
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
PRINCIPAL STRUCTURE APPLICATION Office Use Only
Date: Permit No.
Tax Map ID Permit Fee A boo
Zone G 1 Historic? _Yes X No Rec Fee lryziw_ ybo
Subdivision Name Lot# Site Plan#
Project Location Subdivision
SOWN SD.RESOLUTION 96-2013: $850 recreation Fee for new dwelling units—single family,duplexes/two-family,multiple family,
apartments,condaminiums,townhouses,and/or manufactured&modular homes,but not mobile homes. This is In addition to the
permit fee(s).
Primary Owner(s)
Address 17 00 W4247&•j K00JV LAGt Z6-L— tiJ 09O5+
Phone/EmaiI 6tq _ 4-4As --7 333 I'd
Applicant , y
Address 5M 4-30Nsr r J p �q
Phone/Ernail ��� �� .�n n �.•�rn
Contractor
Address
Phone/Email
Contact Person for Building& Codes Compliance: DTC~ �1F'l�Acr�} Phone $ =74$ ,
TYFr OF CONS'T'RUCTION
✓Check all that apply New Addition Alteration Ist floor sf 2"floor sf Total sf Height
Single Family
Two-Family
Multi-Family
(#of units--)
Townhouse
Business Office
,r' 3 o6a 3,ona
Retail-Mercantile
Factory-Industrial
Attached Garage
(1, 2, 3, 4-i-) 076
Other
Town of Queensbury Building&Codes Principal Structure Application revised January 2016
K '
If commercial or industrial please indicate name of business
Proposed use of building or addition �1�
Source of Beat(circle one) s OR Propane Solar Other
Fireplace: Complete a separate application for Fuel Burning
Appliances&Chimneys
Are there structures not shown on plot plan? N/A'
Are there easements on the property? 1,11A
Site Information:
a. Dimensions or acreage of lot
b. Is this a corner lot? Yes No
c. Will the grade be changed as a result of construction Yes No
d. Public water or Private well(circle one) li Private
e. Sewer or Private Septic System(circle one) a Private
Value of all work to be performed(labor or materials) $ dt
&ECL4RATION
1. I acknowledge no construction shall be commenced prior to issuance of a valid permit and will be
completed within a 12 month period.
2. If work is not complete by the 1 year expiration date the permit may be renewed,subject to fees and
department approval.
3. I certify that the application, plans and supporting materials are a true and complete statement i
description of the work proposed, that all work will be performed in accordance with the NYS
Building Codes,local building laws and ordinances,and in conformance with local zoning regulations
4. I acknowledge that prior to occupying the facilities proposed,I or my agents will obtain a certificate
of occupancy.
5. 1 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 agree to the above:
PRINT NAME: DATE: 7121 l�
SIGNATURE: DATE:
For office us
Operating Permit Issued: Yes No
Occupancy Type
Construction Classification
Assembly Occupancy Limit
Special Conditions
Town of Queensbury Building&Codes Principal Shucture Application Revised January 2016