CC-000490-2016 TOWN OF QUEENSBURY
4k 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building& Codes (518)761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: CC-000490-2016 Date Issued: Monday, June 12, 2017
This is to certify that work requested to be done as shown by Permit Number CC-000490-2016
has been completed.
Tax Map Number: 309.13-2-31.2
Location: 151 Carey RD
Owner: HHHN
Applicant: Richard E. Jones Architects
This structure may be occupied as a: Commercial Alterations 6944 s.f.
By Order of Town Board
TOWN OF QUEENSBURY
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-000490-2016
Tax Map No: 309.13-2-31.2
Permission is hereby granted to: HHHN
For property located at: 151 Carey 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
lype of Construction
Owner Name: HHHN Business Office-Alteration $988,937.00
Owner Address: 9 CAREY RD Total Value $988,937.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Hilltop Construction
51 Crowley RD
Hudson Falls,NY 12839
Plans& Specifications
Commercial Alterations 6944 s.f.
S 1,388.80 PERMIT FEE PAID -THIS PERMIT EXPIRES: Wednesday,August 2, 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 th expiration e
Dated at the Town Quee ury; 4TU ugust 2,2016
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
` PIUNCIPAL STRUCTURE APPLICATION Office Use only
Date: 7/2112016 460
Permit No. Cc--D� -zoi to
Tax Map ID 309.13-2-31.2 Permit Fee13 dol
Zone CL1 Historic? _Yes X No Rec Fee �Y vcO Q,_4(51
Subdivision Name NIA Lot# Site Plan#
Subdivision#
Project Location 151 Carey Road,Queensbury, NY 12804
TOWN BID.RESOLUTION 86-2013: $850 recreation fee for new dwelling units—single family,duplexes/two-family, multiple family,
apartments,condominiums,townhouses,and/or manufactured&modular homes,but not mobile homes. This is in addition to the
permit fee(s).
Primary Owner(s) Hudson Headwaters Health Network
Address 9 Carey Road,Queensbury, NY 12804
Phone/Email 518-824-8622/jmccormick@hhhn.org
Applicant Richard E.Jones Associates Architects
Address 339 Aviation Road, Queensbury, NY 12804
Phone/Email 518-793-1015 i info@rejaarchitects.com
Contractor Hilltop Construction JUL 2 7 2016
Address 51 Crowley Road, Hudson Falls, NY 12839
Phone/Email 518-798-0338/alb71275@aol.com
Contact Person for Building& Codes Compliance: Richard Jones,Architect Phone 518-793-1015
TYPE OF CONSTRUCTION
,/Check all that apply New Addition Alteration l'i floor sf 2,d floor sf Total sf Height
Single Family
Two-Family
Matti-Family
(#of units
Townhouse
Business Office xx 6,944 6,944 32,
Retail -Mercantile
Factory-Industrial
Attached Garage
(1, 2, 3, 4+)
Other
Town of Queensbury Building&Codes Principal Structure Application revised January 2016
If commercial or industrial please indicate name of business West Mountain Primary Care 2
Proposed use of building or addition Health Center
Source of Heat(circle one) Gas Oil Propane Solar Other
Fireplace: Complete a separate application for Fuel Burning
Appliances&Chimneys NO
Are there structures not shown on plot plan? No
Are there easements on the property? Yes
Site Information:
a. Dimensions or acreage of lot 10.67 Acres
b. Is this a corner lot? XX Yes No
c. Will the grade be changed as a result of construction Yes xx No
d. Public water or Private well(circle one) Public Private
e. Sewer or Private Septic System(circle one) Sewer Private
Value of all work to be performed(labor or materials) $ 96/3,937
DECLARATION.-
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 /
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.
S. I 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: Richard E.Jones,Architect DATE: 7/21/2016
SIGNATURE: DATE:
7/21/2016
For office use only
Operating Permit Issued: Yes No
Occupancy Type
Construction Classification
Assembly Occupancy Limit
Special Conditions
Town of Queensbury Building&Codes Principal Structure Application Revised January 2016
FIRE MARSHAL'S OFFICE
Town of Queensbury
742 Bay Road, Queensbury, NY 12804
" Home of Natural Peouty ... A Good Place to f ivc "
PLAN REVIEW
HHHN
CC-000490-2016
151 Carey Road
6944sf fit up
Plan review based on submittals:
• Exit and emergency lighting layout appears compliant, perform
function test
• Carbon Monoxide detection is required.
• Fire extinguisher locations to be discussed with contractor
• Provide submittals for sprinkler modifications plans
• Provide drawings for fire alarm system modifications
• Provide specifications for elevator
• Verify Truss ID signage
• Verify compliant locks/latches
Michael J Palmer
Fire Marshal
742 Bay Read
Queensbury NY 12804
firemarshal@queensbury.net
Fi r c Marshal's Office • P It o rt e: 518-761-8206 Fax: 518-745-4437
fr'remarshal@@c ueensbury.net • UUM ueensburt .net