2013-554 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20130554 Date Issued: Friday, March 21, 2014
This is to certify that work requested to be done as shown by Permit Number P20130554
has been completed.
Location: 406 CORINTH Rd
Tax Map Number: 523400-308-016-0001-001-000-0000
Owner: VITO J. CAVALLARI
Applicant: MIA PIZZERIA
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 /� �//�
owner of the responsibility for compliance with Site Plan,Variance, or �Q �y`�
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
EE�
` a 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20130554 Application Number: A20130554
Tax Map No: 523400-308-016-0001-001-000-0000
Permission is hereby granted to: MIA PIZZERIA
For property located at: 406 CORINTH 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: VITO J. CAVALLARI Commercial Alteration $285.00
406 CORINTH Rd
QUEENSBURY,NY 12804 Total Value $285.011
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2013-554 MIA PIZZERIA
Comm. Alterations -remove 1 wall
$75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,December 04,2014
(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 ex iration date.)
Dated at the To of Q sb ; :441 i ; 1 ecember 04,2013
SIGNED BY - for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
Town of Queensbury Building & Codes
Received:
PRINCIPPermit No.:AL STRUCTURE APPLICATION Per N 1 g 1 ID- I-
� /3-55
A permit must be obtained before beginning construction Permit Fee: $ 7514b
Please read: 'TB resolution 86-2013(1-28-2013): $850 recreation fee for new dwelling 'Rec Fee: $ /j`f
units, including single-family dwellings,duplexes or two-family dwellings, multiple family Site Plan No.:
•
dwellings, apartments, condominiums, townhouses, and/or manufactured and modular Subdivision No.:
homes,but not includingmobile homes. This is in addition to the permit fee. /� /
Date /2,3//3 Applicant 62c.)4o Ana_
Tax Map ID Address 1379/ &/,h n Ccsn nl
Zoning tc-rt Inn 4V/ /2,02'7
- Phone/E-mail (S/( .1St-,P7/6 ee 7/
c/ (s/t� t 6.y9 —1-3
Property Owner I/ TO Cdr_vo.JAfce/ Contractor/Agent
Address Address
Phone/E-mail (v .3.?-5 h;sti Phone/E-mail
•
Contact Person for Building&Code Compliance: Day Phone:
Building Street Address: 9,0(0 CO3i11/i Ed
Subdivision Name: - - /j17 Lot#: Historic Site: Yes No
Estimated cost of construction: $ I Are".
UL
Type of Construction:
Check all that apply Please indicate measurements as required below:
0 C
Z :o m 1st Floor 2nd Floor Other Total Height
-0
Q Q
Single Family
Two-Family
Multi-Family(#of
units )
Townhouse
Business Office
Retail-Mercantile
Factory-Industrial
Attached Garages(# )) 1
O
Other _sGal/c
�L/ - fib aUM"a- 'Ode -
Town of Queensbury Building&Codes Principal Structure Packet 518-761-8256
If commercial or industrial indicate name of business /17/'0.— P/Z Z2r/iks
Proposed use of building or additioncp/
Source of heat(circle one) C Oil Propane Solar Other
Fireplace-complete a separate application for"Fuel Burning Appliances 8 Chimneys" _Yes No
Are there structures not shown on plot plan? /A
'F O
Are their easements on the property? �/0
Site Information �I
a. Dimensions or acreage of lot O 3
b. Is this a corner lot? Q/O
c. Will the grade be changed as a result of construction: _Yes ,.><No
d. Public water or Private well /0/A 42' W_
e. Sewer or Private Septic System vfiA t�-
civ /fi
Value of all work to be performed(labor and materials) $ ��
I
Declaration: I acknowledge no construction activities shall be commenced prior to issuance of a valid permit and will be completed
within a 12 month period. If work is not complete by the 1 year expiration date the permit may be renewed, subject to fees and
department approval. 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 Building 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 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:
ay at d /491210.10
Signature: �.r cle Date: /Z/��
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 Packet 518-761-8256
Inspection Form
Town of Queensbury Fire Marshal 0 Periodic Inspection Date:Jh///lTime: /a�
742 Bay Road,Queensbury NY 12804 c Re-Inspection :678/3—SSV J Oj3_Sl'i /
518 761 8206/518 761 8205 CO Inspection Pernik#: T
Fire Marshals Representative ���/
MJ Palmer Business Name: Mn "''tet"
Location: 4/06 azpyft,
XGK Stillman Contact: 6701.10Rf4-1o..1-0
Type of Inspection N/A Yes, No
EXITS Exit Access FC 1014&FC1029NOTES
Exit Enclosure FC 1020&FC1029
Exit Discharge FC 1024&FC1029
Locks and latches FC1008& FC1029.2
Sign:Normal FC 1011 &FC1029 ./...
Sign:backup FC 1011.5.3&FC1029.7.5
AISLES:
Main Aisle Width FC 1024/1025&FC1029.11 />
Secondary Aisle Wdth FC 1025&FC1029.11
FIRE EXTINGUISHER: Hung FC 906 �r��^ ` r��
Inspection of extinguisher FC 906 � ATF� l,.•fL eW_]j_
EVAC Plan FC 404.2 �l 1 f� vt131/
TRUSS ID SIGNAGE FC 505.3 j e>C_-
EMERGENCY LIGHTING: /
Intenor FC 1006.3&FC7029.6
Extenor FC 1006.3
Clearance to Electrical FC 605.3 �i
Electric Wiring Enclosed/Labeled FC 605.3.1
Combustibles in Equipment Rooms FC315.2.3 ------
ED.
F.D.Signage- FC 510 _
No Smoking Signs FC 310.3 .------...-/ p�� `la_
I ,�/�,,- .�.Lt�-,�,.
Storage FC 315.2 / Awes iy 1t't4e derAtiec-L
Compressed Gas FC 3003 EX,` Pia
Vehicle Impact Protection FC 312.1
Interior Finishes FC 803-804
Smoke Detectors FC 907
CO detectors FC 610
Clearance to Sprinkler/Ceiling FC 315.2.1
18" / 24"
EVAC SIGNS IN Rooms FC 404.6(R1 &R2) /` � op f0
Fuel Pump Warning Signs FC2205.6 C.• `�v - �.Fuel Station Emer Procedures FC2204.3.5 / y ._ % % v QyP� --
Exterior Storage FC 315.3 / \ REINSPECTION DUE APPROXIMATELY
Vacant Buildings FC 311
Emergency Disconnect FC 2203.2 ....,.../
21 DAYS
SYSTEMS: FC 901.6 Insp OK NC DATE: OK NC
Date
Generator Annual DATE: OK NC
Hood Installation
Elevator Semi Annual
FIRE ALARM Annual DATE: OK NC
HVAC Shutdown
Sprinkler System Annual
Sprinkler FDC
Kitchen Suppression Semi Annual iir.(f ,(
Fuel Island Suppression Semi Annual I�'
Hood Cleaning 3-6-Annual
Knox Box:installed/checked FC506
Operating Permit, if required will be issued after
Completion of Inspection
...........
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