2013-567 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20130567 Application Number. A20130567
Tax Map No: 523400-309-013-0002-031-002-0000
Permission is hereby granted to: HUDSON HEADWATERS HEALTH NETWORK
For property located at: 161 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. Type of Construction Value
Owner Address: HUDSON HEADWATERS HEALTH Commercial Alteration $50,000.00
PO BOX 3253 Total Value $50,000.00
GLENS FALLS,NY 12801-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2013-567
Comm. Alterations 1,000 Sq ft.
$200.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Tuesday,December 16,2014
(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 expiration date.)
Dated at the TownfefQurr-<e)nsbuMid. ,December 16,2013
SIGNET)BY JL I for the Town of Queensbury.
n
Director of Building&Code En orcement
TOWN OF QUEENSBURY
i
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20130567 Date Issued: Wednesday, January 22, 2014
This is to certify that work requested to be done as shown by Permit Number P20130567
has been completed.
Location: 161 CAREY Rd
Tax Map Number: 523400-309-013-0002-031-002-0000
Owner: HUDSON HEADWATERS HEALTH NETWORK
Applicant: HUDSON HEADWATERS HEALTH NETWORK
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 (-- J 4 4tct--
owner of the responsibility for compliance with Site Plan, Variance, or
other issues and conditions as a result of approvals by the Planning Board Director of Building&Code Enforcement
or Zoning Board of Appeals.
1
TOWN OF QUEENSBURY
..4 .
742 Bay Road,Queensbury,NY 12804-5902 (518)vg.1
Community Development-Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20130567 Application Number: A20130567
Tax Map No: 523400-309-013-0002-031-002-0000
Permission is hereby granted to: HUDSON HEADWATERS HEALTH NETWORK
For property located at: 161 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. Type of Construction Value
Owner Address: HUDSON HEADWATERS HEALTH Commercial Alteration $50,000.00
PO BOX 3253 Total Value
GLENS FALLS,NY 12801-0000 $50,000.00
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2013-567
Comm. Alterations 1,000 Sq ft.
$200.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday,December 16,2014
(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 expiration date.)
Dated at the Town o sbury 4.0, 'a ./December 16, 2013
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
Town of Queensbury Building & Codes DEC i (� 2013
Received:
ID:
PRINCIPAL STRUCTURE APPLICATION PN
Per mit No.: l3- Jt(07
A permit must be obtained before beginning construction Permit Fee: $ a ODA-
"7
Please read: *TB resolution 86-2013(1-28-2013): $850 recreation fee for new dwelling *Rec Fee: $ p)
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 including mobile homes. This is in addition to the permit fee.
Date 1_Z - 7 - 1 3 Applicant C ARE`t v A�
Tax Map ID ? Oct 13 - 2 ''II. 2 Addressv&&'N S QR`r \ 7 € Ll
Zoning
Phone/E-mail X24- B(6?2 34 RMI CK p
mw,).oR
Property Owner 11UpSDN u�t�nw� ER-S Contractor/Agent Gots .
Address I Cfakize4 Rok Address G"towLEY ?D
S uospt.
Phone/E-mail ?b1.03vo S Mc,Go12m v,< e N 1 Phone/E-mail 19 (233 >
Contact Person for Building&Code Compliance:-S PA rk ULn zm,cY- Day Phone:EjZ -8622
Building Street Address: )b( CA al:-.02Y
Subdivision Name: Lot#: Historic Site: Yes X No
Estimated cost of construction: $ 5 0,0 a o
Type of Construction:
Check all that apply Please indicate measurements as required below:
c
o g
1st Floor 2nd Floor Other Total Height
s- a
41
Single Family
Two-Family
Multi-Family(#of
units )
Townhouse
Business Office X 4 Do FT l)(fp0 sq,
Retail-Mercantile
Factory-Industrial
Attached Garages(# )
Other
Town of Queensbury Building&Codes Principal Structure Packet 518-761-8256
If commercial or industrial indicate name of business
UASt7►J IA 6 ki)tiv f'W S
Proposed use of building or addition H 6 kt:7 1,4 GEN-TER
Source of heat(circle one) Gas Oil Propane Solar Other
Fireplace-complete a separate application for"Fuel Burning Appliances&Chimneys" Yes Zi No
Are there structures not shown on plot plan?
\\'• D
Are their easements on the property? \\
b
Site Information
AUS' F
a. Dimensions or acreage of lot L r7 C
J �L
b. Is this a corner lot?
c. Will the grade be changed as a result of construction: _Yes No
d. Public water or Private well �L WA-
TER-e. Sewer or Private Septic System S C Ex) STn N
Value of all work to be performed(labor and materials) $ 5th,
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: —171 \' 1 (.-0"-rYN) 111
Signature: fr L1-114/1/11, Date: Z ( 3
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
Town c Queensbury Building&Code Enforcement
Office No.(518)761-8256
Commercial Final Inspection Report
Inspection request received:
Name: 4-\ bbd \��C�rC�v�B 1�— Inspected on: I — Z—
Location: `(Q\ e.� 2E- �� Arrive: - �� •.m.
Permit No.: .3 -5(c7 Inspector's Initials:
/I"'
COMMENTS
Y N NA
Chimney/"B"Vent/Direct Vent Location
Plumbing Vent Through Roof 6"!Roof Complete
Exterior Finish I Grade Complete 6"in 10'or Equivalent
Interior I Exterior Guardrails 42 inch Platform 1 Decks
Interior!Exterior Balusters 4 inch Spacing Platform/Decks
Stair Handrail 34 inch-38 inch/Step Risers 7"!Treads 11"
Vestibules For Exit doors>3000 sq.ft.
All Doors 36 inch w/Lever Handles/Panic Hardware,if required
Exits At Grade Or Platform 36"(w)x 44"(I)/Canopy or Equiv.
Gas Valve Shut-off Exposed&Regulator(18")Above Grade
Floor Bathroom Watertight/Other Floors Okay
Relief Valve,Heat Trap 1 Water Temperature 110 Degrees Maximum
Boiler/Furnace Enclosure 1 hour or Fire Extinguishing System
Fresh Air Supply for Occupancy I Ventilation Combustion
Low Water Shut Off For Boilers
Gas Furnace Shut Off Within 30 ft.or Within Line Of Site
Oil Furnace Shut Off at Entrance to Furnace Area
Stockroom/Storage/Receiving/Shipping Room(2 hr.), 1 1/2 doors >10%>1000 sq.ft.
'/.Hour Corridor Doors&Closers
Firewalls/Fire Separation,2 Hour,3 Hour Complete/Fire Dampers/Fire Doors
Ceiling Fire Stopping,3,000 sq.ft.Wood Frame1-2
Attic Access 30"x 20"x 30"(h),Crawl Space Access 18"x 24" 1 y-3\'`V-L \-\ -\
Smoke Vents Or Fan,if required D
Elevator Operation and Signage/Shaft Sealed
Handicapped Bathroom Grab Bars/Sinks/Toilets!Mirrors
Handicapped Bath/Parking Lot Signage
Public Toilet Room Handicapped Accessible
Handicapped Service Counters,34 inch,Checkout 36 inch
Handicapped Ramp/Handrails Continuous/12 inch Beyond[Both sides]
Active Listening System and Signage Assembly Space
Final Electrical/Flex Gas Piping Bonded yj
Site Plan I Variance required
Final Survey,New Structure/Flood Plain certification, if req.
As-built Septic System Layout Required or On File
Building Number or Tenant Address on Building or Driveway 4"
Water Fountain or Cooler
Building Access All Sides by 20'/Drivable Surface 20'wide
Special Inspections/Engineer or Architect Approval
Okay To Issue Temporary or Permanent C/O \ 5 S J a_ C_
Okay To Issue C/C
Commercial Final Inspection_11 27 12
rs; i;11I)I)I 1: I)!:l'.1,hr1 X11_> 11\ I)1:(. I-I()\ .11i1:NC'�', INC'. c?
Y,a
S-'>
i�,; `. ,-.i7rr. that the electrical wiring to the electrical equipment I steel oetow has been examined and is approved as
0 being in accord with the National Electrical Code. applicable governmental: utility and Agency rules in effect on the dates
gel noted below and is Issued subject to the following conditions V.:
• Owner: Date '4,
Hudson Head Waters 01/03/2014 'r,�
SV
OCcupart: -ocat .
fi Same •
161 Carey Road s,�"
• Occupancy: Queensbury. Warren Co. NY
r._Non Residential
3 Applicant:
S-:-..-:
Cindy Albrechd ;
Hilltop Construction
51 Crowley Rd.
Hudson Falls. NY {
y.o
e$1 No 14.576215F543F1 Ye
Equipment:
Y
• 2 - Switches: 21 - Receptacles: 8- Fixtures ti
C.''. .Qi.;''''
',Fy `(�
y��
4.'C - k>•14'
. This certificate applies h> the✓iectr.ca, „:-:ng to•re c_ie,' .: -._:.. - ,. . :.•: . . .inc voic • >certificate applies only to the use oco"panc. a-c”. �T;'y�
above and the installation inspected as of the chore. nel e .e:r- -,.c^ '• 'i:cater here- upon a change in the use.occupancy o•cwr.crsh c 1
inspection No warranty is expressed or implied as to roe rnern ai ti ai .gid ated above,this certificate shall be immediately null and wio ?
riency or fitness of the equipment lot any particular purpose n t certificate becomes invalid based upon the above conrnhor v
be valid for a period of one year from the above rated date 5 ar re revalidated upon reinspection by Middle Ge:,artmen;
system io which this certificate applies be altered•,i i An application for inspection must be submitted to Middle
4 ed to the introduction of additional e'ecineai eow.."c• . • _-. Agency Inc to initiate the inspection and revalidario"
V,,is, any of the components installed as or the above rotor .a r _ _ -- .. r..‘,crarged for this service
^'`f'.04 ori,a,c P4`6 afi-a>"rS�v''a•-• Slay _ ,�r: �>�, ,� >- r`Y''>-?. ,e;} Y�, Y'� .:>r• .....N..,s;'I't..!`/.A!: �i�`rsr-;&,'& '�.a,3,&,' 9Y,'& '
Town of Queensbury Building&Code Enforcement
Office No.(518)761-8256 -31\
Commercial Final Inspection Report
Inspection request received:
Name: NlS D.1)013 Inspected on: _ 1 — Adi'
Location: Vet\ �1�RE`t P-1 C Arrive: . � � j •.m.
Permit No.: Inspector's Initials:
•
• COMMENTS
Y N NA
Chimney/"B"Vent!Direct Vent Location
Plumbing Vent Through Roof 6"!Roof Complete
Exterior Finish/Grade Complete 6"in 10'or Equivalent
Interior!Exterior Guardrails 42 inch Platform/Decks
Interior I Exterior Balusters 4 inch Spacing Platform/Decks
Stair Handrail 34 inch—38 inch/Step Risers 7"/Treads 11"
Vestibules For Exit doors>3000 sq.ft.
All Doors 36 inch w/Lever Handles I Panic Hardware,if required
Exits At Grade Or Platform 36"(w)x 44"(1)1 Canopy or Equiv.
Gas Valve Shut-off Exposed&Regulator(18")Above Grade
1//-
Floor Bathroom Watertight 1 Other Floors Okay
Relief Valve,Heat Trap I Water Temperature 110 Degrees Maximum
Boiler/Furnace Enclosure 1 hour or Fire Extinguishing System
Fresh Air Supply for Occupancy/Ventilation Combustion
Low Water Shut Off For Boilers
Gas Furnace Shut Off Within 30 ft.or Within Line Of Site
Oil Furnace Shut Off at Entrance to Furnace Area
Stockroom/Storage/Receiving/Shipping Room(2 hr.), 1 '/2 doors >10%>1000 sq.ft.
3/•Hour Corridor Doors&Closers
Firewalls/Fire Separation,2 Hour,3 Hour Complete 1 Fire Dampers I Fire Doors
Ceiling Fire Stopping,3,000 sq.ft.Wood Frame
Attic Access 30"x 20"x 30"(h),Crawl Space Access 18"x 24"
Smoke Vents Or Fan,if required
Elevator Operation and Signage I Shaft Sealed
Handicapped Bathroom Grab Bars/Sinks I Toilets/Mirrors
Handicapped Bath/Parking Lot Signage
Public Toilet Room Handicapped Accessible
Handicapped Service Counters,34 inch,Checkout 36 inch
Handicapped Ramp!Handrails Continuous/12 inch Beyond[Both sides]
Active Listening System and Signage Assembly Space
Final Electrical I Flex Gas Piping Bonded — IU GGA \ i\
Site Plan/Variance required
Final Survey,New Structure/Flood Plain certification,if req.
As-built Septic System Layout Required or On File
Building Number or Tenant Address on Building or Driveway 4"
Water Fountain or Cooler
Building Access All Sides by 20'!Drivable Surface 20'wide
Special Inspections/Engineer or Architect Approval
Okay To Issue Temporary or Permanent C/O
Okay To Issue C/C
Commercial Final Inspection_ 11 27 12
RX Date/Time 01108/2014 10:53 P.003
;s;, r��Jan. 8. 2014~10:50AM-''`''''Home Funding Finders '' ' ' ,A,J, '/.• ✓� -=i-4'No. 1540V? P. 3/6i\iv•,;
<< MIDDLE DEPARTMENT INSPECTION AGENCY, INC. e,
(<b I�H.
e ce,4 ec that the electrical wiring to the electrical equipment listed below has been examined and is approved as (••
ro being in accord with the National Electrical Code, applicable governmental, utility and Agency rules in effect on the date
4 noted below and is issued subject to the following conditions.
Cat' OWnef:
�
t.'0Hudson Head Waters Date: 4:0
�3�
Occupant: 01/03/2014
Location:
V) Same •rt:
lea
161 Carey Road
�i Occupancy: Queensbury,Warren Co. NY (Gy)
' Non-Residential •
k::. Applicant: 0
c,1 Cindy Albrechd ., •. ; fir•:
�'� Hilltopa..� . ;
Construction •-.'. ••• t') , ',.i...' •,•r •-.::,,,y>,,,.
h.
” 51 Crowley Rd. ,•;:;,.•....,.., �' •t- ..•••-•:—„, . ' e• ''` . �'•`, ea.:A
`s L ri s''. :,I ,
JHudson Falls, NY•` .> 'c;, s•.'; 5
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tQ! ., - •;;•'..c? :L'rL::' F':: t*.:.' :v4:.+:. Y.r ^a" +e..✓.H•:.Ati:.e`• •'
.', �;rl r >rN•:�}q•` r A.r4 n ��'Fl.•'-!':.:r+G'•r r} lr�
t�it..'i?.:.',fir ?.�,.•r i''di:�,:>Y+„:} ••;,>"j .;ry.,f '.":1°.:,..4-•$•. 3'i•;+y, ., ]'�
2 Switches;21 Rece • , -•y",. +`.:, :;'s;4 f _ -.,
Wi
r\ p Fixtures
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tacles;8- Fi F
Cyyd < .'.. :4•eci c -. h -,�..•
.
zi
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