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CC-000016-2017 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development - Building& Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: CC-000016-2017 Date Issued: Monday, January 29, 2018 This is to certify that work requested to be done as shown by Permit Number CC-000016-2017 has been completed. Tax Map Number: 303.15-1-25.1 Location: 24 QUAKER RIDGE BLVD Owner: Wal-Mart REBT Applicant: Harrison French&Associates, Ltd. This structure may be occupied as a: Commercial Alterations 2040 s.f. Cash Wrap Area By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Compliance 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. r TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development-Building&Codes (518)761-8256 BUILDING PERMIT Permit Number: CC-000016-2017 Tax Map No: 303.15-1-25.1 Permission is hereby granted to: Wal-Mart REBT For property located at: 24 QUAKER RIDGE BLVD 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 Tvne of Construction Owner Name: Wal-Mart REBT Retail-Mercantile-Alteration $250,000.00 Owner Address: 702 SW Eighth ST Total Value $250,000.00 Bentonville,AR 72716 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications Commercial Alterations 2040 s.f. Cash Wrap Area $408.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,January 26,2018 (If a longer period is required,an application for an extens'on must be made to the code Enforcement Officer of the Town of QueensbuQ611vfore the a fy atio date.) Dated at the Town o ueensb �Th uary 26,2017 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement PRINCIPAL STRUCTURE APPLICATION Office Use Only Date: 1/12/2017 Permit No. Tax Map ID Permit Fee %O Zone Historic? _Yes No Rec � F ,�� Q c� _ 02- Subdivision Name Lot# e Plan# Project Location 4& Subdivision# TOWN BD.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) Wal-Mart REBT _;11 Address 702 SW 8th St, Bentonville, AR 72716 Phone/Email 479-273-4000 Applicant Leticia Martinez w/ Harrison French and Associates Address 1705 S Walton Blvd, Bentonville, AR Phone/Email 479-273-7780x 263 / leticia.martinez@hfa-ae.com Contractor TBD Address Phone/Email Contact Person for Building& Codes Compliance: Phone TYPE OF CONSTRUCTION 2 B ,/Check all that apply New Addition Alteration I"floor sf 2'floor sf Total sf Height Single Family Two-Family Multi-Family 2 (#of units_} D IE Townhouse I JAI I w Business Office T01JVi` OF QUEENS llRY Retail-Mercantile '20 1A l7 S - 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 Walmart Store 4403 Proposed use of building or addition Mercantile Source of Heat(circle one) Gas Oil Propane Solar Other Fireplace: Complete a separate application for Fuel Burning Appliances &Chimneys Are there structures not shown on plot plan? Are there easements on the property? 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) Public Private e. Sewer or Private Septic System(circle one) Sewer Private Value of all work to be performed(labor or materials) $ 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. 5. 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: lelticlq lKqn�lZ DATE: Z 2a�7 SIGNATU DATE: / VI-7 For offic use onl Operating Permit Issued: Yes o Occupancy Type M Construction Classification Assembly Occupancy Limit Special Conditions Town of Queensbury Building&Codes Principal Structure Application Revised January 2016