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AST-000054-2017 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: AST-000054-2017 Date Issued: Monday, March 12, 2018 This is to certify that work requested to be done as shown by Permit Number AST-000054-2017 has been completed. Tax Map Number: 302.9-1-43 Location: 548 Aviation DR Owner: City of Glens Falls Applicant: Cellco Partnership d/b/a Verizon Wireless This structure may be occupied as a: Antennae added to existing cell tower 880 s.f. By Order of Town Board Cellco Partnership d/b/a Verizon Wireless TOWN OF QUEENSBURY Cross Reference: Z-AV-54-2017 approval by ZBA for modification to previously approved Area Variance PZ-178-2016.; Site Plan Review approval PZ-171-2016 Issuance of this Certificate of Compliance DOES NOT relieve the 4t 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 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development- Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: AST-000054-2017 Tax Map No: 302.9-1-43 Permission is hereby granted to: Cellco Partnership d/b/a Verizon Wireless For property located at: 548 Aviation DR 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: City of Glens Falls Cell Tower $50,000.00 Owner Address: 42 Ridge RD Total Value $50,000.00 Glens Falls,NY 12801 Contractor or Builder's Name/Address Electrical Inspection Agency Speedcor Industries 3448 River RD Rensselaer,NY 12144 Plans&Specifications Antennae added to existing cell tower 880 s.f. Cellco Partnership d/b/a Verizon Wireless Cross Reference: Z-AV-54-2017 approval by ZBA for modification to previously approved Area Variance PZ-178-2016.; Site Plan Review approval PZ-171-2016 $ 100.00 PERMIT FEE PAID THIS PERMIT EXPIRES: Friday,February 23, 2018 (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 d e.) Dated at the Town f Quee s ury; 4Th ruary 23, 2017 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement PRINCIPAL STRUCTURE APPLICATION Office Use Only Date: Permit No. *E�—N 2►J Tax Map ID 30 L.q - 'A3 Permit Fee $r 10© — Zone (1(Z - `41- Historic? _Yes _✓No Re e Wit, 45 Subdivision Name Lot# Site Plan# Subdivision# Project Location _544's A v i o l rlo n TOWN BD.RESOLUTION 86-2013: $850 recreation fee for new dwelling units—single family,duplexes/two-family,multiple family, apartments,condominiums,townhouses,and/or manufactured&modular homes,but not mobile homes. This is in addition to the permit fee(s). Primary Owner(s) Address Z ink c M ry e a�1 RA r Fr:t t 5 /,J 14 12-10 Phone/Email Applicant j; ii i Address Phone/EmaiI 5 y 17--CA Contractor Address Phone/Email 1,n ��. 1 Y AC i '- r Contact Person for Building&Codes Compliance: Phone L-5 ice) to 4 7C(65 TYPE OF CONSTRUCTION ✓Check all that apply New Addition Alteration 1St floor sf 2°a floor sf Total sf Height Single Family Two-Family Multi-Family - (#of units Townhouse FEB 17 27r_ Business Office Retail-Mercantile Factory-Industrial Attached Garage (1, 2, 3, 4+) Other ��,PQ�v�`-� �S`$d s� 1.r L Town of Queensbury Building&Codes Principal Structure Application revised January 2016 � 1�rd>1 tst a CA to�� If commercial or industrial please indicate name of business Proposed use of building or addition Source of Heat(circle one) Gas Oil Propane Solar Other Fireplace: Complete a separate application for Fuel Burning Appliances&Chimneys 1 Are there structures not shown on plot plan? Are there easements on the property? Site Information: a. Dimensions or acreage of lot , r b. Is this a corner lot? Yes o c. Will the grade be changed as a result of construction Yes o d. Public water or Private well(circle one) N A Public Private e. Sewer or Private Septic System(circle one) 61 A 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: DATE: t SIGNATURE: ` DATE: t 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 MIDDLE DEPARTMENT INSPECTION AGENCY, INC. that the electrical wiring to the electrical equipment listed below has been examined and is approved as being in accord with the National Electrical Code, applicable governmental, utility and Agency rules in effect on the date noted below and is issued subject to the following conditions. Owner: Verizon Date: 08/16/2017 Occupant: Cell Tower Location-Aviation Mall Road Occupancy-Services Queensbury, Warren Co. NY Applicant: John Coyne Elec. Contr. Inc. 43 Langenbach Road East Greenbush, NY 12061 E C E 0 W E 140. Joseph A.Holmes 1401361359548EL OCT 18 2017 Equipment 200 -Amp. Service Equipment, 3/0- Service Conductor, 1 3/0 Feeder To Shelter TOWN OF QUEENSBUR BUILDING&CODES This certificate applies to the electrical wiring to the electrical equipment listed immediately null and void. This certificate applies only to the use,occupancy and above and the installation inspected as of the above noted date based on a visual ownership as indicated herein. Upon a change in the use,occupancy or ownership inspection. No warranty is expressed or implied as to the mechanical safety,effi- of the property indicated above,this certificate shall be immediately null and void. ciency or fitness of the equipment for any particular purpose. This certificate shall In the event that this certificate becomes invalid based upon the above conditions, be valid for a period of one year from the above noted date. Should the electrical this certificate may be revalidated upon reinspection by Middle Department system to which this certificate applies be altered in any way,including but not limit- Inspection Agency, Inc. An application for inspection must be submitted to Middle ed to,the introduction of additional electrical equipment and/or the replacement of Department Inspection Agency, Inc. to initiate the inspection and revalidation any of the components installed as of the above noted date,this certificate shall be process. A fee will be charged for this service.