CC-0140-2018 i
TOWN OF QUEENSBURY -
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building& Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY -
Permit Number: CC-0140-2018 Date Issued: Thursday, June 21, 2018
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This is to certify that work requested to be done as shown by Permit Number CC-0140-2018
has been completed.
Tax Map Number: 301.8-1-18
Location: 340 AVIATION RD
Owner: DLS Enterprises
Applicant: Allstate Insurance- The Deutsch Agency, Inc. j
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This structure may be occupied as a: Commercial Interior Alterations 1,900 sq.
ft By Order of Town Board
Suite No. 5 at Sokol's Plaza TOWN OF QUEENSBURY
Deutsch Agency,Inc. (Allstate Insurance Sales)
Issuance of this Certificate of Occupancy DOES NOT relieve the /�,(
property owner of the responsibility for compliance with Site Plan, vv
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.
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- � TOWN OF QUEENSBURY
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742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: CC-0140-2018
Tax Map No: 301.8-1-18
Permission is hereby granted to: Deutsch Agency,Inc.
For property located at: 340 AVIATION 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
Tvoe of Construction
Owner Name: Matt Sokol Retail-Mercantile-Alteration $20,000.00
Owner Address: 340 Aviation RD Total Value $20,000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
JGS Home Improvements
5 Second ST
Queensbury,NY 12804
Plans&Specifications
Commercial Interior Alterations 1,900 sq.ft.
Suite No.5 at Sokol's Plaza
Deutsch Agency,Inc.(Allstate Insurance Sales)
$ 570.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Saturday,April 6,2019
(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 bury; rid A 018
for the Town of Queensbury.
SIGNED BY: Q ury
Director of Building&Code Enforcement
Office Use OnIv
Permit#: CC- q-0-,)�O
ADDITION/ALTERATION PERMIT
APPLICATION Permit Fee: -900
Tbim of Q_ueensbury
742 Bay Road,Queensbury,NY 12804 Invoice#:
P:518-761-8256 www,auee.-isburv.net
U J V LE;
,Project Location: 3 0 AV 4 e,'.A, > 5
I q APR 3 2018
Tax Map ID Subdivision Name:
CONTACT INFORMATION:
• Applicant:
Name(s): --To kll---�, "'-�-�CA
Mailing Address, C/S/Z: It? 17A-1.41 5+114 &Ve4%dJ---t11 Al
Cell Phone: ( 6-16 a je'1 ' '? -2yq Land Line: AAW- -7 7 3
Email:
• Primary Owner(s):
Name(s): 0 LS
Mailing Address, C/S/Z: 'J �a /v-/
Cell Phone: Land Line: SIV
Email:
'D Contractor(s):
Business Name: 'T r, .�
Contact Name(s):
Mailing Address, C/S/Z: Sb'le vY lZec-%L1
Cell Phone: ( S-1,3 1 3 3 - 3 7 3 7 Land Lin 07-9 -21 -3
Email:
• Architect(s)/Engineer(s):
Business Name: A/
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email:
Contact Person for Building& Code Compliance:
Cell Phone: ( 5-4 34-1 -777L/L/ Land Line: (Sig J -723-J-eif )
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017
PROJECT INFORMATION:
TYPE: Commercial Residential
WORK CLASS:
Single-Family Two-Family Multi-Family(#of units
Townhouse' Business Office Retail
I ndustria[/Warehouse Garage(#of cars other(describe
ADDITION DARE FO ' GE: ALTERATION SQUARE FOOTAGE:
1st flo 1 st floor: 0 Z,
UAR flo
2nd floor: 2nd floor:
3rd floor- 3,d floor-
4 fl th floor:
th flo r: 4
Total square feet: Total square feet: C)
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction: $
2. If Commercial project,what is the proposed use:
3. Source of Heat(circle one
yCGas) Oil Propane Solar Other
Fireplaces need a separate Burning Appliances&Chimney Application
4. Are there any structures not shown on the plot plan? YES (Ngjxplain:
5. Are there any easements on the property? YES NO
6. SITE INFORMATION:
a. What is the dimensions or acreage of the parcel?
b. Is this a corner lot? YES (�_'Ro)
c. Will the grade be changed as a r e construction? YES
d. What is the water source? PUBLIC__' PRIVATE WELL
M —
e. Is the parcel or(!W:E)or a PRIV SEPTIC system?
ration Application Revised February 2017
Town of Queensbury Building&Code Enforcement Addition/Alte
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DECLARATION:
1. 1 acknowledge that no construction shall be commenced prior to issuance of a valid permit and will be
completed within a 12 month period.
2. If thework is not completed by the 1 year expiration date the permit may be renewed, subject to
fees and department approval.
3. 1 certify that the application, plans and supporting materials are a true and complete statement and/or
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. 1 acknowledge that prior to occupying the facilities proposed 1, or my agents, will obtain a certificate
of occupancy.
5. 1 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:
SIGNATURE: DATE: ' "
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Town of 4ueensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017
INSPECTION WORKSHEET (BINS-004454-2018)
Town of Queensbury - Building and Codes - Fire Marshal
742 Bay Road - (518) 761-8256 Building (518) 761-8206 Fire Marshal
Case Number:CC-0140-2018Case Module:Permit
Inspection Date:06/21/2018Inspection Status:Passed
Inspector:John O'BrienInspection Type:Commercial Final Inspection
Job Address:340 AVIATION RDParcel Number:301.8-1-18
Queensbury, NY 12804
Contact TypeCompany NameName
Contractor\[JGS Home Improvements\],
Primary Owner\[DLS Enterprises\]Sokol, Matt
Granted Permission\[Deutsch Agency, Inc.\],
Applicant\[Deutsch Agency, Inc.\],
Checklist ItemPassedComments
Doors 36 inch wLever Hand Panic Hardware, if reqYES
Exits At Grade Or Platform 36 (w) x 44 (l)YES
Gas Shut-off Exposed & Regulator (18) Above GradeYES
Floor Bathroom Watertight Other Floors OkayYES
Relief Valve ,Heat Trap/Water Temp 110 deg or lessYES
Gas Furnace Shut OffYES
H/C Bathroom Grab Bars /Sinks/Toilets/MirrorsYES
Handicapped Bath/Parking Lot SignageYES
Universal Symbol of Access displayed - on all H/CYES
signs
Public Toilet Room Handicapped AccessibleYES
Handicapped Service Counters 34 inchYES
Final Electrical / Flex Gas Piping BondedYES
Bldg Num or Tenant Address on Bld or DriveYES
Bldg Access All Sides 20ft Drivable SurfaceYES
OK to Issue C/OYES6/21/18 Final Inspection Approved-Ok to issue CO!
O'Brien, John (Inspector)
Jun 21, 2018Page (2)