CC-0044-2019TOWN OF QUEENSBURY
a
y
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: CC-0044-2019 Date Issued: Monday, June 24, 2019
This is to certify that work requested to be done as shown by Permit Number CC-0044-2019
has been completed.
Tax Map Number: 309.7-1-55
Location: 28 WESTERN AVE SOUTH
Owner: Hudson Headwater Health Network-
Applicant: BBL Construction Services
This structure may be occupied as a: New Commercial Building 5700 s.f.
Tenant: HHHN By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve thepropertyownerowneroftheresponsibilityforcompliancewithSitePlan,
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
f-=s Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: CC-0044-2019
Tax Map No: 309.7-1-55
Permission is hereby granted to: Hudson Headwater Health Network
For property located at:28 WESTERN AVE SOUTH
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: Hudson Headwater Health Network Business Office-Alteration 656,367.00
Owner Address: 9 Carey RD Total Value 656,367.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
BBL Construction Services
302 Washington AVE,Extension
Albany,NY 12203
Plans&Specifications
New Commercial Building 5700 s.f.
Tenant: HHHN
1,710.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Thursday,February 20,2020
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 of Queensbury; Wednesday,February 20,2019
SIGNED BY: T d/
J
for the Town of Queensbury.
Director of Building&Code Enforcement
r
r O `,
e Jse Only
ADDITION/AL ' iA`T ONPER1VIIT--' it#• l
4^. .. APPLIC I NJAN 2 8 2019 , f) .
i
it Fee: $ 7J
Ti»r'n oIQuccnsbutv
742 Bay Road,Queensbury,NY 12804
TOWN OF QUEENSBUIbice#: i 2-0 C
P:518-761-8256 www.aueensburv.net BUILDING&CODES
Project Location: 28 S.Western Ave
Tax Map ID #: 30q .) --1 - sf 5 6 -)16L 63 Subdivision Name:
CONTACT INFORMATION:
Applicant:
Name(s): BBL Construction Services, LLC (Mike Rank)
Mailing Address, C/S/Z: 302 Washington Avenue Extension,Albany, NY 12203
Cell Phone: ( 518 ) 265-3053 Land Line: ( 518 ) 452-8200 x4293
Email: mrank@bblinc.com
Primary Owner(s):
Name(s): Hudson Headwaters Health Network(Dal Valentini)
Mailing Address, C/S/Z: 9 Carey Road, Queensbury, NY 12804
Cell Phone: ( 518 ) 857-3408 Land Line: ( 518 ) 761-0300 x31624
Email: dvalentini@hhhn.org
Contractor(s):
Business Name: BBL Construction Services, LLC
Contact Name(s): Mike Rank
Mailing Address, C/S/Z: 302 Washington Avenue Extension,Albany, NY 12203
Cell Phone: ( 518 ) 265-3053 Land Line: ( 518 ) 452-8200 x4293
Email: mrank@bblinc.com
Architect(s)/Engineer(s):
Business Name: HCP Architect's, LLP
Contact Name(s): Ben Nassivera
Mailing Address, C/S/Z: 302 Washington Avenue Extension,Albany, NY 12203
Cell Phone: ( 518 ) 265-7625 Land Line: ( 518 )218-0614
Email: bnassivera@hcpdesign.com
Contact Person for Building & Code Compliance: Ben Nassivera (Architect)
Cell Phone: ( 518 ) 265-7625 Land Line: ( 518 ) 218-0614
Email: bnassivera@hcpdesign.com
Mike Rank(Construction Project Manager)
Cell: 518-265-3053 Email: mrank@bblinc.com
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised March 2018
PROJECT INFORMATION:
TYPE: X Commercial Residential
WORK CLASS:
Single-Family Two-Family Multi-Family(#of units
Townhouse Business Office Retail
Industrial/Warehouse Garage (#of cars X Other (describe Medical Office-Fit-Up )
ADDITION SQUARE FOOTAGE: ALTERATION SQUARE FOOTAGE:
1st floor: 1st floor: -5,63- C oe
2nd floor: 2nd floor: N/A
3rd floor: 3rd floor: N/A
Basement (habitable space): Basement (habitable space): N/A
Total square feet: N/A Total square feet: -;f0T s )CO
Please note: This project consists of interior fit-up only, with minor modifications to the existing entry in order to
accommodate a new vestibule area. The fencing for the existing dumpster enclosure will also be replaced with new wood
fencing. There will be no modifications to the existing site.
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction: $ 656,367.00
2. If Commercial project, what is the proposed use: Medical Services-Primary Care
3. Source of Heat (circle one): 1420 Oil Propane Solar Other
Fireplaces need a separate Fuel Burning Appliances&Chimney Application Existing shed at NW corner of
parking lot,which is to remain
4. Are there any structures not shown on the plot plan? ®NO Explain: as is.
5. Are there any easements on the property? YES
6. SITE INFORMATION:
a. What is the dimensions or acreage of the parcel? 1.31 Acres
b. Is this a corner lot? YES NO
c. Will the grade be changed as a result of the construction? YES NO
d. What is the water source? (PUBLIC PRIVATE WELL
e. Is the parcel on SEWER or a PRIVATE SEPTIC system? Sewer
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised March 2018
DECLARATION:
1. I 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 the work is not completed 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 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. 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: Michael. Rank
SIGNATURE: DATE: 1 I2e—(l,
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised March 2018
COMcheck Software Version 4.1.1.0
NI/lic Mechanical Compliance Certificate
Project Information
A Energy Code: 2015 IECC
Project Title:Hudson Headwaters JAN 2 8 2019 J
Location: Glens Falls, New York
Climate Zone: 6a TOWN OF QUEENSBURY
Project Type: Alteration BUILDING&CODES
Construction Site: OwnerlApent Designer/Contractor:
28 Southwestern Ave McD Metals
Queensbury, NY REVIEWED FOR
20 Corporate
Albany, NY 12203e
ENERGY CODE COMPLIANC,
Mechanical Systems List
Quantity System Type&Description I FILE COPY
1 HVAC System 1 (Multiple-Zone):
Heating:1 each-Hydronic or Steam Coil,Hot Water,Capacity=185 ki3tufn
No minimum efficiency requirement applies
Cooling:1 each-Single Package DX Unit,Capacity=185 kBtulh.Air-Cooled Condenser,Air Economizer
Proposed Efficiency=11.00 EER,Required Efficiency: 10.80 EER +12.2 IEER
Fan System: FAN SYSTEM 1 I All—Compliance(Brake HP method):Passes
Fans:
FAN 1 Supply,Multi-Zone VAV,5120 CFM,5.0 motor nameplate hp,3.2 design brake hp(3.2 max.BHP),0.0 fan efficiency grade
1 Plant 1:
Heating:Hot Water Boiler,Capacity 185 kBtulh,Gas
No minimum efficiency requirement applies
1 Water Heater 1:
Electric Storage Water Heater,Capacity:40 gallons w/Circulation Pump
Proposed Efficiency:1.00 SL,%/h(if>12 kW),Required Efficiency:0.98 SL,%/h(if>12 kW)
Mechanical Compliance Statement
Compliance Statement: The proposed mechanical alteration project represented in this document is consistent with the building
plans, specifications,and other calculations submitted with this permit application.T proposed mechanical systems have been
designed to meet the 2015 IECC requirements in COM ion 4.1. 0 an o co ply with any applicable mandatory
requirements listed in the Inspection Checklist.
t Me]rJ>Q N
1
r
I Z'3riavrIcavas(1 j l ( `Name-Title ( • Signature—. Date
TiLEulc co Slc t A Sso Gil-f'C X7-C.
OFNSE 309.7-1-55 CC-0044-2019
P\
LI
HHHN
r— tii..al 28 Western Ave S
1`at _. z New Commercial Bldg 5700 s.f.
t10FEssio,
Project Title: Hudson Headwaters Report date: 01/23/19
Data filename: \\MCD2003SBS\Users\Brian\My Documents\COMcheck\Hudson Headwaters.cck Page 1 of 11
COMcheck Software Version 4.1.1.0
Inspection Checklist
Energy Code: 2015 IECC
Requirements: 92.0% were addressed directly in the COMcheck software
Text in the"Comments/Assumptions" column is provided by the user in the COMcheck Requirements screen. For each
requirement,the user certifies that a code requirement will be met and how that is documented,or that an exception
is being claimed.Where compliance is itemized in a separate table. a reference to that table is provided.
Section j
Plan Review Complies?Comments/Assumptions
R
C103.2 Plans,specifications,and/or Complies Requirement will be met.
PR2]1 calculations provide all information Does Not
with which compliance can be
determined for the mechanical Not Observable
systems and equipment and Not Applicable
document where exceptions to the
standard are claimed.Load
calculations per acceptable
engineering standards and
handbooks.
C103.2 Plans,specifications,and/or Requirement will be met.
PR3]1 calculations provide all information. -maces Not
with which compliance can be
Not Observabledeterminedfortheservicewater
heating systems and equipment and got Applicable
document where exceptions to the
standard are claimed.Hot water
system sized per manufacturer's
sizing guide.
C406 Plans,specif:catcrs, and/or Complies
PR9]1 calculations provide all information Does Not
with which compliance can be
determined for the additional energy
Not Observable
efficiency package options. Not Applicable
Additional Comments/Assumptions:
1 High Impact(Tier 1) 12 1-Medium Impact(Tier 2) 13 (Low Impact(Tier 3)
Project Title: Hudson Headwaters Report date: 01/23/19
Data filename: \\MCD2003SBS1Users\Brian\My Documents\COMcheck\Hudson Headwaters.cck Page 2 of 11
Footing/Foundation Inspection Complies?Comments/Assumptions
Req.ID;
C403.2.4. Snow/ice melting system sensors for OComplies Exception:Requirement does not apply.
5. future connection to controls.Freeze ElDoes Not
C403.2.4. protection systems have automatic
rt 6 controls installed. Not Observable
FO973 DNot Applicable
Additional Comments/Assumptions:
t'.1 jHigh Impact(Tier 1) T 2 1Medium Impact(Tier 2) 1-37-Low Impact(Tier 3)
Project Title: Hudson Headwaters Report date: 01/23/19
Data filename: \\MCD20035B5\Users\Brian\My Documents\COMcheck\Hudson Headwaters.cck Page 3 of 11
Seecction —
1 Plumbing Rough-In Inspection ! Complies?Comments/Assumptions
R ..IDS
C404.5. Heated water supply piping conforms OComplies Requirement will be met.
C404.5.1. to pipe length and volume Does Not
C404.5.2 requirements.Refer to section details. :
Not ObservablePL6]3
Not Applicableti
C404.5, Heated water supply piping conforms OComplies Requirement will be met.
C404.5.1, to pipe length and volume Does Not
C404.5.2 requirements.Refer to section details.
PL6]3 Not Observable
Not Applicable
C404.5, Heated water supply piping conformsDComplies Requirement will be met.
C404.5.1, 'to pipe length and volume ODoes Not
C404.5.2 requirements.Refer to section details.
PL613 Not Observable
Not Applicable
C404.6.1. Automatic time switches installed to Complies Exception: Requirement does not apply.
C404.6.2 automatically switch off the Does Not
PL3]1 recirculating hot-water system or heat
trace. Not Observable
Not Applicable
C404.6.3 Pumps that circulate water between a Complies Exception: Requirement does not apply.
PL713 heater and storage tank have controls Does Not
that limit operation from startup to
5 minutes after end of heating [Not Observable
cycle. Not Applicable
C404.6.3 Pumps that circulate water between a OComplies Requirement will be met.
PL713 heater and storage tank have controls Does Not
that limit operation from startup to
5 minutes after end of heating Not Observable
cycle. Not Applicable
C404.6.3 Pumps that circulate water between a OComplies Exception: Requirement does not apply.
PL713 heater and storage tank have controls Does Not
that limit operation from startup to
5 minutes after end of heating Not Observable
cycle. Not Applicable
C404.7 Water distribution system that pumps OComplies Exception: Requirement does not apply.
KS]3 water from a heated-water supply `Does Not
pipe back to the heated-water source
through a cold-water supply pipe is a
Not Observable
demand recirculation water system. Not Applicable
Pumps within this system have
controls that start the pump upon
receiving a signal from the action of a
user of a fixture or appliance and
limits the temperature of the water
entering the cold-water piping to
104°F.
C404.7 Water distribution system that pumps OComplies Exception: Requirement does not apply.
PL813 water from a heated-water supply :DDoes Not
4 pipe back to the heated-water source
through a cold-water supply pipe is a
ONot Observable
demand recirculation water system. Not Applicable
Pumps within this system have
controls that start the pump upon
receiving a signal from the action of a
user of a fixture or appliance and
limits the temperature of the water
entering the cold-water piping to
104°F.
1 High Impact(Tier 1) 1 2 !Medium Impact(Tier 2) 3 Low Impact(Tier 3)
Project Title: Hudson Headwaters Report date: 01/23/19
Data filename: \\MCD2003SBS\Users\Brian\My Documents\COMcheck\Hudson Headwaters.cck Page 4 of 11
Section
Plumbing Rough-In Inspection Complies?Comments/Assumptions
Req.ID,. _
J404.7 Water distribution system that pumps OComplies Exception: Requirement does not apply.PL1313 water from a heated-water supply Does Not
pipe back to the heated-water source
through a cold-water supply pipe is a DNot Observable
demand recirculation water system. Not Applicable
Pumps within this system have
controls that start the pump upon
y i receiving a signal from the action of a
user of a fixture or appliance and
limits the temperature of the water
entering the cold-water piping to
104°F,
Additional Comments/Assumptions:
1 High Impact(Tier 1) f 2 Medium Impact(Tier 2) j 3 (Low Impact(Tier 3)
Project Title: Hudson Headwaters Report date: 01/23/19
Data filename: \\MCD20035B5\Users\Brian\My Documents\COMcheck\Hudson Headwaters.cck Page 5 of 11
Section r
i Mechanical Rough-In Inspection Complies?Comments/Assumptions
Req.ID j
C402.2.6 Thermally ineffective panel surfaces of DComplies Exception:Requirement does not apply.ME4113 sensible heating panels have Does Not
insulation>=R-3.5.
Not Observable
Not Applicable
C403.2.13 Unenclosed spaces that are heated Complies Exception:Requirement does not apply.ME7112 use only radiant heat. Does Not
M
Not Observable
Not Applicable
C403.2.3 'HVAC equipment efficiency verified. _ ['Complies See the Mechanical Systems list for values.
ME5512 : Does Not
Not Observable
Not Applicable
C403.2.4. Zone isolation devices and controls Complies Requirement will be met.
4 installed where applicable. Does Not
ME112J3
Not Observable
Not Applicable
C403.2.4. Fault detection and diagnostics Complies Exception:Requirement does not apply.
7 installed with air-cooled unitary DX Does Not
ME3:1312 units having economizers.Not Observable
Not Applicable
C403.2.5. Hot water boilers supplying heat via Complies Exception: Requirement does not apply.
1 one-or two-pipe systems include Does Not
ME11412 outdoor setback control.
Not Observable
I Not Applicable
C403.2.6 Demand control ventilation provided Complies Exception: Requirement does not apply.
1 for spaces>500 ft2 and>25 Does Not
ME5911 people/1000 ft2 occupant density and
served by systems with air side
Not Observable
economizer, auto modulating outside Not Applicable
air damper control,or design airflow
3,000 cfm.
C403.2.6. Enclosed parking garage ventilation Complies Exception:Requirement does not apply.
2 has automatic contaminant detection Does Not
ME115]3 and capacity to stage or modulate
fans to 50%or less of design capacity.
ONot Observable
Not Applicable
C403.2.7 Exhaust air energy recovery on Complies Exception: Requirement does not apply.
ME57J1 systems meeting Table C403.2.7(1) Does Not
and C403.2.7(2).
Not Observable
Not Applicable
C403.2.8 Kitchen exhaust systems comply with Complies Exception: Requirement does not apply.
ME11613 replacement air and conditioned Does Not
supply air limitations,and satisfy hood
rating requirements and maximum
Not Observable
exhaust rate criteria. Not Applicable
C403.2.9 HVAC ducts and plenums insulated. Complies Requirement will be met.
ME60]Z :Where ducts or plenums are installed Does Not
in or under a slab,verification may
need to occur during Foundation
Not Observable
Inspection. Not Applicable
C403.2.9 Ducts and plenums sealed based on Complies Requirement will be met.
ME10]2 static pressure and location. ODoes Not
Not Observable
i Not Applicable
High Impact(Tier 1) `
j
2 (Medium Impact(Tier 2) 3!Low Impact(Tier 3) j1
Project Title: Hudson Headwaters Report date: 01/23/19
Data filename: 11MCD2003SBStUsers\Brian\My Documents\COMcheck\Hudson Headwaters.cck Page 6 of 11
Section {
Mechanical Rough-In Inspection ' Complies?Comments/Assumptions
ReglDI
C403.3 Air economizers provided where Complies Requirement will be met.
ME62)1 required,meet the requirements for Does Not
design capacity,control signal,
ventilation controls,high-limit shut-off. :Not Observable
integrated economizer control,and Not Applicable
provide a means to relieve excess
outside air during operation.
C403.4.1. Hydronic and multizone HVAC system Complies Exception:Requirement does not apply.
1 controls areVAV fans driven by Goes Not
ME7512 mechanical or electrical variable
speed drive per Table C403.4.1.1. Not Observable
Not Applicable
C403.4.1. VAV fans have static pressure sensors Complies Exception:Requirement does not apply.
2 located so controller setpoint<=1.2 Does Not
ME6712 .w.c..
Not Observable
Not Applicable
C403.4.1. Reset static pressure setpoint for DDC Complies _ Requirement will be met.
3 controlled VAV boxes reporting to Does Not
ME24]2 central controller based on the zones
requiring the most pressure.
Ivct Observable
Not App;:cable
C403.4.2. 'Three-pipe hydronic systems using a Complies Requirement will be met.
1 common return for hot and chilled Does Not
ME5012 water are not used.
Not Observable
Not Applicable
C403.4.2. Two-pipe hydronic systems using a Complies Requirement will be met.
2 common distribution system have Does Not
ME6412 controls to allow a deadband>=15 F.
Not Observableallowoperationinonemodeforat
least 4 hrs before changeover,and Not Applicable
have rest controls to limit heating and
I cooling supply temperature to<=30
QF.
J
C403.4.2. Chilled water plants with multiple Complies Requirement will be met.
6 chillers have capability to reduce flow Does Not
ME2613 automatically through the chiller plant
when a chiller is shut down.Boiler Not Observable
plants with multiple boilers have the Not Applicable
capability to reduce flow automatically
through the boiler plant when a boiler
is shut down.
C403.4.4. Multiple zone VAV systems with DDC Complies Requirement will be met.
6 of individual zone boxes have static Does Not
ME110]3
pressure setpoint reset controls.
Not Observable
See the Mechanical Systems list for values.
Not Applicable
C403.4.5 Condenser heat recovery system that Complies Exception:Design SWH load=1 MMBtu/h.
ME31]3 can heat water to 85 QF or provide Does Not
60%of peak heat rejection is installed
for preheating of service hot water. [Not Observable
Not Applicable
C408.2.2. Air outlets and zone terminal devices Complies Requirement will be met.
x
1 have means for air balancing. ODoes Not
ME5333
DJNot Observable
ONot Applicable
C408.2.2. HVAC hydronic heating and cooling Complies Requirement will be met.
2 coils have means to balance and have Does Not
ME5413 pressure test connections.
Not Observable
Not Applicable
1 1High Impact(Tier 1) 12 1Medium Impact(Tier 2) I 3 'Low Impact(Tier 3) j
Project Title: Hudson Headwaters Report date: 01/23/19
Data filename: \\MCD2003SBS1Users\Brian\My Documents\COMcheck\Hudson Headwaters.cck Page 7 of 11
Section
i # Mechanical Rough-In Inspection i Complies?Comments/Assumptions
Req-ID;
C403.5, Refrigerated display cases,walk-in Complies Exception:Requirement does not apply.
C403.5.1, coolers or walk-in freezers served by Does Not
C403.5.2 remote compressors and remote
ME12313 condensers not located in a
Jot Observable
condensing unit, have fan-powered ENot Applicable
condensers that comply with Sections
C403.5.1 and refrigeration compressor
systems that comply with C403.5.2..
Additional Comments/Assumptions:
I 1 IHigh Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) 1
Project-title: Hudson Headwaters Report date: 01/23/19
Data filename: \\MCD20035BS\Users\Brian\My Documents\COMcheck\Hudson Headwaters.cck Page 8 of 11
r, Section 1 i
I
Final Inspection Complies?Comments/Assumptions
Re..IDi
C303.3, Furnished O&M manuals for HVAC Complies Requirement will be met.
C408.2.5. systems within 90 days of system Oboes Not
3 acceptance.
FI813 Not Observable
Not Applicable
C403.2.2 HVAC systems and equipment Complies Requirement will be met.
F127]3 capacity does not exceed calculated ODoes Not
loads.
Not Observable
Not Applicable
C403.2.4. Heating and cooling to each zone is Complies Requirement will be met.
1 controlled by a thermostat control. ODoes Not
FI47]3 Minimum one humidity control device
per installed Not Observable
humidification/dehumidification Not Applicable
system.
C403.2.4. Thermostatic controls have a 5 °F Complies Requirement will be met.
1.2 deadband. ODoes Not
F138]3
Not Observable
Not Applicable
C403.2.4. Temperature controls have setpoint Complies Requirement will be met.
1.3 overlap restrictions. ODoes Not
F120]3
Not Observable
DNot Applicable
C403.2.4. Each zone equipped with setback Complies Requirement will be met.
2 controls using automatic time clock or !_',-Does Not
FI39J3 programmable control system.
Not Observable
Not Applicable
C403.2.4. Automatic Controls:Setback to 55°F Complies Requirement will be met.
2.1,heat)and 85°F(cool); 7-day clock,2- ODoes Not
C403.2.4. hour occupant override,10-hour
2.2 backup
Not Observable
F14013 Not Applicable
C403.2.4. Systems include optimum start Complies Requirement will be met.
2.3 centres. ODoes Not
j[FI41]'
Not Observable
L„_ ONot ApplicableC404.3 Heat traps installed on supply and Complies -Exception:Requirement does not apply.
FI21]3 discharge piping of non-circulating ODoes Not
systems.
Not Observable
Not Applicable
C404.4 All piping insulated in accordance with Complies Requirement will be met.
I(
F12511 section details and Table C403.2.10. ODoes Not
Not Observable
Not Applicable
C404.6.1 Controls are installed that limit the Complies Exception:Requirement does not apply.
FI12]3 operation of a recirculation pump ODoes Not
installed to maintain temperature of a
storage tank.System return pipe is a
Not Observable
dedicated return pipe or a cold water Not Applicable
supply pipe.
C408.2.1 Commissioning plan developed by 'Complies 1t Goos Cta
FI28]1 registered design professional or ODoes Not
approved agency. Not Observable
I21Not Applicable
1 High Impact(Tier 1) j 2 1Medium Impact(Tier 2) 1 3 jLow Impact(Tier 3)
Project Title: Hudson Headwaters Report date: 01/23/19
Data filename: \\MCD2003SBS\Users\Brian\My Documents\COMcheck\Hudson Headwaters.cck Page 9 of 11
Section I
S I Final Inspection I Complies?Comments/Assumptions
Req.ID l
C408.2.3. HVAC equipment has been tested to Complies Requirement will be met.
1 ensure proper operation.Does Not
Ft31]1
ONot Observable
ONot Applicable
C408.2.3. •HVAC control systems have been DComplies Requirement will be met.
2 tested to ensure proper operation. Does Not •
F110]1 calibration and adjustment of controls.
ONot Observable
Not Applicable ,
C408.2.3. .Economizers have been tested to Complies Requirement will be met.
W f f
3 ensure proper operation. Does Not
FI32J1
ONot Observable'
ONot Applicable
C408.2.4 Preliminary commissioning report Complies
F12911 completed and certified by registered Does Not
design professional or approved
agency. ONot Observable
Not Applicable
C408.2.5. :Furnished HVAC as-built drawings Complies Requirement will be met.
1 submitted within 90 days of system Does Not •
F1713 acceptance.
Not Observable
ONot Applicable
C408.2.5. An air and/or hydronic system DComplies Requirement will be met.
3 balancing report is provided for HVAC Does Not
FI43]1 systems.
Not Observable
ONot Applicable
C408.2.5. Final commissioning report due to Complies —
y
4 building owner within 90 days of Does Not
F130]1 receipt of certificate of occupancy. ONot Observable
Not Applicable
Additional Comments/Assumptions:
1 High Impact(Tier 1) 2 {Medium Impact(Tier 2)- 3 {Low Impact(Tier 3)
Project Title: Hudson Headwaters Report date: 01/23/19
Data filename: \\MCD20035B51Users\Brian\My Documents\COMcheck\Hudson Headwaters.cck Page 10 of 11
I •
Project Title: Hudson Headwaters Report date: 01/23/19
Data filename: \\MCD2003SB5\Users\Brian\My Documents\COMcheck\Hudson Headwaters.cck Page 11 of 11
HVAC SYSTEMS TESTING:
Air Balance Report
for
Hudson Headwaters Health Network
Michael J. Lucarelli
June 8, 2019
PO Box 719
Glens Falls, New York 12801
20 Corporate Circle
Albany, New York 12203
Location:
MJL ADTEK Enterprises, LLC
P.O. Box 16144, Albany, NY 12212
Phone: (518)218-0497
Date:
Prepared by:
Engineer:
Contractor:
Queenbury, New York
Strenkowski Associates, P.C.
McD Metals, LLC
28 Southwestern Ave.
Project:
Project:
Address:
DATE:
PROJECT # :
MJL ADTEK Enterprises, LLC.TESTING AND BALANCING FIRM:
BALANCED BY:
SIGNATURE:
June 8, 2019
Michael J. Lucarelli
Michael J. Lucarelli
THE DATA PRESENTED IN THIS REPORT IS AN EXACT RECORD OF SYSTEM PERFORMANCE AND
WAS OBTAINED IN ACCORDANCE WITH NEBB STANDARD PROCEDURES. ANY VARIANCES
FROM DESIGNED QUANTITIES WHICH EXCEEDS NEBB TOLERANCES ARE NOTED THROUGHOUT
THIS REPORT.
THE AIR DISTRIBUTION SYSTEMS HAVE BEEN TESTED & BALANCED AND FINAL ADJUSTMENTS
HAVE BEEN MADE IN ACCORDANCE WITH NEBB "PROCEDURAL STANDARDS FOR TESTING
AND BALANCING OF ENVIRONMENTAL SYSTEMS" AND THE PROJECT SPECIFICATIONS.
THE WATER DISTRIBUTION SYSTEMS HAVE BEEN TESTED & BALANCED AND FINAL
ADJUSTMENTS HAVE BEEN MADE IN ACCORDANCE WITH NEBB "PROCEDURAL STANDARDS
FOR TESTING AND BALANCING OF ENVIRONMENTAL SYSTEMS" AND THE PROJECT
SPECIFICATIONS.
CERTIFICATION
28 Southwestern Ave.
Queenbury, New York
Hudson Headwaters Health Network
M7041
CD - Ceiling Diffuser
CS - Circuit Setter
DD - Direct Drive
ER - Exhaust Register
LD - Linear Diffuser
NA - Not Accessible
ND - No Volume Damper
NG - No Gauges
NI - Not Installed
NR - Not Required
NS - Not Specified
OBD - Opposed Blade Damper
OD - Open Duct
RG - Return Grille
SR - Supply Register
SD - Supply Diffuser
TP- Thermally Protected
EP-Electronically Protected
WMS - Wire Mesh Screen
NN - Diffuser, Register or Grille Noisy: All available
adjustments made to correct condition. Additonal
Dampers, sound lining or duct change required to
correct condition.
MJL ADTEK Enterprises, LLC
P.O. Box 16144, Albany, NY 12212
Phone: (518)218-0497
Following are code definitions as used in a balancing report:
PROJECT NAME:
ADDRESS:
ACTUAL
5116
4983
4108
1008*
2.62
2.02
0.6
943
CENTURY
5.0
3
211/212/211
13.0/12.6/12.6
1755
1.0
VFD 60 HZ
Remarks: * Min. O.A. damper position set at 30%.
MOTOR SHEAVE & NO. GROOVES
FAN SHEAVE & NO. GROOVES
BELTS
1VP50 x 1-1/8" ( 50% CL)
BK80 x 1-3/16"
BX60
9.2
NS
NS
AMPERAGE
MOTOR RPM
MOTOR SERVICE FACTOR
STARTER HEATER ELEMENTS
NS
MOTOR MANUFACTURER
MOTOR HP/BHP
PHASE
VOLTAGE
FAN RPM
NS
NS
3
208
INLET PRESSURE
DISCHARGE PRESSURE
TOTAL STATIC PRESSURE 1.0
NS
NS
SPECIFIED
5120
5100
4095
1025
NS
SERIAL NUMBER
TOTAL CFM-FAN
TOTAL CFM-OUTLET
R/A CFM
O/A CFM
0819P13292
SPECIFIED ACTUAL
AIR MOVING EQUIPMENT TEST SHEET
SYSTEM
EQUIPMENT LOCATON
AREA SERVICED
EQUIPMENT MANUFACTURER
MODEL
RTU-1
OUTSIDE PAD
1ST FLOOR
CARRIER
50TC-D16A2A5A2W1J0
TOTAL PAGES:7
MJL ADTEK Enterprises, LLC
Phone: (518)218-0497
P.O. Box 16144, Albany, NY 12212
PAGE NUMBER:1
Hudson Headwaters Health Network
28 Southwestern Ave.
Queenbury, New York
PROJECT
NUMBER:M7041
6/8/2019DATE:
PROJECT NAME:
ADDRESS:
Zone/Branch Building Floor & Column Duct Size
Effect
Area
Velocity
FPM
CFM
Velocity
FPM
CFM
Velocity
FPM
CFM
RTU-1
SUPPLY
1 123 36" x 16"4.0 1280 5120 1279 5116 1279 5116
RETURN
1 123 36" x 16"4.0 1024 4095 1027 4108 1027 4108
Remarks:
DATE:
PROJECT NUMBER:M7041
MJL ADTEK Enterprises, LLC
P.O. Box 16144, Albany, NY 12212
Phone: (518)218-0497
6/8/2019
Hudson Headwaters Health Network
2
TOTAL PAGES:7
DUCT TRAVERSE TEST FORM
CONDITIONSLOCATON REQUIRED FIRST TEST FINAL TEST
PAGE NUMBER:28 Southwestern Ave.
Queenbury, New York
TYPE SIZE Ak FPM CFM TEST 1 TEST 2 TEST 3 FPM CFM
RTU-1
SUPPLY
RH-6
1 114 SD 8"RD 1.0 HOOD 135 126 126 NR HOOD 126
2 112 SD 8"RD 1.0 HOOD 135 128 128 NR HOOD 128
3 108 SD 8"RD 1.0 HOOD 135 133 133 NR HOOD 133
4 107 SD 8"RD 1.0 HOOD 135 127 127 NR HOOD 127
5 103 SD 6"RD 1.0 HOOD 50 47 47 NR HOOD 47
6 TOTAL 590 TOTAL 561
VAV-4
1 135 SD 6"RD 1.0 HOOD 95 94 94 NR HOOD 94
2 136 SD 10"RD 1.0 HOOD 262 263 263 NR HOOD 263
3 136 SD 10"RD 1.0 HOOD 263 267 267 NR HOOD 267
4 137 SD 6"RD 1.0 HOOD 90 90 90 NR HOOD 90
TOTAL 710 TOTAL 714
VAV-3
1 146 SD 6"RD 1.0 HOOD 75 71 71 NR HOOD 71
2 105 SD 8"RD 1.0 HOOD 175 173 173 NR HOOD 173
3 105 SD 8"RD 1.0 HOOD 175 174 174 NR HOOD 174
4 106 SD 6"RD 1.0 HOOD 75 75 75 NR HOOD 75
TOTAL 500 TOTAL 493
RH-2
1 139 SD 8"RD 1.0 HOOD 135 125 125 NR HOOD 125
2 140 SD 8"RD 1.0 HOOD 135 131 131 NR HOOD 131
3 141 SD 6"RD 1.0 HOOD 75 75 75 NR HOOD 75
4 142 SD 8"RD 1.0 HOOD 135 123 123 NR HOOD 123
5 143 SD 8"RD 1.0 HOOD 135 124 124 NR HOOD 124
TOTAL 615 TOTAL 578
Remarks:
Queenbury, New York
28 Southwestern Ave.
PROJECT NUMBER:M7041
6/8/2019DATE:
MJL ADTEK Enterprises, LLC
P.O. Box 16144, Albany, NY 12212
Phone: (518)218-0497
PROJECT NAME: Hudson Headwaters Health Network
PAGE NUMBER:
TOTAL PAGES:
3
7
FINAL
AIR DISTRIBUTION TEST SHEET
TERMINAL
NUMBER
ROOM NUMBER
TERMINAL DESIGN TEST-FPM or CFM
ADDRESS:
TYPE SIZE Ak FPM CFM TEST 1 TEST 2 TEST 3 FPM CFM
RTU-1
SUPPLY continued
RH-5
1 124 SD 8"RD 1.0 HOOD 135 136 136 NR HOOD 136
2 125 SD 6"RD 1.0 HOOD 100 102 102 NR HOOD 102
3 126 SD 6"RD 1.0 HOOD 100 106 106 NR HOOD 106
4 130 SD 6"RD 1.0 HOOD 100 93 93 NR HOOD 93
5 132 SD 10"RD 1.0 HOOD 300 297 297 NR HOOD 297
TOTAL 735 TOTAL 734
RH-8
1 122 SD 8"RD 1.0 HOOD 135 139 139 NR HOOD 139
2 117 SD 8"RD 1.0 HOOD 135 134 134 NR HOOD 134
3 116 SD 8"RD 1.0 HOOD 115 116 116 NR HOOD 116
4 115 SD 8"RD 1.0 HOOD 135 128 128 NR HOOD 128
TOTAL 520 TOTAL 517
RH-7
1 113 SD 6"RD 1.0 HOOD 100 103 103 NR HOOD 103
2 118 SD 8"RD 1.0 HOOD 135 132 132 NR HOOD 132
3 119 SD 8"RD 1.0 HOOD 135 136 136 NR HOOD 136
4 120 SD 8"RD 1.0 HOOD 135 138 138 NR HOOD 138
5 121 SD 6"RD 1.0 HOOD 100 95 95 NR HOOD 95
TOTAL 605 TOTAL 604
Remarks:
MJL ADTEK Enterprises, LLC
P.O. Box 16144, Albany, NY 12212
Phone: (518)218-0497
PROJECT NAME: Hudson Headwaters Health Network PROJECT NUMBER:M7041
DATE:6/8/2019
ADDRESS: 28 Southwestern Ave.PAGE NUMBER:4
FINAL
Queenbury, New York TOTAL PAGES:7
AIR DISTRIBUTION TEST SHEET
TERMINAL
NUMBER
ROOM NUMBER
TERMINAL DESIGN TEST-FPM or CFM
TYPE SIZE Ak FPM CFM TEST 1 TEST 2 TEST 3 FPM CFM
RTU-1
SUPPLY continued
VAV-1
1 102 SD 8"RD 1.0 HOOD 225 217 217 NR HOOD 217
2 101 SD 8"RD 1.0 HOOD 200 193 193 NR HOOD 193
3 102 SD 8"RD 1.0 HOOD 225 211 211 NR HOOD 211
4 102 SD 8"RD 1.0 HOOD 175 161 161 NR HOOD 161
TOTAL 825 TOTAL 782
UNIT TOTAL 5100 UNIT TOTAL 4983
Remarks:
MJL ADTEK Enterprises, LLC
P.O. Box 16144, Albany, NY 12212
Phone: (518)218-0497
PROJECT NAME: Hudson Headwaters Health Network PROJECT NUMBER:M7041
DATE:6/8/2019
ADDRESS: 28 Southwestern Ave.PAGE NUMBER:5
FINAL
Queenbury, New York TOTAL PAGES:7
AIR DISTRIBUTION TEST SHEET
TERMINAL
NUMBER
ROOM NUMBER
TERMINAL DESIGN TEST-FPM or CFM
PROJECT NAME:
ADDRESS:
ACTUAL
NA
670
0.43
0.35
0.08
NA*
BROAD OCEAN
1/4
1
120
1.8
300-1750
1.0
EP
Remarks:
PROJECT
NUMBER:M7041
6/8/2019DATE:
Queenbury, New York
Hudson Headwaters Health Network
28 Southwestern Ave.PAGE NUMBER:
TOTAL PAGES:7
6
PHASE 1
DISCHARGE PRESSURE NS
FAN RPM NS
MJL ADTEK Enterprises, LLC
P.O. Box 16144, Albany, NY 12212
Phone: (518)218-0497
BELTS
MOTOR SERVICE FACTOR NS
STARTER HEATER ELEMENTS NS
DIRECTDRIVEMOTORSHEAVE & NO. GROOVES
FAN SHEAVE & NO. GROOVES
VOLTAGE 115
AMPERAGE 2.55
MOTOR RPM NS
MOTOR MANUFACTURER NS
MOTOR HP/BHP 1/4
GREENHECK
MODEL SQ-99-VG-4-X
NS
TOTAL CFM-FAN 675
TOTAL CFM-OUTLET 665
INLET PRESSURE
TOTAL STATIC PRESSURE 0.75
SYSTEM EF-1
Speed Pod set at 7.0
EXHAUST FAN DATA SHEET
EQUIPMENT LOCATON CEILING
AREA SERVICED BATHROOMS
DIRECT DRIVE
DIRECT DRIVE
SERIAL NUMBER 15776074
SPECIFIED SPECIFIED ACTUAL
EQUIPMENT MANUFACTURER
TYPE SIZE Ak FPM CFM TEST 1 TEST 2 TEST 3 FPM CFM
EF-1
1 127 EG 8"RD 1.0 HOOD 120 82 123 123 HOOD 123
2 126 EG 8"RD 1.0 HOOD 120 97 131 126 HOOD 126
3 129 EG 6"RD 1.0 HOOD 85 81 115 89 HOOD 89
4 131 EG 6"RD 1.0 HOOD 85 76 121 84 HOOD 84
5 145 EG 6"RD 1.0 HOOD 85 66 110 83 HOOD 83
6 110 EG 6"RD 1.0 HOOD 85 56 87 84 HOOD 84
7 103 EG 6"RD 1.0 HOOD 85 44 66 81 HOOD 81
TOTAL 665 TOTAL 670
Remarks:
MJL ADTEK Enterprises, LLC
P.O. Box 16144, Albany, NY 12212
Phone: (518)218-0497
PROJECT NAME: Hudson Headwaters Health Network PROJECT NUMBER:M7041
DATE:6/8/2019
ADDRESS: 28 Southwestern Ave.PAGE NUMBER:7
FINAL
Queenbury, New York TOTAL PAGES:7
AIR DISTRIBUTION TEST SHEET
TERMINAL
NUMBER
ROOM NUMBER
TERMINAL DESIGN TEST-FPM or CFM
RX Date/Time 0611212019 11:41 15182731202 P.008
Jun. 12. 201911_19A MDIA No, 9164 P. 818
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: HHHN Pediatric Center Date: 05/29/2019
Occupant: Locatio
Comm. 58 South Western Ave
OccupancyNon-Residential Queensbury, Warren Co. NY
Applicant F �
Comalli Group Inc.
7 Westview Rd :..
Pittsfield, MA 01201
Joseph A.Holmes
No.
• •141222109840EL' r _
Equipment: -.......
1 -125 Amp Transfer Switch; 1 -225-Amp Panel;'31•='Switches; 148-Receptscles;'82 Fixtures; 1 -30 Amp Water
Heater;2-1000 KW Electric Heaters.
•'�•.;-•`'-•.... ... -.r .. .... ... 17,^roc 9 W
JUN' 1.2 2019
TOWN OF OUEENSBURY
BUILDING&OODES
This certificate applies to the electrical wiring to the electrical equipment listed Immediately null and void- This certificate applies only to the use,occupancy aril
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,of i- 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 u%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 rainspection by Middle Department
system to which this certificate applies be altered in any way,Including but not limit- Inspection Agency.Inc. An application tot 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 revalidatlon
any of the components installed as of the above noted date,this certificate shall be process. A fee will be charged for this service.
INSPECTION WORKSHEET (BINS-003079-2019)
Town of Queensbury - Building and Codes - Fire Marshal
742 Bay Road - (518) 761-8256 Building (518) 761-8206 Fire Marshal
Case Number:CC-0044-2019 Case Module:Permit
Inspection Date:Fri May 31, 2019 Inspection Status:Passed
Inspector:John O'Brien Inspection Type:Building Framing
Job Address:Parcel Number:28 WESTERN AVE SOUTH
Queensbury, NY 12804
309.7-1-55
Contact Type Company Name Name
Granted Permission Hudson Headwater Health Network
Applicant BBL Construction Services
Contractor BBL Construction Services
Primary Owner Hudson Headwater Health Network
Engineer HCP Architects, LLP
Checklist Item Passed Comments
Building Inspector Notes YES 4/2/19 Framing Partial Approval
Interior non-bearing metal partitions approved
4/23/19 Framing Partial Approval
Vestibule exterior and interior framing approved.
5/31/19 Framing Approved - Above ceiling inspection for
ceiling lights bracing and sheetrock plenum intact.
Framing YES 4/2/19 Framing Partial Approval
Interior non-bearing metal partitions approved
4/23/19 Framing Partial Approval
Vestibule exterior and interior framing approved.
5/31/19 Framing Approved - Above ceiling inspection for
ceiling lights bracing and sheetrock plenum intact.
Bracing Bridging YES 4/2/19 Framing Partial Approval
Interior non-bearing metal partitions approved
May 31, 2019 Page (1)
O'Brien, John (Inspector)
INSPECTION WORKSHEET (BINS-003639-2019)
Town of Queensbury - Building and Codes - Fire Marshal
742 Bay Road - (518) 761-8256 Building (518) 761-8206 Fire Marshal
Case Number:CC-0044-2019 Case Module:Permit
Inspection Date:Mon Jun 17, 2019 Inspection Status:Failed
Inspector:John O'Brien Inspection Type:Commercial Final Inspection
Job Address:Parcel Number:28 WESTERN AVE SOUTH
Queensbury, NY 12804
309.7-1-55
Contact Type Company Name Name
Primary Owner Hudson Headwater Health Network
Engineer HCP Architects, LLP
Applicant BBL Construction Services
Granted Permission Hudson Headwater Health Network
Contractor BBL Construction Services
Checklist Item Passed Comments
Ext Finish /Grade Complete/6 in 10ft or
Equivalent
YES - Fill in around main entrance foundation
Attic Access 30 x 20 x 30 (h)YES - Label ceiling grid for location of attic access
Handicapped Bath/Parking Lot Signage YES - Completed handicapped parking signage and striping as
discussed.
Universal Symbol of Access displayed - on all
H/C signs
YES - Completed handicapped parking signage and striping as
discussed.
Jun 17, 2019 Page (1)
INSPECTION WORKSHEET (BINS-003639-2019)
Checklist Item Passed Comments
Site Plan Variance required NO - Site Inspection by Bruce Frank (TOQ Code Compliance
Officer)
Decision on Handicapped Parking Requirements based on
future parking. Existing parking meets the requirements.
Expansion of parking lot would require additional
handicapped parking space.
Engineer or Architect Approval YES - Provide Final Approval Letter from Architect stating the
building has been completed in accordance with the
approved plans and COMcheck for HVAC and Electrical.
Special Inspections YES HVAC Air Balancing Report Approved
OK to Issue C/O NO 6/13/19 Final Inspection Not Approved
Fill in around main entrance foundation
Label ceiling grid for location of attic access
Completed handicapped parking signage and striping as
discussed.
Site Inspection by Bruce Frank (TOQ Code Compliance
Officer)
Provide Final Approval Letter from Architect stating the
building has been completed in accordance with the
approved plans and COMcheck for HVAC and Electrical.
Complete all site items as per Bruce Frank.
6/17/19 Final Inspection Not Approved
Remaining Items:
Site Inspection by Bruce Frank (TOQ Code Compliance
Officer)
Decision on Handicapped Parking Requirements based on
future parking. Existing parking meets the requirements.
Expansion of parking lot would require additional
handicapped parking space.
Jun 17, 2019 Page (2)
O'Brien, John (Inspector)
INSPECTION WORKSHEET (BINS-003823-2019)
Town of Queensbury - Building and Codes - Fire Marshal
742 Bay Road - (518) 761-8256 Building (518) 761-8206 Fire Marshal
Case Number:CC-0044-2019 Case Module:Permit
Inspection Date:Mon Jun 24, 2019 Inspection Status:Passed
Inspector:John O'Brien Inspection Type:Commercial Final Inspection
Job Address:Parcel Number:28 WESTERN AVE SOUTH
Queensbury, NY 12804
309.7-1-55
Contact Type Company Name Name
Granted Permission Hudson Headwater Health Network
Engineer HCP Architects, LLP
Primary Owner Hudson Headwater Health Network
Contractor BBL Construction Services
Applicant BBL Construction Services
Checklist Item Status
Ext Finish /Grade Complete/6 in 10ft or Equivalent Passed
Fill in around main entrance foundation
Attic Access 30 x 20 x 30 (h)Passed
Label ceiling grid for location of attic access
Handicapped Bath/Parking Lot Signage Passed
Completed handicapped parking signage and striping as discussed.
Universal Symbol of Access displayed - on all H/C signs Passed
Completed handicapped parking signage and striping as discussed.
Site Plan Variance required Passed
Site Inspection by Bruce Frank (TOQ Code Compliance Officer)
Jun 24, 2019 Page (1)
INSPECTION WORKSHEET (BINS-003823-2019)
Checklist Item Status
Decision on Handicapped Parking Requirements based on future parking. Existing parking meets the
requirements. Expansion of parking lot would require additional handicapped parking space.
Engineer or Architect Approval Passed
Provide Final Approval Letter from Architect stating the building has been completed in accordance with the
approved plans and COMcheck for HVAC and Electrical.
Special Inspections Passed
HVAC Air Balancing Report Approved
OK to Issue C/O Passed
6/13/19 Final Inspection Not Approved
Fill in around main entrance foundation
Label ceiling grid for location of attic access
Completed handicapped parking signage and striping as discussed.
Site Inspection by Bruce Frank (TOQ Code Compliance Officer)
Provide Final Approval Letter from Architect stating the building has been completed in accordance with the
approved plans and COMcheck for HVAC and Electrical.
Complete all site items as per Bruce Frank.
6/17/19 Final Inspection Not Approved
Remaining Items:
Site Inspection by Bruce Frank (TOQ Code Compliance Officer)
Decision on Handicapped Parking Requirements based on future parking. Existing parking meets the
requirements. Expansion of parking lot would require additional handicapped parking space.
6/24/19 Final Inspection Approved - Ok to Issue CO!
Jun 24, 2019 Page (2)
O'Brien, John
Site Data Worksheet
REQUIRED PROPOSED NOTES:
Lot Size =20,044SQFT. 57,463 SF. 100% Poo A>Am
1. CONSTRUCTION IS TO PROCEED IN ACCORDANCE .WITH. THE:
Site Statistics:CONSTRUCTION PHASING SCHEDULE SUPPLIED BY THE CONTRACTOR OR
SHOWN ON THE PLANS. ALL ELEMENTS OF EASEMENTS AND RIGHT-OF-Greens oce 3a% rr r T WAY PROCUREMENT ARE TO BE COMPLETED PRIOR TO BEGINNING
p 20,908 SF. 36.6X
L, BEG N G THEAsphalt14,418.4 SF. 25.3% la ;y I T .A t!1 1 Zr NEXT CONSTRUCTION PHASE. THESE ELEMENTS INCLUDE ALL UTILITYBuilding/Sidewalk I '_' 'r r 1 11V;SURrD THE DISTN'01E INSTALLATION, THE BASE COURSE OF ASPHALT PAVING.p V NG, ANDWoods374.85 SF. 12.
2%
GAS MAIN FRv"; " +E RO ; RTY' LINES TO THE TEESTABLISHING GRASSES ON ALL OTHER R.O.W. AREAS AND ANY OTHER14,374.85 SF. 25.2aG
SCTURE(S) OR 'IGN ) AREAS DISTURBED BY CONSTRUCTION. FOR TIME FRAMESBuildingHeight40' MAX 30'
1 q OUTSIDE THE GROWING SEASON, OTHER METHODS OF SOIL WParkingSpaces2$ spaces (on site) si ,u DAi STABILIZATION (SUCH AS THE USE OF JUTE MESH AND EXCELSIOR3Handicapspaces (on sited MATTING) WILL BE USED UNTIL SUCH TIME AS GRASS CAN BETotalspaces31
G , ESTABLISHED: U
W
Setbacks .(Building): fSS
C<J IFrontwt51.70• 2. IMMEDIATELY FOLLOWING THE COMPLETION OF CONSTRUCTION
Z ACTIVITIES IN ANY PORTION OF THE SITE, PERMANENT VEGETATION v asSide (L} 20' 9.3' W'---
w fir
Side (R) 20' 30.4'
0'
9S W V SHALL BE ESTABLISHED ON ALL EXPOSED SOILS.rzLO
W 12» WA AV,,,,
eRear2098.3 0L, TER MAIN 3. IN SOME INSTANCES ESTABLISHING VEGETATION ON R.O.W. AREASIPF
W GAS PIPING WILL BE NECESSARILY DELAYED WHILE CONSTRUCTION IS IN
CzT
W
W
DETAIL 1 /C-7 PROGRESS. DURING THESE TIMES SEDIMENT CONTROL MEASURES WILL C
Y c ZWATERTAPPINGVALVEBEEMPLOYEDTOPREVENTSEDIMENTFROMLEAVINGTHESITE.U nrs W
VEGETATION IS TO BE ESTABLISHED IN THESE AREAS AS SOON AS 1T a `'t>DETAIL 4 C-7PARKINGCALCULATIONSFALLSJOFw----_ 1' WIDE PAINTED STOP BAR & SIGN IS PRACTICAL. C) 4 -
SOU £
SB 4Y
c w --J.,BUILDING SQUARE FOOTAGE = 5600.0SM, = 18.66 WCqS
304 W----
W
Q 4. THE SEDIMENT CONTROL MEASURES DETAILED ON SHEET C-3 SHALL14EMPLOYEES = 7
1 BE IN PLACE PRIOR TO CONSTRUCTION START-UP FOR EACH2 tonctRF
W
CONSTRUCTION PHASE. THESE MEASURES CONSIST OF HAY BALE
DIKES, SILT FENCES, DRAINAGE DITCH SEDIMENT FILTERS, STORM
o
I25.66 GATE VA YE ---- of GLENS DRAIN INLET FILTERS, AND STABILIZED CONSTRUCTION ENTRANCES.0 ItsSIGNTnrVNQEgUEENBURYONCECONSTRUCTED, ALL MEASURES SHALL BE PROPERLY MAINTAINED 00
ADD 20X = 1.20 x
2 .4 DETAIL 16/C-631SPACESY AND/OR REPLACED AS NECESSARY, AND THEN REMOVED FROM THE SITE
LO
N 3 3 2
PRESSURE SEWER DETAIL ONCE VEGETATION AND PAVEMENT ARE IN PLACE. U
DETAIL 15 j C-6 U NIX)WATER & SEWER DEMAND C. SANITARY GRINDER PUMP 5. DAMAGE TO SURFACE WATERS RESULTING FROM EROSION AND t m LoAowWDETAIL5jC-7 SEDIMENTATION SHALL BE MINIMIZED BY STABILIZING DISTURBED w -75.7
Z v
FLOW :PER. EMPLOEE 10.2 GPD x 14 EMPLOYEES = 142.8 GPD
AREAS AND. BY REMO VING SEDIMENT FROM CONSTRUCTION SITEFIREHYDRANT5600SOFTx1/10 GAL/SOFT = 560 GPD j
DETAIL i 2/C-6 DISCHARGES.702.8 GPD V( 1' J
z otWvW U S GRADE CLEAN OUT 1 D4 J BA DETAIL 13 jC-6 s. INSOFAR AS PRACTICABLE, EXISTING VEGETATION SHALL BE OPLIMITSOFCLEARING
7g
PRESERVED. SITE PREPARATION ACTIVITIES SHALL BE PLANNED TO 01MINIMIZETHEAREAANDDURATIONOFSOILDISRUPTION. ALL m13PROPSED4PAINTEDCENTERLINE
a HEALTHY TREES OF DESIRABLE SPECIES ARE TO BE PROTECTED FROM
WOODS FRENCH BUILDING DRdt N NDS OF DAMAGE. ALL UNNECESSARY REMOVAL OF HEALTHY TREES SHALL BE c Qin
L ETAIL 3/C-3 SWEET AVOIDED.D C'
HANDICAP DETAIL 1/C-6 a80,x70•
t8'
7, PERMANENT TRAFFIC CORRIDORS SHALL BE ESTABLISHED AND "ROUTES a
1 MEDICAL PROPOSED 5 WIDE OF CONVENIENCE SHALL BE AVOIDED_ CONSTRUCTION TRAFFIC
5800 S ARTS' BPI LDfNG CONCRETE WALK 8/C-6 SHALL NOT CROSS STREAMS OR DITCHES EXCEPT AT SUITABLEcRFFF•_ 9973 PROPOSED ASPHALT t CROSSING FACILITIES, AND SHALL NOT OPERATE UNNECESSARIL(30.4
CIRf'
SURFACE 6 6 f WITHIN WATERWAYS OR DRAINAGE DITCHES.
r g. TOPSOIL AND FILL THAT IS TO REMAIN STOCKPILE ON-SITE FOR
1 j ! PERIODS GREATER THAN 14 DAYS SHALL BE STABILIZED BY SEEDING.PROPOSED BERM CURB E.y PRIOR TO THE SEEDING OPERATION, THE STOCKPILED MATERIALytt
1 9/C-6 SHALL BE GRADED AS NEEDED AND FEASIBLE TO PERMIT THE USE OFNCHIM#RK PROPOSED CURB CONVENTIONAL EQUIPMENT FOR SEEDBED PREPARATION, SEEDING,
ms'1 W MULCH APPLICATION, AND MULCH ANCHORING. IN NO CASE SHALL oE99.35,
ERODIBLE MATERIALS BE STOCKPILED WITHIN 25 FT OF ANY DITCH co
STREAM, OR OTHER SURFACE WATER. Cq
wPROPSEDWD. LATiCE 9. EMBED HAY BALES 4 INCHES. STAKE ALL BALES TO RESI:' J'
SipEyyA FENCE do GATE 5/C 6
HAY BALES SHOO T WATER FORCES. Q f
LK LS EXTEND FAR ENOUGH UP SLOPE TO ?REVENT WATER
i
l
L -FROM FLOWING AROUND ENDS AND CAUSING WASHOUT. HAY BALES COLLECTPROPSEDLIMITSOFCLEARINGOILUNDERLOWFLOWCONDITIONS. HAY BALES SHOULD BE USED INLlltSLAWSN/F of 1 t1 R?0. DRAINAGE CHANNELS FROM MAINTENANCE AREA.1i`RI ER
i
W
Z
Li
10. HAY BALE BERMS SHALL BE CONSTRUCTED AROUND ALL STr,Ct;PILES OF
WOODSFILL, TOPSOIL AND EXCAVATED OVERBURDEN THAT ARE TO REMAIN WEXPOSEDFORPERIODSLESSTHAN14AYL
1Q `' --- 31 PARKING DAYS. HAY BALL BERMS SHALLSPACESIBEANCHOREDANDMAINTAINEDINGOODCONDITIONUN'`IL SUCH TIME
5p AS SAID STOCKPILES ARE REMOVED AND STOCKPILING AREAS ARE WSMACXBROUGHTTOFINALGRADEANDPERMANENTLYSTABILIZED.
Ck?
GENERAL SITE NOTES: r
I. PRIOR TO CONSTRUCTION, CONTRACTOR SHALL OBSERVE EXISTING
4. CONDITIONS; VERIFYING GRADES AND FIELD MEASUREMENTS AND NOTIFYTHEENGINEERORLANDSCAPEARCHITECTOFANYDISCREPANCIES. j SL 7 .
O
F c; ADJUSTMENTS MUST BE APPROVED BY THE ENGINEER OR LANDSCAPEARCHITECTPRIORTOINSTALLATION
INV=94.
2. THE UTILITIES SHOWN HAVE BEEN PLOTTED FROM AVAILABLE NAPPING, fl ,
r THEY ARE NOT CERTIFIED AS TO THE ACCURACY OF THEIR LOCATION, 13 R ofTHEIRCOMPLETENESS. IT IS THE CONTRACTOR'S RESPONSIBILITY TO D w
VERIFY THE LOCATI[ri AND EXTENT OF ALL STRUCTURES ANT) UTILITIES. m
AIX 1ASW
ofINY=94, 0
w« cow oR CONOWoN o -Me"3. CONTRACTORS SHALL OBTAIN ALL REQUIRED APPROVALS, PEPMITS, vw 2y 0m
INSPECTIONS APPROVALS, ETC. FOR WORK PERFORMED FROM AG' ANuWEtrC ir"r
C =4•r ftVKAN- .t NORTH A1 1 All
per 1 HAVING JURISDICTION THEREOF. NCIES N
Nfi
4. C13NTRACTUR SHALL PROVIDE PROPER SIGNS, BARRICADES AND/17RFDiETTOO
INJURY.T WORK, PROPERTY, EQUIPMENT AND PERS IS f?QM OF THE Comm
DNOlt 6w= sNouLu
F 5. DAILY TRAFFIC IN THE VICINITY OF THE SITE' SHALL NOT BE-IMPEDER of N0M' _AMEREAWITHOUTPRIERAPPROVAL13FGOVERNINGHIGHWAYPERSONNEL. SPEED XTA. I t f2D,HOLDENAND TRAFFIC CONTROL SICIIS ARE TO LONF`(M WITH LOCAL, COUNTY,AND/OR STATE SPECIFICATIONS.
N6. CONTRACTOR IS RESPONSIBLE TO REPAIR AND REPLACE ALL ITEMS
Wv
ITDISTUFDAMAGED
tN2BED ON THIDE13F
E
PROPERTY
E WHICH
CONSTRUCTIONNOTPARTLIMI t#' TF,
OR ANY
E,THIS PROJECT / CONTRACT.
D4 7. PRIOR TO PROJECT CLOSE-OUT, CONTRACTOR SHALL REMOVE (MD SITE PLANLEGALLYDISPOSEOF) ALL DEBRIS AND EXCESS MATERIAL FROM THE SITE.a CONTRACTOR SHALL TAKE EVERY PRECAUTION TO AVOID DAMAGE TO NTSANYVEGETATIONTOREMAIN,APPROVED UNDER AUTHORITY OF A RESOLUTION ADOPTED s. ALL Exlsnl STRUCTURES TA26ALLENANDUTILITIESINCLUDINGBUTNOTLIMITEDTO; SEWERS, CATCH BASINS, INLETS, MANHOLES, WATER SERVICE, PUBLIC 5%ZQ O5ANDPRIVATEUTILITIES, POLES TO REMAIN SHALL BE LOCATED' AND51TE 'L AEI
ry_
BY THE PLANNING PROTECTED. IF SUCH STRUCTURES AND/ORUTILITIES
CONTRACTOR SHALL REPAIR OR PAY IRARE DAMAGED, THEC-2
FOR THE REPAIR OF THE SAME TO ABOARDOFTHETOWNOFQUEENSBURYscAl . 1`=20 MINI" PRE CONTRACT/PROJECT CONDITION 1 TAD 7/12/o 3(} 60 gp 10. IF IN THE COURSE [#' CONSTRUCTION A CONDITION EXISTS WHICH MLWAIXDISAGREESWITHWHATISINDICATEDO+1 THESE PLANS, THE CONTRACTOR 2 TAT} 7/2:
SHALL STOP WORK AND NOTIFY THE ENGINEER IBR LANDSCAPE ARCHITECT.SHOULD HE/SHE FAIL TO FOLLOW THIS PROCEDURE AND CONTINUE WORK,3CHAIRPERSONHE/SHE SHALL ASSUME ALL RESPONSIBILITY AND LIABILITY ARISINGTHEREFROM.
11. THE CONTRACTOR SHALL NOTIFY CALL BEFatE YOU DIG 1-800--922-4455 FOR SWAP: tle¢ ,T tto.VERIFICATION OF THE LOCATION 1 UMDERGRD ID UTILITIES AT LEASTDATESIGNED------.._.. ...... 72 HOURS PRIOR TO THE START OF EXCAVATION. HMNA05-
12. CONTRACTOR SHALL COMPLY WITH CO+tSTRUCTION INSPECTIONREQUIREMENTSANDPHASEWORKACCORDINGLY.
11 IT IS T HE CONTRACTORS RESPONSIBILITY TO MAINTAIN EXISTINGUTILITYSERVICESENCOUNTEREDANDRESTOREANYSERVICESDAMAGEDORINTERRUPTEDBYNEWWOW.
ER NEST J. GAILOR, P.E.
MAP REFERENCE
0 i'i i iMAPOFASURVEYMADEFORyPGRWESTERNREALTY. LLG
600,r
BY* VAN DUSEN SIEVES Owl
ZDATAMAY3. 2003
LAST REVISED+ MAY 31 20(?5 O
Q
U
W
ClIIiTJIC AS PZR YAP JtCPZA M
Q
0
EST.ERIVAVEjVjjE
S07°14` aw
1 NOTICE a W
r R A,FT 3 ULATI ON 0
1-:9ED BY
1
s
y u
0 a
LANDS F OF 56.925.00 sq.ft.W
MIJLDER 1.31 acres NOTICE
dFOAMINSULATIONMUSTBE
t° COVERED BY A 15 MINUTE
THERMAL BARRIER GO
y CO aui
LANDS N/Fof REVIEWED FORSWEET
ENERGY CODE COMPLIANCE T' °
1 STORY V
WOOD FRAMED
i
OFFICE w
45.00
74 32
PARKING
0 NOTICE
y
h
LEVER HANDLES REQUIRED
ON ALL PASSAGE DOORS 1;0 9
WHETHER IN z
EXTERIOR DOORS a l l 1 a
07 1
A 0
COTE c0
SIDEWALK E..i i O
LU
LANDS N/F OF 0
RINGER
V
ASPHALT a)
PARKING Q
v
O
c crt-re r
FILE COPY
MM = N Z
V!
1 0 z
0
TOWN OF QUEENSBURY
BUILDING DEPARTMENT
Z
Based on our limited examination,compliance
with our comments shall not be construed as
indicating the plans and specifications are in
I full compliance with the Building Codes of
I HEREBY GERTIFY 7MT TINS MAP WAS PREPARED NO 74
New York State. C z
FRCM AN AGTUAL FIELD SURVEY.
TENS GERTrIGATON ShALL RUM ONLY TO THE PERSONS j Or
FOR WMOM THE SrLIKVEY WAS PREPARED AND ON THER Q)
BEMALF TO THE TITLE COMPANY. GOVERNMENTAL ACAMY i U
AND LENDING NSTRUnON LISTED WREON. T'
G0t71 TATI1ONS ARE NOT TRANSFERAKE TO ADDITIOMAL T^
NSTITLRIONS OR SUBSCO ENT OWNERS.
GERTEED TOsPGR WESMTM REALTY. LLG HOLDGLNSFALLSNATIONAL5AW TRUST COMPANY. EN
ITS SUCCESSORS AND/OR AS AVEN UE M O>°
GIM CAGO TITLE b 10
Gll!RTM aY
r
x
w TTHEw G. S LL
LEGEND m aDATEDeARCH10. 200f r
F ,-
4
LAMP F05T
v
FAZE HYDRANT Ddw hARpi 3M 2M
A N['t
8C7r! T-2I+r
TOWN OF QU
BUILDING & O ' T. S- 1ReviewedBy:-
Date: f- I CO
1/1 - SHEEr I OF I
PGR WESTERN D%q
DWG_ NO. OSOG5AB