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2005-583 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number. P20050583 Date Issued: Friday, August 26, 2005 This is to certify that work requested to be done as shown by Permit Number P20050583 has been completed. Tax Map Number: 523400-296-019-0001-002-000-0000 Location: 123 QUAKER Rd Owner. FIRST NIAGARA BANK Applicant: LEXINGTON CENTER DB/A HOME BASE OF GLENS FALLS This structure maybe occupied as a: Commercial Alteration By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the (�2)j W 00t 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,ICY 12804-5902 (518)761-8201 Community Development-Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20050583 Application Number: A20050583 Tax Map No: 523400-296-019-0001-002-000-0000 Permission is hereby granted to: LEXINGTON CENTER DB/A HOME BASE OF GL For property located at: 123 QUAKER 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. Tyne of Construction Value Owner Address: FIRST NIAGARA BANK Commercial Alteration $20,000.00 ATTN: REAL ESTATE MGR/FACIL Total Value P.O. BOX 514 $20,000.00 LOCKPORT, NY 14095-0000 Contractor or Builder's Name /Address Electrical Inspection Agency Plans&Specifications 2005-583 LEXINGTON CENTER DB/A HOME BASE OF GLENS FALLS (SURVIVORS OF TRAUMATIC BRAIN DAMAGE COMMERCIAL INTERIOR ALTERATION $50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday, July 29, 2006 (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 11�T-Ozly Q s ,July 29, 2005 o Queensbury. SIGNED BY for the Town of Q ry. Director of Building&Code Enforcement Permit No R = Building&Codes Office-Department of Community Development-Town of Queensbury Fee Paid : 742 Bay Road,Queensbury,NY 12804 Dave Hatin,Director s;Qdes@aueensbury.net Recreation Fee � Phone: (518) 761-8256 FAX: (518) 745-4437 J Principal Structure Building Permit A li o f nf, r s Application & Plans sub-ect to review before issuance of a valid Permit p•r construction. Instructions: A permit must be obtained before beginning construction. No inspections will be made until the applicant has received a valid building permit. All applicants' spaces on this application must be completed and must appear on the application form. Applicant/Bb*cter t G r' l 'd1 S Address: Owner: t�7 Address: Home Phone: 3 6 c ' Home Phone: c,�c Email Address: Email Address: Cell Phone: Cell Phone: - 7 FAX Phone: FAX Phone: Person responsible for supervision of work with respect to building and codes compliance: Name: ��� n Address: Phone 3U7- Location of proposed Cconstruction: Lot No. Legal Address: jcz 3 � r Tax Map Number: La� Subdivision Name: Estimated Cost of Construction: $ a� o/ mo Proposed construction is for: _Residential Use _Commercial Use G� Name of Business: �' n �E��� h Cti. - 1,,., :sc C C`7 If proposed construction is an addition,what will use of new addition be? i49 C - 75' -v' v`'-S New Addition Alteration Proposed Construction Id Floor 2nd floor Other Total Proposed structure (Occupancy Type) Sq.Ft. sq.ft. Sq.Ft. Square feet Height Ft.&in. Single-Family Dwelling Two-Family Dwelling Townhouse Multifamily Dwelling Number of Units: Office Mercantile Manufacturin Other: Attached Garage 1, 2, 3 Type of Heating System: Electric, Oil, Gas, Wood, Forced Hot Air, Baseboard, Other: Is a fireplace and/or woodstove being installed, please refer to a separate application. —Yes —No Applications are subject to Zoning Administrator, Code Compliance, and Structural Plan review. The Building and Codes Office will allow commencement of your proposed project only after issuance of your permit. Declaration: Please sign below after you have carefully read the statement: To the best of my knowledge, the statements contained in the application, together with the plans and specifications submitted, are a true and complete statement of all proposed work to be done on the described premises and that all provisions of the Building Codes, the Zoning Ordinance, and all other laws pertaining to the proposed work shall be complied with,whether specified or noted, and that such work is authorized by the owner. Further, it is understood that I/we shall submit prior to a Certificate ;ff O ancy or tificate of Compliance being issued, as requested by the Zoning Administrator or Director uil g and des, an As-Built Survey by a licensed surveyor, drawn to scale, showing actual location of all ew tr cti Date: 1 414 Applicant/Builder Signature: The application of dated is hereby approved and permission granted for the construction, reconstruction or alteration of a building/and or accessory structure as set forth above. y Date: Authorized Signature: L:\Sue Hemingway\Building.Permit.FORMS\Principal Structure Permit Application.doc V:12/14/04 l�fiu�$wat��,1i��Bt EIP Fab r���o►�.ro, C.3e�t*�i�i��t� of Tom dfulsomob," ammiawy,Nr 12ms (518)761-3256 Por oamwa vq oaf vWA iv worA'nvAft&dMbwpdm& no fm nvwbvd for 1A'Pwm& NmeoadHneitMeee: c�-r.lf Yr, 1TBA � 1� of SPY �a iac c�rac er: 7Wrnm✓ A�gy susmee�P�c+ae ee': ,ZL3- 7A Typo of Baueea` (f ,moue *no m ant,hoWy abop.PbmbmB SMOY. owm of hopeely: Erecr t e�IE2?lq Addron� ,4 �,�T � f ... aaec pe+Qntds aM wdnwe layow aJ A as waft avft srocbvm%Yes room Dvx, i aawd jia4 r*ad •f DOW' Motc3e/Gamnoaoe� SD L.Z irr g•d 8�60�%�6L 8 t S Town of Queensbury Fire Marshal's Office 742 Bay Road Queensbury, NY 12804 Phone (518) 761-8205 Fax(518) 745-4437 Fire Marshal's Inspection Report Request SCHEDULE �v Received: Permit# INSPECTION ON: air Name: (� v M PM ANYTIME Location: JL APPROVED N/A YES NO COMMENTS EXIT ACCESS EXIT ENCLOSURE EXIT DISCHARGE _ MAIN AISLE WIDTH SECONDARY AISLE WIDTH n EXIT SIGN-NORMAL (LJ�4 �r, -� (a o-,C t i EXIT SIGN-BATTERY EMERGENCY LIGHTING FIRE EXTINGUISHER HUNG FIRE EXTINGUISHER INSPECTION FIRE EXTINGUISHER HYDRO �vy\ FIRE ALARM SYSTEM FIRE ALARM -FAN SHUTDOWN ,+ FIRE SPRINKLER SYSTEM FIRE SUPPRESSION-KITCHEN FIRE SUPPRESSION-GAS ISLAND HOOD INSTALLATION INTERIOR FINISHES STORAGE COMPRESSED GAS CLEARANCE TO SPRINKLERS CLEARANCE TO ELECTRICAL ELECTRIC WIRING ENCLOSED COMBUSTIBLE WASTE _ VEHICLE IMPACT PROTECTION FIRE LANE F.D.SIGNAGE-UTILITY ROOMS NO SMOKING SIGNS MAXIMUM OCCUPANCY SIGN EMERGENCY EVAC PLAN OK THIS DATE FOR NOT OK INSPECTED BY COMDEV/CHRISJIWORDILETTERS2001IF IREMARSHAUNSPECTIONREPORT11022001 WHITE-BUILDING DEPARTMENT COPY YELLOW-OCCUPANT COPY Town of Queensbury Fire Marshal's Office 742 Bay Road Queensbury, NY 12804 Phone (518) 761-8205 Fax(518) 745-4437 Fire Marshal's Inspection Report Request SCHEDULE Received: Permit# INSPECTION ON: _ Name: PM ANYTIME Location: V APPROVED N lA YES NO COMMENTS EXIT ACCESS EXIT ENCLOSURE D r EXIT DISCHARGE MAIN AISLE WIDTH SECONDARY AISLE WIDTH �>�1 `t w f EXIT SIGN-NORMAL EXIT SIGN-BATTERY ��� EMERGENCY LIGHTING _ FIRE EXTINGUISHER HUNG FIRE EXTINGUISHER cos`� INSPECTION aC �! cp FIRE EXTINGUISHER HYDRO P� FIRE ALARM SYSTEM FIRE ALARM -FAN SHUTDOWN FIRE SPRINKLER SYSTEM ` FIRE SUPPRESSION-KITCHEN FIRE SUPPRESSION-GAS ISLAND HOOD INSTALLATION � INTERIOR FINISHES STORAGE _ COMPRESSED GAS CLEARANCE TO SPRINKLERS CLEARANCE TO ELECTRICAL ELECTRIC WIRING ENCLOSED COMBUSTIBLE WASTE VEHICLE IMPACT PROTECTION _ FIRE LANE F.D.SIGNAGE-UTILITY ROOMS NO SMOKING SIGNS MAXIMUM OCCUPANCY SIGN EMERGENCY EVAC PLAN_.,_. OK THIS DATE OK CO ( —OT OK I COMDEVICHRISJIWORDILETTERS2001IF IREMARSHALINSPECTIONREPORT 11022001 WHITE-BUILDING DEPARTMENT COPY YELLOW-OCCUPANT COPY Commercial Final Inspection Report Office No.: (518) 761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: ►Jt-J am/p Depart: am/pm 742 Bay Road, Queensbury,NY 12804 Inspector's Initials: - 1 f NAME: �r ' C —�'" PERMIT#: LOCATION: JX3 �Y DATE: Pt 0MMENTS: 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 in. Platform/Decks Interior/Exterior Ballisters 4 in. Spacing Platform/Decks Stair Handrail 34 in.—38 in./Step Risers 7"/Treads 11" Vestibules For Exit doors>3000 s . ft. All Doors 36 in.w/Lever Handles/Panic Hardware,if required Exits At Grade Or Platform 36(w)x 44"(1)/Canopy or Equiv. Gas Valve Shut-off Exposed&Regulator 18" Above Grade Floor Bathroom Watertight/Other Floors Oka Relief Valve,Heat Trap/Water Temp. 110 Degrees Maximum Boiler/Furnace Enclosure 1 hi% 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 '/z doors > 10%> 1000 s . ft. 3/4 Hour Corridor Doors&Closers Firewalls/Fire Separation, 2 Hour, 3 Hour Complete/Fire Dampers/Fire Doors Ceiling Fire Stopping, 3,000 s . 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 Si a e/Shaft Sealed Handicapped Bathroom Grab Bars/Sinks/Toilets Handicapped Bath/Parking Lot Si na e Public Toilet Room Handicapped Accessible Handicapped Service Counters, 34 in., Checkout 36" Handicapped Ram /Handrails Continuous/12 in.Beyond Active Listening System and Signage Assembly Space Final Electrical 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 Water Fountain or Cooler Building Access All Sides by 20' /Driveable Surface 20' wide VZ Okay To Issue Temp. or Permanent C/O Okay To Issue C/C Last printed 6/3/2003 9:27 AML:\PamW\Building&Codes\Commercial Final Inspection Report.doc Commercial Final Inspection Report Office No.: (518) 761-8256 Date Inspe on request received: !fo U� Queensbury Building&Code Enforcement Arrive: am/pm Dep rt: am/pm 742 Bay Road, Queensbu�ray,NY 12804 Inspector's Initials: NAME:v�L� !.� Ci Son. ^ _ �/=PERMIT#: �C-.3 LOCATION: () /a 3 DATE: 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 in. Platform/Decks Interior/Exterior Ballisters 4 in. Spacing Platform/Decks Stair Handrail 34 in.=38 in./Step Risers 7"/Treads 11" Vestibules For Exit doors>3000 s . ft. All Doors 36 in. w/Lever Handles/Panic Hardware,if required Exits At Grade Or Platform 36 (w)x 44"(1)/Canopy or Equiv. Gas Valve Shut-off Exposed&Regulator 18" Above Grade Floor Bathroom Watertight/Other Floors Oka Relief Valve,Heat Trap/Water Temp. 110 Degrees Maximum Boiler/Furnace Enclosure 1 hr. 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 s . ft. 3/a Hour Corridor Doors&Closers Firewalls/Fire Separation, 2 Hour, 3 Hour Complete/Fire Dampers/Fire Doors Ceiling Fire Stopping, 3,000 s . 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 Si a e/Shaft Sealed Handicapped Bathroom Grab Bars/Sinks/Toilets —711 Handicapped Bath/Parking Lot Si na e Public Toilet Room Handicapped.Accessible Handicapped Service Counters, 34 in., Checkout 36" Handicapped Ram /Handrails Continuous/12 in.Beyond_ Active Listening System and Signage Assembly Space Final Electrical Site Plan/Variance required Final Survey,New Structure/Flood Plain certification,if reg. As-built Septic System Layout Required or On File Building Number or Tenant Address on Building or Driveway Water Fountain or Cooler Building Access All Sides by 20' /Driveable Surface 20'wide Okay To Issue Temp.or Permanent CIO Okay To Issue C/C Last printed 6/3/2003 9:27 AML:\PamW\Building&Codes\Commercial Final Inspection Report.doc Ca Town of Queensbury y Fire Marshal's Office X 0` 742 Bay Road Queensbury, NY 12804 Phone (518) 761-8205 Fax(518) 745-44 77 Fire Marshal's Inspection Report Request C SCHEDULE J r� Received: Permit# J INSPECTION ON: �� / J Name: LL>m, ► C-t t52 1 AM 'PM ANYTIME Location: 2�3 APPROVED N/A YES NO COMMENTS EXIT ACCESS EXIT ENCLOSURE sl S I�r �c� EXIT DISCHARGE �l MAIN AISLE WIDTH SECONDARY AISLE WIDTH EXIT SIGN-NORMAL Grt E- `-3. i S Lu 'S 0 EXIT SIGN-BATTERY EMERGENCY LIGHTING _ t 1� f c,r r Sic. t,, FIRE EXTINGUISHER HUNG `— �1 n 1 FIRE EXTINGUISHER ,/ \ INSPECTION FIRE EXTINGUISHER HYDRO FIRE ALARM SYSTEM FIRE ALARM -FAN SHUTDOWN FIRE SPRINKLER SYSTEM FIRE SUPPRESSION-KITCHEN �--1 FIRE SUPPRESSION—GAS jV�\h'c,*' ISLAND HOOD INSTALLATION _ INTERIOR FINISHES STORAGE COMPRESSED GAS CLEARANCE TO SPRINKLERS D 1 C,t P CLEARANCE TO ELECTRICAL ELECTRIC WIRING ENCLOSED COMBUSTIBLE WASTE_ VEHICLE IMPACT PROTECTION FIRE LANECt F.D.SIGNAGE-UTILITY ROOMS ,< / 1 � NO SMOKING SIGNS MAXIMUM OCCUPANCY SIGN_ EMERGENCY EVAC PLAN I OK THIS DATE OR CO NOT OK INSPECTED BY COMDEVICHRISJIW ORDILETTERS20011FtREMARS HALINS PECTIONREPORT 11022001 WHITE—BUILDING DEPARTMENT COPY YELLOW—OCCUPANT COPY CUFF OFF . OFF , OFF OFF , CONF . - ,�""' a u n J L �� u r is. 1 � 1 lIJ KITCHEN ;OFF . OFF . OFF . `dt OFF I l LOBBY r z CD MECH . oto di N N Q) `l U CaNF , OFF tA 50 °+ty l r OFF OFF . OFF . OFF (n�;) OFF , 0 CON F , sue•••• o C) U) np a ', r" Lft m OFF , O zrcHEN FF . OFF . OFF w m LOBBY MECH. a � co Ln ri Ln C , { CONF , d OFF ry P a (� X 7 r, � bi C '� v � (�'GG OQ Ilk ui C 0