2004-102 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. P20040102 Date Issued: Friday, February 16, 2007
.This is to certify that work requested to be done as shown by Permit Number P20040102
has been completed.
Tax Map Number. 523400-309-011-0002-018-001-0000
Location: 5 MAIN St Suite 2
Owner. FIVE MAIN STREET, LLC
Applicant: TOTAL CARE CHIROPRACTIC P.C.
This structure maybe occupied as a:
Storage Building By Order of Town Bowl
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the
property owner of the responsibility for compliance with Site Plan, C )4t"Vp
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 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040102 Application Number: A20040102
Tax Map No: 523400-309-011-0002-018-001-0000
Permission is hereby granted to: TOTAL CARE CHIROPRACTIC P.C.
For property located at: 5 MAIN St Suite 2
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 Value
Owner Address: FIVE MAIN STREET, LLC Storage Building $4,500.00
12 ROLLING BROOK Dr Suite 2 Total Value
STARTOGA SRPINGS, NY 12866 $4,500.00
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2004-102 TOTAL CARE CHIROPRACTIC CENTER
300 SQ FT STORAGE BUILDING Renewed Permit
valid until April 2, 2007 paid $25 on 4/20/2006
$0.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Monday, April 02, 2007
(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 To of Q ensb ZVO
02, 2004
SIGNED BY for the Town of Queensbur
y.
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbuiy;NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040102 Application Number: A20040102
Tax Map No: 523400-309-011-0002-018-001-0000
Permission is hereby granted to: TOTAL CARE C;HMOPRAC;TTC P.C.
For property located at: 5 MAIN St Suite 2
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: KEITH CAVAYERO
ELYSA BARON Storage Building $4,500.00
Total Value $4,500.00
12 ROLLING BROOK Dr
SARATOGA SPRINGS, NY 12866
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2004-102 TOTAL CARE CHIROPRACTIC CENTER
300 SQ FT STORAGE BUILDING
$0.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: unday, April 02, 2006
(If a longer period is required,an application for an extension must be made to the code
of the Town of Queensbury before the expiration date.)
Dated at the Town of QueensbUrv, Friday,April 02, 2004
SIGNED BY /4� for the Town of Queensbury.
Director of Building& ode §forcetnent
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-K56
BUILDING PERMIT
Permit Number: P20040102 Application Number: A20040102
Tax Map No: 523400-309-011-0002-018-001-0000
Permission is hereby granted to: TOTAL CARE CHIROPRACTIC P.C.
For property located at: 5 MAIN St Suite 2
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 Value
Owner Address: KEITH CAVAYERO
ELYSA BARON Storage Building $4,500.00
12 ROLLING BROOK Dr Total Value $4,500.00
SARATOGA SPRINGS, NY 12866
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2004-102 TOTAL CARE CHIROPRACTIC CENTER
300 SQ FT STORAGE BUILDING
$0.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Saturday, April 02, 2005
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbu befoytheiration date.
Dated at the Tow of Q F ' 02 2004
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Building Permit Application
Town of Queensbury—Dept of Community Development,742 Bay Road,Queensbury,NY
(518)761-8256
A permit must be obtained before beginning construction. Permit File No. d f
No inspection will be made until applicant has received a Fee Paid $
valid building permit. All applicants' spaces on this Rec.Fee Paid $
application must be completed and must appear on the Reviewed By:
application form.
1GEI'I N !� EP4
Applicant: CLJ Owner: C/O TO L, C,6 .,Q41 �[G r-j l m
Address: Q1Yj21 a0J / Address:
LA
Phone#(��i$). �-.�� j Phone#(jib)
Property Location: Lot Numb�r / Douse Number ! () � l l _1
Subdivision Name: 1-114 Tax Map Number: 130 - 5.;
New Building: residence commercial Estimated Market Value of Construction:$ �t�Q'7-
❑ Addition: residence/ commercial If an Addition,what will use of new addition be?
❑ Alteration: residence/ commercial
❑ No change to exterior size: residence/com'l
❑ Other work(describe )
Check OccupancyInformation 1' Floor 2° Floor Other floo Total
Below sq.ft. sq.ft. sq,ft. uare Feet
• a
o Single fare ly dwelling
o Two fwnfly dwelling 1
❑ Townhouse
o Multifamily dwelling !(0! GA r�p�Sis
PRY
#of units CO
❑ Office
❑ Mercantile
o Maaufacturin
c] 1 car detached garage
❑ 2 car detached garage
❑ 3 car detached garage
❑ 1 car attached garage
❑ 2 car attached garage
❑ 3 car attached garage
�( storage building- 3Q7 3co
/ commercial
❑ Storage building-
residential
❑ Other
What is the proposed height of the structure I,��feet inches
Will any second-hand or ungraded lumber be used? If so,for what?
Type of Heating System; electric/ oil / gas/wood /forced hot air! baseboard/other: UkJk4esir o
Number of Erer laces to be installed Number of Woodstoves to be installed
List below the person(s)responsible for supervision of work as regards to building codes:
Name Address Pho a Number
Builder oLjf, i o L1 ( U-3! I-U I i
Plumber
Mason
Electrician
Declaration please sign below after you have carefully read the statement:
To the best of my knowledge the statements contained in this 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 Code,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 Uwe shall ,
submit,prior to a Certificate of Occupancy or Certificate of Compliance being issued,as requested by the Zoning
Administrator or Director of Building and Codes,an As Bu&Survey by a licensed surveyor;drawn to scale,showing actual
location of all new constru
Signature: OLA owner,owner's agen azchitec contractor
Commercial Final Inspection Report /
Office No.: (518) 761-8256 Date Ins Pctio}z -equest retied:j
r,,
tueensbury Building&Code Enforcement Arrive: ��'�-)Iaf'-njprii �r'"Depart:
742 Bay Road, Queensbury,NY 12804 Inspecto ""-�_—
t��` l
NAME: PERMIT#. r 02
LOCATION: DATE: r;
Y
COMMENTS:
Y r,/NNNAChimne /"B"Vent/Direct Vent Location - -
Plumb.in Vent-Throu h Roof 6"` Roof let ✓�
xterior Fipis de Com lets 6"in 10' or E uivalent \/
or/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 Ex osed-&R� or 18" Above Grade
Floor Bathroom Waterti tl�er Floors®ka V
Relief Valve,Heat Trap/Water Temp.TFU egress 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
Stocicroom/Storage/Receiving/Shipping Room(2 hr.), 1 '/z 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
Handicapped Bath/Parking Lot Si na e
Public Toilet Room Handicapped Accessible
Handicapped Service Counters, 34 in., Checkout 36"
Handicapped Ramp/Handrails Continuous/12 in.Beyond [Both sides]
Active Listening System and Signage Assembly Space
Final Electrical �(
Site Plan/Variance required
Final Survey,New Structure/Flood Plain certification,if req.
As-built Se tic System La out 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 1
Okay To Issue Temp. or Permanent C/O
Okay To Issue C/C \
LABuilding&Codes Forms\Building&Codes\Inspection Forms\Commercial Final Inspection Report.doc
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o� INDEX OF DRAWINGS : i
1 . SITE PLAN '
ROAD
�IJ��RNE
/ 2 . UTILITY PLAN g oil
I >- w i I"' m
3 . GRADING PLAN SITE a
rEN 1ERLIN Q UI i i h
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of T
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4 . LANDSCAPE & LIGHTING PLAN `��,
24" WHITE STOP BAR I o a
NYSDOT ITEM 688.01 y o Q
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W. `' ,_ _ _` �1.k• `\� \\ ` I V)
- �- - �, \ LU 5 . UTILITY PROFILES I -_ ;cr T
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7.
AILS & NOTES
PROP. REVEAL �� ��• , ; s'�s A , , !� \, LOCATION SKETCH
CONC. CURB • 'tl ��, E Sc q..` �` �� v ti oil
14, s (f c�4000) ___ i _- _ !/ 00. j GV;r• `
OF
00
cr Zap
46
( 3 poi! E gRFq .' `� \�•� j 4' SITE DATA:
3a
s�34• 1. PARCEL ZONING CR-15 f.j.,7t.4• A
o
U
g r31 ENCLOSED DUMPSTER AREA i �a , �� ; 2. PARCEL AREA 2.1 AC. .,
j 15•x20'x6" CONC. SLAB ,,, '
(fc-4000) ON 6" #1.STONE r -A R�10 •�� �gNOSC S \`� J 3. TAX ACCT. NO. 130-3-18 c F"•':y, ,`w w
r ; i / /�gN��'f3�• -\ I 3. PARCE ADDRESS =5 MAIN ST �. ro
t ,` c �., 9' ♦E ,\ 4. SETBACKS: �� J
ALTERNATE ENTRANCE DESIGN `� " •y ''�° , , P R QUIRFD PROVIDED i = t•`' /
ENO 8� .� s `\
(REQUIRES TO1N1 APPROVAL.) ;� 20.00' 16: SCgPF � ` �O' FRONT 75 75.84'
o _
x ts•\ SIDE 20' 29.07'
v _ e1,�r► �, y \
REAR 25' > 25'
' NO PARKING FIRE LANE \•� 'SIGN MOUNTED ON / "� . 33•
BUILDING WALL i �� � 5 REQUIRED =: ';`✓S =8775 SF + 3634 �F =-= 12,409 SF x
3 3,e� S �� ' 5/1000 SF = 62 SPAc'F S '-
TEMPORARY PARKING, Q•A'f , �. �� �\ DR.'S OFFICE=3000 SF x 1/150 SF = 20 SPACES
FUTURE ACCESS TO E I a LET \\`� (/? w
ADJACENT LAND '' 3 ae R�3' ~ v TOTAL REQUIRED = 82 S�nr_ES W u v 6 , c cdi o, •• PROVIDED = 84
ao I ,� 3 R 'S p roo -� ?p• ; ?0. di 2�c 6. LOT COVERAGF.
s c, PROP. 6" REVEAL
W CONC. CURB
20•00 '�O S CE 7 BLDG./PAV.'T I AWN/LANDSCAPE }
it w T . l'',F Q, � H � � �
W U (fc=4000) 20 accov 3¢q 5Q 0' R= , `� �r 4• l8 3 6590 35% d 1� i
Zoe 3 w Re • 5 H • I O
7. THERE ARE NO WE TLANDS OR FLOOD ' LAiN IDENTIFIED .•:1 ;; �
62-16 '� END CURB r'/ I a ON THIS PARCEL. Y) uI to
�,7
•4g• 'i
R=3 y 1
' ENCLOSED TRASH COMPACTOR 8. PROJECT IS LOCATED WITHIN 40'x12'x6' CONC. SLAB 65.00 ApE .' ��
(fc-4000) ON 6' #1. STONE- - 141• L/►ND�ND .•' $' idr GLENS FALLS SCHOOL DISTRICT AND Tla�
• SST GLENS FP
LEGEND: �� PROTECTION DISTRICT.
ENCLOSED DUMPSTER AREA BEG1N CV �,�- C$ �� H � I I K
12'x12'x6" CONC. SLAB -''� � RB Z
EXIST. ROW LINE f c-4000 ON 6" STONE
( ) v+ 1A F��' s� o T I 9. THIS PLAN IS CONSISTENT WITH THE ZCNIN(7,
'�v= O s n W ' o^
_ EXIST. LOT LINE S Z - Z f/ 10 j N _ ORDINANCE OF THE TOWN OF QUEENSR1.1r • '
PAINT ON PAVEMENT M 7?, '� c'• N cr
�..
EXIST.CENTER LINE ROAD * CURB ! o
� 2 � 10. PROPOSED /IRON ROD MARKERS TO 9E
E" END O '`' .o �� 1-a" 18 ' O ;> AT EACH LOT CORNER OR TURN OF h -r Tin
EXIST. CURBING IR O ;'. Rip �' 13 N
aD P r 1 ,.
, • • I f0 � i�_. i.��• s'�t.r�j.
-- - - - EXIST. EASEMENT LINE 20x10x6 CONC. SLAB 11. OWNER: KEITH �AV.AYERO `
(f c=4000) ON 6" 10 STONE- -- C -�' �- Z3
PROPERTY BOUNDARY 14.10p 8•'�75 5�') •5p g �, �. 12 ROLLING BROOK DR.
g.19 SARATOGA SPRING, N.Y. 12866
*OP. CURBING & EDGE OF PAVEMENT O. �• �' N ' �
`� 0p0' F• DNaE TELEPHONE 518-798-2225 a m
PROP. PARKING STALL g 1� r,
'OZ• i R SO ARCµO D ENj10N ; ZO• ZD 12. APPLICANT: BEPk:SHIRE ACQUISITION ;I: j w j<
PROP. ANDICAP STALL i 5 15�4 ENE REf F� �y11D 1, 2
J r 1500 MAIN ST., SUITE 20i;'
1NG f IRE PLANS 1 'v 1^ r'1
NO PARK OH 2Z - rr,, SPPINGFIELD, MASS. 01115
PROP. EASEMENT LINE 000 w i
Az 51GIN D wAE1. z �\ '; �� , TELEPHONE 413-781-28C
I
PROP. BUILDING
13. SURVEY REFEP.ENCE: 4 i
,1 , P THIS PLAN WAS PPEPARED FROM A SUPS �' I>
PROP LIGHT POLE y?• RAM 1 1
t f 5•p0' - -' Rw I R.16 BY Von DUSSEN 1t STEVES SURVEYORS F j o
AND TOPOGRAPHIC INFORMATION.
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' Ott iwv � RECEIVED
�0 - s R�5' 5• o. N pER FOIR
15•.S/g MAR 2 7 2004 m, N
TOWN OF QUEE.NSBU�Y
• �ti 51 BUILDING AND COD x W a s
R=34' w, ,,,• " 0 1 PE p►R�A ,5«,5'4�"" PLANNING BOARD AP
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EIR �i0 G 119.95. 5� t ':S/9 FOR • � x $
5 f SO4 ,
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1. SIGN S TSh� U Ow0 `�cl
Rxm34' ;� �- APPROVED UNDE AUTHORITY
EJS
ADOPTED BY THE •
DOUBLE 4" YELLOW EPDXY STRIPEos l U O (�� ,( t
� E
OF THE TOWN 0. QUEENSBUR +
\\ 24" WHITE STOP BAR , _ , -' 1
6• REVEAL' �-•-J 'M"R '� '. � � _.•
PROP• CURS
ALTERNATE ENTRANCE DESIGN „ ' rill
._�. ✓��- . gg'1 _ �.0 l
",� E� p A I , �F
K
(REol�s couNTr APPROVAL) •Q
1• AND EE1 / tv i t
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SAS A�L�.��„�• �� _ ' t �, .
FEBRUARY, 1996