2003-856 `SOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761.8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20030856 Date Issued: Tuesday, December 23,2003
This is'to certify that work requested to be done as shown by Permit Number P20030856
has been completed.
Tax Map Number: 523400-288.008.0001.022-000-0000
Location: 61 STATE ROUTE 149
Owner: JAMES&DIANE MARIE FOWLER
Applicant: AT&T WIRELESS SERVICES
This structure may be occupied as a:
By Order of Town Board
Commercial Alteration TOWN OF QUEENSBURY
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 161-8256
BUILDING PERMIT
Permit Number: P20030856 Application Number: A20030856
Tax Map No: 523400=288-008-0001-022-000-0000
Permission is hereby granted to: AT & T WTRF,I,F,SS SF,RVIC ES
For property located at: 61 STATE ROUTE 149
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 comphance,with the NYS Uniform Building Codes and the Queensbury Zoning
Ordinance. Type of Construction Value
Owner Address: JAMES &DIANE MARIE FOWLER
61 STATE ROUTE 149 Commercial Alteration $25,000.00
Total Value $25,000.00
LAKE GEORGE,NY 12845
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2003-856 AT & T WIRELESS SERVICES
TELECOMMUNICATIONS INSTALLATION TO EXISTING TOWER AS PER APPLICATION
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday, October 22,2004
(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 a�f'{ uee s71 A 1"ay, October 22, 2003
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. 0 3-- 4j
No inspection will be made until applicant has received-a Fee Paid $ �0•o a
valid building permit. All applicants'spaces on this Rec.Fee Paid $
application must be completed and must appear on the Reviewed By
application form. -�
Applicant:/��s% � �,�/Yss �CvccFs Owner:U4 "i-riu.7
Address: , nJO Address: (o 5~c- -r-W of-C t 44?
Phone#(51 )3(-14 -W.3`9 f Phone#(_) -
Property Location: Lot Number: f / House Number
Subdivision Name: Tax Map Number: & c)
•❑ -Ne ding"-W1,1 ommercial Estimated Market Value of Construction:$ Dc�.
❑ Ad `on: �' zesidenceT commercial
❑ Atterao (� s / commercial if an Addition,what will use of new addition be?
❑ No change%"eactienorlff?residence/com'l
}s Other work be . .� .. t e lie c cs r.+w.v n. c.."c io•-s r rt g Tip}c.�.RT i o u .
TO WN O c� � ,d ° IE% 1 sil l fir. t�"'?b LAj4,ie
Cheeky iQcp = 3ition 1` Floor 2" Floor Other floor Total
Below sq.ft, sq.ft. sq.ft. Square Feet
• E i
ci Single family dwelling
❑ Two family dwelling
❑ Townhouse
❑ Multifamily dwelling
#of units
❑ Office i
❑ Mercantile
❑ Manufacturing
❑ 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-
commercial
❑ Storage building-
residential _
Other l u c-m ens n , ro , o
t What is the proposed height of the structure, N feet inches
Will any second-hand or ungraded lumber be used? If so,for what? A/0
Type of Heating System: electric/ oil / gas./wood /forced hot air/ baseboard 1 other:�.
Number of Flreplapes to be installed A—Number of W400dstoves to be installed
List below the person(s)responsible for supervision of work as regards to building codes:
Name Address Phone Number
Builder 'SfjL-�p -r&24T 1 -
Plumber
Mason
Electrician
Deeclaratiom 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 tither 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 of Occupancy or Certificate of Cbmgiiance being issued,as requested by the Zoning
Administrator or Director ofBuiiding and Codes,an As Built Survey by a licensed surveyor;drawn to scale,showing actual
location of ew c nstruc o
C
oSignature: �g= wnewner's agent, chitect,contractor
12/23/2003 11:11 3154529911 ` .SBA NETWORK.SERVICES PAGE 02
�RP��L�IG�.PL��tl � ��Cif �CC 1t C CC.�10
BY THIS C'ERTIFICATE,',017 COMPLIANCE THE
NEW YO,PK' BOARD , OF FIFZE 'UNDEI'Vl:BITERS 5
F3UI;EALJ Of ELECTRICITY
' 40 FUL.TON STREET NEW.YORKI NY 10038.
LSE CER"1-`tFIES THAT
Upomthe application of upon premisos owneJ Iiy
SBA NETWORK SERVICES, INC. *AT&T WIRELES.3
N.SYRACUSE NY 1321.2 QUEENSB'URY, 1214' 12845
Located'at. 61 STATE RD 149 QUEENS$URY, 12NYI-21845-
Application Nuimbew 1178037 Cenificatc Number: 1. 78037
Section: Block: )not:. Building Permit, BDQ A239
. . Described as a occupancy,wherein the premises:eloctriza I system consisting of
electrical devices and wiring,described below,iodated iri/641he premises at:
Outside,, .
Was inspected in accordance with the, National:Electrical Cddi and the detail of the installation, is set forth below,was
found to be in compliance therewith on the '5th Day,isf_ November,2003,
Nance BALC R&Lg Circuit lym Al—notinil
L Alarm and Emergency Equipment`
Transfer Switch 1 4 $15.00
fill
Panels
1. 20(Y 24 $10,0
Wiring and Devices
Receptacle 1 0' Special $1.70 21
"Service
1.Phase 3W Service hating 200 Amperes- $20.00
L+�! Service Disconnect: 1 200, ob
Meters: l CU
L�U htvoice Total $50.00
....,_.:. sear
This-certificate may not be altered In any way and is validated only by the presence of a raised seal at thE ation indicated.
tE3 Fc01iirJ�rJ"rc Ic i-c rlr� M
Commercial Final lrispection Report
Office No.: (518)761-8256 Date Inspection re st ec
Queensbury Building&Code Enforcement Arrive: a p Depai am/pm
742 Bay Road, Queensbury,NY 12804 Inspector's Initi s-
p a
NAME: ky-,4 PERMIT an?)
LOCATION: i DATE:
�Bj R -3
C0MNTMNTS:.
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 sq. 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 Okay
Relief Valve,Heat Trap/Water Temp.110 Degrees Maximum
Boiler/Furnace Enclosure I 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 V2doors
> 10%> 1000 sq.ft
3/411our Corridor Doors&Closers
Firewalls Fire Separation,2 Hour,3 Hour Complete/Fire
Dampers Fire Doors
Ceiling Fire Stopping, 3,000 sq. 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 Signage/Shaft Sealed
Handicapped Bathroom Grab Bars/Sinks/Toilets
Handicapped Bath/Parking Lot Signage
Public Toilet Room Handicapped Accessible
Handicapped Service Counters, 34 in., Checkout 36"
Handicapped Ramp/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 201 wide
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