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2001-652 TOWN OF QUEENSBURY 742 Ba Road ueensb NY 12804-5902 518 761-8201 Y ,Q �Y, � ) Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20010652 Date Issued: Tuesday, January 29, 2002 - This is to certify that work requested to be done as shown by Permit Number P20010652 has been completed. Tax Map Number: 523400-278-000-0001-020-000-0000 Location: 373 STATE ROUTE 149 Owner: MICHAEL &KIMBERLY MELLON Applicant: INDEPENDENT WIRELESS/SPRINT PCS This structure may be occupied as a: By Order of Town Board Commercial Alteration TOWN OF QUEENSBURY (173avP Director of Building& Code Enforcement 41111111110114- TOWN OF QUEENSBURY A742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20010652 Application Number: A20010652 Tax Map No: 523400-278-000-0001-020-000-0000 Permission is hereby granted to: INDEPENDENT WIRELESS/SPRINT PCS For property located at: 373 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 compliance with the NYS Uniform Building Codes and the Queensbury Zoning Ordinance. Type of Construction Value Owner Address: MICHAEL &KIMBERLY MELLON 373 STATE ROUTE 149 Commercial Alteration 20,000.00 LAKE GEORGE,NY 12845 Total Value 20,000.00 Contractor or Builder's Name/ Address Electrical Inspection Agency Plans &Specifications 2001-652 INDEPENDANT WIRELESS/SPRINT 114 SQ FT SLAB FOR WIRELESS COMMUNICATION FACILITY AS PER APPLICATION: Note: The project received Administrative Review as C.T. Male Assoc. conducted Administrative Engineering Review. (See: Chris Round, Exec. Director- Community Dev. for further information). $50.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Wednesday, September 11,2002 (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 own Qu "fry °ur day, September 11,2001 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement Building Permit Application Town of Quccnsbury-Dept of Community Development, 742 Bay Road, Qucensbury,NY =5i (518) 761-8256 •4 A permit must be obtained before beginning construction. Permit File No A-- S? No inspection will be made until applicant has received a Fee Paid $ • QC valid building permit. All applicants' spaces on this Rec. Fee Paid $ application must be completed and must appear on the Reviewed l3 application form. r I I- y' �U ,i,rdclepPrdew`I-- — //�� II- w,reles5 ` Applicant: E/0 �-d.vll p19dl(V- ()Ale. Owner: N1 c gQ� Me,\`6nJ Address: 05 {�� ,N A-ye Address: 1-2, 5+, Rocpte 41 bu 6-eotoi P to y ° ' , Phone# ('IB ) 48q- 1 Phone# ( /i3 ) 1c) - 17.33 ,� : .:_ Property Location: Lot Number: 12.6 / House Number / TOW Subdivision Name: Tax Map Number: 0 e () 0 Bub(5CI PLIEENSBur v • AND OODE ❑ New Building: residence /commercial Estimated Market Value of Constrilction: $ Z6(000 ❑ Addition: • residence/ commercial If an Addition, what will use of new addition be? Alteration: residence comae '❑ No change to exterior size: residence/com'I ❑ Other work(describe ) Check 1 I Ill�ur "' 'Total Occuhaucylnform:�tion 2 Floor Other floor Below sq. U. sq. B. sq.ft. Square Feel O Single family dwelling ❑ Two family dwelling ❑ Townhouse ❑ Multifamily dwelling #of units ❑ Office ❑ Mercantile • ❑ Manufacturing ❑ 1 car detached garage ❑ 2 car detached garage ❑ 3 car detached garage ❑ 1 car attached garage ❑ 2 car attached garage O 3 car attached garage U Storage building- -.. - ---------- ----- — commercial ❑ Storage building- residential A Other Will any second-hand or ungraded lumber be used? If so, for what? i J A Type of Ileating System: electric/ oil / gas/wood /forced hot air/ baseboard/other: N A • Number of Fireplaces to be installed Al> Number of Woodsloves to be installed jJ • List below the person(s)responsible for supervision of work as regards to building codes: Name Address Phone Number Builder Plumber _ Mason Electrician { 1AV. CnN7f-12ue.i .) Aibaw..( !1J Y _ 5l8 -?$3 — 338 t I Declaration: please sign below oiler you have carefully read the statement: '1'o the best of my knowledge the statements contained in this application, together with the plans and specifications submitted,arc a true and complete statement ol-all proposed work to be done im 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('odes, an As Built,Verve ,by a licensed surveyor;drawn to scale,showing actual location of all new construction • Signature: owner,owner's agent,architect,contractor FINAL — COMMERCIAL INSPECTION REPORT Request received: Office Use Town of Queensbuiy (518) 761-8256 ARRIVE _ e/pia: DEPAR rn 742 Bay Road Ready at time:.4_,` Queensbury, NY 12804 Inspector'slnit` �� 1 ..i , , C Meet: ( P_ o • NAME �J i I e��5 PERMIT# • At time: /e) ' d LOCATION-3 3 L( 9 SSO/ OF STRUCTURE INSPECT ON(date): Notes: 3 co S- SSO/ N/A YES NO Chimney/"B"Vent/Direct Vent location Plumbing Vent Roof Complete COMMENTS Exterior finish grade complete Interior/exterior guardrails 42 in.platform/decks Interior/exterior balusters 4 in.spacing platform/decks Stair handrail 34 in. -38 in. Step risers 7%in. Main door 44 in. All others 36 in. Lever handles Exits at grade or platform Canopy to cover req. exit doors ! Gas valve shut-off exposed&regulator(18 in.)a ove grade Floor bathroom watertight Other floors okay / Hot water relief valve I Boiler/furnace enclosure <250,000 BTU ITT/R 250,000 BTU to 1,000,000 BTU's our) >1,000,000 BTU's(2 hour) ' Gas furnace shut off within 30 ft. or within line of site Oil furnace shut off at entrance to furnace area Stockroom enclosure(1 hour),'/4 hour door Storage/receiving/shipping room(2 hour), 1 ''A doors 1 '/z hour doors and closers 3/4 hour corridor doors and closers 1 Firewalls/fire separation,2 hour,3-hour complete Fire dampers,2-hour fire walllseparatio or greater Fire door/shutters 1 '/z hour,3 hour Ceiling fire stopping 3,000/5,000 sq. ft. Fan shutdown,smoke vents or fan Exit door/panic bars assembly hardware I Elevators Elevator signage Handicapped bathroom grab bars/sinks/toikets Handicapped bath/parking lot signage Handicapped service counters 34 in.,chec_{out 36 in. Handicapped ramp/handrails continuous/ 12 in.beyond f Active listening system and signage assembly space Final Electrical I V Site Plan/Variance required I Final Survey,new structures As-built septic system layout required Okay to issue TEMPORARY C/O—Certificate of Occupancy yes no Okay to issue PERMANENT C/O—Certificate of Occupancy yes no Okay to issue C/C—Certificate of Compliance yes • no El.1EPLIEM PE_PLI PLO r�tricil LOPED ��Ln�LIEFERIPP n��LP LIMPLP nEdra 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 5 S BUREAU OF ELECTRICITY 5 40 FULTON STREET — NEW YORK, NY 10038 5 5 5a� 5 CERTIFIES THAT �� 5 5 5 5 Upon the application of upon premises owned by 5 55 5 ALTONE ELECTRIC/D. DAVENPORT * INDEPENDENT WIRELESS ONE 5 400 LANG ST 373 ST RT 149 SCH NETADY, NY 12308, QUEENSBURY, NY 12804 5 5 Located at 373 ST RT 149 QUEENSBURY, NY 12804 5 5 Application Number: 1031553 Certificate Number: 1031553 5 5 5 Section: Block: Lot: Building Permit: BDC: A239 5 5 5 g Described as a Commercial occupancy,wherein the premises electrical system consisting of 5 electrical devices and wiring, described below, located in/on the premises at: 5 5 Outside, 5 5 5 5 g was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below,was found to be in compliance therewith on the 14th Day of January,2002. 5 Name OTY Rate Rating Circuit Type 5 Service 5 5 1 Phase 3W Service Rating 400 Amperes 5 Service Disconnect: 1 200 cb C5 5 Service Disconnect: 1 100 cb 5 Meters: 1 5 5 5 5 5 5 5 5 5 5 5 5 = 5 5 � : 5 5 _ - 5 5 - seal 5 5 5 5 1 of 1 = ta g C5C This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 B. 5 on��EPEPLIMPED ��LMP��dfo