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2011-429 iA 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: P20110429 Date Issued: Tuesday, September 13, 2011 This is to certify that work requested to be done as shown by Permit Number P20110429 has been completed. Location: 24 QUAKER RIDGE Blvd Tax Map Number: 523400-303-015-0001-025-001-0000 Owner: WAL-MART REAL ESTATE BUSINESS TRUST Applicant: SUBWAY This structure may be occupied as a: Certificate of Occupancy(COM) By Order of Town Board TOWN OF QUEENSBURY ( l P� Issuance of this Certificate of Occupancy DOES NOT relieve the ( I/ s �� 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,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20110429 Application Number: A20110429 Tax Map No: 523400-303-015-0001-025-001-0000 Permission is hereby granted to: SUBWAY For property located at: 24 QUAKER RIDGE Blvd 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: WAL-MART REAL ESTATE BUSIN WAL-MART STORES, INC. Certificate of Occupancy(COM) $65,000.00 PROPERTY TAX DEPT. - STORE#, Total Value $65,000.00 PO BOX 8050 MS 0555 BENTONVILLE,AR 72712-8050 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications 2011-429 1270 sq ft commercial alteration- SUBWAY $50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,August 24,2012 (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 Torn- Queennbury¢ (,Wednesday,August 24,2011 # I' "µ for the Town of Queensbury. SIGNED BY �y: // r Q 3 Director of Building Code nforcement <LI C/O -, t ���� � � OFFIC�IS ONLY ! 4� ,71 7, Cr:- v ��rou�,l"�'� 3! !1 i ERMIT NO. TAX MAP NO._ � �� "" c �( 47_ r.;;'i `. ,1 .. 'I f i iIvi ��i If', t !I t- ' ,) (.EZ 4 i :I per FEES: PERMI gill►/kI RECREATION ENGINEERING , •177%,' — (If applicable) , ! __ Cr _ ...,,,L_1 ..+ PRINCIPAL STRUCTURE: APPLICATION FOR ZONING AP . PERMIT f '1 A,,Ce — A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMIT FOR CONSTRUCTION. APPLICANT/BUILDER: ,,�,gct2/j Yt l / -Lc7MOWNER: T �; � S ADDRESS: �i 4 ��c,,,ic,e0 f2-i' ,3 1,...,) ADDRESS: /707 //IL 5S_.,,' 344, / ..,i-f>tu PHONE NOS. 5 73 - 07 90 PHONE NOS. .5-7.3 _ o7`6) CONTACT PERSON FOR BUILDING &CODES COMPLIANCE:�LP_ !3)Ckle)i PHONE: 6 7,3 c.:,-7 7 o LOCATION OF PROPERTY: d,5L �-t /2,4, �j/ )¥ 0 ,l HAS THERE BEEN A SITE PLAN REVIEW;VARIANCE OR SUBDIVISION APPROVAL? ❑ YES 0 NO 7 IF SO, INDICATE APPLICATION NO.AND DATE OF APPROVAL: PLEASE INDICATE MEASUREMENTS AS REQUIRED BELOW: CHECK ALL THAT zo �- rY C'1 0( www APPLY TO YOUR Z F. cc O cn u) cn w PROJECT � rY Op w -j o = _ w � w ww Q OU Z < < rC NU) Ou.. I— U- CLIors SINGLE FAMILY 'TWO-FAMILY MULTI-FAMILY (NO.of UNITS ) TOWNHOUSE BUSINESS OFFICE RETAIL- // MERCANTILE )( I x`77) /d1700 FACTORY OR INDUSTRIAL ATTACHED GARAGE(1,2,3) OTHER Town of Queensbury* Community Development Office * 742 Bay Road, Queensbury NY 12804 Revised 4/14/2010 IF COMMERCIAL OR INDUSTRIAL—NAME OF BUSINESS: _ '- /1`10 ESTIMATED CONSTRUCTION COST:)& 6"/ 113"r.J FUEL TYPE: HEAT TYPE: *HOW MANY FIREPLACE(S): AND/OR WOODSTOVES(S): ZONING CATEGORY: ARE THERE WETLANDS ON THIS SITE? IS THIS A HISTORIC SITE? PROPOSED USE OF BUILDING OR ADDITION: /25 ARE THERE STRUCTURES NOT SHOWN ON PLOT PLAN? ARE THERE EASEMENTS ON PROPERTY? *Please complete a separate Application for"Fuel Burning Appliances&Chimneys"available in our office I acknowledge no construction activities shall be commenced prior to issuance of a valid permit. I certify that the application, plans, and supporting materials are a true and complete statement/description of the work proposed, that all work will be performed in accordance with the NY State Building Codes, local building laws and ordinances, and in conformance with local zoning regulations. I acknowledge that prior to occupying the facilities proposed, I or my agents will obtain a certificate of occupancy. 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. Signed W _ Director of Building & Codes: 761-8256 (for questions regarding Building Permits, construction codes or septic systems) Zoning Administrator: 761-8218 (for questions regarding required permits, the permit process, application requirements or to schedule an appointment) Town of Queensbury* Community Development Office * 742 Bay Road, Queensbury NY 12804 rCompletion of inspection I Revised 4/14/2010 Permission is hereby granted to the above This application / proposed action described Applicant to erect or alter the building herein is found to be in accordance with the described herein in accordance with said zoning Laws of the Town of Queensbury. Application: / A, 4P B LD ' : CODES APP-• AL ZONING APPROVAL DATE DATE QUESTIONS? CALL 761-8256 OR EMAIL codesCa queensburv.net Office Use Only VISIT OUR WEBSITE FOR MORE INFORMATION www.queensburv.net Operating Permit Issued: Yes No Occupancy Type: Construction Classification: Assembly Occupancy Limit: Special Conditions: Town of Queensbury* Community Development Office * 742 Bay Road, Queensbury NY 12804 • Revised 4/14/2010 PROJECT NAME: �� `(� t�7� Office Use Only Staff Initials: BUILDING PERMIT SUBMISSION Date: CHECKLIST FOR: MULTIPLE DWELLING OR COMMERCIAL PROJECTS 1. Building Permit Application Completed? Yes No N/A 2. Energy Code CommCheck and Inspector's Report Form? (2 copies) 3. Septic application completely filled out? (if applicable) 4. Electrical inspection agency selected? 5. Two (2) sets of the plans for each of the following: a. Floor plan(s) b. Foundation plan c. Cross Sections d. Elevations e. Design loads including floor, snow load and wind load f. Seismic design (required after January 2003) g. Plans signed and sealed by registered architect or engineer h. Window and door schedule 6. Two (2) site plans showing location of the structure to be built, location of well or water lines, location of septic system or sewer line with all setbacks and separation distances shown, and all improvements to the property 7. Solid Fuel Burning or Gas Appliance Form (if applicable) 8. Driveway Permit Town of Queensbury* Community Development Office * 742 Bay Road, Queensbury NY 12804 QCommunity Development Office D 4 © E ° \leEll Town of Queensbury • 742 Bay Road • Queensbury, New York 04I� is I David Hatin, Director of Building& Codes ��G j_ 7 fl Craig Brown, Zoning Administrator• Michael J. Palmer, Fire Marshal BU1LDING ESTABLISHMENT OF A NEW BUSINESSc _ . r _� �� _. CERTIFICATE OF OCCUPANCY PERMIT APPLICATION *Note: This application is for occupancy only, with no work requiring a building permit. TAX MAP # BLDG. PERMIT FILE# IfIfapplicable Name of Business: .5";..)-�j l,cirki! of &�,(,2e✓? v.5L al`s' Address ll. 1, �.4� / o 77 1 /� 9v'T of Business: , 7 � �/ QUESTIONS? CALL 761-8256 OR EMAIL codesAqueensbury.net VISIT OUR WEBSITE FOR MORE Person in Charge or Manager: / j- _. J;C-09INFORMATION www.queensburv.net Business Phone Number: 5/y .S 7 3 7(3.) Type of Business: Re-3-7- ' Owner of Property: f1/41.that, Phone Number(s): Home Cell Owners Address: (9\ C)c, .prey i A✓all � � +�� Ah/ /a�g!)'y Provide an accurate layout of your store showing all walls, exits, stockrooms, rest rooms, counters and fixture layout on a separate sheet of paper. Signature: � . . Date: I'c,/l Of person submitting this fore!./ / Notes/ Comments: EMERGENCY CONTACT UPDATE TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 1,7! F!c LE I V ro PLEASE PRINT L AUG 1 2tI11 110 DATE: c//5_/2_// t_ 8UjLJjN9NSSURyO©E / S BUSINESS NAME: <v-Lt,�i y! 41.(404'15 " tag BUSINESS ADDRESS: a 4 G?(.- x i.e3A/, 6-1.w74,y �d 269' BUSINESS PHONE: fa - 5-7 3 - 0-7 9v CONTACT 1: ce_. LkI y HOME PHONE 5.--/k- YY5-/)7a, ADDRESS: // 2,1- 0-1J--- i--e-�n Aa , / /olU°t CONTACT 2: / OJ/V_ it HOME PHONE �/S - s 8/- O/zie) ADDRESS: Ag 1 , 'A_ 447/ /1/4-/ This form is used to assist Emergency Service personnel who may be called to your business after hours. Please be sure that the persons listed on this form will be willing and available to respond during off-hours to assist Police and/or Fire personnel in gaining entry to your building. PLEASE BE ADVISED THAT FAILURE TO RESPOND TO ASSIST EMERGENCY SERVICE PERSONNEL MAY RESULT IN DAMAGE TO YOUR BUILDING TO FACILITATE ENTRY BY POLICE AND/OR FIRE PERSONNEL. Inspection Form Town of Queensbury Fire Marshal O Periodic Inspection Date: q)ii2J )/Time:/Z, 7L"'/74'7 742 Bay Road,Queensbury NY 12804 c2 Reinspection //-z72-7 518 761 8206/518 761 8205 �''CO Inspection Permit#: Fire Marshals Representative � % _MJ Palmer Business Name: b�� Location: /� • 2 r � .� gh.ej) K Stillman Contact: n& ' eictiel Type of Inspection N/A Yes, No EXITS: Exit Access PC 1014&FC1029 V, NOTES Exit Enclosure FC 1020&FC1029 Exit Discharge FC 1024&FC1029 Locks and latches FC1008& FC1029.2 Sign:Normal FC 1011 &FC1029 Sign:backup FC 1011.5.3&FC1029.7.5 v AISLES: Main Aisle Width FC 1024/1025&FC1029.11 a..'"'/ Secondary Aisle Width FC 1025&FC1029.11 Y FIRE EXTINGUISHER: Hung FC 906 L/' Inspection of extinguisher FC 906 EVAC Plan FC 404.6 _f TRUSS ID SIGNAGE FC 505.3 EMERGENCY LIGHTING: Interior FC 1006.3&FC1029.8 Exterior FC 1006.3 1 Clearance to Electrical FC 605.3 Electric Wiring Enclosed/Labeled FC 605.3.1 LK' Combustibles in Equipment Rooms FC315,.2.3 F.D.Signage- FC 510 No Smoking Signs FC 310.3 r Storage FC 315.2 1.7 Compressed Gas FC 3003 V Vehicle Impact Protection FC 312.1 . 60 Interior Finishes FC 803,-804 / Smoke Detectors FC 907 CO detectors FC 610 .� Clearance to Sprinkler/Ceiling FC 315.21 l. 41- 18" / 24" / EVAC SIGNS IN Rooms FC 404.6(R1 &R2) Fuel Pump Warning Signs FC2205.6 Fuel Station Emer Procedures FC2204.3.5 Exterior Storage FC 315.3 / REINSPECTION DUE APPROXIMATELY Vacant Buildings FC 311 21 DAYS SYSTEMS: FC 901.6 Insp OK NC DATE: OK NC Date Generator Annual DATE: OK NC Hood Installation Elevator Semi Annual FIRE ALARM Annual $f/i i DATE: OK NC HVAC Shutdown Sprinkler System Annual Q/!1 Sprinkler FDC Kitchen Suppression Semi Annual Fuel Island Suppression Semi Annual Hood Cleaning 3-6-Annual Knox Box:installed/checked FC506 Operating Permit, if required will be issued after Completion of Inspection Commercial Final Inspection Report Office No.: (518) 761-8256 Date Inspection =• = = ed: Queensbury Building&Code Enforcement Arrive: 677 Depart: Queensbury, NY 12804 Inspector's In *FMF.. 742 Bay Road,// rY NAME: A 0,Bk ( afkikk_—ty;RTPERMIT _e — 21.LOCATION: 2)-1 ( ' A E 12A_ }D DATE: ` — —1 COMMENTS: 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 I Exterior Ballisters 4 in. Spacing Platform/Decks Stair Handrail 34 in.—38 in.I Step Risers 7"I Treads 11" Vestibules For Exit doors>3000 sq.ft. Ail Doors 36 in.w/aver Handles I Panic Hardware, if required (/ Exits At Grade Or Platform 36(w)x 44'(I)/Canopy or Equiv. Gas Valve Shut-off Exposed&Regulator(18")Above Grade Floor Bathroom Watertight/Other Floors Okay Relief Valve,Heat Trap I 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/StoragelReceiving/Shipping Room(2 hr.), 1 IA doors > 10%> 1000 sq.ft. ' Hour Corridor Doors&Closers /Fire Firewalls/Fire Separation, 2 Hour, 3 Hour Complete Dampers I 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 I Sinks I 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(Both sides] 411IActive Listening System and Signage Assembly Space Final Electrical/Flex Gas Piping Bonded 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 4' Water Fountain or Cooler Building Access All Sides by?�I ndvveab a Surface 20'wide Okay To Issue Temp.oeermanent C> V-N To � �'._x3 E C Okay To Issue C/C L:\Building&Codes Forms\Bulding&Codes Inspection FamsVCornmerciai Final inspection Report.doc Revised January 7,2008