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2015-241 .4�� TOWN OF QUEENSBURY wojo 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20150241 Date Issued: Monday, July 27, 2015 This is to certify that work requested to be done as shown by Permit Number P20150241 has been completed. Location: 360 QUAKER Rd Tax Map Number: 523400-303-005-0001-086-000-0000 Owner: NORTHGATE ENTERPRISES INC Applicant: STATE FARM AGENCY- SEAN AKINS This structure may be occupied as a: Certificate of Occupancy (COM) By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the property /j 44. owner of the responsibility for compliance with Site Plan, Variance, or �d other issues and conditions as a result of approvals by the Planning Board «\ Director of Building&Code Enforcement or Zoning Board of Appeals. TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 *SI Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20150241 Application Number: A20150241 Tax Map No: 523400-303-005-0001-086-000-0000 Permission is hereby granted to: NORTHGATE ENTERPRISES INC For property located at: 360 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. Type of Construction Value Owner Address: NORTHGATE ENTERPRISES INC PO BOX 4514 Certificate of Occupancy(COM) QUEENSBURY,NY 12804-0000 Total Value Contractor or Builder's Name /Address Electrical Inspection Agency Plans&Specifications 2015-241 C/0 Only State Farm Agency -- Sean M. Akins (former chiropractor's office) $50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Sunday,June 12, 2016 (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 o eens d;! . i e 12,2015 i SIGNED BY ' %. for the Town of Queensbury. Director of Building&Code Enforcement nn,1 It 1 ffice Use Only Town of Queensbury Fir Marshal � a Jori 0 2015 U eceived: ESTABLISHMENT OF A NEW BUSINESSax Map ID: 36') CERTIFICATE OF OCCUPANCY PERMIT APPLICATION,'Ry Permit No.: 1-0‘1.`'' 2- 41 Permit Fee: *Note: This application is for occupancy only,with no work requiring a building permit. Name of Business Cwt,` I' 4 :: t N S Lrm,-1--6' F& n'�� ale v e_ Address 3 5S' &L l'e,W., "lc S, 6'. v<`-e f. t'y N' Type of Business ''15��v�,z�•CsL k c. F 4i L,5 Manager 'Cv� VV\ _ A iK r ius OR Person in charge Business Phone No. 51 ` - DCS L t I (5, i WSJ 301( 5.1 GI Property Owner 46,4r '\ - C{.�2 Lvt-kv 1oV,r 5C 5 j_tic - Address t 4 l Phone (5 it 2cS _ c�Q (0 I ✓Provide an accurate layout of your store showing all walls, exits, stockrooms, rest rooms, counters, and fixture layout on a separate sheet of paper. Print Name: _ A, Ask Ada ` !v S-- Signature:Signature: Date: (iV9/ Notes I Comments: L Ckiry if 4P Liz- IMPORTANT: The business owner is responsible for keeping exits clear and maintaining exit signs and emergency lights. Fire extinguishers, fire sprinkler systems, and fire alarm systems require annual inspections by an outside contractor and the corresponding documentation must be provided to the Fire Marshal's office. Fire extinguishing systems found in kitchens and gas stations require semi-annual inspections. Any violations noted during an inspection, require immediate corrective action. CONTACT NUMBERS: Director, Building and Codes-761-8253 Zoning Administrator-761-8218 Zoning-761-8238 Fire Marshal-761-8206 Planning-761-8220 Town of Queensbury Fire Marshal—New Business Permit 518-761-8206 Inspection Form , ^/Town of Queensbury Fire Marshal 0 Periodic Inspection Date: " I��11S Time: 1 • 742 Bay Road,Queensbury NY 12804 o Re-Inspection 518 761 8206/518 761 8205 JP CO Inspection 'ection Permit#: _ `' Fi Marshals Representative MJ Palmer Business Name: SIAN fr V-4Y`-, i S'i-PFTL- inviN Location: 3S Q%o►Kc.h c .C319 GK Stillman Contact: Type of Inspection N/A Yes No EXITS: Exit Access FC 1014&FC1029 NOTES Exit Enclosure FC 1020&FC1029 Exit Discharge FC 1024&FC1029 Locks and latches FC1008& FC1029.2 �( Sign: Normal FC 1011 &FC1029 f Sign: backup FC 1011.5.3&FC1029.7.5 AISLES: Main Aisle Width FC 1024/1025&FC1029.11 Secondary Aisle Width FC 1025&FC1029.11 C FIRE EXTINGUISHER: Hung FC 906 /A21 t qInspection of extinguisher FC 906 EVAC Plan FC 404.2 TRUSS ID SIGNAGE FC 505.3 EMERGENCY LIGHTING: //�� Interior FC 1006.3&FC1029.8 /t ) L c 1 Exterior FC 1006.3 �/ Clearance to Electrical FC 605.3 Electric Wiring Enclosed/Labeled FC 605.3.1 £:I_Combustibles in Equipment Rooms FC315.2.3V F.D.Signage- FC 510 No Smoking Signs FC 310.3 Storage FC 315.2 Compressed Gas FC 3003 Vehicle Impact Protection FC 312.1 Interior Finishes FC 803-804 Smoke Detectors FC 907 CO detectors FC 610 Clearance to Sprinkler/Ceiling FC 315.2.1 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 Emergency Disconnect FC 2203.2 21 DAYS 3rd Party Electrical SYSTEMS: FC 901.6 Insp OK NC DATE: OK NC Generator Annual FM Type Suppression Semi Annual DATE: OK NC Elevator Semi Annual FIRE ALARM Annual DATE: OK NC Paint Booth Suppression Semi Annual Sprinkler System Annual Sprinkler FDC Fire Marshal In .n Complete Kitchen Suppression Semi Annual Fuel Island Suppression Semi Annual OK to Issue Ce ,.�p �fny Hood Cleaning 3-6-Annual Knox Box:installed/checked FC506 20 ' , itiiikbarr, --, Operating Permit, if required will be issued after Fire Marshal Completion of Inspection Town of( ueensbury _4 r Inspection Form Town of Queensbury Fire Marshal O Periodic Inspection Date:GIM"� Time: 742 Bay Road,Queensbury NY 12804 c=:' Re-Inspection i S �1 y I 518 761 8206/518 761 8205 CO Inspection Permit#: o� Fir Marshals Representative X MJ Palmer Business Name: 5 +� `i"°^'^^ • Location: Z5U aacM CIO GK Stillman Contact: S � Type of Inspection N/A Yes No EXITS: Exit Access FC 1014&FC1029 // NOTES Exit Enclosure FC 1020&FC1029 Exit Discharge FC 1024&FC1029 Locks and latches FC1008& FC1029.2 / 1 EA I rSE4 y 1 N 41 N Sign: Normal FC 1011 &FC1029 , (�A YJrJ Sign: backup FC 1011.5.3&FC1029.7.5 6 UTn `t''iped.6.0 AISLES: Main Aisle Width FC 1024/1025&FC1029.11 1 Secondary Aisle Width FC 1025&FC1029.11 f � " FIRE EXTINGUISHER: Hung FC 906 /' 0 l,0 SILO+CKs) Inspection of extinguisher FC 906 (Wu(Ni ct,a151‘ NeAv ✓ EVAC Plan FC 404.2 / EC Q(14 war TRUSS ID SIGNAGE FC 505.3 // EMERGENCY LIGHTING: Interior FC 1006.3&FC1029.8 / Exterior FC 1006.3 Clearance to Electrical FC 605.3 / Electric Wiring Enclosed/Labeled FC 605.3.1 f/' Combustibles in Equipment Rooms FC315.2.3 / F.D.Signage- FC 510 No Smoking Signs FC 310.3 l Storage FC 315.2 Compressed Gas FC 3003 Vehicle Impact Protection FC 312.1 / / Interior Finishes FC 803-804 Smoke Detectors FC 907 /j CO detectors FC 610 Clearance to Sprinkler/Ceiling FC 315.2.1 / 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 Emergency Disconnect FC 2203.2 21 DAYS 3rd Party Electrical SYSTEMS: FC 901.6 Insp OK NC DATE: OK NC Generator Annual FM Type Suppression Semi Annual DATE: OK NC Elevator Semi Annual FIRE ALARM Annual DATE: OK NC Paint Booth Suppression Semi Annual Sprinkler System Annual 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 Inspection9 3 6ekk.,,c,K.e.,,,- 113 & s< N y -II e'GkAEC' 1-- 1I F. ?Nef:›+r001,111 0 c ck Ci- "" i v4 'O0M- Ci D CICk c,, . i _-� 1 0-C-(1, 0 E c T iE , ititd 0 71115 .J .I TOWN OF QUEENSBURY '"rp.,,‘. :'1-41/Giv1 BUILDING& CODES AVv-U-1 :..:' . .•x. •''a '. 1r �{.� - O WC. ! r ay'� yTt.4r Wi �Y' .eS � , • yg.,"..- qJ _ � , �' . i , s , ! i -4.4.... s ' , 1' i .1 R.'►•{ 4Yi • ': 'qy l Jc r y y 's l'l' • re d•`',Y....-., a., ykil--,'`'S P: IL. 7• t C ,.i. q Y • F J j ;' !EN WRY -`. .1--!-• rnmt!!/Y[' q ,.R••r�D, �rmrtFl:'��c� J !7. —._.-- _ �� n Pp!. 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