2015-302 TOWN OF QUEENSBURY
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742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20150302 Date Issued: Friday, July 31, 2015
This is to certify that work requested to be done as shown by Permit Number P20150302
has been completed.
Location: 1424 STATE ROUTE 9
Tax Map Number: 523400-288-016-0001-001-000-0000
Owner: LAKE GEORGE NORTHWAY LLC
Applicant: LAKE GEORGE NORTHWAY LLC
This structure may be occupied as a:
Certificate of Occupancy (COM) By Order of Town Board
TOWN OF QUE NSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the property (DJ 4
owner of the responsibility for compliance with Site Plan,Variance, or
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
01"
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
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Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20150302 Application Number: A20150302
Tax Map No: 523400-288-016-0001-001-000-0000
Permission is hereby granted to: LAKE GEORGE NORTHWAY LLC
For property located at: 1424 STATE ROUTE 9
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: LAKE GEORGE NORTHWAY LLC
C/O SOBERT REALTY CORP Certificate of Occupancy(COM)
2700 WESTCHESTER Ave Total Value
SUITE 407
PURCHASE NY 10577-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2015-302 Coleman Factory Outlet
C/O only, space 6
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Sunday,July 10,2016
(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 Townr7isbul Fr'I :y/1 , 10, 2015
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
Town of Queensbury Fire Marshal
Received:
ESTABLISHMENT OF A NEW BUSINESS Tax Map ID: (-PSI,go-(- /
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION Permit No.: 2-0I''. - ' 2-
Permit Fee: 41')6`_31firr
*Note: This application is for occupancy� only,with no work requiringra building permit. /
Name of Business C, tr1 {�"*(._/Z r c-Q'
Address /�o'�` ✓/ - c U J L 1 L C E il WE
Type of Business . .. L.::: ./ '�i i
Manager .a.A-« 5� -- -r.-4-e-�4�'� I I JUL 09 2015
OR
Person in charge - TOWN OF.QUEENSBURY 1
Business Phone No. 5) - 2`j-- i, . (o S BUILDING& CODES
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Property Owner 50/-tr 1-- /I
Address 6' e) 1---e'�-�t1r r 1 ../. L- 1(&�7 Pi-,L,_, ( 10s---, )
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Phone
,/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:
Signature:
Date:
Notes I Comments:
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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
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Inspection Form
Town of Queensbury Fire Marshal 0 Periodic Inspection Date:p [-6I)) Time: 10�
742 Bay Road,Queensbury NY 12804 <=)Re-Inspection
II
518 761 8206/518 761 8205 42)CO Inspection Permit#: iS 3
Ve Marshals Representative
/ MJ Palmer Business Name: euk- vwrJ Oji co-
Location: I -1 4 tc 9
GK Stillman Contact: '�ownV s'zeci,
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
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
FIRE EXTINGUISHER: Hung FC 906 TV‘i
Inspection of extinguisher FC 906
EVAC Plan FC 404.2 TRUSS ID SIGNAGE FC 505.3 C6AAP/
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 A
Combustibles in Equipment Rooms FC315.2.3 t(- 66
'
F.D.Signage- FC 510 1 )
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
SYSTEMS: FC 901.6 Insp OK NC DATE: OK NC
Date
Generator Annual DATE: OK NC
Hood Installation
Elevator Semi Annual
FIRE ALARM Annual DATE: OK NC
HVAC Shutdown
Sprinkler System Annual
Sprinkler FDC Fire WOW In • tort Cm qlwtw
Kitchen Suppression Semi Annual OK to Issue Certi = of uparlcy
Fuel Island Suppression Semi Annual
Hood Cleaning 3-6-Annual
Knox Box:installed/checked FC506 JUL P 9 115
Operating Permit, if required will be issued after 1' LI'
Completion of Inspection Town oaf Queensbury