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2015-054 .4_ TOWN OF QUEENSBURY vzso742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20150054 Date Issued: Tuesday, March 24, 2015 This is to certify that work requested to be done as shown by Permit Number P20150054 has been completed. Location: 81 MAIN St Tax Map Number: 523400-309-010-0001-038-000-0000 Owner: HESS RETAIL OPERATIONS LLC C/O SPEEDWA Applicant: SPEEDWAY#07706 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 04 owner of the responsibility for compliance with Site Plan, Variance, or P tY P 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 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20150054 Application Number: A20150054 Tax Map No: 523400-309-010-0001-038-000-0000 Permission is hereby granted to: SPEEDWAY#07706 For property located at: 81 MAIN St 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: HESS RETAIL OPERATIONS LLC C/O SPEEDWAY LLC Certificate of Occupancy(COM) PO BOX 1580 Total Value SPRINGFIELD OH 45501 Contractor or Builder's Name /Address Electrical Inspection Agency Plans&Specifications 2015-054 Speedway#07706 Certificate of Occupancy ONLY $0.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday, March 24, 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 xpiration d t;.) Dated at the To n of e s �/�,/ / . ay,March 24,2015 v 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: CERTIFICATE OF OCCUPANCY PERMIT APPLICATION Permit No.: 2CO3 Permit Fee: 4D h1Du c `Note: This application is for occupancy only,with no work requiring a building permit. Name of Business Hess Retail Operations LLC d/b/a Speedway#07706 Address 81 North Main Street,West Glens Falls, NY 12801 Type of Business Gas station and convenience store A LS[ I V �1 ` C Manager Scott Bieber OR Person in charge MAR 18 2015 k'd Business Phone No. (518)792-7155 TOWN OF QUEENSBURY BUILDING&CODES Property Owner Hess Retail Stores LLC Address do Speedway LLC, P.O. Box 1580, Springfield, OH 45501, Attn: Lic Dept. Phone 937-863-6464 ,(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: Jason Cetel, Esq.,Attorney-in-Fact Signature: 114401 Date: /'�! r Notes 1 Comments: 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 EMERGENCY CONTACT UPDATE TO: Warren County Sheriff's Department 1. 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. 2. 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. PLEASE PRINT DATE: 10/01/2014 BUSINESS NAME: Hess Retail Operations LLC d/b/a Speedway#07706 BUSINESS ADDRESS: 81 North Main Street, West Glens Falls, NY 12801 BUSINESS PHONE: (518)792-7155 CONTACT 1: Scott Bieber HOME PHONE (607)237-7040 ADDRESS: 102 Hollister Way, Burnt Hills, NY 12027 CONTACT 2: Tammy Staunches HOME PHONE (518) 338-3842 ADDRESS: Town of Queensbury Fire Marshal—New Business Permit 518-761-8206 . 3 ° 1 I S I l GLADSON SETS ' — AUTO BEER PEPSI BONCAKE a FEM A�Em „1 GDM12 2 OPV 2FT INLINE SETS DAIRY y 1/ N 0 CANDY UTC X 2' OPM y// • W (UNDER THE COUNTER) ISO/JUICE �f LA o p AUTO 2FT WATER/MN -i ®% z \:,.. ' m - a z w 0 CANDY INCLUSIVE 8FT PEPSI ig o s ®� m 0 SWEET 4FT W x o f/ (W/ OR W/O EBT) SINKTEA / o Y' I ❑ SALTY 4FT COKE C r41 WM 3 \\1��"'111 z z /� �� o Q m ° p HBA (MULTIPLE OPTIONS) V 2' 0PM o a 0 G.M.(MULTIPLE OPTIONS) �•+ W EXISTING BEER a u`S \ Y O SLIM JIM POWERWING COOLER 7' TALL (MEAT SNACK) TOWER CIGARETTE 4FT 4FT SUM OF CABINET BEER POWER sy CANDY CANDY aql. o 0 BEER SALTY SWEETo ce `Z� W/EBT __ 4FT 4FT WASTE 1 0 I 1 ATM PEPSI COKE FRITO TH RACK TH RACK TAKE 0 0 0 0 HOME •l MARKETING PLAN 1200-1M W/BEER * AUTO AND TOWER OF POWER ARE FEBRUARY 2014 INTERCHANGEABLE DEPENDING 12 -- (\! ON LOCATION OF ELECTRICAL ** IF EBT APPROVED, SWEET PLANOGRAM WILL INCLUDE EBT PRODUCTS 3 ° 1 0 '► GLADSON SETS AUTO BEER PEPSI BONFEM APPenr CAKE o1-7=110 "'"" GDM122FT INLINE SETS DAIRY S 2' OPM y N 0 CANDY UTC '" (UNDER THE COUNTER) ISO/JUICE." WATER/TEA O� W o ❑ AUTO 2F7 m a� a „lot, _w 0 CANDY INCLUSIVE 8FT �� o O PEPSI oCOND. 05) m 0 SWEET 4FT W 2 0 (W/ OR W/O EBT) W X SINK TEA ?- y t COKE c rai2� a Z z E 0 SALTY 4FT ;:C V , a m ° p HBA (MULTIPLE OPTIONS) J V 2' OPM o a 0 G.M. (MULTIPLE OPTIONS) / EXISTING BEER \y n Y 0 SLIM JIM POWERWING COOLER r TALL (MEAT SNACK) TOWER CIGARETTE 4FT 4FT suM OF &Pros BEER r POWER „,- CANDY CANDY // x f/O 0 BEER "v SALTY SWEETEK 0 W/EBT _/ 47 4FT r_ WASTE ° ATM PEPSI COKE FRITO TH RACK TH RACK TAKE _ 0 0 0 0 HOME V MARKETING PLAN 1200-SM W/BEER * AUTO AND TOWER OF POWER ARE FEBRUARY 2014 INTERCHANGEABLE DEPENDING ON LOCATION OF ELECTRICAL 1200--IM ** IF EBT APPROVED, SWEET PLANOGRAM WILL INCLUDE EBT PRODUCTS