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f, TO" OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: CO-000135-2016
Tax Map No: 296.19-1-1
Permission is hereby granted to: Adirondack Enrichment PLLC
For property located at: 60 GLENWOOD AVE
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
Tyne of Construction
Owner Name: RGJC,LLC Certificate of occupancy $0.00
Owner Address: 60 Glenwood AVE Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
CIO Only
Adirondack Enrichment
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES:
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the ex 'ration date.)
Dated at the Town of ueensb /'Thur d re 17,2016
SIGNED BY: /� for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
Town of Queensbury Fire Marshal
Received:
ESTABLISHMENT OF A NEW BUSINESS Tax Map ID:
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION Permit No.: Co 135. SIC t b
Permit Fee: T ZQ I ryo ire )
*Note: This application is for occupancy only,with no work requiring a building permit.
Name of Business r i 1"0(1cI,c4c..V E_;V%r- c_In e-0 e ry
Address 00 �JAc-Z_S C7L{
Type of Business {-o zt Cm,"Ctf0 f
Manager
OR
Person in charge Z i"Di U-iJ O 2016
Business Phone No. I A- 3o ay
SEN SURA
'1"0 OP ��0�
Property Owner �.0 TC L_L..C. � �u'��r U,II 010
Address ` lj
LJ
Phone ,'o-7 - .3
✓Provide an accurate layout of your store showing all walls,exits,stockrooms, rest rooms,counters,and fixture layout on a
separate sheet of paper.
Print Name: V T 0,LlLdo:,!
Signature: .
Date:
Notes/Comments:
IMPORTANT: The.business owner is responsible for keeping exits clear and maintaining exit signsand emergency lights. Fire
extinguishers,fire sprinkler systems,and fire'alarm systems require annual inspections by an outside contractor and the corresponding
documentation must be provided to the;Fire Marshal's office. Fire extinguishing systems found in kitchens and gas stations require
semi-annual inspections. Any violations noted during an inspection,require immediate`correctiye action.
CONTACT NUMBERS:
Director,Building and Codes-761-8253 Zoning Administrator-761-8218; 'Zoning-761-8238
Fire Marshal-761-8206 Planning-761-8220
Town of Queensbury Fire Marshal-New Business Permit 518-761-8206
.EMERGENCY CONTACT UPDATE
Please print clearly °--
DATE: I U, MAR 15 2016 U
LBUILDINlG Du$� BU6
BUSINESS NAME: LLC'
BUSINESS ADDRESS: tca �. •� �� ��rr � b �s �� r� �I ( `
BUSINESS PHONE: I
PHONE 1: '-]ctf/ -- lot
CONTACT 1: GCS. t..yAcUr`w�,,,S--- PHONE 2:. &�5-L - 3t9-1
TOWN/VILLAGE RESPONDING FROM: alfeon156J��_
PHONE 1: 757
CONTACT 2: PHONE 2: LL' -3 w a:j
TOWN/VILLAGE RESPONDING FROM: 1e-e.,L- r
This form is used to assist Emergency Service personnel who may be called to
your business afterhours. 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.
TOWN OF QUEENSBURY FIRE MARSHAL'S OFFICE
P h.o n e. 518-761-8206 - Fax. 518-745-4437
firemarshal fteensburly.net zvzvzv.queensbupj net
Fire Marshal Michael j Palmer Deputy Fire Marshal Garii K Stillman
FIRE MARSHAL'S OFFICE
Town of Queensbury
742 Bay Road, Queensbury, NY 12804
" Home of Natural Beauty ... A Good Place to Line "
PLAN REVIEW
Adirondack Enrichment
60 Glenwood Avenue
C®-000135 -2016
3/17/2016
® Verify Lock/ latches on egress doors are compliant
® Compliant combo exit sign / emergency lights at egress doors, to be
verified
® Add carbon monoxide detection throughout the space
® Verify Fire extinguishers locations throughout
® Verify aisles and storage
Michael J Palmer
Fire Marshal
742 Bay Road
Queensbury NY 12804
firemarshal@queensbury.net
Fi r e M a r s It a 1's Off i c e - P It o 71 e: 518-761-8206 - F a x: 518-745-4437
firemarshal@gzceensbunl net - Z=70.queensburiI net
ir�l.l Illlmr.,.
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