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2012-136 4011111K TOWN OF QUEENSBURY IF 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20120136 Date Issued: Tuesday, September 11, 2012 This is to certify that work requested to be done as shown by Permit Number P20120136 has been completed. Location: 1043 STATE ROUTE 9 Tax Map Number: 523400-296-009-0001-002-000-0000 Owner: GARY & JILL WILSON Applicant: ENTERTAINMENT ONE RENTALS 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 (—Dj i / 1- - 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. -,; Community Development Office VECEOW Town of Queensbury • 742 Bay Road • Queensbury, New York •12804 David Hatin, Director of Building& Codes �.• . Craig Brown, Zoning Administrator• Michael J. Palmer, Fire Marshal f,-•1; r,. TOWN OF Ql FM13 RY BUILDING & CODES ESTABLISHMENT OF A NEW BUSINESS CERTIFICATE OF OCCUPANCY PERMIT APPLICATION *Note: This application is for occupancy only, with no work requiring a building permit. TAX MAP # 2_9 A —� BLDG. PERMIT FILE# ` � ��0 I I If applicable Name of Business: En-I- Address ,j I� of Business: 1O`CS ROUTL ( QC31-3.- S(2.0R.LA. QUESTIONS? CALL 761-8256 OR EMAIL codes@queensburv.net 1(3h1--) Vie `�S VISIT OUR WEBSITE FOR MORE Person in Charge or Manager: r ` INFORMATION I Q I 'FI Q www.queensbury.net ' Business Phone Number: l V `40. ^ d `Gn Type of Business: \PCUz-1 V-0174-a Owner of Property: 0)WN Rr�� ILL ,UII—S� Phone Number(s): 119(8-337107 9210-910 oaulaa. gop.L Home Cell Owners Address: 22aWN6 `Rfl-1' ( N'1 Provide an accurate layout of your store showing all walls, exits, stockrooms, rest rooms, counters and fixture layout on a separate sheet of paper. Ai /AO' (2/2 /� Signature: Of pers. submitting airs form Notes / Comments: EMERGENCY CONTACT UPDATTECIEEIVIE1] TO: WARREN COUNTY SHERIFF'S DEPT. FA 'IP SBUDESRY Pl PLEASE PRINT DATE: 3/3(V/2- BUSINESS NAME: 6114<dr-i- l'il Lw t Re-114n t BUSINESS ADDRESS: ! 1 �� pv s' F /02- U BUSINESS PHONE: 79c2- O ?,2 CONTACT 1: J v-v 1 e r S HOME PHONE vW7 363 V c,eri ya.1 - roves ADDRESS: CONTACT 2: HOME PHONE ADDRESS: 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: / (ime: C '' 742 Bay Road,Queensbury NY 12804 o Re-Inspection 518 761 8206/518 761 8205 1 CO Inspection Permit#: -13 6 Fire Marshals Representative MJ Palmer Business Name: -i icerr- ,0A; ,14. -1--1-41 S Location: /& 13 c '+ 7 ,-"\-- K Stillman Contact: kLiy gir 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 C 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 FIRE EXTINGUISHER: Hung FC 906 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 Clearance to Electrical FC 605.3 „/r Electric Wiring Enclosed/Labeled FC 605.3.1 .� Combustibles in Equipment Rooms FC315.2.3 .--- -- F.D.Signage- FC 510 IW No Smoking Signs FC 310.3 ----" • Storage FC 315.2 / 1ialliJ_' Compressed Gas FC 3003 i 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 ExtVacant Storageuildg C 33513 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 12- DATE: OK NC HVAC Shutdown 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 Inspection Inspection Form Town of Queensbury Fire Marshal O Periodic Inspection Date: J 31`1ZTime: a2 742 Bay Road,Queensbury NY 12804 o R pection 518 761 8206/518 761 8205 O Inspection Permit#: 1 i 134 Fire Marshals Representative i r _MJ Palmer Business Name: i� i?� �/ f3 Location: / fit` = 714' GK Stillman Contact: Ji1in Yh%' 4 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 f ON Chq t-z 1k') Sign:Normal FC 1011 &FC1029 /' L I r f Sign:backup FC 1011.5.3& FC1029.7.5 e �,�— tic G &S." '-' 46,1e) AISLES: Main Aisle Width FC 1024/1025&FC1029.11 Secondary Aisle Width FC 1025&FC1029.11 FIRE EXTINGUISHER: Hung FC 906 x- •_/->fA,c� F7 . vlol5A� Inspection of extinguisher FC 906 Y 4*- y� �� COrA'l cf- EVAC Plan FC 404.6 „/ !yam' TRUSS IDC SIGNAGE FC 505.3 _ j r f <r EMERGENCY LIGHTING: 4h tz� *► ul J Nr� Interior FC 1006.3&FC1029.8 ---)c rf'! / 1L176J Exterior FC 1006.3 Clearance to Electrical FC 605.3 Electric Wiring Enclosed/Labeled FC 605.3.1 ! ' 17 J - k i re._ eeteir"e6eL Combustibles in Equipment Rooms FC315.2.3 / 19 d5- F.D.Signage- FC 510 _,...---"PY NSt Smoking Signs FC 310. / ' — A A401 S�� r Storage FC 315.2 /"' ri 516 Compressed Gas FC 3003 Vehicle Impact Protection FC 312.1 ....-----d Interior Finishes FC 803-8041�. 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 B.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 Insp OK NC DATE: OK NC SYSTEMS: FC 901.6 Date Generator Annual DATE: OK NC Hood Installation Elevator Seml Annual FIRE ALARM Annual 2.PI7- A DATE: OK NC HVAC Shutdown 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 Inspection