2012-164 011140.1N TOWN OF QUEENSBURY
f4t 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20120164 Date Issued: Tuesday, May 01, 2012
This is to certify that work requested to be done as shown by Permit Number P20120164
has been completed.
Location: 6 STATE ROUTE 149
Tax Map Number: 523400-288-012-0001-014-000-0000
Owner: FIVEASIDE, LLC
Applicant: STARLA'S SHOPPE
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
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
4 _
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
1
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20120164 Application Number: A20120164
Tax Map No: 523400-288-012-0001-014-000-0000
Permission is hereby granted to: STARLA'S SHOPPE
For property located at: 6 STATE ROUTE 149
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: FIVEASIDE, LLC
C/O SILVER BUILDERS,INC. Certificate of Occupancy(COM)
3109 STIRLING Rd Suite 200 Total Value
FT. LAUDERDALE, FL 33312-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2012-164
CO only - Starla's Shoppe
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday, May 01,2013
(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 Town of Queensbury; Tuesday,May 01,2012
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
SI-)
w;_ __:: Community Development Office ,
-` Town of Queensbury• 742 Bay Road • Queensbury, New York •I— 4 .�' 1,,
C� E
,
David Hatin, Director of Building& Codes
Craig Brown,Zoning Administrator• Michael J. Palmer, Fire Marshal AP �� J
R4
J Ct0 O D _....
ESTABLISHMENT OFA NEW BUSIJJESt m OI- QUEEN SBU RY
CODES ,
c P CERTIFICATE OF OCCUPANCY PERMIT APPLICATION -
*Note: This application is for occupancy only, with no work requiring a building permit.
TAX MAP# g /) 1-/'T BLDG. PERMIT FILE# i d--/(�1-i
If applicable
Name of Business: 34aria's 5 h. e
of
AddressBusiness: V I il.1t\ St to `1 t i Lig L.(Lk..Qeof , QUESTIONS? CALL 761-8256 OR
/ EMAIL codes(a)queensbury.net
i
YY.,C
Z�Uj5VISIT OUR WEBSITE FOR MORE
Person in Charge or Manager: 0 a r i er l r i e. ( 1 r e_ INFORMATION
www.queensbury.net
Business Phone Number: _6-1Sl (03b -- 831 (i' Lt : 37- c3 8
Type of Business: r e -1-tL ( )41 f's1
civ ft S
Owner of Property: I' ( Y Q Ot5 i GI.e LC Phone Number(s): —
cs� 793170&3
Home ceu x 30/
Owners Address: c l 0 "--Po ;,)-Q e I F If L ni kg ,3.5'j �d (j .eei. i
1 i Pk /
Provide an accurate layout of your store showing all walls, exits, stockrooms, rest rooms,
counters and fixture layout on a separate sheet of paper.
Signatt(---�-���w_9--. \CCs.Date: AR /A.
Of person submitting this form
Notes/ Comments:
•
EMERGENCY CONTACT UPDATE
TO: WARREN COUNTY SHERIFF'S DEPT. D FAX: 743-2502, i
PLEASE PRINT APR 1
2012
DATE: - 13 - I.Z TO\NN OF QUEENSBURY
BUILDING& CODES
BUSINESS NAME: �, ±O r(S � 1/0 9p
rl
BUSINESS ADDRESS: 10 Sm f e 7 c tJ e J / L 6_14 ec rC c
towel of ( LLeeL �L
BUSINESS PHONE: I (OA - 32 3
CONTACT 1: Lrkete (fl HOME PHONE C l/:LQ 3 ' SUO'
ADDRESS: 3'Mtase Dueekt4tv
CONTACT 2: 1'1AGt.Y► e. l 6OTIDS t HOME-PHONE�r//: Q�,M3 )
OT
ADDRESS: G £3 riga Jjtiv2 o 361.0-k
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 -D
Town of Queensbury Fire Marshal O Periodic Inspection Date:4'�1� Time:
742 Bay Road,Queensbury NY 12804 o Re-Inspection / L,�
518 761 8206/518 761 8205 o CO Inspection Permit#: /?- /67
Fire Marshals Representative
X MJ Palmer Business Name: ;�`I1 QLA 'S S'AO ppi
Location: 6 S1gle i Li F
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 r,
Locks and latches FC1008& FC1029.2 4
Sign:Normal FC 1011 &FC1029 /
Sign:backup FC 1011.5.3&FC1029.7.5
AISLES: /' j9
Main Aisle Width FC 1024/1025&FC1029.11 / • r\
Secondary Aisle Width FC 1025&FC1029.11 •,-\. / �--U
FIRE EXTINGUISHER: Hung FC 906 /
��1 )\Il
Inspection of extinguisher FC 906 J
EVAC Plan FC 404.6 /
TRUSS ID SIGNAGE FC 505.3
EMERGENCY LIGHTING: /
Interior FC 1006.3&FC1029.8
Exterior FC 1006.3 r:,..}0
�.
Clearance to Electrical FC 605.3
Electric Wiring Enclosed/Labeled FC 605.3.1
Combustibles in Equipment Rooms FC315.2.3 J
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
21 DAYS
Insp OK NC DATE: OK NC
SYSTEMS: FC 901.6 Date
Generator Annual DATE: OK NC
Hood Installation
Elevator Semi Annual
FIRE ALARM Annual DATE: OK NC
HVAC Shutdown
Sprinkler System Annual
Sprinkler FDC
I Fire Nizir .'..r.11 inSOeL Co,- !:;:;,
Kitchen Suppression Semi Annual 1r tO:SSi}L Cortif:-ie cit '•Edr,,
Fuel Island Suppression Semi Annual
Hood Cleaning 3-6-Annual t
Knox Box:installed/checked FC506 1 , Op
Ya b
3 i2 i
Operating Permit, if required will be issued after I \ .......-,
Completion of Inspection I Fire.;rrsh a
if-as'\
I
3C'—O
f ,
i
a c c
L
T 1
T
I 1 o ❑ - 1
ai
I T
1
7 — v-t1
1
''
IOE CEr i
L
I
LI
1 . AlbeekOm 1_1
,— 1 ( .
s 1-
i
i
1SECOND FLOOR PLAN
" _ _ = r
,_)t � la's S -,__)
cz
: V... 1-4-Kc (met,3 A5 045
7-- RTE 149 •
I a
30"—C-=
_
aGR 16..2012 o '
8U/LD/NQUEENS/3
1 I
G& CODES UR y
1 ,
!
eALco , I T
. 11 ! ABovz
I
I
. 1 /- .. i
7
H
Or CatA.11-Fe-r
7' 0 0
1 1
7 eash 1-0,5131-ev- J
I
.--7-.
I
' — 1
•
[
I
;---TelLET- .s.
\,
._ .
- ' I
'-'• ° - • I '` '''' T
.. -
—
.. F.:AMP DOwN I
• .
. 1
. J -_-J •
. i
.= .
.. .1" . i •
, z, ,
"----_..-- K- ....
•
.
, •
,.„
J
, i (
. , •
• . . ,
I I !
! ,
' ! .
.7;
, •
•
•
,
- • _ 1
• I
I i
1 I
FIRST FLOOR PLAN
„..- -r.:, .E...'..::•_F. $ 1
i 3f6LY I It S ,Svic,e .e.._
1_
cz ,
105( RA 1L1 el 0
z
Lak be orle 1 ilgLi5
...)