2012-385 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20120385 Date Issued: Friday, September 21, 2012
This is to certify that work requested to be done as shown by Permit Number P20120385
has been completed.
Location: 1424 STATE ROUTE 9
Tax Map Number: 523400-288-016-0001-001-000-0000
Owner: JOCKY LAKE GEORGE PLAZA LLC
Applicant: LINDT CHOCOLATES
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 avP
ii
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
742 Bay Road,Qtieensbur,y,NY 12804-5902 (519)761-8201
Conimunity Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P201,20385 Apl)lication Number a20120385
T,,t\ .\l,ip No: 523400-288-016-01001-001-000-0000
I)ermissions hereby gn.intcd to:
t I..,INDTCI IOCOLA'I"ES
For property located m: 1424 STATE ROtJ']-'E 9
in the.Town of Queensbury,to construct or place
,it the above location in »lccordance witli-q-,)plicmion together with plot phins and other lliformation hereto Filed
mid approved and in complince with the NYS Uniform Building Codes ,,ind the Queens-buil, Zoning
Ordimince. Type..of Construction Value
Owner Address: LAKE GEORGI'l NORTHWAY LLC Certificate of Occupancy(COM)
C/O SOBER'I' REAI..,'I'Y CORI) Tofill Value
2700 WESTCHESTER Ave
SI. ITE 407
PURCHASE NY 10577-000�O
("or tractor Or Builder's Nmne / Address 1"Jectricid Inspection Agency.
Plans & Specifications
2012-3,85
CO Only - Undt Chocolates
Space 3 - Lake George I'laza
$50.00 PERMIT FEE PAID -THIS PERMIT EXPIRES- Friday, August 16, 2013
(If a banger period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of twee nsbory before the expiralion date.)
Dated at the Town of Queensbuty; Thursday, August 16, 2012
SIGNEI�
BY for rthc'fown of Qucensbury.
Dircaor of Building& Cocle Enforcement
o r
Community Development Office
Town of Queensbury • 742 Bay Road • Queensbury, New York •12804 ' fit► r 2Q12
David Hatin, Director of Building & Codes
Craig Brown, Zoning Administrator• Michael J. Palmer, Fire Marshal J f�l j
ESTABLISHMENT OFA NEW BUSINESS
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION
*Note: This application is for occupancy only, with no work requiring a building permit.
TAX MAP # 3 R . f ? — , BLDG. PERMIT FILE# I ar '
If applicable
Name of Business: L I NDT. CHOCOLATES _ ,
' tc S
Address
of Business: STATE RTS q SPA _
epee 0o Ny QUESTIONS? CALL 761-8256 OR
, 12_^ 5 EMAIL codesqueensbury.net
r3`f VISIT OUR WEBSITE FOR MORE
Person in Charge or Manager: Me] ssc. ,mc.ra.(M e.-. war) INFORMATION
www.queensbury.net
Business Phone Number: 6 18 -77 3 -7ll,/
Type of Business: le-i-CO }�C-packc9ed chocoki-I'L
co, fyvdt
Owner o Property: .' rgi' c •-' Aw' , Phone Number(s): 1Q
I4-91-8-55O3b
Hem& c:5 F i LE Cell
Owners Address: Teti 3TA-TE RTE 9 I Quenshurt,' NY 12.8515
Provide an accurate layout of your store showing all walls, exits, stockrooms, rest rooms,
counters and fixture layout on a separate sheet of paper.
Signature Date:
g �--- 115/12.
Of person submitting this form
Notes / Comments:
h9,2-01)-
EMERGENCY CONTACT UPDATE
TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 743-2502
PLEASE PRINT
DATE: 7/1 �J /2
BUSINESS NAME: Li N l]T CI-10 COL ATF.. _
•
43
621a 660:eZ:Pc-Kry -c.
BUSINESS ADDRESS:•, .J (
z/-; sTirrE Q-rt 9, aks UEENSgu , 284-5-
BUSINESS
84-SBUSINESS PHONE: ;S 18 - 75,3 - 7((01
CONTACT 1:tv S4-wLA-z F " HOME PHONE As"CI ' 1201
ADDRESS:'e2Z 0...A-K.00 S , k)k.? D
CONTACT 2: v HOME PHONE C81:7 'MO " g�
ADDRESS: I LS &Flo e_em 038"
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.
0 /
Inspection Form
Town of Queensbury Fire Marshal Periodic Inspection Date: 6 )�r Time!--7' 4�"
742 Bay Road,Queensbury NY 12804 c Re-Inspection „---•
518 761 8206/518 761 8205 CO Inspection Permit#: /�' i.)'
Fire Marshals Representative J� ��G
-- MJ Palmer Business Name: `��J.
Location: / - j, , p f '
X GK Stillman Contact: - // 7/9
Type of Inspection N/A Yes No
EXITS: Exit Access FC 1014&FC1029 NOTES
Exit Enclosure FC 1020&FC1029 ',..-----
Exit
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 .f
AISLES:
Main Aisle Width FC 1024/1025&FC1029.11 /
Secondary Aisle Width FC 1025&FC1029.11
FIRE EXTINGUISHER: Hung FC 906 -..---'
Inspection of extinguisher FC 906 /
EVAC Plan FC 404.6 ...-- --
TRUSS
/TRUSS ID SIGNAGE FC 505.3 ..f.-
EMERGENCY
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
Combustibles in Equipment Rooms FC315.2.3 .-----
F.D.
F.D.Signage- FC 510 .......---
No Smoking Signs FC 310.3
Storage FC 315.2 �-------
Compressed Gas FC 3003 _,----
Vehicle
Vehicle Impact Protection FC 312.1 ..✓
Interior Finishes FC 803-804 -�/-o 1 i
Smoke Detectors FC 907 i
CO detectors FC 610 O
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
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 k /
Sprinkler FDC
Kitchen Suppression Seml 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
-1 ha (Is d l; /0eRrn
Inspection FormQ
Town of Queensbury Fire Marshal cD Periodic Inspection Date: !/0/f, _T1me:/0.'470
742 Bay Road,Queensbury NY 12804 Re-I spection Q t`
518 761 8206/518 761 8205v Inspection Permit#: / �C — 3 �) L)
Fire Marshals Representative
—MJ Palmer Business Name: t.(t1 --}r O c-
Location: P---1 d' J -�, R t- 9
GK Stillman Contact: //%f g.Lvic
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
0.-
Sign:backup FC 1011.5.3&FC1029.7.5
AISLES: •
Main Aisle Width FC 1024/1025& FC1029.11n
Secondary Aisle Width FC 1025&FC1029.11 ° �-'rl > I /�15 1=5"FIRE EXTINGUISHER: Hung FC 906 .....--"T„ 1j
Inspection of extinguisher FC 906 /
EVAC Plan FC 404.6
TRUSS ID SIGNAGE FC 505.3
EMERGENCY LIGHTING:
Interior FC 1006.3& FC1029.8
Exterior FC 1006.3 ,..--
Clearance
�Clearance to Electrical FC 605.3
Electric Wiring Enclosed/Labeled FC 605.3.1
Combustibles In Equipment Rooms FC315.2.3
F.D.Signage- FC 510 / .
No Smoking Signs FC 310.3 .� I� + `�
Storage FC 315.2Fr
`1)'1 `L �iy) Efa?4,,c
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
Vacant Buildings FC 311 REINSPECTION DUE APPROXIMATELY
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 'j,/L
Sprinkler FDC 42,-
Kitchen Suppression Semi Annual �j /_ 5-tk ,I L- -
Fuel Island Suppression Semi Annual U `� J��i�-
Hood Cleaning 3-6-Annual
Knox Box:installed/checked FC506 a4,, zfy„,-, pt.,
Operating Permit, if required will be issued after 15 (01.11x„.,0
Completion of Inspection
NNI v\taaq .1: _i..4.6t_t_s. q--1 1
Inspection Form
Town of Queensbury Fire Marshal O Periodic Inspection Date:4 1 it 61. Time: / vo
742 Bay Road,Queensbury NY 12804 I Re-Inspection :),• -
3 3��
518 761 8206/518 761 8205 CO Inspection Permit*: r
Fire Marshals Representative
_ MJ Palmer Business Name: 1110
/ Location: % i\ .A/ S--frc-de P-4- cid
/ GK Stillman Contact: ryi)cr K H ern m e.,-- e I -i0(-o - 0 3 y
Type of Inspection N/A Yes No
EXITS: Exit Access FC 1014& FC1029NOTES
Exit Enclosure FC 1020& FC1029 / NOTES
Exit Discharge FC 1024& FC1029
Locks and latches FC1008& FC1029.2 /
Sign:Normal FC 1011 &FC1029 ,1C
Sign:backup FC 1011.5.3&FC1 029.7.5
AISLES: •
Main Aisle Width FC 1024/1025& FC1029.11 (]fir
Secondary Aisle Width FC 1025&FC1029.11 y'— z4"' +t '
FIRE EXTINGUISHER: Hung FC 906
Inspection of extinguisher FC 906
EVAC Plan FC 404.6 tZ,‘ ± J r C/� (4--,
TRUSS ID SIGNAGE FC 505.3
EMERGENCY LIGHTING: .
Interior FC 1006.3& FC1029.8 ,/ 1� �" lZ
Exterior FC 1006.3
Clearance to Electrical FC 605.3 / 4��
Electric Wiring Enclosed/Labeled FC 605.3.1n c
Combustibles in Equipment Rooms FC315.2.3 .,�! 2j.1 'Y1 064J/e 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 f 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 DATE: OK NC
HVAC Shutdown
Sprinkler System Annual Cl�'-3- )('
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
•
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3Plan Possession date of B/01/12
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