2013-016 TOWN OF QUEENSBURY
742 Bay Road,Qucensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20130016 Date Issued: Thursday, March 21, 2013
This is to certify that work requested to be done as shown by Permit Number P20130016
has been completed.
Location: 1557 STATE ROUTE 9
Tax Map Number: 523400-288-008-0001-006-000-0000
Owner: NCE BUILDING, CORP
Applicant: PECKHAM ROADS
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 propertyavP )45t
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owner of the responsibility for compliance with Site Plan, Variance, or VVV
other issues and conditions as a result of approvals by the Planning Board Director of Building&Code Enforcement
or Zoning Board of Appeals.
j� TOWN OF QUEENSBURY
Ora742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20130016 Application Number: A20130016
Tax Map No: 523400-288-008-0001-006-000-0000
Permission is hereby granted to: PECKHAM ROADS
For property located at 1557 STATE ROUTE 9
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: NCE BUILDING, CORP Certificate of Occupancy(COM)
KLEIN, DAVID M. Totai Value
1557 STATE ROUTE 9
LAKE GEORGE,NY 12845-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2013-016 PECKHAM ROADS
CO Only Suite 4
•
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday, January 23,2014
(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 f Que sbu, 1 We ,ey ay,January 23, 2013
SIGNET)BY �4 'V or
.icl. for the Town of Queensbury.
Director of Building&Code Enforcement
: :w:,!-_ .:;'', Community Development Office ;
�`= `w Town of Queensbury • 742 Bay Road • Queensbury, New York •12804 'y r .�,�
+r : J'. i
David Hatin, Director of Building& Codes V�11>� 1 :--; LU].? _ (-
Craig Brown, Zoning Administrator• Michael J. Palmer, Fire Marshal -,. - 4 t
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 # 2 66,g ' I — G BLDG. PERMIT FILE# /0 .a f
+ If applicable
Name of Business: ?ecide\cx,.w ,�7\ S
Address 15-57 s't t.-4-e- Iq _
of Business: 1-suc-e G eoJ C N Y (ZEiY. QUESTIONS? CALL 761-8256 OR
v EMAIL codes[a�queensbury.net
1:›o►Ve..- luet:-✓t Of 644-irtc-Pe--f-rokAyisIT OUR WEBSITE FOR MORE
Person in Charge or Manager: -"le_ INFORMATION
www.queensbury.net
Business Phone Number: 7? --O f 2.5
Type of Business: Cov•.. r' �-1 0 LA
Owner of Property: NC.E -gv,..Av��C_orq=. Phone Number(s): 795-0125
R.,4-
44. ,e-irk cac
Owners Address: 15'5 7 s+ct e° 1`,4 9l LAY-e G ,r e /tY /2153`745
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: P-,bu �Qg �` Date: \/ IS-/20 1 3
Of person submitting this form
Notes / Comments:
) 3 - )r �
EMERGENCY CONTACT UPDATE JAN 2013
TO: WARREN COUNTY SHERIFF'S DEPT FAX: 743-2502
PLEASE PRINT
DATE: 11 1.51 ZO 13
BUSINESS NAME: FCLka,,Ak i2c=k9,- 5
BUSINESS ADDRESS: 15 S � IZ� q Loi . e Geo u 1(J r28`fS
BUSINESS PHONE: 7/2-- 3 is"7
CONTACT 1: Y\ko,,,rk Pe ,r Q\e
y�",viE PHONE 2Z-5--"6573
ADDRESS:
CONTACT 2: -1>,-•,<e lae I\ HOME PHONE 65-6 - 3. SI
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: Time: ))
742 Bay Road,Queensbury NY 12804 o Re-Inspection
518 761 8206/518 761 8205 o CO Inspection Permit#: i L
e Marshals Representative
Fe /
.
Mi Palmer Business Name: //�/
Location:
GK Stillman Contact:
/
Type of Inspection N/A Yes No
EXITS: Exit Access FC 1014&FC1029 / NOTES
Exit Enclosure FC 1020&FC1029 f
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
AISLES:
Main Aisle Width FC 1024/1025&FC1029.11j
Secondary Aisle Width FC 1025&FC1029.11
FIRE EXTINGUISHER: Hung FC 906 _ _
Inspection of extinguisher FC 906
EVAC Plan FC 404.2
TRUSS ID SIGNAGE FC 505.3
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 / I UAL.
F.D.Signage- FC 510 .� I
No Smoking Signs FC 310.3 ``
Storage FC 315.2 /�
Compressed Gas FC 3003
Vehicle Impact Protection FC 312.1 r-e-
Interior Finishes FC 803-804
Smoke Detectors FC 907j
CO detectors FC 610
-,---
Clearance
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 APPROXIMA TEL Y
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 'i
FIRE ALARM Annual 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
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