2013-233 TOWN OF QUEENSBURY
�� Q742 BayRoad,Queensbury,NY 12804-5902
ury, 518( ) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20130233 Date Issued: Friday, May 31, 2013
This is to certify that work requested to be done as shown by Permit Number P20130233
has been completed.
Location: 959 STATE ROUTE 9
Tax Map Number: 523400-296-013-0001-018-000-0000
Owner: RAYMOND HIPPELE
Applicant: ROBIN'S NEST HOME IMPROVEMENTS
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 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 r �
Director of Building&Code Enforcement
or Zoning Board of Appeals.
0.4 TOWN OF QUEENSBURY
mi .
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20130233 Application Number: A20130233
Tax Map No: 523400-296-013-0001-018-000-0000
Permission is hereby granted to:
For property located at: 959 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: RAYMOND HIPPELE
50 ACORN Dr Certificate of Occupancy(COM)
DIAMOND POINT,NY 12824-0000 Total Value
Contractor or Builder's Name /Address Electrical Inspection Agency
ROBIN'S NEST HOME IMPROVEMENTS
RICKY RAINBOW 744-8100 .
959 STATE ROUTE 9 Suite D
OUEENSBURY NY 12804-0000
Plans&Specifications
2013-233 ROBIN'S NEST Home Improvements
Cert. of Occupancy ONLY
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,May 29,2014
(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 pf Que sbu We, e i ay,May 29,2013
SIGNED BY if- \ for the Town of Queensbury.
Director of Building&Code Enforcement
r
,f=ilillCommunity Development Office Mi' 2 3 2013
Town of Queensbury • 742 Bay Road • Queensbury, New York •12804
David Hatin, Director of Building& Codes
Craig Brown, Zoning Administrator• Michael J. Palmer, Fire Marsha! , ' ; ^_i
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# A9 Lo, 13 1-/ 8 BLDG. PERMIT FILE# / -'`Dr33
f f applica e
Name of Business: b1j(n`S 'V F'`� [-Lc
+meI ryso fern eicc 5Q ectel`\ t 3 `'S
otlBusiness: (dress da, 5 / R+ 1 r s 0r i 4-� D QUESTIONS? CALL 761-8256 OR
EMAIL codes(&queensbury.net
Kik)/ �) VISIT OUR WEBSITE FOR MORE
Person in Charge or Manager: L _k) ' Q ow INFORMATION
/ www.queensbury.net
Business Phone Number: 7 l 1 —2 (06
Type of Business: 0 FF ( C E --VsUrif)()Iryve___. 1 /liprd v eine/1i
CO r/Y\ p Q (1/
may
Owner of Property: Z t M `�
1/C yMPi Phone Number(s): 79 " -0026
P
(} Home Cell
Owners Address: 951 Rt ( , 5 VL (1_ 13Q C
Provide an accurate layout of your store showing all walls, exits, stockrooms, rest rooms,
counters and fixture layout on a separate sheet of paper.
Signatur ,G?i0.p/ ,171(.. x' Date: �,Z ,/ 3
Of person &14,‘y_
bmitting this form
Notes / Comments:
Ni 3- 33
EMERGENCY CONTACT UPDATE
U13
TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 743-2502
PLEASE PRINT
DATE: 5/ Z5 [ 3
BUSINESS NAME: ?lc)tOi n5 e5 'I've- ey ro5p e
BUSINESS ADDRESS: 1 5 / Qu e e2 Stu r y
BUSINESS PHONE:( 1 S) 711 °U
(1r 8�
CONTACT 1: l Ck R (/1 bO ) HOME PHONE `'r SO ( < 66
ADDRESS: 57 kk. "I ``tUOSOn F4
1
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:3'46Time: II 00
742 Bay Road,Queensbury NY 12804 Re-Inspection7$�
518 761 8206/518 761 8205 o _.23 CO Inspection Permit#:
Fire Marshals Representative r � --_�I�
MJ Palmer Business Name: A�-�5�
Location: cS� �f
GK Stillman Contact: )�
Type of Inspection N/A Yes No
EXITS: Exit Access FC 1014&FC1029 .-..`':..„, NOTES
Exit Enclosure FC 1020&FC1029 ....•-- Y
Exit Discharge FC 1024&FC1029
Locks and latches FC1008& FC1029.2 /®
Sign: Normal FC 1011 &FC1029 ......‹....-
Sign:
/�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 EXTINGUISHER: Hung FC 906
Inspection of extinguisher FC 906 �/
EVAC Plan FC 404.2
TRUSS ID SIGNAGE FC 505.3 l
EMERGENCY LIGHTING:
Interior FC 1006.3&FC1029.8 .f
Exterior FC 1006.3
Clearance to Electrical FC 605.3 .--•'''
Electric Wiring Enclosed/Labeled FC 605.3.1 a/:
Combustibles in Equipment Rooms FC315.2.3 A
F.D.Signage- FC 510 / MOW
No Smoking Signs FC 310.3 / -�
Storage FC 315.2
Compressed Gas FC 3003 +f .,MEW
Vehicle Impact Protection FC 312.1 ..--**--
Interior Finishes FC 803 -804 �...- 'i�1
Smoke Detectors FC 907 r
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
Emergency Disconnect FC 2203.2 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 ---------1-\''
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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