2013-261 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: P20130261 Date Issued: Friday, June 28, 2013
This is to certify that work requested to be done as shown by Permit Number P20130261
has been completed.
Location: 959 STATE ROUTE 9
Tax Map Number: 523400-296-013-0001-018-000-0000
Owner: RAYMOND HIPPELE
Applicant: JP RE-PLAY SPORTS
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. ij
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20130261 Application Number: A20130261
Tax Map No: 523400-296-013-0001-018-000-0000
Permission is hereby granted to: JP RE-PLAY SPORTS
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
Certificate of Occupancy(COM)
50 ACORN Dr
DIAMOND POINT,NY 12824-0000 Total value
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2013-261 JP RE-PLAY SPORTS
Certificate of Occupancy ONLY- Store Space "X"
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,June 14,2014
(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 ofween ry; ,wei_id J e 2013
SIGNED BY �`� for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
Town of Queensbury Fire Marshal
Received:
ESTABLISHMENT OF A NEW BUSINESS Tax Map ID: (x, 1.3-9- I -9
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION Permit No.:
Permit Fee:
'Note: This application is for occupancy only,with no work requiring a building permit
Name of Business t Bq_- p(A / S ID fff�
Address 0/ 6'2 _11G,T� E?t" !2 ,j Qx Pte; c 1 14
Type of Business Ie V-3 + c x'( St�orzT►�C� (�a�c�s
Manager
OR
Person in charge o DA PJ P)
Business Phone No. ��f6)7rjS- 6 q/� 7
Property Owner P',V 14, Do(e
Address gr Que_e_& 56 t e 0.-1.
Phone
,/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 12 I
Notes I Comments:
IMPORTANT: The business owner is responsible for keeping exits clear and maintaining exit signs and emergency lights. Fire
extinguishers,fire sprinkler systems, and fire alarm systems require annual inspections by an outside contractor and the corresponding
documentation must be provided to the Fire Marshal's office. Fire extinguishing systems found in kitchens and gas stations require
semi-annual inspections. Any violations noted during an inspection,require immediate corrective action.
CONTACT NUMBERS:
Director, Building and Codes-761-8253 Zoning Administrator-761-8218 Zoning-761-8238
Fire Marshal-761-8206 Planning-761-8220
Town of Queensbury Fire Marshal-New Business Permit 518-761-8206
EMERGENCY CONTACT UPDATE
TO: Warren County Sheriffs Department
1. 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.
2. 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.
PLEASE PRINT
DATE: 06�/l(��E�
BUSINESS NAME: '
BUSINESS ADDRESS: -Gl- pr, 4 0jee o3 6c)rw ",Y. !`2r,_19
BUSINESS PHONE: Z 17-3 - 64 2, 7
CONTACT 1: C/i s. ^ N nJ HOME PHONE
ADDRESS: I()5 DA(ZJ`nnoJV�_ RV. nA,)�4 1z,3-70
J
CONTACT 2: HOME PHONE
ADDRESS:
Town of Queensbury Fire Marshal—New Business Permit 518-761-8206
Inspection Form
-'town of Queensbury Fire Marshal Periodic Inspection Date:��Time:
742 Bay Road,Queensbury NY 12804 Re-Inspection ,ate
518 761 8206/518 761 8205 CO Inspection Permit#:
_HrEyMarshals Representative
MJ Palmer Business Name:
Location:
GK Stillman Contact: r-
Type of Inspection N/A Yes No
EXITS: Exit Access FC 1014&FC1029 NOTES
Exit Enclosure FC 1020&FC1029
Exif=Dischar a 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&FC1029.11 �A
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 _
F.D.Signage- FC 510 '
No Smoking Signs FC 310.3
Storage FC 315.2 -� g
Compressed Gas FC 3003
Vehicle Impact Protection FC 312.1 y }
Interior Finishes FC 803-804
Smoke Detectors FC 907 ,,, ,
CO detectors FC 610 u'UN
Clearance to Sprinkler/Ceiling FC 315.2.1 —
18" / 24" _
EVAC SIGNS IN Rooms FC 404.6(111 &112
Fuel Pump Warning Signs FC2205.6 Fire KwshL
Fuel Station Emer Procedures FC2204.3.5 � -
Exterior Storage FC 315.3 REINSPECTIONDUE 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
Sprinkler FDC
Kitchen Suppression Semi Annual
Fuel Island Suppression Semi Annual
Hood Cleaning 3-6-Annual j
Knox Box:installed/checked FC506 r t' It
t • 7
Operating Permit, if required will be issued after
Completion of Inspection M 4
uy�JCl G„QUA
p�e
ment 0 ice
t C)
eFYIYOOM--e�n-�
ConmO 742 Bay P11- PLOT PLAN
'bury all property VVI
York Towt, Of Q"e"
Nev, Cy
isting and proposed structures.indicate
the setbacks of all structures and buil'Slngs
S PROPERTY LINE
,OgEp
SIDE
0
0
,a
fn
Ul
LU
z 3Q
0
B 14-LTR
SIDE pROPERTY LINE
SQUARE FT.
J
AP*
R 4 P Y1t R
Sol
mooNo.U e 9
g69 State IROUte 13.1-18
fax
map
d{yoor
..Suites nd St re
aY to 2n Store fl
t Ut be,ween
on lay°
tit
N
,Stores!'
°utshrtieve
,
V-31of
A$LtAoo
a
a"