2013-402 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: P20130402 Date Issued: Tuesday, October 15, 2013
This is to certify that work requested to be done as shown by Permit Number P20130402
has been completed.
Location: 437 DIX Ave
Tax Map Number: 523400-303-016-0001-008-000-0000
Owner: WILLIAM BARRETT
Applicant: NEW 2U CONSIGNMENT SHOP - GIGNAC & LEVEN
This structure may be occupied as a:
Certificate of Occupancy (COM) By Order of Town Board
TOWN OF QUEENSBURY
(DJIssuance of this Certificate of Occupancy DOES NOT relieve the property 4 f/
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.
Aet` TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20130402 Application Number: A20130402
Tax Map No: 523400-303-016-0001-008-000-0000
Permission is hereby granted to: WILLIAM BARRETT
NEW 2U CONSIGNMENT SHOP- GIGNAC &LEV:
For property located at: 437 DIX Ave
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: WILLIAM BARRETT
PO BOX 142 Certificate of Occupancy(COM)
GLENS FALLS,NY 12801-0000 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
BP 2013-402 NEW 2 U Consignment Shop
C/O Only - cross ref. SP 27-2013 approved by Planning Board 6/25/2013
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,August 30,2014
(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/it/ Fr' y,/ ugust 30, 2013
fir
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: 'O 3. 1(0-I- e
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION Permit No.: c/ 3- 0.)--
Permit Fee: / a
*Note: This application is for occupancy only,lwith no work requiring a building permit.
Name of Business `eA) c2 U.. UnS iyert\tc'k S1w e
Address V51 D1i., ,l�l�ciU�-- .
AEA; % . 2013
Type of Business ngl�r u lStStw
Manager ILeik n L -_0(t
OR , A
Person in charge k0( �l i y"--
p us- �'m S Com.(
311 o c0 0
Business Phone No. n0 buSvw r b“ C-• c� r4"
Property Owner 1C.c\J 5 auVRA _
Address Y-{� - �U x \4 7i 61 t.2C1s {(Ml ,t 1,k , t)'O I
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: 1(,)0(t
Notes/Comments: 6A)SS CPK 57_01-0 13 P1 4,1-r,---( 4.47 /3
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
/ S 4/0
EMERGENCY CONTACT UPDATE
ALC: C
TO: Warren County Sheriff's 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: qidt1O
BUSINESS NAME: 6\1 a Cor\ \?() r-,JK
BUSINESS ADDRESS: '3-1 A Qe Cr3h4 N - 1 O4
BUSINESS PHONE:
CONTACT 1: pC,a__ core_ HOME PHONE I ( " (0 ()(0°
4 � i� . US OW
ADDRESS: n '
CONTACT 2: 16-IL1', -'"`d°5 HOME PHONE`5( V)__ (
ADDRESS: 1�l ' V '� ` v�S� ( O
Town of Queensbury Fire Marshal—New Business Permit 518-761-8206
Inspection Form
Town of Queensbury Fire Marshal o f nJi,/Periodic Inspection Date: �Time: ie/ 0_
742 Bay Road,Queensbury NY 12804 c e-Inspection ~ 77
518 761 8206/518 761 8205 �` CO Inspection Permit#: ! r
Fire Marshals Representative �>
J Palmer Business Name: / `'iL • V #/.S' "/
Location: / 7 >,r
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
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
Secondary Aisle Width FC 1025&FC1029.11 ,
FIRE EXTINGUISHER: Hun. FC 906 /l
Inspection of extinguisher FC 906
EVAC Plan FC 404.2 ,---f
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 ,/ A
Combustibles in Equipment Rooms FC315.2.3 -
F.D.Signage- FC 510
No Smoking Signs FC 310.3
Storage FC 315.2 111=1150I.
Compressed Gas FC 3003IIIi
Vehicle Impact Protection FC 312.1 . �� V
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 f
Exterior Storage FC 315.3 ./.......' REINSPECTION DUE APPROXIMA TEL Y
Vacant Buildings FC 311 --- '
Emergency Disconnect FC 2203.2 21 DAYS
SYSTEMS: FC 901.6 Insp OK NC DATE: OK NC
Date
Generator Annual PATE: OK NC
Hood Installation sr
./..
Elevator Semi Annual
FIRE ALARM AnnualTE: OK NC'
HVAC Shutdown
Sprinkler System Annual
Sprinkler FDC
_ Kitchen Suppression Semi Annual
Fuel Island Suppression Semi Annual
Hood Cleaning 3-6-Annual \rKnox Box:installed/checked FC506
Operating Permit, if required will be issued after
Completion of Inspection
Inspection Form
Town of Queensbury Fire Marshal (41E)Periodic Inspection Dater )5/I ime:
742 Bay Road,Queensbury NY 12804 o Re-Inspection
518 761 8206/518 761 8205 o CO Inspection /ection Permit#: I `-'1
Fyfe Marshals Representative
I\MJ Palmer Business Name: Ni- 7LJ
Location: .D% } Otk.6,/-r`.
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 1
Locks and latches FC1008& FC1029.2 ( +10%46
Sign: Normal FC 1011 &FC1029 n e
Sign: backup FC 1011.5.3&FC1029.7.5 4 "`'
AISLES:
Main Aisle Width FC 1024/1025&FC1029.11 � �/ ' ��
Secondary Aisle Width FC 1025&FC1029.11 w 5
FIRE EXTINGUISHER: Hung FC 906 PIG R'S CYA
Inspection of extinguisher FC 906
EVAC Plan FC 404.2 `
TRUSS ID SIGNAGE FC 505.3 1 R% f-� J S--LA 1
EMERGENCY LIGHTING: f
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 C�
Compressed Gas FC 3003
Vehicle Impact Protection FC 312.1 e U;.nc.‘G(�
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
Emergency Disconnect FC 2203.2 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
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
1
BP 2013-402
NEW 2U Consignment Shop
437 Dix Avenue
C/O only cross ref. SPR 27-2013
((
AUG 2C 2013
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