2013-415 TOWN OF QUEENSBURY
742 Bay Road,Qucensbury,NY 12804-5902 (518)761-8201
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Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20130415 Date Issued: Monday, September 23, 2013
This is to certify that work requested to be done as shown by Permit Number P20130415
has been completed.
Location: 4 WESTERN Ave S
Tax Map Number: 523400-309-011-0002-036-000-0000
Owner: HAYES & HAYES LLC
Applicant: HAYES & HAYES LLC
This structure may be ocLJ&1JsQ6ET CONSIGNMENT BOUTIQUE
Certificate of Occupancy (COM) By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the property 1 .
/ '41
owner of the responsibility for compliance with Site Plan, Variance, or t ��
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,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20130415 Application Number: A20130415
Tax Map No: 523400-309-011-0002-036-000-0000
Permission is hereby granted to: KIDS CLOSE CONSIGNMENT BOUTIOUE
HAYES &HAYES LLC
For property located at. 4 WESTERN Ave S
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: HAYES &HAYES LLC
297 SARATOGA Rd Certificate of Occupancy(COM)
SOUTH GLENS FALLS NY 12803-0 Total value
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2013-415 KIDS CLOSET CONSIGNMENT BOUTIQUE
CO ONLY
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday, September 11,2014
(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 Quee bury /We i s•i. . •ptember 11,2013
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: 3D'111 .-- 3(47
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION'' " PPrihht No.: /5
Permit Fee:
*Note: This application is for occupancy only,with no work requiring a building permit.
Name of Business CICS CtO Y ec i 6 A/Tfl€fY &o('ri ali
Address 11 s(,t,TA'I tmiTEN AIF face tY_SPfu')y UR-0/ t 7 SUIT V 1
Type of Business coNs I(Yf i /12 YT S1 CkF-
Manager J1 I97 ( 5/q) .cc8/F+2n.7S16.9 — STML'!7"Ckes
OR
Person in charge �+
Business Phone No. (570 V 36 6-6- 64/ (5ic ) ctt ; 9e etz 5 c
Property Owner p tits 41 I E LL c
Address
Phone Cie —02)Ii
✓Provide an accurate layout of your store showing all walls,exits,stockrooms, rest rooms, counters,and fixture layout on a
separate sheet of paper.
Print Name: "Ph-Q0 i97 (Sj/p-Pi9,yc/a9 - dmwr ns
Signature: `.Zttig alSk cc a
Date: 1/30/x /3
Notes 1 Comments:
DituA5 t?'`a�J613 SLC,4e
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
'BP ,2o13- 40
EMERGENCY CONTACT UPDATE
AUG 30 2013
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: 9t'AC1202)
BUSINESS NAME: X(05 CLCW f 001N-Sr-ffM*11T 7 OL 1
BUSINESS ADDRESS: Lt S• A-UEQue E1SA U 2-`-/ f H l2Z1'o2-/
BUSINESS PHONE: 518 6', G LI
CONTACT 1: c.c.sl H `cegfi-JSk—S/ALS PHONE sit gI.2 550.2
ADDRESS: G3 /`/ Sr. Ct7I1-$ PiUS NY / (
410-reLPHONECONTACT 2: TROW93 =STi1v/YC/'I - 6-7C 4Cq' 05 e4
ADDRESS: 6.3 /3/9Ai C(-6-/YS F/9- LS NY A28-0/
Town of Queensbury Fire Marshal—New Business Permit 518-761-8206
Inspection Form
Town of Queensbury Fire Marshal ql `11(5 Periodic Inspection Date: Time: ro`'
742 Bay Road,Queensbury NY 12804 'CORe-Inspection t/
518 761 8206/518 761 8205 Inspection Permit#: 'tel
Fir Marshals Representative
MJ Palmer Business Name: .,-b Sj6 .
Location: 4 LA.L.-5-kAA,'
GK Stillman Contact: (2,e-Si C,
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 ,.\C.)
111�! fi
L010 -r.�_
Secondary Aisle Width FC 1025&FC1029.11 \ \ Ol _
FIRE EXTINGUISHER: Hung FC 906
Inspection of extinguisher FC 906 _ P(‘ <"1‘-{
EVAC Plan FC 404.2
TRUSS ID SIGNAGE FC 505.3
EMERGENCY LIGHTING:
Interior FC 1006.3&FC1029.8 �-,
Exterior FC 1006.3 p) tu
Clearance to Electrical FC 605.3 IC)
Electric Wiring Enclosed/Labeled FC 605.3.1
Combustibles in Equipment Rooms FC315.2.3
F.D.Signage- FC 510 f--�
No Smoking Signs FC 310.3 /�/J
_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 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 .
Sprinkler FDC I Fire MaKt al Inspecbun Complete
Kitchen Suppression Semi Annual OK to Issue Certificate of Occupancy
Fuel Island Suppression Semi Annual
Hood Cleaning 3-6-Annual
Knox Box:installed/checked FC506 SEP 11 2013
3
Operating Permit, if required will be issued after I
Completion of Inspection I �__.
Fire Mersh41
i,... Town of Queensbury __
Inspection Form T,
Town of Queensbury Fire Marshal O Periodic Inspection Date41113 rr 1 Time:)3f�
742 Bay Road,Queensbury NY 12804 Re-Inspection c�
518 761 8206/518 761 8205 'a° /CO Inspection Permit#: t 1
Fir- Marshals Representative
MJ Palmer Business Name: 160S Cl��
Location: Li S U S-tT+z N
GK Stillman Contact: CD°S it)
Type of Inspection N/A Yeses No
EXITS: Exit Access FC 1014&FC1029 NOTES
Exit Enclosure FC 1020&FC1029
Exit Discharge FC 1024&FC1029 �,
Locks and latches FC1008& FC1029.2 it.a MQI dd Z,
Sign:Normal FC 1011 &FC1029
Sign:backup FC 1011.5.3&FC1029.7.5 oSU L$�
AISLES:
Main Aisle Width FC 1024/1025&FC1029.11
Secondary Aisle Width FC 1025&FC1029.11 Tn
FIRE EXTINGUISHER: Hung FC 906 !/ oL LmenCpc{�Jct liceW
Inspection of extinguisher FC 906 {/�
EVAC Plan FC 404.2 / \Ao A-4( 1 'Ly
TRUSS ID SIGNAGE FC 505.3
EMERGENCY LIGHTING:
Interior FC 1006.3&FC1029.8 _� 4%
Exterior FC 1006.3 l l 0 5
Clearance to Electrical FC 605.3
Electric Wiring Enclosed/Labeled FC 605.3.1 �
Combustibles in Equipment Rooms FC315.2.3 {�1 I� �
F.D.Signage- FC 51077
II ^
No Smoking Signs FC 310.3 ✓ .! klY '�c+�!51_ 4
L'*"\
Storage FC 315.2
Compressed Gas FC 3003 /
Vehicle Impact Protection FC 312.1 . y ( 1'\ w 5 1:
Interior Finishes FC 803-804
Smoke Detectors FC 907 /'�
CO dance rsto 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
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
Knox Box:installed/checked FC506
Operating Permit, if required will be issued after
Completion of Inspection
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