2014-124 ,��` TOWN OF QUEENSBURY
,0 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20140124 Date Issued: Monday, April 28, 2014
This is to certify that work requested to be done as shown by Permit Number P20140124
has been completed.
Location: 53 LUZERNE Rd
Tax Map Number: 523400-309-010-0001-088-002-0000
Owner: A& Q HOLDINGS INC
Applicant: KENYON PIPELINE INSPECTION
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 p1
owner of the responsibility for compliance with Site Plan, Variance, or I \
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
VA742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20140124 Application Number: A20140124
Tax Map No: 523400-309-010-0001-088-002-0000
Permission is hereby granted to: KENYON PIPELINE INSPECTION
For property located at: 53 LUZERNE Rd
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: A& Q HOLDINGS INC Certificate of Occupancy(COM)
10 SAGAMORE St Total Value
GLENS FALLS,NY 12801-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans &Specifications
2014 - 124 Kenyon Pipeline Inspection, LLC
C / OOnly
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,April 23,2015
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the To of Que sb 1f /1 WI ' ,e-4. • pril 23,2014
SIGNED BY ', for the Town of Queensbury.
Director of Building& Code Enforcement
a [ �1 1eII11 \
Office.'Use•8n{ II
Town of Queensbury Fire Marshal i1ved: p', 18 201k �J
ESTABLISHMENT OF A NEW BUSINESS Tax hlep ID: u�t�.,, tv
''�iN OF ca _
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION �ermif IL ,tr CODE s1. 0)V
Pennit`Fee: so t
'Note: This application is for occupancy�Jonly,with no work requiring a building permit.
/�
Name of Business l��e4,e- ,7norscon �e—
Address C$S -55 5 L 1aer''e eekc tjw ;/VY
Type of Business O rh H e-e
Manager 3et-So - e7on-
OR
Person in charge -
BusinessPhoneNo. 5it- 924- 9t43 a'z 93a-a6 70
Property Owner /g.11-O cuge e.es- !—KP�i• �- lily
Address Sa ore <Sfi C'm.#..s it r�1,57 /" 7 i2 to
Phone et ,Sl r- 7415 - 02[9 7
"Provide an accurate layout of your store showing all walls, exits,stockrooms, rest rooms, counters,and fixture layout on a
separate sheet of paper. r�
Print Name: J So • 1<e-t
Signature: 1 'r
Date: ;`ll
Notes/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:
BUSINESS NAME: /<ev.yon T ro&/:,e T;tspec ibv� r LLC_
BUSINESS ADDRESS: 53 L -t zevv,e Rot Qv.e_eefs Luz 1 bVYt 2$0 y
BUSINESS PHONE: 57r- 926 -9? f3
CONTACT 1: —S—a59r._1<u^y HOME PHONE Sr9--p2(o -jfy3
ADDRESS: 22 rfuen 1 r O,,,eencLry /Z o
CONTACT 2: JUS L kaelov\ HOME PHONE 5/9--832-25/0
ADDRESS: // /0/4411 pert /awns £Ly J A)) /2W5
Town of Queensbury Fire Marshal—New Business Permit 518-761-8206
Inspection Form
3v
Town of Queensbury Fire Marshal CD Periodic Inspection Date: IAL I Time: Ji
742 Bay Road,Queensbury NY 12804 o Re-Inspection + i
518 761 8206/518 761 8205 ®CO Inspection Permit#: 1 U f 421
„tip Marshals Representative MJ Palmer Business Name: t NSVc� 1'n
19_1, n .
Location: 53 - 65 L' 2-anti- 20
GK Stillman Contact: .ti
Type of Inspection N/A 7 No
EXITS: Exit Access FC 1014&FC10297 NOTES
Exit Enclosure FC 1020&FC1029
Exit Discharge FC 1024&FC1029 /
Locks and latches FC1008& FC1029.2
Sign. NormalFC 1011 &3 /
Sign. backup &FC1 FC 1011.5.3&FC1029.7.5
AISLES:
Main Aisle Width FC 1024/1025&FC1029.11 itIllr
Ir
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 !!!/ 0
EMERGENCY LIGHTING:
Interior FC 1006.3&FC1029.8 / /
Exterior FC 1006.3 //
Clearance to Electrical FC 605.3 /'_
Electric Wrrinq 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
Compressed Gas FC 3003 41
Vehicle Impact Protection FC 312.1
Interior Finishes FC 803-804 f
Smoke Detectors FC 60
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 imp oK N 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 .I OKIretoMsauershCea_Ino a
tef1�®11
U(atifl
ySprinkler FDC
Kitchen Suppression Semi Annual
Fuel Island Suppression Semi Annual I
Hood Cleaning 3-6-Annual APR 231D
Knox Box:installed/checked FC506
Operating Permit, if required will be issued after Fire Marshal
Completion of Inspection Town of•ueensbu