2014-391 TOWN OF QUEENSBURY
Foca 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20140391 Date Issued: Monday, September 15, 2014
This is to certify that work requested to be done as shown by Permit Number P20140391
has been completed.
Location: 1540 STATE ROUTE 9
Tax Map Number: 523400-288-008-0001-014-000-0000
Owner: LYNTON REALTY CORP.
Applicant: SPIRIT HALLOWEEN
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 c7 •
)J
other issues and conditions as a result of approvals by the Planning Board Director of Building& Code nforce\ent
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: P20140391 Application Number: A20140391
Tax Map No: 523400-288-008-0001-014-000-0000
Permission is hereby granted to: LYNTON REALTY CORP.
For property located at: 1540 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: LYNTON REALTY CORP.
19 HELENS Ave Certificate of Occupancy(COM)
MERRICK,NY 11566 Total value
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2014-391 SPIRIT HALLOWEEN
C/O ONLY
550.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Friday, September 04,2015
(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, • . • . -ensbu T. s j:y, September 04,2014
SIGNED BY ."rfor the Town of Queensbury.
Director of Building& Code Enforcement
�r 2 r, r Office Use Only
Town of Queensbu ,i a rstlai ll
(� Received:
ESTABLISHMENT OF A NEtV B'tSINE5S2014 .L../ Tax Map ID:
CERTIFICATE OF OCCUPANCY PERMIT.AP.PLICATION Permit No.: 4•5-0• 00
l OVvN OF QUEENSBURY permit Fee: /1 -3 `,/
i n" " rnnt=e .
'Note: This application is for occupancy only,nl 'thno-wbdc'-t gUmng a.bu ldmg-pemM.,_
Name of Business ct rf2-r+ /(ALLdw58N
Address ��'11-10 STRTE Al
Type of Business SEA SoJAL 2.1:174; Lr1-(AI(OGOEE/J COS%vnEs 4- Areo2
Manager Ls 54 I, (G.ows(cr
OR 1113 52$ 0812 (El (
Person in charge
Business Phone No. 1( $- 792- L-1SLF0
Property Owner fJ21Anr LS En) Ft,.N-iior(_ (_012 -
Address i 4Y, N y
Phone S) $ $17- 17 23
'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: L;5ft 1—A- ILS(c ;
Signature: 1 Lt c A'LaQ<c
Date: `611,611i1
Notes I Comments:
f (Rr'NEd ODFrJ' J G cl2t/l1 - /I/24
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 2o/tk-- 3 97
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: 5 P r 2r (,q (( O uiE
BUSINESS ADDRESS: 1646 Sf A (E 2T q
BUSINESS PHONE: 6t ' 7192- -- 145110
CONTACT 1: L t S A I 1 (a.AIS(G: HOME PHONE LI ( 3 S Z? C 37 2-
ADDRESS: 5 Z5 PU CAE-12- ST WAR,20vSb U26) Ott y
CONTACT 2: FeA�C;5 Ift k0 W (4SHOME PHONE Ll(3' g51f- 77 8/5
I
ADDRESS: 505 RI GK--5-L- S%. L1<tEZEA/SSvILG, IVy
AUG 2 5 2014L4J
TOWN P
Town of Queensbury Fire Marshal-New Business Permit 518-761-8206
Inspection Form
Town of Queensbury Fire Marshal O *Ilk?
Periodic Inspection Date: R I'� f
�1k? Time: I 0
742 Bay Road,Queensbury NY 12804 m �1
Re-Inspection i_�O,
518 761 8206/518 761 8205 CO Inspection Permit#: .4 I
Fir Marshals Representative
x.-
MJ Palmer Business Name: 69 l Alt HA LI-0 w& ta
Location: 1540 at
GK Stillman Contact: LI 64
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 Wdth FC 1024/1025&FC1029.11
Secondary Aisle Width FC 1025&FC1029.11
FIRE EXTINGUISHER: Hung FC 906 `^ +NC
Inspection of extlnquisher FC 906 cif Y \ �(tl-J
EVAC Plan FC 404.2 �
TRUSS ID SIGNAGE FC 505.3 U A/�(Irt1 /C
EMERGENCY UGHTING: lJ� ���1
Interior FC 1006.3&FC1029.8
Extenor IC 1006.3
Clearance ton ElectricalEns / 605. b L
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 315.2.2
CO
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 Fire Marshal In .on of COmp :-Occupanay
Kitchen Suppression Semi Annual OK to Issue
Fuel Island Suppression Semi Annual
Hood Cleaning 3-6-Annual
Knox Box:installed/checked FC506 SE! 10
Operating Permit, if required will be issued after I F/'M fat�Lal
Completion of Inspection i Town of., .- bu _
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