CO-000808-2016TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: CO-000808-2016 Date Issued: Friday, December 16, 2016
This is to certify that work requested to be done as shown by Permit Number CO-000808-2016
has been completed.
Tax Map Number: 303.15-1-32
Location: 276 DIX AVE
Owner: Silver Dix LLC, Square Nail Rustics
Applicant: Eric Mattison
This structure may be occupied as a: Certificate of Occupancy Only
Tenant: Square Nail Rustics By Order of Town Board
TOWN OF QUEENSBBURY/
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
Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
QLTOWN OF QUEENSBURY
742 Bay Road.Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: CO-000808-2016
Tax Map No: 303.15-1-32
Permission is hereby granted to: Square Nail Rustics
For property located at: 276 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
Owner Name: Square Nail Rustics Certificate of occupancy 0.00
Owner Address: 15 BOULEVARD Total Value 0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
Certificate of Occupancy Only
Tenant:Square Nail Rustics
50.00 PERMIT FEE PAID-TIES PERMIT EXPIRES: Wednesday,December 6,2017
If a longer period is require(,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 of ueensb Jlues 2016
SIGNED BY:
lwK/
for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
Town of Queensbury
rO / E Received:
ESTABLISHMENT OF A BU D Tax Map ID: 363 / 5= ' 3 2'—
CERTIFICATECERTIFICATE OFOCCUPANC MmiliPtd l(2 no Permit No.: C0 _661 c5 '0'zpl
Permit Fee:
Note: This application is for occupancy only, th n5®AWi'4e0Pi Mlg W
BU LDI G &CODES
Name of Business O ate ,
Address a-7 LP 'D iX Ave
Type of Business F-bk Y1 t`e
Manager C AN
OR
Person in charge
Business Phone No. [51`3 -n1p 141i1:1
Property Owner
AddressAA QCA ` iC h k
Phone MACb"
Provide an accurate layout of your store showing all walls,exits,stockrooms, rest rooms,counters, and fixture layout on a
separate sheet of paper.
n n \
Print Name: t tC N1 k
Signature:
Date: t l a a l i a
T
Notes/Comments:
D E C E D W
HHV 6 D
TOWN OF QUEENSBURY
BUILDING& CODES
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
303.15-1-32 CO-000808-2016
EMERGENCY CONTACT UPDATE Square Nail Rustic
276 Dix Avenue
TO: Warren County Sheriff's Department C/O only
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 DNOVZ8201
DATE: I i 'a. TOWN OF OUEENSBURY
C \
BUILDING& CODES
BUSINESS NAME:
BUSINESS ADDRESS: 1 D X I VQ
BUSINESS PHONE: CA
CONTACT 1: C MA i't 'OA HOME PHONE
ADDRESS: 25Tc Ve1 t-,A- C-1erS 7_
A X15 i 1a Y 01
CONTACT 2:HOME PHONE
ADDRESS:
Town of Queensbury Fire Marshal—New Business Permit 518-761-8206
101 FIRE MARSHAL'S OFFICE
Town ofQueensburyf
Q J
742 Bay Road, Queensbury, NY 12804
Home of Natural Beauty ... A Good Place to Live "
PLAN REVIEW
Square Nail Rustics
276 Dix Ave
CO-000808-2016
12/1/2016
I have reviewed the submitted drawings for the above project, and offer the
following comments:
1'j Fire extinguisher location(s) to be verified / discussed.
Verify locks and latches- shall comply with chapter 10 of the 2015 IFC.
International Fire Code)-
a't Verify existing exit/ emergency lights —
fifVerify aisles and storage
F1 Group B- plans indicate no modifications to space.
6) arbon Mo oxide detection may be required. e
Deputy Fire Marshal
Gary K. Stillman
742 Bay Road
Queensbury NY 12804
518 761 8205
garys@queensbury.net
Fire Marshal 's Office • Phone: 518-761-8206 • Fax: 518-745-4437
firemarshal@queensbury.net • www.queensbury.net
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Town of Queensbury-Building and Codes-Fire Marshal
742 Bay Road-(518)761-8256 Building(518)761-8206 Fire Marshal
Case Number: CO-000808-2016 Case Module: Permit
Inspection Date: 12/07/2016 Inspection Status: Partial Pass
Inspector. Mike Palmer Inspection Type:General(Fire Marshal)
Job Address 276 DIX AVE Parcel Number: 303.15-1-32
Queensbury,NY 12804
Contact Type Company Name Name
Tenant Square Nail Rustics]
Granted Permission Square Nail Rustics]
Primary Owner Square Nail Rustics]
Applicant Mattison,Eric
Property Owner Silver Dix LLC]
Checklist Item Passed Comments
Fire Extinguisher Hung YES
Exit Access YES
Sign:backup YES
EVAC Plan YES
Clearance to Sprinkler/Ceiling FC 18/24" YES
Combustibles in Equipment Rooms YES
CO Detectors NO Add detector as discussed
Main Aisle Width YES
Secondary Aisle Width YES
Storage YES
Inspection of Extinguisher YES
Electric Wiring Enclosed NO Add blank cover shop rear outlet
Clearance to Electrical YES
Energency Lighting Interior YES
Exit Discharge YES
No Smoking Signs YES
Exit Enclosure YES
Interior Finishes YES
Sign:Normal YES
Locks and Latches YES
Eric Palmer Mike(Inspector)
Dec 07.2016 Page(1)
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Town of Queensbury-Building and Codes-Fire Marshal
742 Bay Road-(518)761-8256 Building(518)761-8206 Fire Marshal
Case Number: CO-000808-2016 Case Module: Permit
Inspection Date: 12/16/2016 Inspection Status: Passed
Inspector: Mike Palmer Inspection Type:General(Fire Marshal)
Job Address: 276 DIX AVE Parcel Number: 303.15-1-32
Queensbury,NY 12804
Contact Type Company Name Name
Tenant Square Nail Rustics]
Property Owner Silver Dix LLC]
Applicant Mattison,Eric
Granted Permission Square Nail Rustics]
Primary Owner Square Nail Rustics]
Checklist Item Passed Comments
Sign:backup YES
Energency Lighting Interior YES
Interior Finishes YES
CO Detectors YES Add detector as discussed
Ok 12/16/16
Locks and Latches YES
Combustibles in Equipment Rooms YES
Electric Wiring Enclosed YES Add blank cover shop rear outlet
Ok 12/16/16
Exit Access YES
Secondary Aisle Width YES
Sign:Normal YES
Exit Enclosure YES
Inspection of Extinguisher YES
Main Aisle Width YES
Clearance to Sprinkler/Ceiling FC 18"/24" YES
Storage YES
Clearance to Electrical YES
Exit Discharge YES
EVAC Plan YES
Fire Extinguisher Hung YES
No Smoking Signs YES
Eric Palmer,Mike(Inspector)
Dec 16,2016^
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Page(1)
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ANG INDUSTRIES 27 DIX AVE
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