CO-000378-2015 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
GL Community Development-Building&Codes (518)761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: CO-000378-2015 Date Issued: Monday, December 14, 2015
This is to certify that work requested to be done as shown by Permit Number CO-000378-2015
has been completed.
Tax Map Number: 309.14-1-12
Location: 108 MAIN ST
Owner: PATRICK MERRILL
Applicant: Richard DiDio
This structure may be occupied as a:C/O only
Ugly Phones LLC By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the n
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.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
OL Community Development-Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: CO-000378-2015
Tax Map No: 309.14-1-12
Permission is hereby granted to: Richard DiDio
For property located at: 108 MAIN ST
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: PATRICK MERRILL Certificate of occupancy $0.00
Owner Address: 108 Main ST Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
C/O only
Ugly Phones LLC
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES:
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury befojtmheimtion date.
Dated at the Town QueensWe s ecember 9,2015
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
unite use unly
Town of Queensbury Fire Marshal
Received:
ESTABLISHMENT OF A NEW BUSINESS Tax Map ID: �Xg- Y4 -1-17
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION Permit No.: GC "cote$- Za I=�
Permit Fee: "t'D'o \)-)\i
1��
*Note: This application is for occupancy only,with no work requiring a building permit.
V
Name of Business UCLU F)f)0 ,-)e 3 L L
Address I OS 01 o?+j -J- Quw,),� o^u /Ji 1,; rbc y
Type of Business C0 Ce-Pca�r -�-So, Le 's
Manager car e� i�; c SPS
OR
Person in charge Sam e "
Business Phone No. 1$- (c51 0051
Property Owner /l)er V,
Address l0 ()lAriJ ST ove nshury , AJY l;2fU'f
Phone 7i$- `7q 3'`'9902
✓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: S� t I l o if-
r
Signature: ^ b e
Date: 119 I S
Notes 1 Comments:
IMPORTANT: The business owner is responsible for keeping exits clear and maintaining exit signs and emergency lights. Fire
extinguishers,fire sprinkler systems,and fin: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: 02\ U k or e-S, L � C
BUSINESS ADDRESS: Qoe2nS�,jf . 6�( la�q
BUSINESS PHONE: J g " of-COSI
CONTACT 1: RCC 0, k Dk Q�6 HOME PHONE 5rg G2'I-6051
ADDRESS: 33 AP QJRfor l .N
CONTACT 2: roff.� 010i'n HOMEPHONE
ADDRESS: Clens )5MS,, /f/y4;2&/
Town of Queensbury Fire Marshal—New Business Permit 518-761-8206
Electric Baseboard Heater
F�
206"
69"
66"
o ^ 132" AC
� Unit
6311
0
23"
74"
134"
206"
36'
31" 31"
Breaker Panel
NOV 2 5 20'15
FIRE MARSHAL'S OFFICE
Tozm of Queensbuny
742 Bay Road, Queensbury, NY 12804
(Dw " Hosie of Natural Beauty ... A Good Place to Live "
PLAN REVIEW
Ugly Phones LLC
108 Main Street
CO-000378 - 2015
12/9/2015
• Function test all exit and emergency lighting fixtures.
• All door hardware , locks / latches must comply with Chapter 10 of
the NYS Fire Code. Paddle devices, lever handles or push bars are
acceptable
• Fire extinguisher locations to be determined
• Add (1) carbon monoxide detector in the space ( if CO source exists)
Michael J Palmer
Fire Marshal
742 Bay Road
Queensbury NY 12804
firemarshal@queensbury.net
Fire Marshal's Office • P h o u e: 518-761-8206 • F a z: 518-745-4437
firemarshalQqueensbun/.net • zoeozaqueensbury.ret