CO-000226-2017 TOWN 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-000226-2017 Date Issued: Friday, June 2, 2017
This is to certify that work requested to be done as shown by Permit Number CO-000226-2017
has been completed.
Tax Map Number: 296.13-1-23
Location: 1011 State Rte 9
Owner: Frank Parillo
Applicant: Phantom Fireworks Eastern Region,LLC
This structure may be occupied as a: Certificate of Occupancy Only
Tenant: Phantom Fireworks(main business location 1011 State Route 9) By Order of Town Board
Two Locations for Special Sales Event: Related to this C/O(see Planning TOWN OF QUEENSBURY
Office Files)
1. 663 State Route 149-Stranahan-event location
2. 308 Dix Avenue-K-Mart-event location
Issuance of this Certificate of Occupancy DOES NOT relieve the
property owner of the responsibility for compliance with Site Plan, YYY
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
+� Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: CO-000226-2017
Tax Map No: 296.13-1-23
Permission is hereby granted to: Phantom Fireworks Eastern Region,LLC
For property located at: 1011 State Rte 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
Tvce of Construction
Owner Name: Frank Parillo Certificate of occupancy $0.00
Owner Address: 215 Ballard RD Total Value $0.00
Gansevoort,NY 12831
Contractor or Builders Name/Address Electrical Inspection Agency
Plans&Specifications
Certificate of Occupancy Only
Tenant:Phantom Fireworks(main business location 1011 State Route 9)
Two Locations for Special Sales Event:Related to this C/O(see Planning Office Files)
1. 663 State Route 149-Stranahan-event location
2. 308 Dix Avenue-K-Mart-event location
$50.00 PERMIT FEE PAID-TIES PERMIT EXPIRES: Thursday,May 17,2018
(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 of ueensbu [ / J�Jedn y ,2017
SIGNED BY: /•VJ 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: ;
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION Permit No.: CO -(ZOZZGo -aWl7
Permit Fee: 50,00
"Note: This application is for occupancy only,with no work requiring a building permit.
Name of Business 1-.14 A.1—,-cm /=i2EGUD KS L- ,*s E / ) 44---_
Address L'}�� �ELrt�OnlT �J//E C E 0 �/
Type of Business 7/9 7-,em
�� $ 2017
Manager o 5`y 1 7�Z !
OR
Person in charge V 1t1 L� � fr S t,a¢a!J ' TOWN OF Ot1E NSBURY
g BUILDING &CODES
Business Phone No. S/$ .257 -O LI-L8—
Property Owner Fre, k F?a r- o
Address �lrj pjQ(f0.! cL E✓DJr �a�3�
Phone
,/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 N ANT 8 v
Signature:
Date: S-S-/7 P-SSL-d00 S-ao/7
Notes I Comments:
^ aa nqD Maim t51 E64 loo*y,� h T�77 o n5
Ps5c--
36119 41
aw—
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
Office Use Onlv
Town of Queensbury Fire Marshal
Received;
ESTABLISHMENT OF A NEW BUSINESS Tax Map ID:
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION Permit No.:
Permit Fee:
'Note: This application is for occupancy only,with no work requiring a building permit.
Name of Business f h&wra M rIr—E wo/2K5
Address Gds 5-747e RT - /*?
Type of Business eet7&t- Sjq&i0 G F NV SRfE e1.00Yyg4KS-
Manager
OR
Person in charge 6019joT .SsA$a
Business Phone No. iT-1 aS77'FL8'
Property Owner Srev�/ s N�yN Z n/ApS7�L°/Ff
Address SO/b BAGDSO� 1.uF! `-/ rT FIA'ANC'
Phone �-1$ ' 791 - 0 9'V&
✓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�o8o
Signature:
Date: y--/L ' go i7
Notes I Comments: 24 Xor, t -
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-761.8236
Fire Marshal-761-8206 Planning-761-8220
Town of Queensbury Fire Marshal-New Business Permit 518-761-8206
Office Use Only
Town of Queensbury Fire Marshal
Received;
ESTABLISHMENT OF A NEW BUSINESS Tax Map ID:
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION Permit No.:
Permit Fee:
'Note: This application is for occupancy only,with no work requiring a building permit.
Name of Business P//.W16H1 F/jeewole res
Address 30$ Q 1 X nve
Type of Business &7'it11- it57*?x a NN S07PE P/CFW0�2,l;$
Manager
OR
Person in charge V/jV+d V)V T 6-&.921D
Business Phone No. 461I1?'a57 aVA-1?
Property Owner 9/ri J zX-
Address _t3 0 Y A 11l Ar!&
Phone
,/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: V gNT S&4-06
Signature:
Date: S-/4-17
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
Please print clearly
DATE: ` J
BUSINESS NAME: AIAU7-PA) /`/ '� OXA?S.
BUSINESS ADDRESS: 20
BUSINESS PHONE: 7 `f
PHONE 1: 0
CONTACT 1: [1frjc eA17T PHONE 2:
TOWN/VILLAGE RESPONDING FROM:
PHONE 1: S/9 - ;fit- 9
CONTACT 2: J- 45eykl D nO1, PHONE 2:
TOWN/VILLAGE RESPONDING FROM:
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.
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.
TOWN OF QUEENSBURY FIRE MARSHAL'S OFFICE
P h.o n e: 518-761-8206 • Fax: 518-745-4437
firemarshal@queensbun/ net www.queensbury.net
Fire Marshal Michael J Palmer Deputy Fire Marshal Gary K Stillman
;., -
Town of Queensbury-Building and Codes-Fire Marshal
742 Bay Road-(518)761-8256 Building(518)761-8206 Fire Marshal
Case Number: CO-000226-2017 Case Module: Permit
Inspection Date: 06/02/2017 Inspection Status: Passed
Inspector: Mike Palmer Inspection Type: General(Fire Marshal)
Job Address: 1011 State Rte 9 Parcel Number: 296.13-1-23
Queensbury,NY 12804
Contact Type Company Name Name
Primary Owner Parillo,Frank
Applicant [Phantom Fireworks Eastern Region,LLC]
Granted Permission [Phantom Fireworks Eastern Region,LLC]
Tenant [Phantom Fireworks Eastern Region,LLC]
Checklist Item Passed Comments
Exit Access YES
Exit Enclosure YES
Exit Discharge YES
Locks and Latches YES
Sign:Normal YES
Sign:backup YES
Main Aisle Width YES
Secondary Aisle Width YES
Fire Extinguisher Hung YES
Inspection of Extinguisher YES
Energency Lighting Interior YES
Clearance to Electrical YES
Electric Wiring Enclosed YES
No Smoking Signs YES
Storage YES
Interior Finishes YES
CO Detectors YES
Clearance to Sprinkler/Ceiling FC 18"/24" YES
Lisa Palmer,Mike(Inspector)
Jun 02,2017 Page(1)