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CO-000717-2016 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-000717-2016 Date Issued: Tuesday,November 15, 2016 This is to certify that work requested to be done as shown by Permit Number CO-000717-2016 has been completed. Tax Map Number: 288.8-1-9.3 Location: 1571 State Route 9 Owner: Tracy Kuebler,Michael Stevens Applicant: Tracy Kuebler This structure may be occupied as a:C/O Only,Unit A Pirate Island Daycare LLC By Order of Town Board TOWN OF QUEENSSBUR�Y/ Issuance of this Certificate of Occupancy DOES NOT relieve the � I (/ /J k� property owner of the responsibility for compliance with Site Plan, (((AAA+++rrr111��" V 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. QL 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-000717-2016 Tax Map No: 288.8-1-9.3 Permission is hereby granted to: Tracy Kuebler For property located at: 1571 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 Tvce of Construction Owner Name: Tracy Kuebler Certificate of occupancy $0.00 Owner Address: 1161 PILOT KNOB RD Total Value $0.00 Kattskill Bay,NY 12844 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications C/O Only,Unit A Pirate Island Daycare LLC $50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,October 18,2017 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbu before yextio,,,n///date.) Dated at the Town o ueenb //lues a , r 8,2016 SIGNED BY: 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.: "�I " ZG t\, Permit Fee: 1 'Note: This application is for occupancy-Ionnly,with no work requiring a building permit. Name of Business 'hC Address / W Type of Business Manager OR Person in charge t ' p� � Business Phone No. �� - 4t7 IG1 — 99 r P/ 1 Property Owner 1 _ Address 1 Phone — v/ 0 ✓Provide an accurate layout of your store showing all walls,exits,stockrooms, rest rooms,counters,and fixture layout on a separate sheet of paper. I Print Name: L - Vue Signature: Date: 10•( Notes 1 Comments: ' l j o Oac&u a Sbt-�_ 11 cP n Q�y V;Al wi C'oll2en e,aT✓ 5(8- qlq - )Cpl 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: ib • 14. ZD i Lo BUSINESS NAME: '0?I rQ5�tr1 BUSINESS ADDRESS: I ( VI11 T A waC R'tC 9 L1k &0q BUSINESS PHONE: ��- ►coq - E28q �/ 1 I PHONE 1: CONTACT 1: I YQLU T�(�Q 1J Ucl� PHONE 2: TOWN/VILLAGE RESPONDING FROM: . i PHONE 1: CONTACT 2: 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 Phone: 518-761-8206 • F a z: 518-745-4437 frerriarshal@queensbrril.net • zuunv.queensburilrTet Fire Marshal Michael J Palmer Deputy Fire Marshal Gari,/ K Stillman PAP U■■■■■■u■■■i i■.."NOM r■■■■ ■■■n ■■■■■■■■■AKS■■■■Ata" ■■s ■0 N■■■■■■�■■■■■■■■��r �c ■ice�i ■■■■■■�o■■■■■■■ngmugt7 E■si■■■,!g WARE [�■■■■■moi■■■■■■■■i i�C`�: ��'\■�:E3 son i■l� b . :�!■■■�■■■■■t i:.a� ` '■■■■■I�i■rte■■■■■■■■■■■�I,f��I/�! �, MI■■■■■■■■MMWIWM■■■��■■z � �� 01-FIVEMI*»■■■i:offorl,nV NIFArr i■i■■■O a■■�am■P.:Sidtilra■M■■SMINS �■■■�i■■�■■� ■��r�■r�■■�%�� r>~■� ■■■ail.