CO-000618-2016 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
ism Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: CO-000618-2016
Tax Map No: 302.5-1-92.11
Permission is hereby granted to: Horizon Retail Construction Company
For property located at: 578 AVIATION RD
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: AVIATION MALL NEWCO LLC Certificate of occupancy $0.00
Owner Address: 4 Clinton Square Total Value $0.00
Syracuse,NY 13202
Contractor or Builders Name/Address Electrical Inspection Agency
Horizon Retail Construction Company
1500 Horizon DR
Sturtevant,WI 53177
Plans&Specifications
C/O Only
Kay's Store 1070
Temporary Location at Mall in Space D103
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,September 15,2017
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensb fore the ex Ji tone date.)
Dated at the Town of aet:Zb _ (/ 4hu tern i I5,2016
SIGNED BY: ( /4' V for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Onlv
Town of Queensbury Fire Marshal
Received:
ESTABLISHMENT OF A NEW BUSINESS Tax Map ID:
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION Permit No.: GO �alS-ap/jam
Permit Fee:
'Note: This application Is for occupancy only,with no work requiring a building permit
i Q
Name of Business re- /076
Address
Type of Business
Manager `O
OR C7�
Person in charge
Business Phone No. /
Property Owner n�l.(A 4.&,L In
Address v� CFS
Phone SCC ,Pd
✓Provide an accurate layout of your store sho I walls,exits,stockrooms, rest rooms,counters,and fixture layout on a
separate sheet of paper.
Print Name: /' `01 �� / �� ���
Signature: �z '
Date: �G
Notes/Comments:
( 302.5-1-92.11 CO 618-2016
Kay's (Store 1070)
Aviation Mall Space D103
C/O Only (temp. space)
IMPORTANT: The business owner is responsible for keeping er„a �,va, ,,,, „y„. O„V V,,,V,yu,,,,y „y„,a. FOO
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
D-L CO
DATE: —�/t 3���S�
BUSINESS NAME: 1 S I t L� y1 0
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BUSINESS ADDRESS: v l `� ' " Ya� �/�Un / yi`' O Q U
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BUSINESS PHONE: O^ DrL
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PHONE 1: ; = w
CONTACT 1: PHONE 2: a o
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TOWN/VILLAGE RESPONDING FROM: N >` O
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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 • Fax: 518-745-4437
-firemarshal fteensbumnet • zuruzu.queensburU.net
Fire Marshal Michael J Palmer Deputy Fire Marshal Gary K Stillman
FIRE MARSHAL'S OFFICE
Town of Queensbury
742 Bay Road, Queensbury, NY 12804
(Dw " Home of Natural Beauty ... A Good Place to Live "
PLAN REVIEW
Kay Jewelers
578 Aviation Road
Temporary Space
CO-000618-2016
Plan review based on submittals:
• Verify function of exit/ emergency lighting.
• Verify FE location and inspection
• Verify aisles / Storage requirements
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Michael J Palmer
Fire Marshal
742 Bay Road
Queensbury NY 12804
firemarshal@queensbury.net
Fi r e M a r s h a l's Off i c e • P h o n e: 518-761-8206 • F a x: 518-745-4437
firemarsludQqueensbuni.net • WWW.queensbunt.net
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302.5-1-92.11 CO 618-2016
Kay's (Store 1070)
Aviation Mail Space D103
C/O Only (temp. space)