CO-000252-2016 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-000252-2016 Date Issued: Friday, June 3, 2016
This is to certify that work requested to be done as shown by Permit Number CO-000252-2016
has been completed.
Tax Map Number: 296.13-1-68
Location: 974 State Rte 9
Owner: Jason Southwood
Applicant: Jason Southwood
This structure may be occupied as a: C/O only, Suite A
Benny's Deli & Sandwich's By order of Town Board
Cross Ref. Site Plan PZ-106-2016 2nd use of property for the deli approved by TOWN OF QUEENSBURY
Planning Board.
Issuance of this Certificate of Occupancy DOES NOT relieve the
property owner of the responsibility for compliance with Site Plan, �d
Variance, or other issues and conditions as a result of approvals by the Director of Building&Code En orcement
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-000252-2016
Tax Map No: 296.13-1-68
Permission is hereby granted to: Benny's Deli&Sandwiches
For property located at: 974 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
Tyne of Construction
Owner Name: Jason Southwood Certificate of occupancy $0.00
Owner Address: PO Box 226 Total Value $0.00
Cleverdale,NY 12820
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
C/O only,Suite A
Benny's Deli&Sandwich's
Cross Ref.Site Plan PZ-106-2016 2nd use of property for the deli approved by Planning Board.
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,May 5,2017
(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 To bury; /J T r da ,2016
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: 13-1L?
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION Permit No.: '��
Pelmit Fee:
*Note: This application is for occupancy only,with no work requiring a building permit. ?pA 5 H"
Name of Business �Y1 Q_V SC, f�Vil�C�� S�ele
R-Y
Address 17 ` , �rK
-1 — P2,
Type of Business 0 "(' i e'e'
Manager
OR I n,
Person in charge �S�.J SVW OJ
Business Phone No.
Property Owner
Address 1p C vt 4c,"I A y
Phone 5,I)-" o Co)_
✓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.j1W C)o
Signature:
Date: 1 (0 S CI00 JN;®�lIf18
�Atf?':7-fie t'^+•`?r,r ,,. . „q
Notes 1 Comments: NO
I
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
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AP
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DATE: a�� T < ;
611 ENis3
ODS
BUSINESS
BUSINESS NAME: Y�'Y�`
BUSINESS ADDRESS:
BUSINESS PHONE: ��1
PHONE 1:
CONTACT 1. ONE 2: �/
V✓ e� &S-Co _-7013
�I� PH �
TOWN/VILLAGE RESPONDING FROM: V-e-eyisS Li
n fPHONE 1: 51 5-330 __2)qZ
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CONTACT 2: I � C,,,. ,s.,A \ 0Cj PHONE 2: G-6-` '701-3
TOWN/VILLAGE RESPONDING FROM: �'VlS�2
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 QUEENSBLIRY FIRE MARSHAL'S OFFICE
Phone. 518-761-8206 - Fax: 518-745-4437
-flremarshal@queensbury.net www.queensbuLy.net
Fire Marshal Michael J Palmer Deputy Fire Marshal Gary K Stillman
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TOWN OF QUEENSBIIRY
BUILDING&CODES
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(ZLFIRE MARSHAL'S OFFICE
Tozm of Queensbury
742 Bay Road, Queensbury, NY 12804
" Hone of Natural Beattty ... A Good Place to Live "
PLAN REVIEW
Benny's Deli & Sandwiches
974 State Route 9, Suite A
CO-000252-2016
4/29/2016
I have reviewed the submitted drawings for the above project, and offer the
following comments:
1) All egress door hardware shall comply with chapter 10 of the Fire Code
of NYS. The use of a key operated or thumb turn device is not
permitted.
2) A function test will be required of all Exit/ Emergency lights including
exterior heads prior to CO.
3) Verify fire extinguisher locations.
4) Provide key for Knox Box. (see C0000440-2015)
5) Verify Carbon Monoxide detection.( no combo units per NYS part
1228)
41<,-
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Deputy Fire Marshal Gary K. Stillman
742 Bay Road
Queensbury NY 12804
518 761 8205
garys@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
1"irenmarshal fteensbury.net - zuzuzu.queensbunjnet
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 357 Elwyn Terrace — Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
LAO Panel Board ..... Cert. 5 7 1255 Cut-in Card No..44..........
Owner..... �A� .......................................................................
Occupant .... ....... ............ ....
. ...... .... ...
Location
ljjsto lation consisting of ...01.I
.. .... .......
Installed By.,_,) ........................................................ Lic. RM,....................
The conditions following governed the issuance of this certificate,and any certificate previously
issued is cancelled:—
This
ancelled:—This certificate only covers the electrical equipment an installation conditions as of date. Upon
the introduction of additional equipment or alterations, application I be promptly made for
inspection.
Inspectors of this Company shall have the privilege of aking ins ect' a a e,and if its
rules are ated the Company shall have the right to revo his ett. ica
D ....................... INSPECT ...
Member N P.A.,I.A.E.I.
,—l'or
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