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CO-0261-2018 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-0261-2018 Date Issued: Thursday, May 17, 2018 This is to certify that work requested to be done as shown by Permit Number CO-0261-2018 has been completed. Tax Map Number: 296.13-1-18 Location: 959 State Rte 9 Owner: Mount Royal Plaza(Zim Realty), Mike Metzger Applicant: Mike Metzger This structure may be occupied as a: Certificate of Occupancy Mount Royal Plaza, Office E By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the property owner of the responsibility for compliance with Site Plan, Variance, or other issues and conditions as a result of approvals by the Director o ui ding&Code rcem t 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-0261-2018 Tax Map No: 296.13-1-18 Permission is hereby granted to: Mike Metzger For property located at: 959 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 Tvpe of Construction Owner Name: Mike Metzger Certificate of occupancy $0.00 Owner Address: Total Value $0.00 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications Certificate of Occupancy Mount Royal Plaza,Office E $ 100.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Friday,May 17, 2019 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Quee before expiratio to Dated at the Town?f Que T ,May 17, 2018 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement CERTIFICATE OF OCCUPANCY ONLY office use Only APPLICATION Permit#: C-0 - 0 2. o k• 10 0$ t Permit Fee: 742 !day Road,Queensbury, NY 12804 Invoice#: P: 518-761-8206 or 518-761-8205 www.gueensbury.net "This application is for occupancy only, with no work requiring a building permit" CONTACT INFORMATION: • Applicant: Name(s): m iO4Act, M s-rz i ek Mailing Address, C/S/Z: efry 5444. oL,jt 9 5fc 3,' c ft� Cell Phone: T 1b ) 2 Z,� - '6 11 7 Land Line: ( Yis Email: kM z 63 M'4''/. c�� • Business Owner(s): Contact Name(s): ,A /"Erzcz7g Mailing Address, C/S/Z: z Cell Phone: _( rt� )'12 --t - 8 3 -1 6 Land Line: _( ri t io i 3 Email: fike ,-,.k2-ime't1 • Manager: Contact Name(s): Mailing Address, C/S/Z: J Cell Phone: _( ) Land Line: _(ffBUILDING Email: LV OE OtUEENSBLiRY &CODES • Property Owner(s): ---- - - - Business Name: -L t +tii 1)t;"t Cs✓ T" Contact Name(s): Ar N1) ill C"W AAKS 0 Mailing Address, C/S/Z: Cell Phone: _( ) Land Line: _( 5-1% ) - ©o 2 Email: G„cl z� .�,�s� Zv04 -4�Iwg ,.,4-_ cc,M Contact Person for Building & Code Compliance: ^' Cell Phone: Land Line: (VS) '7 9 S - 00 2C. Email: Certificate of Occupancy Only Revised December 2017 296.13-1-18 CO-0261-2018 Metzger, Mike 959 State Route 9, Ofc. E Certificate of Occupancy Only 742 Bay Road,Queensbury,NY 12804 P:518-761-8206 or 518-761-8205 www.gueensbury.net BUSINESS INFORMATION: Name of business: H ►KC +C e7,,v C'e Address (including suite, space, etc.): 5 5 �. � ��-�� S', 4� Type of business (i.e.: retail, car repair, etc.): areAC �9 Please provide an accurate layout of your store showing all walls, exits, stockrooms, rest rooms, counters and fixtures on a separate sheet of paper. IMPORANT: 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 Town of Queensbury 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 and a re-inspection. Applicant name: M (IMAC'- M�-VZGf-4 Applicant signature: nn-4 Date: 5-1' s' I a Certificate of Occupancy Only Revised December 2017 r 742 Bay Road,Queensbury, NY 12804 P: 518-761-8206 or 518-761-8205 www.gueensbury.net EMERGENCY CONTACT INFORMATION "THIS FORM IS USED TO ASSIST EMERGENCY SERVICE PERSONNEL WHO MAY BE CALLED TO YOUR BUSINESS AFTER HOURS. PLEASE BE SURE THE CONTACTS LISTED BELOW ARE WILLING AND AVAILABLE TO REPSOND DURING OFF-HOURS TO ASSIST POLICE AND/OR FIRE PERSONNEL IN GAINING ENTRY TO YOUR BUILDING." PLEASE BE ADVISED THAT FAILURE TO ASSIST EMERGENCY SERVICE PERSONNEL MAY RESULT IN DAMAGE TO YOUR BUILDING BY POLICE AND/OR FIRE PERSONNEL. Date: 5- 1 Business Name: M1KC' r-fuTlccp j '45 x.4' C' ACEjCy Business Location (including suite, space, etc.): �J s`1 S T4TC Ac'"{ A/ r.vS6Vje A/;� �ZSSS `i Business Phone#: S 3 1. Contact name: r M{ f 2 t C (e Main Phone:_( 'a' 1 15 ) 22 4 - S t 7 0 ; Secondary Phone:_( ) Coming from what town/village? C �� "' S F-A t-1,S 2. Contact name: Main Phone:_( ) ; Secondary Phone:_( ) Coming from what town/village? TOWN OF QUEENSBURY FIRE MARSHAL'S OFFICE P: 518-761-8206 F: 518-745-4437 FIREMARSHAL@QUEENSBURY.NET FIRE MARSHAL MIKE PALMER DEPUTY FIRE MARSHAL GARY STILLMAN Certificate of occupancy Only Revised December 2017 'st 'Z 29613.1,18 959 S at' Mike CO.p2 Ce�tiftcate o f°ute 9, O f 61�2p18 ._y ccc. 4pancy O ICU e C-)m r 13i O ��T C x R