2011-091 " TOWN OF QUEENSBURY
IFITM 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20110091 Date Issued: Thursday, June 30, 2011
This is to certify that work requested to be done as shown by Permit Number P20110091
has been completed.
Location: 15-17-19 BOULEVARD
Tax Map Number: 523400-303-020-0002-034-000-0000
Owner: NICHOLAS DAIGLE
Applicant: 4ALLVITAMINS
This structure may be occupied as a:
Certificate of Occupancy (COM) By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the6rj//'
property owner of the responsibility for compliance with Site Plan,
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
00011%*
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20110091 Application Number: A20110091
Tax Map No: 523400-303-020-0002-034-000-0000
Permission is hereby granted to: 4ALLVITAMINS
For property located at: 15-17-19 BOULEVARD
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 Value
Owner Address: NICHOLAS DAIGLE
11 SUGAR PINE Rd Certificate of Occupancy(COM)
QUEENSBURY,NY 12804-0000 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2011-091
19 Boulevard-4Allvitamins LLC - CO only
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,April 11,2012
(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 T w t&Queen ry;4 /1V,Jowlay,April 11,2011
77 SIGNED BY t. I.%, ;=,rz ,=t �" for the Town of Queensbury.
Director of Building&Code :nforcement
Community Development Office
Town of Queensbury- 742 Bay Road - Queensbury, New York •12804 D-
d e
David Hatin, Director of Building&Codes
Craig Brown,zoning Administrator Michael J. Palmer,Fire Marshal
NEW BUSINESS CERTIFICATE OF OCCUPANCY PERMIT
APPLICATION
1 I
TAX MAP# 36) 3 z- BLDG. PERMIT FILE#
If applicable
Name of Business: 1-1/4 -1-74 1-v6 tO 5 I
Address
of Business: / QUESTIONS?v a(--) QUESTIONS? CALL 761-8256 OR
EMAIL cedesOsweensburv.net
VISIT OUR WEBSITE FOR MORE
Person in Charge or Manager: i&::/hc;te.,/ 8,66LL,6 INFORMATION
www.gueensburvmet
Business Phone Number:
Type of Business: 3,7001/ 0 A )c- e- r•->4 erziA /36 / ///
Owner of Property: Nvc-L(Ls r Ie Phone Number(s): 793- 1-/fr'3,..5 66-0
Home Cell
Owners
Address: 5 Lk-1 n-a-40//u2, aD Oue64, Any. /24-6y
Please provide an accurate layout of your store showing all walls, exits, stockrooms, rest rooms,
counters and fixture layout on a separate sheet of paper.
Signature: ' 9/69,,,./ Date: 5/64011
Of person submitting this form
Notes/Comments:
poi i
E ERGENCY C • NTACT UPDATE
TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 743-2502
PLEASE PRINT
DATE: G//l0b6//
BUSINESS NAME: L/4f/✓/7/A/u,w_s G L c
BUSINESS ADDRESS: /5 eva_,, J2
BUSINESS PHONE: `79z/
HOME
CONTACT 1: ,-Aa / PHONE z-Z'
ADDRESS: 1 o,,,/e J, 4
HOME
CONTACT 2: PHONE
ADDRESS:
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
Phan e: 518-761-8206 • F a x: 518-745-4437
firenzarshal@queensbury.net • www.queensbury.net
Inspection Form
Town of Queensbury Fire Marshal O Periodic Inspection Date: �j Time: /7W
742 Bay Road,Queensbury NY 12804 o e-Inspection /
518 761 8206/518 761 8205 C e O Inspection Permit#: f/ /
Fire Marshals Representative
_MJ Palmer Business Name:
Location: // ���
A.7
Gib Stillman Contact:/, 064 i51, /
Type of Inspection N/A Yes No
EXITS: Exit Access FC 1014&FC1029 NOTES
Exit Enclosure FC 1020&FC1029 ��
Exit Discharge FC 1024&FC1029 --�
Locks and latches FC1008& FC1029.2
Sign:Normal FC 1011 &FC1029
Sign:backup FC 1011.5.3&FC1029.7.5
AISLES:
Main Aisle Width FC 1024/1025&FC1029.11
Secondary Aisle Width FC 1025&FC1029.11 �`-
FIRE EXTINGUISHER: Hung FC 906
Inspection of extinguisher FC 906
EVAC Plan FC 404.6
TRUSS ID SIGNAGE FC 505.3
EMERGENCY LIGHTING:
Interior FC 1006.3&FC1029.8
Exterior FC 1006.3 d/
Clearance to Electrical FC 605.3
Electric Wiring Enclosed/Labeled FC 605.3.1 --'
Combustibles in Equipment Rooms FC315.2.3
F.D.Signage- FC 510 -�
No Smoking Signs FC 310.3 v/
Storage FC 315.2
_ Compressed Gas FC 3003
Vehicle Impact Protection FC 312.1
Interior Finishes FC 803-804
Smoke Detectors FC 907
CO detectors FC 610
Clearance to Sprinkler/Ceiling FC 315.2.1
18" / 24"
EVAC SIGNS IN Rooms FC 404.6(R1 &R2)
Fuel Pump Warning Signs FC2205.6 �•
Fuel Station Emer Procedures FC2204.3.5
Exterior Storage FC 315.3 REINSPECTION DUE APPROXIMATELY
Vacant Buildings FC 311 21 DAYS
SYSTEMS: FC 901.6 Insp OK NC DATE: OK NC
Date
Generator Annual DATE: OK NC
Hood Installation
Elevator Semi Annual
FIRE ALARM Annual DATE: OK NC
HVAC Shutdown
Sprinkler System Annual
Sprinkler FDC
Kitchen Suppression Semi Annual
Fuel Island Suppression Semi Annual
Hood Cleaning 3-6-Annual
Knox Box:installed/checked FC5O.
Operating Permit, if requ' ed will be issued after
Completion of Inspection