application CERTIFICATE OF OCCUPANCY ONLY Office Use Only
Permit#: (-)c1/ ' 2-0\9
APPLICATION _
Town of(Zurcnchun
Permit Fee: $ 1°�
Invoice#: 1 C)\21
742 Bay Road,Queensbury, NY 12804
P: 518-761-8206 or 518-761-8205www.queensbury.net
**This application is for occupancy only, with no work requiring a building permit**
CONTACT INFORMATION:
• Applicant:
Name(s): North Country Property Management, LLC
Mailing Address, C/S/Z: 207 Maple St., Glens Falls, NY 12801
Cell Phone:( ) Land Line: ( 518 ) 793-0717
Email: mmerrill@northcountrysnowplowing.com
• Business Owner(s):
Contact Name(s): Michael Merrill
Mailing Address, C/S/Z: 207 Maple St., Glens Falls, NY 12801
Cell Phone: ( 518 ) 361-3936 Land Line: ( 518 ) 793-0717 lecEllve
Email: mmerrill@northcountrysnowplowing.com
• Manager & Owner: SEP 03 2019 DI
Contact Name(s): Scott McDonald To WA]OF
Mailing Address, C/S/Z: 207 Maple St., Glens Falls, NY 12801 8 LDING&C�gBSRY
Cell Phone: ( 518 ) 307-4561 Land Line: ( 518 ) 793-0717
Email: smcdonald@northcountrysnowplowing.com
• Property Owner(s):
Business Name: R & P Quaker Realty, LLC
Contact Name(s): Josh Nemer
Mailing Address, C/S/Z: P.O. Box 369 , Latham, NY 12110
Cell Phone: ( ) Land Line: ( 518 ) 366-7796
Email: nemerica@gmail.com ii
X
VU�tvt� Ri-rvContact Person for Building & Code Compliance: ichael Merrill
Cell Phone: (518 )361-3936 Land Line: ( 518 )793-0717 \5-t
Email: mmerrill@northcountrysnowplowing.com
Certificate of Occupancy Only Revised February 2019
lawn a C .orrn. 1n•
742 Bay Road,Queensbury, NY 12804
P: 518-761-8206 or 518-761-8205www.queensbury.net
BUSINESS INFORMATION:
Name of business: North Country Property Management, LLC
Address (including suite, space, etc.): 415 Big Bay Rd., Queensbury, NY 12804
Type of business (i.e.: retail, car repair, etc.): Construction and Exterior Services
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: Mi ha . Merrill
\ -
Applicant signature:
Date: 09/03/2019
Certificate of Occupancy Only Revised February 2019
111.144
Town d clucc:n4min
742 Bay Road,Queensbury, NY 12804
P: 518-761-8206 or 518-761-8205www.queensbury.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: 09/03/2019
Business Name: North Country Property Management, LLC
Business Location (including suite, space, etc.): 415 Big Bay Rd., Queensbury, NY 12804
Business Phone#: 518-793-0717
1. Contact name: Michael Merrill
Main Phone: (518 )361-3936 Secondary Phone: ( 518 ) 793-0717
Coming from what town/village? Corinth
2. Contact name: Scott McDonald
Main Phone: ( 518 )307-4561; Secondary Phone: ( 518 ) 793-0717
Coming from what town/village? Glens Falls
TOWN OF QUEENSBURY FIRE MARSHAL'S OFFICE
P: 51 8-7 61-8206 F: 518-745-4437
FIREMARSHAL@QUEENSBURY.NET
FIRE MARSHAL MIKE PALMER DEPUTY FIRE MARSHAL GARY STILLMAN
Certificate of Occupancy Only Revised February 2019