CO-0295-2019TOWN OF QUEENSBURY
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742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: CO-0295-2019 Date Issued: Thursday, June 27, 2019
This is to certify that work requested to be done as shown by Permit Number CO-0295-2019
has been completed.
Tax Map Number: 296.17-1-42
Location: 919 State Rte 9
Owner: Kenneth Ermiger
Applicant: Adirondack Car Wash
This structure may be occupied as a: Certificate of Occupancy only
Tenant: Sparkling Devices and Fountain of Sparks By order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve
thepropertyownerowneroftheresponsibilityforcompliancewithSitePlan,
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
742 Bay Road,Queensbury,NY 12804-5904 (518) 761-8201
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Community Development - Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number: CO-0295-2019
Tax Map No: 296.17-1-42
Permission is hereby granted to: Sparkling Devices and Fountain of Sparks
For property located at:919 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
Type of Construction
Owner Name: Kenneth Ermiger Certificate of occupancy 0.00
Owner Address: 3494 Lake Shore DR Total Value 0.00
Lake George,NY 12845
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
Certificate of Occupancy only
Tenant: Sparkling Devices and Fountain of Sparks
100.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Wednesday, May 20, 2020
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 Town of Queensbury; Tuesday, May 21, 2019
SIGNED BY:for the Town of Queensbury.
Director of Building&Code Enforcement
CERTIFICATE OF OCCUPANCY ONLY Office Use Only
Permit#: 6d D-
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APPLICATION de-
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Permit Fee:
742 Bay Road,Queensbury,NY 12804
Invoice#: /S /tt
P:518-761-8206 or 518-761-8205 www.queensbury.net
This application is for occupancy only, with no work requiring a building permit**
CONTACT INFORMATION:KrupefLo r)
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A licant: P h Del'6e.S
Name(s): C t. Sty f[ ' -- Spa-rk s
Mailing Address, C/S/Z: ac) bizimji-r GLEA/I CML3 ; Air iijo
Cell Phone: ( 3/ 22 Land Line: ( Sti ) 76/ Q43O
Email: (10/<CatvvAil A1L-CI)
Business Owner(s):
Contact Name(s): A0m/vvilmk CA4 wN'/l 11Vcitnet, ff rd
Mailing Address, C/S/Z: gQ./ 4 3 G-1. I.i4U MY (Aso
Cell Phone: _( .572 ) f -. ) Land Line: _( 578 ) 76 / - 04..30
Email: 4D/4.CA4v`A'.NL-C-
Manager:
Contact Name(s): /wUL .SOU
Mailing Address, C/S/Z: a403 e'RAO ', C- J /=4Ltr ;Air /1SO/
Cell Phone: ( S®/8 ))1i— ) Land Line: ( /8 ) 76f -a Gt3O
Email: M/_Ar co
Property Owner(s):
Business Name: /(.v 6.41'VCf
Contact Name(s): A/` (4WarX
Mailing Address, C/S/Z: 3`9`\ 1-i{-MJ(1 I/ LARF a- /es. Air 12S Li5
Cell Phone:_( 36 i-io30 Land Line: _( Sty ) 66-a- (7,0
Email: fc.r o A6 twe:J,1'driAt,Cam'
Contact Person for Building & Code Compliance: ( ' '
Cell Phone: ( ;71 ) LJ2 Land Line: ( PS ) 76 0_ 41430
Email: A/0/<east/ 40L
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TOWN OF OUEENSBURY
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Certificate of Occupancy Only Revised December 2017
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742 Bay Road,Queensbury,NY 12804
P:518-761-8206 or 518-761-8205 www.queensbury.net
BUSINESS INFORMATION:
Name of business: it W 1 (,+ C W SFt co- LA C
Address (including suite, space, etc.): 9i 9 A F 4"/T( ? ; 0-v(.Nh/3V/U' /i//" (L8O(
L'NG-7l3KfMt(rJ
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Type of business (i.e.: retail, car repair, etc.): PAP--1`UNG" — FJ' SPAS
ks
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:
Applicant signature:MM f
Date: 57077(9
Certificate of Occupancy Only Revised December 2017
town of(Zueeni bur,
742 Bay Road,Queensbury,NY 12804
P:518-761-8206 or 518-761-8205 www.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:s5;ia 7///
Business Name: 6l,/1-. /"Ad( 014 W,iS ciQ- ftC
Business Location (including suite, space, etc.): 9 vt 1 - ( vg/vf4vfifrii ,iY /e4°j
Business Phone#: 5 7) ?" /r 014)0
1. Contact name: / '\
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Main Phone:_( 5;1 ) W_043 D
Secondary Phone:_( '2 )
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2. Contact name: & 4
Main Phone:_( - 1 ) 4'> ' _ <P3 ;Secondary Phone: (
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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
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