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application
CERTIFICATE OF OCCUPANCY ONLY_|oveeuse on permit _C O-000bf~2000 Permit Fee:$_100.OO Invotee #:__2-274‘owen of Queensbury “This application is for occupancy only,with no work requiring a building permit** CONTACT INFORMATION: .ppl int: Name(s):Qadeoa Hopkia S Malling Address,C/$/2:__BNI 37 Fox Holos Waae ure asbun Cell Phone:(4a|_)S4S-3044)land Line:_(_Ws Email:___Qadeah3i7 €aco Aer ©Business unex . Contact Name(s):(Andrew Hook ias Mailing Address,C/s/z:__37 Go Upllow (ane Qsb-) Cell Phone:_(Ho1~)_S45 -2044 Land Line:_(_eX gw Email:__Quidreadad(2 @ pine on «Manager: Contact Name(s):__<Saene-_(dune told Mailing Address,C/S/Z: Cell Phone:_()Land Line:_() Email: +Property Owner(s):: Business Name:Parker +een mond Castucton Contact Name(s):Kesin Hammond _ A Mailing Address,C/s/Z:JU Siwer Cirle,Queensbury OY 1240] Cell Phone:_()Land Line:(<]&_)_743~5220 Email:{a Contact Person for Building &Code Compliance:ia.mond Cell Phone:)land Line:(1S)74-3220 Email:aif Certificate of Occupancy Only Revised December 2017 Town of Queensbury 742 Bay Road,Queensbury,NY 12804 P:518-761-8206 or 518-761-8205 www.queensbury.net BUSINESS INFORMATION: Name of business:ULpfowa Charm Cowouyrouot (ancy Address (including suite,space,etc.):UTUpperCleanSPQuaashinyOtv2 Type of business (i.e.:retail,car repair,etc.):_C stqnnunt S$ 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: __ (Dade Hopkias Applicant signature:Cede < Date:“A 2,2020 Certificate of Occupancy Only Revised December 2017