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applicationCERTIFICATE OF OCCUPANCY ONLY|officeuseonly 2020inCQ-poor~20ataeGiElWom—;a a |nl JAN 03 2020] \aluel a.224]742 Bay Road,Queensbury,NY 12804 uu eeP:518-761-8206 or 518-761-8205—www.queensbury.n.ORY DES | **This application is for occupancy only,with no work requiring a building permit** CONTACT INFORMATION: ©Applicant:/Name(s):Vm es fever Wey ‘w'tle Cele mee Mailing Address,C/s/2:__3 %Mnuwkcalm CL.Lake Georg,MY JOYECellPhone:(S'§_)260-Faoz landline:_(S!8)666.s7ggEmait_Leeer \clan Good rns.(om ©Business Owner(s):‘Contact Name(s):Lav ra FertMailingAddress,C/S/Z:_3 3 Mowreolw Sh,Lee George WY /OF4S-Cell Phone:(Sf)6g 3-|§A)landline:_(_S/€)669%-SPE&E Email:ecciachin @ Qoedry:sch °Manager;rContactName(s):owe FerryMailingAddress,C/S/Z:_3 ®Mowtcatm S\,Lele.Gea.VY Ip PSUCellPhone:_(S/£)AZq-EA?landline:(S/§)6ER-SFREEmait:_e cv’)clin @ Poed cumneys cow ¢Property Owner(s): BusinessName:_Advndec Oulul Mat) Contact Name(s):(ay Kotly Mailing Address,C/S/z:_JY <4 Pte 2,Lda Gone NY Lesy~Cell Phone:_()Land Line:_() Email: Contact Person for Building &Code Compliance:Ser,4)bowCellPhone:)land Line:_() Email:, Certicate of Occupancy Only Revised December 2017 Town of Qocensbury 742 Bay Road,Queensbury,NY 12804 P:518-761-8206 or 518-761-8205 www.queensbury.net BUSINESS INFORMATION: Name of business:Way wy’Wee Candl Matcns Qeseo Address (including suite,space,etc.):_UY Rew Lake ewe.NY so cys Type of business (i.e.+retail,car repair,etc.):Ccaf\ws /Rela. 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:__~J ames Applicant signature:___/7 Date:__(9/B19 Certificate of Occupancy Only Revised December 2017