2007-626 (zt TOWN OF QUEENSBURY
742 Bay Road,Qwensbury,NY 12804-5902 (518) 761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number. P20070626 Date Issued: Thursday, November 15, 2007
This is to certify that work requested to be done as shown by Permit Number P20070626
has been completed.
Location: 1476 STATE ROUTE 9
Tax Map Number. 523400-288-012-0001-017-000-0000
Owner. ED & ED T ENTERPRISES, LLC
Applicant: ED & ED T ENTERPRISES, LLC
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 the
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
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20070626 Application Number. A20070626
Tax Map No: 523400-288-012-0001-017-000-0000
Permission is hereby granted to: ED & EDT ENTERPRISES, LLC
For property located at: 1476 STATE ROUTE 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 QueensburyZoning
Ordinance. Type of Construction Value
Owner Address: ED &ED T ENTERPRISES, LLC
1439 STATE ROUTE 9 Certificate of Occupancy(COM)
#16 Total Value
LAKE GEORGE, NY 12845-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans &Specifications
$0.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Saturday,November 15,2008
(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 wn Quee u ' 'ty,November 15,2007
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Coiiaminity Development Office �1 0
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Town olfareerasbrcrtC :42 Bad Roar{ • t<?areertsburti, Nezct Fork -12 0 f
0 OCT
Mai Ryba,Executive Director•David.Hahn,Director of Building��C���e.� �
Craig Brown,Zoning Administrator•�Hichael f.Palmer,Fire it�larshal �-� �"���'�� 0
NEW BUSINESS CERTIFICATE OF OCC PANCY PERMIT
APPLICATION
2-�06.12--/-/7�1.
TAX MAP # BLDG. PERMIT FILE#
applicable
Name of Business:
Address ")/ l S� QUESTIONS? CALL 761-8256 OR
Of Business: (1O EMAIL codes aC?gueensbuly.net
iIn\ /i VISIT OUR WEBSITE FOR MORE
Person in Charge or Manager: r �`� r` � --a� INFORMATION
wslvv.aueensbu ry.net
Business Phone Number: i � � � �"' " lG�
Type of Business: <X j0-11
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Owner of Property: =�� ®d�` Phone Number(s):�tO qR-o dC� o266—YS67
Home Cell
Owners r---�
Address: G4, �'l \ G �12r��5 �j
Please provide an accurate layout of your store showing all walls; exits, stockrooms, rest rooms,
counters and fixture layout on a separata-sheat of paper.
Signature: Date:
erson submitting this form
Notes / Comments:
*Note: This application is for occupancy only, with no work requiring a building permit. No fee required for this permit
10/6512007 10:45 5187983475 PFALTZGRAFF 53___ PAGE 01/01
EMERGENCY CONTACT UPDATE
TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 743-2502
PLEASE PRINT
DATE: lo
BUSINESS NAME:
BUSINESS ADDRESS:
BUSINESS PHONE
CONTACT l: " '�` (� P ONEd 6-1 4 7y?
ADDRESS:
HOM y✓�
CONTACT 2: Jt- ' PHON
ADDRESS: &e Br�'
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,4his 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 FIR RSHA OFFICE
P h o n e: 518-761-820 - F a x: 51 8-745-"37
fxzremarshal@queensbumixt wymn een net
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Inspection for Permit to Occupy
Fire Marshals office Request Rec'd Permit No.
Town of Queensbury
Qu Bay Road �,� /f �/'r
Queensbury,NY 12804 Scheduled Inspection Date: i�l� / Time: ..1..'
Phone: (518)761-8206 Business Name:/" / �i /
Fax: (518) 745-4437 Location:
Typo of Ins ecflon N/A Yes No
EXITS:
Exit Access
Exit Enclosure leol COMMENTS
Exit Discharge
AISLES:
Main Aisle Width ✓'
Secondary Aisle Width
EXIT SIGNAGE
Sign—normal
Sign-batter
EVAC signs in rooms
TRUSS ID SIGNAGE
EMERGENCY LIGHTING
FIRE EXTINGUISHER:
Hun
Inspection of extinguisher
FIRE ALARM SYSTEM
Fan Shutdown
Fire Sprinkler System
Fire Suppression—kitchen ✓'
Fire Suppression—Gas Islan //
Generator
Hood Installation
Elevator
Interior Finishes
Storage
Compressed Gas
Clearance to Sprinklers 666
Clearance to Electrical
Electric Wirinc
j Enclosed/Labeled L
Combustible Waste
Vehicle Impact Protection
Knox Box
F.D.Si na e—Utility Rooms
No Smoking Signs V
Maximum Occupancy Sign
Emergency Evacuation Plan
Approved (if no other approvals apply,the B&C Office will issue the Certificate of Occupancy)
v Denied / call for Recheck
Inspect dB
L:\HreMarshal\New Folder\permitto occupyform.doc