2007-684 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF OCCLT-A-N- CY
Permit Number. P20070684 Date Issued: Tuesday, January 15, 2008
This is to certify that work requested to be done as shown by Permit Number P20070684
has been completed.
Location: 20 MAIN St
Tax Map Number. 523400-309-011-0001-048-000-0000
Owner. LAWERNCE LUSSIER
Applicant: DIAMOND GLASS
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, Q)4!
Variance, or other issues and conditions as a result of approvals by the Director of Building Ml&de EN&rcernent
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: P20070684 Application Number. A20070684
Tax Map No: 523400-309-011-0001-048-000-0000
Permission is hereby granted to: DIAMOND GLASS
For property located at: 20 MAIN St
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 Value
Owner Address: LAWERNCE LUSSIER
4 DARTMORE Dr Certificate of Occupancy(COM)
QUEENSBURY,NY 12804 Total value
Contractor or Builders Name/Address Electrical Inspection Agency
Plans &Specifications
2007-684
CERTIFICATE OF OCCUPANCY - DIAMOND GLASS
$0.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Sunday,November 16,2008
(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 Town of Queensbury-, Friday,November 16, 2007
SIGNED BY °� for the Town of Queensbury
ctor o Buil ' g f d orcement
r r r s r-s r r r r.r%
Community Development Office
Town of Queenshury • 742 Bath Road • Queenslrury, Nev, York •12804
David Hatin,Director c f Building&Codes ;
Craig Brown,Zoning Administrator•Michael J. Palmer,Fire Marshal
r'
-----------------
ESTABLISHMENT OF A NEW BUSINESS
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION
TAX MAP # BLDG. PERMIT FILE#
it PP Ica e
Name of Business: i
Address ( ` d/
of Business: �� S QUESTION ? CALL 761-8256 OR
EMAIL codes(ftueensburv.net
VISIT OUR WEBSITE FOR MORE
Person in Charge or Manager: INFORMATION
www.aueensbury.net
t
Business Phone Number: TO a 6--- d�Tt�2nsvXE�
Type of Business:
Owner of Property: ��4u9�E rL� C. /099AhoeNumber(s): n/-?,,(--77 — ,Q�P"048-3
Home Cell
Owners ✓ ,
Address: e2 cpl l�/ (AmAC/\�//� dIl/ (/
2-o
Please provide an accurate layout of your store showing all walls, exits, stockrooms, rest rooms;
counters and fixture layout on a separate sheet of paper
Signature: 6te:
Of person 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
EMERGENCY CONTACT UPDATE
TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 743-2502
PLEASE PRINT
DATE:
BUSINESS NAME:
BUSINESS ADDRESS:
BUSINESS PHONE:
HOME
CONTACT 1: PHONE
ADDRESS:
HOME
CONTACT 2: PHONE
ADDRESS:
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 this 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 FIRE MARSHAL'S OFFICE
Phone. 518-761-8206 Fax. 518-745-44.37
iremarshal@queensburj.net wwzv.queensburj iet
Communi Development Of ice
Town of Queensbury - 742 Bay Rd.
Queensbury, New York -12804 PLOT PLAN
Show all existing and proposed structures. Indicate the setbacks of all structures and buildings from all property lines.
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SIDE PROPERTY LINE
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Communify Development Office
Town of Queensbury • 742 Bay Rd.
Queensbury, New York •12804 PLOT PLAN
Show all existing and proposed structures. Indicate the setbacks of all structures and buildings from all property lines.
SIDE PROPERTY LINE
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Inspection for Permit to Occupy
Fire Marshal's Office Request Rec'd Permit No. 07 4/, f
Town of Queensbury
742 Bay Road
Queensbury,NY 12804 Scheduled Inspection Date: Time:
Phone: (518)761-8206 Business NaA�e:: w 5
Fax (518) 745-4437 Location: ,w -,
T of Ins ecHon N/A Yes No
EXITS:
Exit Access
Exit Enclosure COMMENTS
Exit Discharge
AISLES:
Main Aisle Width
Secondary Aisle Width
EXIT SIGNAGE
Sign-normal 1r
Sign-batter
EVAC signs in rooms
TRUSS ID SIGNAGE
EMERGENCY LIGHTING
FIRE EXTINGUISHER: �-
Hun
Ins action of extinguisher
FIRE ALARM SYSTEM j
Fan Shutdown
Fire Sprinkler p System
Fire Suppression
ression-kitchen /{
Fire Suppression-Gas Isian
Generator
Hood Installation
Elevator
Interior Finishes
Storage
Compressed Gas 1"
Clearance to Sprinklers
Clearance to Electrical -A"
Electric Wiring Enclosed/Labeled
Combustible Waste
Vehicle Impact Protection •-t
Knox Box
F.D.Si na e-Utility Rooms
No Smoking Signs
Maximum Occupancy Sign
Emergency Evacuation Plan
�pproved (if no other approvals apply,the B&C Office will issue the C fic of Occupancy)
o Denied / call for Recheck
Inspect d By: '
L:\FreMorshal\New Folder\permitto occupyform.doc