inspection slips Inspection for Permit to Occupy
Fire Marshal's Office Request Rec'd Permit No.
Town of Queensbury
742 Bay Road
Queensbury,NY 12804 Scheduled Inspection Date: Time:
Phone: (518) 761-8206 Business Name: k {
Fax: (518) 745-4437 Location:
Type of Inspection N/A Yes No
EXITS:
Exit Access COMMENTS
Exit Enclosure
Exit Discharge
EVAC Plan
AISLES: � 1�f'1c+-+f. ►��.. �.a'�
Main Aisle Width t- c.,W' A i t vxC
Secondary Aisle Width
EXIT SIGNAGE
Sign—normal
Sign-battery i*+1' c t t+. C +(a r- i U
EVAC signs in rooms
TRUSS ID SIGNAGE 1 w% "( (f 30
EMERGENCY LIGHTING
FIRE EXTINGUISHER:
Hung t c. l j€ S f 4
Inspection of extinguisher
Hydro extinguisher i R. S,l c,{. _ I f7
FIRE ALARM SYSTEM
Fan Shutdown
Fire Sprinkler System in 00 LL J .. # CS "
Fire Suppression—kitchen r ,s�
Fire Suppression—Gas Island
Hood Installation
Interior Finishes
Storage ..,,
Compressed Gas 1 )
Clearance to Sprinklers
Clearance to Electrical ,-,-.(v,' t10m
Electric Wiring Enclosed
Combustible Waste ( 11160,
Vehicle Impact Protection
Fire Lane
F.D.Signage—Utility Rooms , t ;' .,,. . ; > ,T ci 7
No Smoking Signs
Maximum Occupancy Sign
Emergency Evacuation Plan
❑ Approved (If no other approvals apply,the B&C Office will issue the Certificate of Occupancy)
❑ Denied
a Call for Recheck
Inspected By:
L:\FireMarshal\insptopermitto occupyform.doc
Inspection for Permit to Occupy
Fire Marshal's Office Request Rec'd Permit No.
Town of Queensbury
742 Bay Road
Queensbury,NY 12804 Scheduled Inspection Date: Time:
rPhone: (518) 761-8206 Business Name: ` f '�' `J,� �
Fax: (518) 745-4437 Location:
1
Type of Inspection N/A Yes No
EXITS:
Exit Access COMMENTS
Exit Enclosure
Exit Discharge
EVAC Plan
AISLES: lc" n..-`.
Main Aisle Width UDC(4't�
Secondary Aisle Width 'Does r
EXIT SIGNAGE
Sign-normal It
Sign-battery 1 t C.1, n )i
EVAC signs in rooms
TRUSS ID SIGNAGE 5� r- :•` 4�‘ ((. L
EMERGENCY LIGHTING E
FIRE EXTINGUISHER: .1 ny 91 p
Hung
Inspection of extinguisher
Hydro extinguisher
FIRE ALARM SYSTEM Ors, ` G
Fan Shutdown
Fire Sprinkler System -> 1 Cr '..1 G F r
Fire Suppression-kitchen
Fire Suppression-Gas Island
Hood Installation _ (� v
Interior Finishes `.) CC...>k f( `
Storage
Compressed Gas y � N rCrt l I
Clearance to Sprinklers
Clearance to Electrical
Electric Wiring Enclosed l
Combustible Waste 1 0) �,�� c F 4x Y� c.v.-
Vehicle Impact Protection
Fire Lane O C=r\_.(� C \ - .
F.D.Signage-Utility Rooms
No Smoking Signs
Maximum Occupancy Sign t
Emergency Evacuation Plan ,t
t 9N- I s ' C �4 �, k
LISE u � �ri- 1
❑ Approved (If no other approvals apply,the B&C Office will issue the Certificate of Occupancy)
❑ Denied
a Call for Recheck
Inspected By:
L:\FireMarshal\insptopermitto occupyform.doc
Inspection for Permit to Occupy
Fire Marshal's Office Request Rec'd Permit No.
Town of Queensbury /
742 Bay Road r f f ! )
Queensbury,NY 12804 Scheduled Inspection Date: Time:
Phone: (518) 761-8206 Business Name:
Fax: (518) 745-4437 Location:
Type of Inspection N/A Yes No
EXITS:
Exit Access COMMENTS
Exit Enclosure
Exit Discharge
EVAC Plan
AISLES:
Main Aisle Width
Secondary Aisle Width
EXIT SIGNAGE
Sign—normal �
Sign-battery t.•''
EVAC signs in rooms
TRUSS ID SIGNAGE AMI
EMERGENCY LIGHTING
FIRE EXTINGUISHER:
Hung
Inspection of extinguisher
Hydro extinguisher
FIRE ALARM SYSTEM
Fan Shutdown
Fire Sprinkler System
Fire Suppression—kitchen
Fire Suppression—Gas Island
Hood Installation
Interior Finishes
Storage
Compressed Gas
Clearance to Sprinklers
Clearance to Electrical
Electric Wiring Enclosed
Combustible Waste
Vehicle Impact Protection
Fire Lane
F.D.Signage—Utility Rooms
No Smoking Signs
Maximum Occupancy Sign
Emergency Evacuation Plan
o Approved (If no other approvals apply,the B&C Office will issue the Certificate of Occupancy)
o Denied
o Call for Recheck
Inspected By:
L:\FireMarshal\insptopermitto occupyform.doc
—i 7/7'..,/ ,)7
. " 16,K. ,23.. ,-,ryi i
Inspection for Permit to Occupy
Fire Marshal's Office Request Rec'd Permit No. i • 1
Town of Queensbury
742 Bay Road 21 1i I tXl ,
Queensbury,NY 12804 Scheduled Inspection Date: Time: f
illr
Phone: (518) 761-8206 Business Name: tv . .. , - U i ".. .
Fax: (518) 745-4437 Location: E ,i
Type of Inspection N/A Yes No
EXITS:
Exit Access COMMENTS
Exit Enclosure
Exit Discharge
AISLES: VI 00 M 1` 1 i L... 1 c V c i A t:4,-. i• i.5( (r
Main Aisle Width
Secondary Aisle Width ik (1 f y‘ , 0 f
EXIT SIGNAGE ' ' Ad, > r i'V , I v�
Sign-normal 3
Sign-battery
COI V*i(.r--C, 1 t',..... 1.)--r. ir'<..e-.4
TRUSS ID SIGNAGE
EMERGENCY LIGHTING 0 Ill 5 I i 1 C.°J S v( `L ex.-
IA
FIRE EXTINGUISHER: k, C,r !"- c)
Hung
Inspection of extinguisher -�
Hydro extinguisher ,�) _ .--:..-r- ' ti^r,`. L(`t v r k-f, ti
c
s,....f.)
FIRE ALARM SYSTEM k r`L`-, *�
,
Fan Shutdown t r
Fire Sprinkler System
Fire Suppression-kitchen i \ ' ; 1 1 j S
Fire Suppression-Gas Island
Hood Installation ICe-cr (ti
Interior Finishes '7/ , '�
Storage 1/4�-1 .\: C Y N J C , r t i(-"` , iti..;
Compressed Gas
Clearance to Sprinklers t ' • f ` 1 (t/ l
Clearance to Electrical C.�� S ` �`f+' 4
Electric Wiring Enclosed r
Combustible Waste �\ Lj `a' •-, r 0£
r
Vehicle Impact Protection !;�SC�� �r
Fire Lane
F.D.Signage-Utility Rooms L4'r t" c'(c:.-1
No Smoking Signs
Maximum Occupancy Sign
Emergency Evacuation Plan
o Approved (If no other approvals apply,the B&C Office will issue the Certificate of.Occupancy)
o Denied
o Call for Recheck
Inspected By: ' ;
.._ —.~—,
L:\Sue Hemingway\Fire Marshals Office lnpsection 08.17.2005.doc