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application CERTIFICATE OF OCCUPANCY ONLY Office Use Only Permit#: CO ' � 5 ZC LZ APPLICATION i 0() Permit Fee:.$ Town of Oserniiiury Invoice#: 3c ‘425 742 Bay Road,Queensbury,NY 12804 P:518-761-8206 or 518-761-8205 www.queensburv.net **This application is for occupancy only,with no work requiring a;building permit** CONTACT INFORMATION: • Applicant: Name(s): Ryan McConky Mailing Address, C/S/Z: 12 CandlewoodLane,Delmar NY 12054 Cell Phone: ( )5184953230 Land Line: ( ) Email:rmcconky,@strategicetc.com • Business Owner(s): Contact Name(s): Ryan McConky,Travis Dunklee,Shannon Dunklee Mailing Address, C/S/Z:; 17 Burgoyne Ave,Fort Edward NY 12828 Cell Phone: (51.8 )722'0090 .. Land Line: ,.( ) Email:rmcconky@strategicetc.com,tdunklee@strategicetc.com,sdunklee@strategicetc.com0 Si • Manager: r•' Contact Name(s): m Mailing Address, C/S/Z: torti Cell Phone: ( ) Land Line: _( . ) 19 (TEi Email: • Property Owner(s): Business Name: Sea to Summit LLC Contact Name(s): Mike Patenaude,Chad Quirion Mailing Address, C/S/Z: 10 Sagamore St,Glens Falls NY 12801 Cell Phone:_ 518 745-0207 _( ( ) Land Line: Email:. +.. .. Contact Person for Building& Code Compliance:Travis Dunkee Cell Phone: ( )518-764-0791 Land Line: ( ) Email:tdunklee@strategicetc.com Certificate of Occupancy Only Revised September 2020 Town off fl.bur 742 Bay Road,Queensbury,NY. 12804 P:518-761-8206 or 518-761-8205 www.queensburv.net EMERGENCY CONTACT INFORMATION **THIS FORM IS USED TO ASSIST EMERGENCY SERVICE PERSONNEL WHO MAY BE-CALLED TO YOUR BUSINESS AFTER HOURS. PLEASE BE SURE THE CONTACTS LISTED BELOW ARE WILLING AND AVAILABLE TO REPSOND DURING OFF-HOURS TO ASSIST POLICE AND/OR FIRE PERSONNEL IN GAINING ENTRY TO YOUR BUILDING.** PLEASE BE ADVISED THAT FAILURE TO ASSIST EMERGENCY SERVICE.PERSONNEL MAY RESULT IN DAMAGE TO YOUR BUILDING BY POLICE AND/OR FIRE PERSONNEL. Date: 10/19/2020 Business Name:. Strategic Emergency Training and Consulting 53 Luzerne Road, QueensburyNY 12804 Business Location(including suite,space,etc.): Business Phone#: 518-722-0090 1. Business contact name: Travis Dunklee Main Phone:_(518 )764-0791 ;Secondary Phone:_( ) Coming from what town/village?.Fort Edward 2. Business contact name:- Ryan McConky Main Phone: (518. )495-3230 ;Secondary Phone:_( Coming from what town/village?, Delmar TOWN OF QUEENSBURY FIRE MARSHAL'S OFFICE P:518-761-8206 F:518-745-4437 FIREMARSHAL@QUEENSBURY.NET FIRE MARSHAL MIKE PALMER DEPUTY FIRE MARSHAL GARY STILLMAN Certificate of Occupancy Only Revised September 2020 S3railerct8"e2rgency TrainingC°:C64ontu21°tI2n: 53 Luzerne Rd \r"- ---* • Certificate of Occupancy Only liwn of ftscensbury 742 Bay Road,Queensbury,NY 32804 P:518-761-8206 or 518-763.-8205 unNw.queensbury.net BUSINESS INFORMATION: Name of business Strategic Emergency Training & Consulting LLC : 53 Luzerne Rd, Queensbury NY '12804 Address (including suite, space, etc.):. Detailed explanation of business (attach a separate piece of paper, if necessary): Provide CPR/AED/FA and related training and consulting services ***Please provide•an accurate layout of your space 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: 'Ryan T McConky Applicant signature: . Date: 'I 0/192020 Property Owner name:sr. (lk,) a ri47,1 . Property Owner signature)/ e/ iv i... 621*.•.._ Date: Certificate of Occupancy Only Revised September 2020