2005-763 TOWN OF QUEENSBURY
742 Bay Road,Queensburp,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUP-A-NCY
Permit Number: P20050763 Date Issued: Wednesday, October 12, 2005
This in to certify that work requested to be done as shown by Permit Number P20050763
has been completed.
Tax Map Number: 523400-302-006-0001-015-000-0000
Location: 729 GLEN St
Owner: RICK HAYES
Applicant: R& T ANTIQUES
This structure may be occupied as a:
Certificate of Occupancy (COM)
By Order of Town Board
FOR OFFICE USE ONLY TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the
owner of the responsibility for compliance with Site Plan
property P tY P
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: P20050763 Application Number: A20050763
Tax Map No: 523400-302-006-0001-015-000-0000
Permission is hereby granted to: R& T ANTIQUES
For property located at: 729 GLEN St
in the Town of Queensbury,to constructor 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: RICK HAYES
MICHAEL FITZGERALD Certificate of Occupancy(COM)
63 SARA-JEN Dr Total Value
QUEENSBURY, NY 12804-1959
Contractor or Builder's Name f Address Electrical Inspection Agency
Plans&Specifications
2005-763 R& T ANTIQUES
CERTIFICATE OF OCCUPANCY
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday, September 29, 2006
(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 own Que bu T rsday, September 29, 2005
SIGNED BY �1 -, for the Town of Queensbury.
Director of Building&Code Enforcement
BP File (,
e'�t'" s1.RiCs�
Dept.of Community Development CE'.7�'t1�YCatE ®f
Town ofQueensbwy
742 Bay Road
Queensbwy,IVY 12804 TOWN OF QUEMIOURY
(518) 761-8256 COMMUNITY 0EVELOPMENT
For occupancy only, with no work requiring building permit: no fee required for this permit.
ACO ZONING
B&C PLANNING�
FMB_EXEC.DIR.
R ,_4,4
Name of Business:
Address: :Z 1-7 G tin i -t •(
Person in Charge or Manager.
Business Phone Number. 1 a t
Type of Business: (i.e.,mercantile,restaurant,hobby shop,p1 mbing store):
M -e c
Owner of Property:
Address: - n
Phone Number:
Please provide an accurate Iayout of your store showin walls,exds,stockrooms,rest rooms,
counters and f"ture layout on a separate sheet ofpap
` Date:
Signature. J
ofmlbgrribfo
b(O
Property Tax
Notes/Comments:
r Town of Queensbu TOWN OP OUNNSDUkV
rY COMMUNITY DSVELOPMENT
Fire Marshal's Office RECEIVED
EMERGENCY CONTACTyf�:
LTRS 2000 Pt ANN' '_
FM EXEC,DR.
TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 743-2502
PLEASE PRINT
DATE: J
BUSINESS NAME: �y1,
BUSINESS ADDRESS:• sfv 2,Z (ASw✓
BUSINESS PHONE: U -
1 / HOME
CONTACT l: PHONE J
ADDRESS:
HOME
- -
CONTACT 2i Q - _. _'-PHONE
ADDRESS: n C LA tJ u t _
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
-- -- -PER.- NNEL,-----
Fare Marshal Steve Smith, Deputy Fare Marshal Mike Palmer
Phone 761-8205, FAX 745-4437
Inspection for Permit to Occupy
Fire Marshal's Office Request Rec'd Permit No.�� 7CO3
Town of Queensbury
742 Bay Road
Queensbury, NY 12804 Scheduled Inspection Date: 1 t Time: 7
Phone: (518) 761-8206 Business Name: � �
Fax: (518) 745-4437 Location: _p[4r� c .
Type of Inspection N/A Yes No
EXITS:
Exit Access COMMENTS
Exit Enclosure
Exit Discharge
AISLES:
Main Aisle Width
Secondary Aisle Width
EXIT SIGNAGE
Sign-normal
Sign-battery
TRUSS ID SIGNAGE -i
EMERGENCY LIGHTING I C
FIRE EXTINGUISHER: V
Hun
Inspection of extinguisher
Hydro extinguisher
FIRE ALARM SYSTEM
Fan Shutdown
Fire Sprinkler System
Fire Suppression-kitchen
Fire Suppression-Gas Island
Hood Installation
Interior Finishes
Stora e
Compressed Gas
Clearance to Sprinklers
Clearance to Electrical
Electric Wiring Enclosed
Combustible Waste
Vehicle Impact Protection
Fire Lane
F.D.Si na e-Utility Rooms
No Smoking Signs
Maximum Occupancy Sign
Emergency Evacuation Plan
Approved (If no other approvals apply,the B&C Officet&Ceificateupancy)
❑ Denied
❑ Call for Recheck
Inspected ByY `
LASue Hemingway\Fire Marshals Office Inpsection 08,17.2005.doc
S
Inspection for Permit to Occupy
Fire Marshal's Office Request Rec'd Permit No.
Town of Queensbury
742 Bay Road o
� : �� `��
Time:
Queensbury,NY 12804 Scheduled Inspection Date: L'
Phone: (518) 761-8206 Business Name:
Fax: (518) 745-4437 Location: _:2� 6/fN 5T
Type of inspection N/A Yes No
EXITS:
Exit Access COMMENTS
Exit Enclosure
Exit Discharge.
AISLES:
Main Aisle Width `V
Secondary Aisle Width Aict
EXIT SIGNAGE
Si n-normal x
Sign-batteryk
TRUSS ID SIGNAGE
o.
EMERGENCY LIGHTING
FIRE EXTINGUISHER: ~� S
Hun
Ins ection of extin uisher
Hydro extinguisher
FIRE ALARM SYSTEM `^ L
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 X
Vehicle impact Protection
Fire Lane X
F.D.Si na e-Utility Rooms
No Smoking Signs <
Maximum occupancy Sign.._.,_
Emergency Evacuation Plan
❑ Approved (If no other approvals apply,the B&C Office will issue the rti c to of Occupancy)
-ar Denied
❑ Call for Recheck
Inspected By:
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