2005-924 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20050924 Date Issued: Friday, December 16, 2005
This is to certify that work requested to be done as shown by Permit Number P20050924
has been completed.
Tax Map Number: 523400-302-006-0001-029-000-0000
Location: 777 GLEN St
Owner: MOBIL OIL CORPORATION
Applicant: QUEENSBURY MOBIL
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 ing Code En m
Planning Board or Zoning Board of Appeals.
T, TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20050924 Application Number: A20050924
Tax Map No: 523400-302-006-0001-029-000-0000
Permission is hereby granted to: QUEENSBURY MOBIL
For property located at: 777 GLEN 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: MOBIL OIL CORPORATION
Certificate
C/O EXXON MOBIL CORP PROPE ficate of Occupancy(COIvl)
PO BOX 4973 Total Value
HOUSTON, TX 77210-4973
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2005-924 QUEENSBURY MOBIL,
CERTIFICATE OF OCCUPANCY
$0.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Wednesday, December 06, 2006
(If a longer period is required,an application for an extension mist be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the own o uee ,V , December 06, 2005
SIGNED BY �Q► for the-Town of Queensbury.
Director of Building&Code Enforcement
- S.'B: COLLINS PAGE 02
2"0 5-92 i_Communez� Developmen �1D04-%008
QUEENSBURY i 01531L. - - -- _ ..--. -- - -
- - ---
77 GLEN STREETFale#
vCcRT€FiCA T E OF OCCUPANCY
TAX IU 302.6-1-29
DqC e1'c 1h'DaeAopmem
742 Bay)?W
(520 761-8256
Faroccupancy Wy,with no workra ring ,iAg permit- spa fas?,gV&aA,-t #spe wdf.
Pv
Name o£Bnsi�ess: �ucGnsb�r� l�,�p b!'� .
. Ad&=.i 'I'77 U��r (tr�e�1 �uccn �ur�� Y
Perswa3aCl�rgeoFIvSa�gea� Sh��
Bosin=Thone Number: 512— 773-d,
Type of Business; (i.e.,metcamile'Mb and hobby soap,plumbing store): v
ovmerof y: _ Tdi�c.X Ass��,� s 6j ems' sec r3, zcno 1� .
Rase provIde am accurate layanf of raur si sl�arvutg i�r�s,ez&,&Orl�aaM,rest rnorn�s�
cmtm axd fret=lovat Olt a separ sir of er. .
Signature: / Datq:. 1 10�"
NoteslCom ents:
11/30/2005 13:55 802-527-0115 S.B. COLLINS PAGE 03
__1111512005 TUE 11:52 FA% 5I8 746 :_443:7==T'oq=OQmmu ty-DePe10 R en
Town of Queensbury
MarSWS OMCQ
• . y
E-MERGENCY CONTACT UPDATE
LTRS 2000
TO: WARREN COUNTY SIMIUM DEPT. FAX:•713-W2
PLEASE PRM
�i�-+-f'v� 17cc�+nbcr �y ZOd�
�06JOr
DATE:-- _
BUSINNSS NAMT:,_,_ ysLnS Ur, 1y'A7"L
BUSINESS AnbRESS.- /,Z?EJD�� r-22 Q(45-0 shcO-Z— .
BUSINEss PRONE: -
HOME
CONTACT t: fa-6 gw)y PHONE
ADDRESS►: 52 ZOLae .V-2-1dmr. SA, ZEAL
gip' CONTACT il
ADDRESS:_S jVwc-,1-Lv,i jen .SAP
This dorm is used to assist Emergency Service Personnel,who may be
called to your business after hours,Please be sure that the persons listed.
on*U9 form Will be willing mind available to respond during of ho 9 to .
assist Police and/or F%Renonnel in gaining ebltry to your buildiAS,
PLEASE BE ADVISED TEAT FAILURE TO RESPOND TO ASSIST
EMER.GENCY.SERVICE PRUSONNEL MAY RMULT IN DAMAGE TO
YOUR BUILDING TO FACfI.TATF ENTRY BY POLICE AND/OR FIRE
k7re Afarshal Steve Sm Ith,Deputy Fire Marshal Mike Palmer
Phone 761-8205,FAX 745-4437
11/30/2005 13:52 802-527-0115 S.B. COLLINS PAGE 03
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Inspection for Permit to Occupy
Fire Marshal's Office Request Rec'd Permit Noo —
Town of Queensbury
742 Bay Road l /
Queensbury,NY 12804 Scheduled Inspection Date: , ! / 0 Time: L
Phone: (518) 761-8206 Business Name: CDC s t--
Fax: (518) 745-4437 Location: 4 ry
Type of Inspection N/A Yes No
EXITS:
Exit Access COMMENTS
Exit Enclosure
Exit Discharge
AISLES: I
Main Aisle Width I !V U l_\�r I cl-
Secondary Aisle Width
EXITSIGNAGE
Sign-normal
Sign-battery (X`
TRUSS ID SIGNAGE ell
EMERGENCY LIGHTING v C�
FIRE EXTINGUISHER:
Hun
Inspection of extinguisher
Hydro extinguisher
FIRE ALARM SYSTEM
Fan Shutdown X
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 8,C Office will issu he e tificate of Occupancy)
❑ Denied
❑ Call for Recheck
Inspected By: Ml 'I
L:\Sue Hemingway\Fire Marshals Office Inpsection 08.17.2005.doc