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CO-0042-2021 Ww" E CERTIFICATE 2 np 2N office Use only, C E Q V L5 AN ICA 1110111 Permit#: U— DU 1 'ZOZ FED Q i ,�� Permit Fee:$ ) i 0 , �D Town t�(t cnsbu, 2 742 Bay Road,Queensbury,NY 12804 Invoice#: ✓3 TOWN OF QUEENSBURY P:518-761-8206 or 518-761-8205 www. ueensMWRMG&CODES "This application is for occupancy only, with no work requiring a building permit" BUSINESS INFORMATION: Name of business: business Address'(including suite, space, etc.): - V.a-4_-,L:, Detailed explanation of business (attach a separate piece of paper,'if necessary): t�lo�n Qr D'�qA C., * *Please provide an accurate layout of your space showing all walls, exits, stodkrooms, 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:. C��� " P Applicant signature- Date: I Zz Z Property Owner name: Ktc,, d Property Owner signature: Date.: r z'��-( Certificate of Occupancy Only Revised December 2020 r N Town of Quccnsbun 742 Bay Road,Queensbury,NY 12804 P:518-761-8206 or 518-761-8205 www.gueensbury.net CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Applicant- �N-If cam Name(s): ��f�� n � C t z' Mailing Address, C/S/Z: h,,,,2 ► lS it1 I Z I Cell Phone: Land Line: Email: `,' NVJ;�. z4 -a • Business Owner(s): Contact Name(s): Mailing Address, C/S/Z: Cell Phone:_( ) Land Line: _( ) Email: •. Manager: Contact Name(s): U)pl\1�40 Mailing Address, C/S/Z: Cell Phone:_( � ) �22 �dD Land Line: Email: � • Property.Owner(s): Business Name: Contact Name(s): Mailing Address, C/S/Z: Cell Phone:_ /e ) 7 9 6S a- I Land Line: _( ) Email: Contact Person for Compliance in regards to this project: c- ��� � - Cell Phone: ( Ulv ) C/`�J�� (�OD� Land Line: Email: Certificate of Occupancy Only Revised December 2020 FIRE MARSHAL'S OFFICE Town of Queensbury 742 Bay Road, Queensbury, W 12804 " Hoare of Natural Beauty ... A Good Peace to Line " PLAN REVIEW Syndicate East Coast, Inc. 19 Boulevard CC-0042-2021 2/3/21 The following comments based on review of the submitted plans: 1) Verify Fire Extinguisher locations. 2) Locks & latches shall comply with 2020 NYSFC. 3) Verify CO detection. 4) Verify operation of existing Exit/ emergency lights. 5) Verify aisles & storage. Deputy Fire Marshal Gary K. Stillman 742 Bay Road Queensbury NY 12804 518 761 8205 garys@queensbury.net Fi r e IN4 a r s h al 's O f f i c e - P h o n e: 518-761-8206 - F a s: 51S-74541437 -flrerruarslral@tir-reerrsbrrrU•raet wit,w.queerasburit.rre:t