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TOWN OF QUEENSBURY
742 Bay Road, Queensbury, NY 12804-5902 (518) 761-8201
Community Development -Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20070235
Application Number. A20070235
Tax Map No: 523400-303-005-0001-062-000-0000
Pernvssion is herebygranted to: JOHN HOFFMAN
For property located at: 318 RIDGE Rd
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 QueensburyZoning
Ordinance. ~e of Construction
Owner Address: JOHN HOFFMAN
LINDA CASSE Certificate of Occupancy (COM)
132 5TH Ave Total value
SARTOGA SPRINGS, NY 12866
Contractor or Builder's Name /Address
Value
Electrical Inspection Agency
Plans & Specifications
-235
(AUDIOLOGICAL ACCESSORIES (HEARING TESTS)
$0.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Thursday, June O5, 2008
(If a longerperiod 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 Town of Queensbury; Tuesday, June O5, 2007
SIGNED BY for the Town of Queensbury.
ct orcement
Cor~rmunity Development Office
Tourn o(Queer{shurr~ • 742 Bay Rnad • Q{{eenshury, Neu} York •12804
Blanche Alter, Execaclive Director • Davzd Hl2tttI, DlPector Of BZ{ild{ng £~ Codes
Craig Bmu~n, Zoning Administrator • Michael ]. Palmer, Fire Marshal
~~ ~av~1-x-35
R~~'~
t y~"4 $
Y
i ~~
~. _ _ _ .. BtjitDi ~iQ t=t~'~f~ ~~'~~
ESTABLISHMENT OF A NEW B LISINESS
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION
TAX MAP # 303.5-I - ~Z BLDG MIT FIL
Name of Business
• E#
~~ 6~ ~ app lCa e
~ ~'JC.C
Address ~'~/~`'`~"t ~'~ ~31be ,
n n J
of Business: 3 i ~' K' a~ c~~G. -1~p~ QUESTIONS? CALL 761-8256 OR
EMAIL codes and aueensburv ne+
Person in Charge or Manager: ~~-~ r~ ~tsa ~ VISIT OUR WEBSITE FOR MORE
INFORMATION
www.aueensburv.net
Business Phone Number: ~ 8' 1-}-~ a
Type of Business:
~~,oi i a-m~,~~ 1
~~.c~ssc~ -z~s
~hz,~si.,
'~i' s'~ S
Owner of Property: ~-' ~ ~ a G°~sS LL
Phone Number(s): a~3•eSSS
Home
Cell
Owners
Address: 13 Z ~~ T~ K ~~ C ~ ~a..~~"foq~ S rrC~~ ~`/ 11 ~ ~ t!
II
Please provide an accurate layout of your store showing all walls, exits, stockrooms, rest rooms,
counters and fixture layout on a separate sheet of paper.
S o~-
Of ~erson sul~Fnitting this form
Notes /Comments:
58'~ • L y-SZ
Date: ~ I c~7
*Note: This application is for occupancy only, with no work requiring a building permit. No fee required for this permit
a~ a~~-~3s
EMERGENCY CONTACT UPDATE
TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 743-2502
PLEASE PRINT
DATE: ~ ~' ~ ° ~
BUSINESS NAME: LI<~ ~ L.LC , olba C~,,~-I~ ~~ ~_,}.}~,- yr~,,r-',~,
~
BUSINESS ADDRESS: 3 r $ ~ ~' d~ ~ ~ , ~z~ bw-~-~ ~, y -~-~~
BUSINESS PHONE: ~ ~ ~" ` 4-Fsac~
CONTACT 1: T~ HOME `~ y-S 7 ~ ~1
~"' ~-•s°''' PHONE °~Z~ ~£s-3
ADDRESS• ~ ~ A'~~~ s ' "", ~~c,.-.t ~(y la.~ot~
CONTACT 2: ~-~-~ ~ t -w~ HONE ~ ~7 ~ ~ 65~ 5
ADDRESS: 3 ~ °C~" ^'rs `~ t ~~-~^~ '~{ y r 186 z~
r
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 ANDJOR FIRE PERSONNEL.
TOWN OF QUEENSBURY FIRE MARSHAL'S OFFICE
Phone: 518-761-8206 Fax: 518-745-4437
~irencarshal@queensburt~ net - wwzv.queensbu a .net
Inspection for Permit to Occupy ~' 4s~ ~
fire Marshal's Office
Town of Queensbury
742 Bay Road
Queensbury, NY 12804
Phone: (518) 761-8206
Fax: (518) 745-4437
Request Recd Permit No.
Scheduled Inspection Date: S ` i D / Time: ~ ` 3 ~
Business Name: l rfl~~-~ ~ ~ov ~ n S~ ,-}£~,~~•
Location: daJ f~l-`~~YS~
T e of Ins eciion N A Yea No
EXITS:
Exit Access
Exit Enclosure
Exit Dischar e
EVAC Plan
AISLES:
Main Aisle Width
Secondar Aisle Width
EXiT SIGNAGE
Si n -normal
Si n -batter
EVAC si ns in rooms
TRUSS ID SIGNAGE
EMERGENCY LIGHTING
FIRE EXTINGUISHER:
Hun
Ins action of extin uisher
H dro extin uisher
FIRE ALARM SYSTEM
Fan Shutdown
Fire S rinkler S stem
Fire Su ression -kitchen
Fire Su ression -Gas Island
Hood Installation
Interior Finishes
Stora e
Com ressed Gas
Clearance to S rinklers
Clearance to Electrical
Electric Wirin Enclosed
Combustible Waste
Vehicle Im act Protection
Fire Lane
F.D. Si na e - Utilit Rooms
No Smokin Si ns
Maximum Occu anc Si n
Emer enc Evacuation Plan
COMMENTS
P Ct~'s(._ !7 dot
- Nt~.r~ Nr~~ ~ 3
C cNr Q l t u~ I c ~r-1 ~ >~-~r`-
SQ m N~ f k~ S~ s-}~,-.-
- `~nw,c~4 ~ ~
~J~QS ~. ~o~ncc .~fuo~,~~
5~~~ l ~w~
^ Approved pf no other approvals apply, the B & C Office v~r(II issue
Denied f
^ Call for Recheck \
Inspected By:
of Occupancy)
L:\FireMarshal\insptopermitto occupyform.doc
Inspection for Permit to Occupy
Fire Marshal's ~f~C~ Request Recd Permit No. _f~(Lc/ 7 Z ~ v
Town of Queensbury
742 Bay Road
Queensbury, NY 12804 c
Scheduled inspection Da
e: T ~~ Time: ~•~/~~~
Phone: (518)761-8206 t
Business Name:~,e~~~
>'pl~~.~'L ~
;;'7 "_
Fax: (518) 745-4437 ,
,
/
Location: _~j,~~~h.~/z- ,ems-.x.,~
T e of Ins action N A Yes No
EXITS:
Exit Access
Exit Enclosure
Exit Dischar e
EVAC Plan
AISLES:
Main Aisle Width
Secondar Aisle Width
EXiT SIGNAGE
Si n -normal
Si n -batter
EVAC si ns in rooms
TRUSS ID SIGNAGE
EMERGENCY LIGHTING
FIRE EXTINGUISHER:
Hun
Ins action of extin wisher
H dro extin wisher
FIRE ALARM SYSTEM
Fan Shutdown
Fire S rlnkler S tam
Fire Su ression -kitchen
Fire Su ression -Gas Island
Hood Installation
Interior Finishes
Stora e
C ressed Gas
Clearance to S rinklers
Clearance to Electrical
Electric Wlrin Enclosed
Combustible Waste
Vehicle Im act Protection
Fire Lane
F.D. Si na e - Utilit Rooms
No Smokin Si ns
Maximum Occu anc Si n
Emer enc Evacuation Plan
COMMENTS
Fire Marshal Ins a of
OK to Issue
~ 9 2007
~~
Approved (If no other approvals apply, the B & C Office will issue the Certificate of Occupancy}
^ Denied
^ Call for Recheck
L:\FireMarshal\insptopermitto occupyform.doc
Fire Mar
Town of Queensbury
742 Bay Road r ~aa I ~ ~ (s~
Queensbury, NY 12804 Scheduled Inspection Date: J 1 Time:
Phone: (518) 761-8206 Business Name: ~, ~~ ~~
Fax: (518) 745-4437
Location:
~a~ ( __
~ ~
T e of ins action N A Yes No
EXITS:
Exit Access -~
Exit Enclosure
Exit Dischar e
EVAC Plan
AISLES:
Main Aisie Width
Secondar Aisle Width
EXIT SIGNAGE
Si n -normal
SI n -batter
EVAC si ns in rooms
TRUSS ID SIGNAGE
EMERGENCY LIGHTING
FIRE EXTINGUISHER:
Hun
Ins action of extin uisher
H dro extin uisher
FIRE ALARM SYSTEM
Fan Shutdown
Fre S rinkler S tam
Fre Su ression -kitchen
Fire Su ression -Gas Island
Hood Installation
Interior Finishes
Stora e
Com ressed Gas
Clearance to S rinklers
Clearance to Electrical
Electric Wirin Enclosed
Combustible Waste
Vehicle Im act Protection
Fire Lane
F.D. Si na e - Utiltt Rooms
No Smokin Si ns
Maximum Occu anc Si n
Emer anc Evacuation Plan
COMMENTS
~tsl~s ~ ~~n~~S
^ Approved (If no other approvals apply, the B & C Office will issue
Denied '~~
^ Call for Recheck _
Inspected By:
Inspection for Permit to Occu y
SI1Cl~~S Office Request Recd Permit No.
of Occupancy)
L:\FireMarshal\insptopermitto occupyform.doc D ~~
d~
Inspection for Permit to Occupy
Fire Marshal's Office Request Recd Permit No. ~~`-~;J
Town of Queensbury
742 Bay Road p~-~ I L~ / t~
Queensbury, NY 12804 Scheduled Inspection Date: ~~11 l `~ ~ Time:
Phone: (518) 761-8206 Business Name: ~~'~ -~nllG.
Fax: (518) 745-4437 Location: ~~ ~ ~
T e of Ins ect(on N/A Yes No
EXITS:
Exit Access
Exit Enclosure
Exit Dischar e
AISLES:
Main Aisle Width
Seconda Aisle Width
EXIT SIGNAGE
Si n -normal
Si n - batte
TRUSS ID SIGNAGE
EMERGENCY LIGHTING
F{RE EXTINGUISHER:
Hun
Ins ection of extin uisher
H dro extin uisher
FIRE ALARM SYSTEM
Fan Shutdown
Fire S rinkier S stem
Fire Su ression -kitchen
Fire Su ression -Gas Island
Hood Installation
Interior Finishes
Stora e
Com ressed Gas
Clearance to S rinklers
Clearance to Electrical
Electric Wirin Enclosed
Combustible Waste
Vehicle Im act Protection
Fire Lane
F.D. Si na e - Utilit Rooms
No Smokin Si ns
Maximum Occu anc Si n
Emer enc Evacuation Plan
Approved (If no other approvals apply, the B & C 01
o Denied
^ Call for Recheck
Inspected By:
COMMENTS
~~~~~
c~ml~~4~
OK t0 issue
/~~
L:\Sue Hemingway\Fire Marshals Office Inpsection 08.17.2005.doc
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