2004-912 TOWN OF QUEENSBUIRY -
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
4E L -
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20040912 Date Issued: Monday, December 20, 2004
This is to certify that work requested to be done as shown by Permit Number P20040912
has been completed.
Tax Map Number: 523400-303-016-0001-061-000-0000
Location: 438 DIX Ave #32391
Owner: MAPLEWOOD ICE CO., INC.
Applicant: MAPLEWOOD ICE CO., INC.
This structure may be occupied as a:
By Order of Town Board
Certificate of Occupancy (COM) TOWN OF QUEENSBURY
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040912 Application Number: A20040912
Tax Map No: 523400-303-016-0001-061-000-0000
Permission is hereby granted to: MAPT,RW00D TCF, CC).. TNC.
For property located at: 438 DIX Ave 432391
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: MAPLEWOOD ICE CO., INC.
#32391 Certificate of Occupancy(COM)
PO BOX 62 Total Value
WHITEHALL, NY 12887-0000
Contractor or Builders Name /Address Electrical Inspection Agency
Plans&Specifications
2004-912 MAPLEWOOD ICE CO. INC.
CERTIFICATE OF OCCUPANCY
$0.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Tuesday, November 29, 2005
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the T wn o ueen ovember 29, 2004
4c!��
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Nov 15 04 04: 41p MAPLEWOOD ICE 4992347
p. 1
Town of Queensbury
Fire Marshal's Office ��Q
EMERGENCY CONTACT UPDATE
LTRS 2000
TO: WARDEN COUNTY SBERIFF'S DEPT. FAX: 761-6210
PLEASE PRINT
DATE: / I S� �2—vu L1
BUSINESS NAME: IW 4' ''L e Cc j&c'D �'E 6—�e
BUSINESS ADDRESS: _
BUSINESS PHONE-.— .� �1�7 J S
�+.� HOME
CONTACT 1: r.VI ' Jr' PHONE /J-�1�-7 4�29"
TOWN RESPONDING FROM:
_ now 7 Y �--� � 7j Cw/
CONTACT 2: 4 G (Y s �r' /-� Gl�"j<r !� pgONE t`��' --t ! H)
TOWN RESPONDING FROM: A�ry �ti r(-% f ,
HOME r7` -7-137I �
CONTACT 3- ����� PHONE 7 11 7- IFn 7
TOWN RESPONDING FROM:
Fire Marshal Steve Smith, Deputy Fire Marshal Mike Palmer
Phone 761-8205,FAX 745-4487
r BP File �1�---
Ne�$ASi11eSS
Dept. of Community Development CeY'tlflCate Of
Town of Queensbury Occupancy Permit
742 Bay Road
Queensbury,NY 12804
(518) 761-8256
For occupancy only, with no work requiring buildingpermit: no fee req
NOV 16 2004
'OWN OF QUEENSBURY
BUILDING AND CODE
Name of Business: 4114-,de ty Lo n �-
Address: q.3,�- Z)IIY 1171e. uz%f t O
Person in Charge or Manager: 0"10/ (V o 0 c
Business Phone Number: 43 S= 2SI S L -ed 3eW s-3 6
Type of Business: (i.e.,mercantile,restaurant,hobby shop,plumbing store):
Owner of Property: 1W,011eziva e,0 G
Address:
Phone Number: FO6 - 3�- 2 S 7'S ^e
Please provide an accurate layout of your store showing all walls, exits, stockrooms, rest rooms,
counters and fixture layout 7onZsep;Qsheet fpaper.
Signature: ate:Uopersform:
Z r
Property Tax Map No. J d3 / 16 l / f� 6
a
Notes/Comments: / L
Ce S,—
Town of Queensbury
Fire Marshal's Office
742 Bay Road
Queensbury, NY 12804
Phone (518) 761-8205 Fax(518) 745-4437
Fire Marshal's Inspection Report
Request G �/ SCHEDULE
I I Received: Permit# INSPECTION ON: `
=tie'
Name: iM�1n'�4�-�(�'�% AM ANYTIME
Location: `✓ `�...` �'
APPROVED
N/A, YES NO COMMENTS
EXIT ACCESS
EXIT ENCLOSURE
EXIT DISCHARGE
MAIN AISLE WIDTH
SECONDARY AISLE WIDTH UAo&(
EXIT SIGN-NORMAL N Nv—
EXIT SIGN-BATTERY
EMERGENCY LIGHTING
FIRE EXTINGUISHER HUNG
FIRE,EXTINGUISHER v
INSPECTION
FIRE EXTINGUISHER HYDRO v
FIRE ALARM SYSTEM n
-FIRE ALARM -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
VEHICLE IMPACT PROTECTION
FIRE LANE
F.D.SIGNAGE-UTILITY ROOMS
NO SMOKING SIGNS
MAXIMUM OCCUPANCY SIGN
EMERGENCY EVAC PLAN
OK THIS DATE OK - CO NOT OK
INSPECTED
COMDEV/CHRISJMIORD/LETTERS2001/F IREMARS HALINSPECTIO NREPORT11022001
WHITE-BUILDING DEPARTMENT COPY YELLOW-OCCUPANT COPY
Town of Queensbury
Fire Marshal's Office
742 Bay Road
Queensbury, NY 12804
Phone (518) 761-8205 Fax(518) 745-4437
Fire Marshal's Inspection Report
Request ' , SCHEDULE
Received: Permit# "� w INSPECTION ON:
i�
Name: . �'nd10��, LUv C- 1 a� AM PM ANYTIME
Location: `� 'p`y 1�.
APPROVED
N/A. YES NO I COMMENTS
EXIT ACCESS
EXIT ENCLOSURE �.a c N UK�Cz+ t.E{ 2�
EXIT DISCHARGE
MAIN AISLE WIDTH U4 Ct
SECONDARY AISLE WIDTH
EXIT SIGN—NORMAL
EXIT SIGN-BATTERY
EMERGENCY LIGHTING
FIRE EXTINGUISHER HUNG �}•�i � �. �v+ '�%�
FIRE EXTINGUISHER j
INSPECTION
FIRE EXTINGUISHER HYDRO
FIRE ALARM SYSTEM
FIRE ALARM -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
VEHICLE IMPACT PROTECTION
FIRE LANE
F.D.SIGNAGE—UTILITY ROOMS
NO SMOKING SIGNS
MAXIMUM OCCUPANCY SIGN
EMERGENCY EVAC PLAN
OK THIS DATE ® OR CO NOT OK
INSPECTED BY
COMDEVIC HRISJIW ORDILETTERS2001/F IREMARS HALINS PECTIONREPORT11022001
WHITE-BUILDING DEPARTMENT COPY YELLOW-OCCUPANT COPY
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