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Application kEGEME IIII IIII CERTIFICATE OF OCCUPANCY ONLY Qfseust4nK APPLICATION ►a.mRt (M �nn0�04� 'L�LI s, P~far.S (I!Y 742 a"Row.Ou«nsbwr,W 1=Ma inrace r. P 51L7614M w 51a-7614M Vflrff rjt2MkVf art "This application is for occupancy only, with no work requiring a building permit•• BUSINE56 INFORMATION Name of business:,fin(t'L� Business Address (including suite, space, etc.):Sr R V I c+, 1rl w �. eu, tr�sbury N'� Id�u�4 Detailed explanation of business (attach a separate piece of paper, if necessary): R-C+oy l - ill ) n a allbtUt'�►'l :••Please provide an acmate tayaac of yow spate s6owft all wads, ezks, stod=*ms, rest rooms, counen aed rocum oa a separate smear 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 Marshars office. Fire extinguishing systems found in kitchens and gas stations require semi-annual inspections. Any violations noted du�an inspection require immediate corrective action and are inspection Applicant name: p Applicant signature: Date: b Property Owner name: Jason Tyler Property Owner signature: _Jason Tyler -�--- w+-� 8/13121 r,n�nnww CaWkso of oaupncy ON, rw/Or•at 11120 '+ Jih 742 Ray Road,Qw ni",NY IZRW PSia-761 i206 or SiL761-RZRS w7lw�nfQyp,n�j EMERGENCY CONTACT INFORMATION "THIS FORM IS USED TO ASSIST EMERGENCY SERVICE PERSONNEL WHO MAY BE CALLED TO YOUR BUSINESS AFTER HOURS. PLEASE BE SURE THE CONTACTS LISTED BELOW ARE WIWNG AND AVAILABLE TO REPSOND DURING OFF-HOURS TO ASSIST POLICE AND/OR FIRE PERSONNEL IN GAINING ENTRY TO YOUR BUILDING." PLEASE BE ADVISED THAT FAILURE TO ASSIST EMERGENCY SERVICE PERSONNEL MAY RESULT IN DAMAGE TO YOUR BUILDING By POLICE AND/OR FIRE PERSONNEL Date: ' )3 _a 1 Business Name:4-la, Business London(I^^qquding suite,space,etc.): S 1 O /'"1'y t a+i pn k c)Q j__ _ u er Sty ru Ny 1aso4 - Business PAorte _ 1. Business contact name: cJ�tj��b f / UI ✓ Main Phone: � a_(S 1 LS 1 `41 No n Ph ne:_u Coming from what town/vvNIW?G( ►e m 2. BUSIneSS cantaa nanw. JC] , CaUW-)q LlQh Main Phone _IJ O 1 •$eMANY Phoo Coming from what town/vlNaNe)�I'� TOWN OF OUEENSOURY FIRE MARSHAL'S OFFICE P: 51&761-820E F:51&7454137 Cnt FRE MARSHAL MRCE PALMER DEPUTY Fum MARSHAL GARY STujImm Certdlola d Omipray onr: Rtwa1 tw'oMar MCI 5EC 211, �16 2021 D QUEENSBURYG& CODES CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Applicant: Name(s): Mailing Address, C/S/Z:ly DIA110. Cell Phone: (R )�$� �{ �()� LadLlne: 1Email: � n13 1 � _ /1 t • business Owner Contact Name(s): C �� Mailing Address, C/S/Z: q 1 Cell Phone:_ 0N 63 Land Line: _( Email: — -- — • Manager: Contact N ime(s): Mailing Address, C/S/Z: 1 ) Cell Phone:_ Land Line: _(_ Emai • Property Owner(s): Business Name: Aviation Mall NEWCO, LLC Contact Name(s): Jason Tyler Mailing Address, C/S/Z: 578 Aviation Rd Queensbury NY 12804 Cell Phone: _(_J Land Line: _ 5( 18 )793-8818 005 Email: com Contact Person for Compliance In regards to this project: Cell Phone: "70 Email �� Unit: en am Crabn a1 O=ww"Ony s.wr D�oriiw 7010 �■/�!Nin�i■/■■■■■■■/■ ■■■■■■//■ "■ ■/■■■/■■■■■/iiiiiEMO i■■ A Not MEMO mom an all AM NO ad �'iI1Ill1lls�li�•.: ,+f►■Gq■■■�■■■//////■■■�I1 _ ■■/Do■o F1111111loin rL = o m��■�/�■■�■■■�■■■�■■�■N■0InONO■■ i � ■■ ■ ■ l ■on *agoo �� ■�■■� ■■/■icR1■[:■■■m■ t■■�iiii■i�■i■/ ■�■■■■■■■■ OJ�q MOMS ap so N VON ■■■■//■■■/■■■■■■:/t■A■■/■ /■■■■■■■�ii �1■ // ■//■■■ � ■�■any■■■■g■mom ■■■■■■■ ■■_■■■■■■/■■/ ON ■/■■■ mom 0 NOON mmoom No mm Memos MCA■c�c■n■■rcA■■■■■■ ■■mmmkv%NNND�dom NNE No 0 !/■■■■■■■■■■ mmosicAss ON MEMO an A■■ ■m/■E:l�v■■7■■■■■■r/■Fo(tR1■/■■■■■■ ■ �la s�1�1�� m■m■a0 01-110 NEWSMEN RAISE Not ■i r■m■■■■■■■■■■■■■■.r■■■■■■■■■■■■■ . /■■■■■I■/■■■miom■/■■miJ�� ■■■■■■■/■■■■ mom ■m■■■■d■■■■■■!Cs■ F■■■■■■■■■■■ ■■■■■■■■■■■■■■ m/■■MEN■mom ■�l■■■■■■■■■■ .. ■■■ ■ Ems ■■■Ira l■■■Di■■■■■■!■■i■ ■■■■■ ■■■ ■■■one 1■a■sl■■■■■mo■mos gmDs■■■■moss ■■■ ■[:3■mni Ism■so■m■I■I!■ommmm■■■■■■momo■ moms ■moffi;■iiim■■ so'X■■■■■■omom■mm■■m■ ■■■o■ENO Oslo oval IFN!pm<1m■mmi■m■m■1■ommom■mm■mmo■ ■■■■■■■■Meiji sisal/m■ams■■■!■■■■piammomm■■■■■■■■ ■■■m■ss■■ui■11■ ■4i lzmmm■miim■■ ms■■mso■moommms ■■■-!■■■fur■Icw [mmmom■ommo!■ONSEEs■■m■mm■■m ■■■:'■■■■�JJ N■i /■iYr!■■■mmss■ 11JII■sm■■■■■■■m■ s■f�'!o■/■■omon _frlmm■■s■■■ssoms mmommmmmb■mE-rm■■m■■■■mrt ■ir•r■mm■■■mmm■ mm■mm■■■■■■■■■■ ■■Rylm■m■■mo■om ■C■[mismmI■s■■ m■■s■■mmm■mmm■■ ,a a� 00 N� t4N ..�► � MALL r_ �Ao 61� ^QTall 21O Np � a i ..