2003-304 BP File#
New Business
Dept of Community Development Of
Town of Queensbury
742 Bay Road
Queensbury,NY 12904
(5-18) 761-8256
For occupancy only,with no work requiring buildingpermit.- no fee required for this permit.
RECEIVSD
MAY 1 9 2003
Name of Business: - E 'OWILDINGN OF r ^ C qAND CODE
UEENSBURy
Address: V\/ V
Person in Charge or Manager: -A C-
Business Phone Number: �
Type of Business: (i.e.,mercantile,restaurant,hobby shop,plumbing store):
Owner of Property: D -e.
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Address: — 4H-C, 0 r
Phone Number: C1. 12,— S-
Please provide an accurate layout of your store showing all walls, exits, stockrooms, rest rooms,
counters and fixture layout an a separate sheet ofpaper.
Signature: ate:
ofperson submitting this form:
Property Tax Map No.
Notes/Comments:
Town of Queensbury (13—
Fire Marshal's Office &ECEIVE6
EMERGENCY CONTACT UFDAT92803
LTRS 2000 UV OFLD11V Qtf�,cA/Say&y
TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 7
PLEASE PRINT
DATE: CA � /a -� -
N
BUSINESS NAME-
BUSINESS ADDRESS: V
BUSINESS PHONE: 61 9,
HOME 9
CONTACT 1: -c- -PHONE
TOWN RESPONDING FROM:
HOME
CONTACT 2: C- C, I-VI10NE—'
TOWN RESPONDING FROM:
HOME
CONTACT 3: D. -- PHONE�
TOWN RESPONDING FROM: G
Fire Marshal Steve'Smith, Deputy Fire Marshal Mike Palmer
Phone 761-8205, F.A.X 7454437
EDDY CHIkOPRACTIC Receiv
32 South Western Ave. 10 .
'Qiieensbury,NY �' Y
Tpwjv OFQUL
(518) 743=922 $DILDI�ICAiyD�S��RY
- CpDE
INCASE OF EMERGENCY ,
1. CALL 911.
2. YELL FIRE.
3. IMMEDIATELY EVACUATE,
4. MIEET OUTSIDE.AT,.TH.E LARGE TREE TO ,THE
RIGHT OF THE PARKING LOT.
5. DOCTOR. OR. THE-RAPISTS: BE SURE YOUR:
PATIENT IS WITH YOU. '
6. DR. EDDY,WILL MADE SURE EVERYONE IS OUT
SAFELY,
7.=DR. EDDY WILL MEET EMERGENCY CREW.
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