CO-0259-2022 CERTIFICATE OF )CCU_P_ANCY O.N.LY_-Of ice use only
APPL T HIV E Q �I E F�I Permit#: CO' 02�j-A ZZ•
Ind LHAY
� Permit Fee:$Tos+n of(LuccnsburyY0e.'?742 Bay Road,Queensbury,NY 12804 _ _.. B Invoice#: S
OWN OF OI.�C-.'��i�S��U iy
P:518-761-8206 or 518-761-8205 www. uee sbTi .netl
**This application is for occupancy only, with no work requiring a building permit"
BUSINESS INFORMATION:
Name of business: 2UPUm q L. L C f� �,1�`�.� . E-L—L
Business Address (including suite, space, etc.): I y 3 '�Aa-Fe R O
T
I a Kp G'e ae. Nil 12 8 u5
Detailed explanation of business (attach a separate piece of paper, if necessary):
Came l�leNIOV414-U &6jaiG
* * *Please provide an accurate layout of your space showing
all walls, exits, stockrooms, rest rooms, counters and factures
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: -- ck 1 e' a
Applicant signature: Date:-
Property Owner name:
Property Owner signature: Date:5116 z 2
Certificate of Occupancy Only Revised February 2022
Oof(Z..�,bwyn
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:
Name(s): '4 PCA 1 �l o 6
Mailing Add s, CS/Z: +
Cell Phone: ( 5I )_2 �o - (5gcr-a Lddd Line: ' ( 51.9 ) ('„3 (; 5' aAq W
Email: olll'
USA
c�`� • Business Owner(s):
Contact Name(s): ►'
Mailing Address, C/S n I
Cell Phone:_(�18 ) Ce q - O $q �' Land Line: _( .5 8 )��3(a L�
Email: y.0 a OtYV) + Q 0VIVI
• Manager:
Contact Name(s): SOS h ' a E h-era bl%
Mailing Address, C/S/Z: OR h �-
Cell Phone:_( ) O - 2 Land Line: _( )
Email: CO 0*1
• Property Owners : 0\C)C1<f'f
Business Nam
Contact Name(s): Pik
Mailing Address, C/S/Z: 0 �n-Yf 4 L vi -r 44
Cell Phone:_(5�) Z. C2q — and Line: _(51 g ) (� ' �' Ll Y.
Email: G O� �'l b V►'1
Contact Person for Compliance in regards to this project: ek -P'rgb1 J
Cell Phone:L ) o Land Line: )
Email-) 1 .
Certificate of Occupancy Only Revised February 2022
Tossm of(Zuccnsbun•
742 Bay Road,Queensbury,NY 12804
P:518-761-8206 or 518-761-8205 www.gueensbury.net
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 WILLING 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: S d lr_7`
Business Name:pefq OGI�� 1.��
Business Location (including suite,space,etc.):
12 9
Business Phone#: �� ^ . 2( i"1 5tg— . G .7(o 5 Y LI.Q
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1. Business contact name: . t'a�7 ,.,Q
Main Phone:_(-SAL)
,( (A-0 ,,� ; Secondary Phone:_( )
Coming from what town/village? U t nS
2. Business contact name: 1 vo P "I^a
Main Phone:_(23 q ) `j�2 O—"I` 9j ; Secondary Phone:_( )
Coming from what town/village? NJ
TOWN OF QUEENSBURY FIRE MARSHAL'S OFFICE
P: 518-761-8206 F: 518-745-4437
FIREMARSHAL@Q UEENSBU RY.N ET
FIRE MARSHAL MIKE PALMER DEPUTY FIRE MARSHAL TYSON CONVERSE
Certificate of Occupancy Only Revised February 2022
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RETAILSPACE FF
288.1 2-1-1 CO-0259-2022 ®®
RocketFizz pE."Wv[b.4E..UFNIXEA � CONSULTANTS
1483 State Rte 9 �� -- STORAGE Wrt1 T[wl
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FIRE MARSHAL'S OFFICE
Tozvn of Queensbury
742 Bay Road, Queensbury, NY 12804
"Home of Natural Beauty ... A Good Place to Live "
PLAN REVIEW
Rocket Fizz
1483 Route 9
CO-0259-2022
5/11/2022
The following comments are based on a review of submittals:
• Verify fire extinguisher location and inspection
• Location of exit/Emergency lighting appear adequate. Function test will be
required
• Lock/ latches shall comply with Chapter 10 of 2020 IFC.
• Verify paths of egress
• Verify storage, including basement
• Verify clearances to electrical service panels
• CO detection is required, if source is present
• Knox Box key is required
• Fire.alarm system inspection and monitoring report required
Michael J Palmer
Fire Marshal
742 Bay Road
Queensbury NY 12804
firemarshal@queensbury.net
Fi.r e Marshal 's Office Phone: 518-761-8206 Fax: 518-745-4437
-firemarshal@queensbualt.net 7V7Vw.queensbun1.net
INEwv�RK Department
STATE OF
OPPORTUNITY ®f Health
KATHY HOCHUL MARY T.BASSETT,M.D.,M.P.H. KRISTIN M.PROUD
Governor Commissioner Acting Executive Deputy Commissioner
J
May 9, 2022
Ygal Elgerabli ONE—an
1444 State Route 9, Suite 8 hcj"S':-12I dC a0 NMOJ
Lake George, NY 12845 -a ®�
Re: Rocket Fizz/Perfuma
Facility Code: 56-AC54 (Proposed)
Queepsbury(T), Warren County, 0 R,
�.- _- !—
Dear Mr. Elgerabli:
This office is in receipt of an Application for a Permit to Operate (DOH-3915), Food Service
Establishment Basic Information Sheet, kitchen floor plan, and numerous ancillary documents
regarding the conversion of Rocket Fizz/Perfuma (formerly Frankie's Pizzeria) to be located at -
1483 State Route 9, Queensbury (T), received April 27, 2022. In reviewing your submission, we
find your proposal to be in substantial compliance with the New York State Sanitary Code
(NYSSC), with the following conditions, and pending the satisfactory completion of a pre-
operational inspection by a representative of this office:
• In accordance with the application, you indicated the seating capacity will be 43 seats.
• All food that requires washing, straining, or will be thawed under running.drained water
must be done in a separate designated food preparation sink or in one of the bays of the
3-compartment sink conditional that the sink bay is thoroughly cleaned and sanitized in
between use. Mounting of chemical and soap dispensers above sink bays where food
prep will occur is prohibited.
• Use of a reduced oxygen packaging machine (vacuum sealer) at the facility to package
food product and Sous Vide cooking is prohibited without approval from the Glens Falls
District Office.
• As a reminder, minimum 4" baseboard coving must be installed at all floor and wall
junctures in food storageand food pmparation areas.to facilitate easv cleaning. The
coving must be smooth, easily cleanable, and non-porous.
• Please note that mechanical ventilation or an openable window to the outside must be
installed in all restrooms. Restroom doors must self-close and latch.
• Please note that no person is to work in a food service establishment in a capacity which
can result in contamination of food or food contact surfaces with disease-causing
organisms; while infected with or carrier of disease-causing organisms capable of
transmission by food; or, while afflicted with a boil or infected wound. As such, this office
suggests that you establish and adhere to a protocol that addresses the treatment of
infected wounds, the screening and exclusion of staff from food handling based on
illness or symptoms, and the reporting of all allegations of patron illness (that which may
be food borne) to this office with 24 hours. It is strongly recommended that your protocol
require the exclusion of ill food workers exhibiting gastrointestinal illness for at least 48
hours after the cessation of illness symptoms. These procedures, along with satisfactory
hand washing, and prevention of bare hand contact with ready to eat foods, constitute
Empire State Plaza,Corning Tower,Albany,NY 122371 health.ny.gov
the most significant-barriers to the potential spread of illness at a food service
establishment.
• Basic CPR equipment must be maintained at the facility. A brochure detailing your
requirements has been included for your review.
As a reminder, section 14-1.190(a) of the New York State Sanitary Code (NYSSC) requires
you to obtain a valid Permit to Operate prior to operating your facility. Please contact me
at (518) 793-3893 to schedule a pre-operational inspection.
Sincerely,
Corey il_orenzo
Principal Sanitarian
NYSDOH —Glens Falls District Office
77 Mohican St.
Glens Falls, NY 12801
(518) 793-3893
Encl: CPR Brochure
cc: Ms. Rebecca Bussert, GFDO
[Que nnsbury_(T)-Code-Enforcement
File