CO-0243-2022 �v
V
CERTIFICATE OF OCCUPANCY ONLY Office Use Only
APPLICATION Permit#: Cb-D�'292Z
Toim ofC nsbury Permit Fee:$
742 Bay Road,Queensbury,NY 12804 Invoice#: M)t)
P:518-761-8206 or 518-761-8205 www.gueensbury.net
IE C0
"This application is for occup P -n-ly;`wit quiring a building permit"
BUSINESS INFORMATION: R MM 0 4 2022
Name of business: S VI &NV A-T Mil OF QUEENSBURY
DING 9t ES
Business Address (including suite, space, etc.): '7�� UPPED �L�N ST
Detailed explanation of business (attach a separate piece of paper, if necessary):
rc—P ! GUc-F- S'O�K V i G&S
***Please provide-an accurate layout of your space showing
all walls, exhs, stockrooms, rest rooms, counters and Mures
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 Queensbu ry-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: jW/Vl280&t Kl
Applicant signature: �`` Date:
Property Owner name: L ?A-C-LEN �P
Property Owner signature: Date:
Certificate of Occupancy Only Revised February 2022
Trnvn of Qtnecn&i
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
l
• Applicant:
Name(s): WL P010PRO (NSi6-- I
Mailing Address, C/S/Z: 2S MPpOM-16 C 612GIe I -NITS I M I A-LBAN `I' N Y 1 Z203
Cell Phone: ( SIR ) ZO C-4-09 3 Land Line: ( SI9 ) fU21-00-1-S
Email: I'd lely rL r- (,Oni
• Business Owner(s):
Contact Name(s): 11T� � ITA-?
Mailing Address, C/S/Z: :73,(,- UP PEE& 6--LENN LST. . 0-VF,-aV-SV UP--`( r NX Z904-
Cell Phone:_(q) 1 !3-- !�Z,64�a Land Line: _( S-i 9 ) �7qZ- 1 of `ZZ
Email: x F a o Ina 0> VVa M Q 6 a fM /h 1T GdIM
• Manager:
Contact Name(s): XV C WAN6- (R ITA-)
Mailing Address, C/S/Z: 731; UrPC—K C--W fF , 6 EENSPUPLY, 6`V` 17
Cell Phone:_( 'I I 7 16 —9 E C6 Land Line: _( 72 Z 41 yZ
Email:
.• Property Owner(s):
Business Name: PLA7_AG-BEN LIP
Contact Name(s): PA-UL nJ)MV72-01N's!c 1
Mailing Address, C/S/Z: ;Z 5 Gr7l2i�9V-A=TE QP-L-E, S-V17t 10Y. f-I-M-N , N)' I2Z0,2
Cell Phone:_( S' 19 ) ' 2.6 r- 4093 Land Line: _( S 4S2 -- 00 Gi S
Email: j2 lA td o h aff-wao-eo S'. C-0M
Contact Person for Compliance in regards to this project: P 4u L PRO y9ow-s'KI
Cell Phone: Land Line: -C� 1 ) +52 - 00q S
Email: w/I rn 0Y4604,0 �V1 �-�✓,Q V-1,S-P_s. COM
Certificate of Occupancy Only Revised February 2022
TMSM ofQutcnshury
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:
Business Name: S MW tvA-4 L
Business Location (including suite,space,etc.): 796 V PPE L-LOV ET.
l,VeENTF V 9 -�Y 12-90-4
Business Phone#: L� .72 -- 19 '27_
1. Business contact name: xVc N c— (Amk)
Main Phone:_( 91 7 ) 6I [9 "9 C 6W ;Secondary Phone:_( 646 ?Q7- 2V 19
Coming from what town/village? HUP-CON PA-USd NY
2. Business contact name: YVKI L( U
Main Phone:_( 6 3 ) 722- 6�( ;Secondary Phone:_( 71 b
Coming from what town/village? 0-11 (VsRUr-Y0 Ny
TOWN OF QUEENSBURY FIRE.MARSHAL'S.OFFICE
P: 518-761-8206 F: 518-745-4437
FIREMARSHAL@QUEENSBURY.NE
FIRE MARSHAL MIKE PALMER DEPUTY FIRE MARSHAL TYSON CONVERSE
Certificate of Occupancy Only Revised February 2022
FIRE MARSHAL'S OFFICE
Town of Queensbury
742 Bay Road, Queensbury, NY 12804
"Home of Natural Beauty ... A Good Place to Live "
PLAN REVIEW
Swan Nail
736 Route 9
CO- 0243-2022
5/4/2022
The following comments are based on a review of submittals:
• Verify fire extinguisher location and inspection
• Verify location of exit/Emergency lighting. Function test will be required
• Lock/ latches shall comply with Chapter 10 of 2020 IFC.
• Verify paths of egress
• Verify storage
• Verify clearances to electrical service panel
• CO detection is required
• Provide an entry key to be locked inside plaza Knox Box
Michael J Palmer
Fire Marshal
742 Bay Road
Queensbury NY 12804
firemarshal@queensbury.net
Fire Marshal 's Office - Phone: 518-761-8206 Fax: 518-745-4437
.firemarshal@queensbunt net - www.queensburi/.net