2002-217 rr
i IN
TOWN 0"F OUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
CommuniV Development•.Building&Codes (518) 761.8256
occup
CATE v
It JL IFI AN
Permit Number. P20020217 Date Issued: Friday,April 12,2002
This is to.c4 that work requested to be done as shown by Permit Number P20020217
has been completed,
Tax Map Number; 523400.289-620.0001.005-000.0000
Location: 169 HAVILAND Rd
Owner, BAY WEST ASSOCIATES LLC
Applicant; HEALTH FOCUS OF NEW YORK
This,structure may be occupied as a:
ByOrderof Town Board,
Certificate of Oecu ancy(COM)
TOWN OF QUEENS$URY
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: P20020217 Application Number: A20020217
Tax Map No: 523400-289-020-0001-005-000-0000
Permission is hereby granted to: HEALTH FOCUS OF NEW YORK
For property located at: 169 HAVELAND Rd
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 Addr,ess: BAY WEST ASSOCIATES LLC Certificate of Occupancy(COM)
169 HAVILAND Rd Total Value
QUEENSBURY,NY 12804
Contractor or Builder's Name Address Electrical Inspection Agency
Plans &Specifications
2002-217 HEALTH FOCUS OF NEW YORK
CERTIFICATE OF OCCUPANCY ONLY.NO STRUCTUAL WORK TO BE DONE
$0.00 PERMIT FEE PAID - THIS PERMIT EXPIRES- Saturday,April 12,2003
(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 f�;f Q ay,April 12,i002
SIGNED By for the Town of Queensbury.
Director of Building&Code Enforcement
BP File#
Dept. of Community Development 404BW-'tIr1C3VLt4a Of
Town of Queensbur Occupancy Permit
, y
742 Bay Road
Queensbury, IV]'12804
(518) 761-8256 "F0
For occupancy only, with no work requiring building permit: no fee required for this perambW%`f
. APR 0'2 2062
TOWN OF QUEENSi3u,,,.
AND CODE
Name I of Business: A-ec I-% k-ocu-s 0 � 4` \�4`�
Address: a tj V" a
Person in Charge or Manager: V'%.C'
Business Phone Number: -I Iq 3-sei36
Type of Business: (i.e.,mercantile,restaurant,hobby shop,plumbing store):
Me 11co ve re-co JS
Owner,of Property: ocke-
Address:
110 q
0%&ecvxs6u!!�j
Phone Number: /S- 7 4 S 1-4400
Please providean accurate layout of your store showing all jvalls, exits, stockrooms, rest rooms,
counters and fixture layout on a separate sheet ofpaper.
Or 4/Signatub,- - ) Date: 2-
of person submitting this form:
Property Tax Map No. 46
Notes/Comments:
—rC:)XM" C)or-= ClUEEVEMSOUF;Vr
ClUr-=f-=Mc3E3Uf:;,w-v-, "-V- 12804
C5118) 769-8205
FIRE MARSHAL INSPECTIC:>N REPORT
REQUEST RECEIVED PERMIT W
NAME IA e-a-I +:h ry L,4
L(DOATION
SCHEDULE INSPECTION ON
AK<cm--)ANYTIME
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY 1-1(31-ITING
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION
INTERIOR FINISHES
STO RAGE:
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING UNITS
REQUIRE-D SIt NAC3E
CHIMNEY
WOOD STOVE
FIREPLACE — MASONRY
FIREPLACE — FACTORY BUILT
REMARKS: OK TO THIS DATE
fA NJ4-161a+t6rj-�7
INSPEC 0
FIRE MAF2SH.4L
-r(Z)VVf%J OF QUaf-==NIc3E3UF;Zkir
CD!LJaaNJE3;E3UF;,'N*'. MY 92004
(518) 761-82O5
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVED PERMITWV
NAME
LOCATION
SCHEDULE INSPECTION ON
A �M ANYTIME
APPRC>VED
N/A 'YES NO
EXITS
AISLE WIDTHS
EXIT SIC3NS
EMERGENCY LI(3H-FIN(:3
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRfNKLEP, SYSTEM
FIRE SUPPRESSION SYS-FE
HC)OE> INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRI KLERS >ell
CLEARANCE -rC:) H IN(-- UNITS
REQUIRED SIr, NAC3E.
CHIMNEY
wac>D S-rc>vr-=
FIREPLACE - MASONRY
FIREPLACE - FACTO RY BUILT
F:ZEMARKS: ,(DK -IFC> THIS DATE
6cuc:�K e-Xt
INSPSUF>.FUE3 INS E TOR
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BAY WEST ASSOCIATES, LLC
FLOOR PLAN 163 HAVILAND ROAD
SCALE, 1,8"= V-0" QUEENSBURY, NY 12804