2001-338 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20010338 Date Issued: Tuesday, May 29, 2001
This is to certify that work requested to be done as shown by Permit Number P20010338
has been completed.
Tax Map Number: 523400-074-000-0001-016-000-0000
Location: 1161 STATE ROUTE 9
Owner: DONALD J DANIELS
Applicant: COUNTRY CAFE
This structure may be occupied as a:
By Order of Town Board
Certificate of Occupancy (COM) TOWN OF QUEENSBURY
(---- 4•19 ?St
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: P20010338 Application Number: A20010338
Tax Map No: 523400-074-000-0001-016-000-0000
Permission is hereby granted to: COUNTRY CAFE
For property located at: 1161 STATE ROUTE 9
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. Tie of Construction Value
Owner Address: DONALD J DANIELS Certificate of Occupancy(COM)
1 GILMORE Ave Total Value
QUEENSBURY,NY 12804
Contractor or Builder's Name/ Address Electrical Inspection Agency
Plans &Specifications
2001-338 COUNTRY CAFE
CERTIFICATE OF OCCUPANCY ONLY. NO STRUCTUAL WORK TO BE DONE.
$0.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Thursday,May 29,2003
(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 a he To �ee�ns,,b{+�y/Tuelda 29,2001
SIGNED BY V�q/NFE)tf � fly�/�z foe the Town of Queensbury.
Director
irect�o/.,rof,B_uuiillding& ode En orcement
LBPFile# ;WO-339
New Business
Dept. ofCommunity Development Certificate of
Town Road
nsbury
742 Bayay Roa Occupancy Permit
Queensbury, NY 12804
(518) 761-8256
For occupancy only, with no work requiring building permit: no fee required fpSt je{Qtrj` ,CD
MAY 2 5 200i
raw✓N OF QUEENS8URv
BUiIkND CODE
Name of Business: C 0 U n'Pry (T OSl°,
Address: I/.59 Lo uk- /✓eenau y /U)
Vance. fc�✓�0�/
Person in Charge or Manager: ( O ken
Business Phone Number: 5/ - 796- 5077')
Type of Business: (i.e.,mercantile,restaurant, hobby shop, plumbing store):
re5+-a.J rc3xi {'
Owner of Property: A/t A(lI2
6 is
Address: Z ' I✓nf9re , ✓, eensky-
Phone Number. / /3 " 536/9
Please provide a layout of your store showing all walls, exits, stockrooms, rest rooms, counters
and fixture layout on a separate sheet of paper.
Signature: it Date: 5 025
on submitting tltls form:
Property Tax Map No. / / .
Notes/Comments:
as
FIRE SHAL
#11110 TOWN OF Q EENSBURY
•�1j QUEENSBURY. NY 12804
(518) 781.8205
FIRE MARSHAL INSPECTION REPORT 2
REQUESTR. EIVED , PERMIT# ( -332
NAME Pitt i.
LOCATION f..Kam.Q'
SCHEDULE INSPECTION ON • ,. I •
',a • Q• ME
APPROVED
WA YES NO Co & tR- CA-4
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AISLE WIDTHS O�Q"�
EXIT SIGNS
EMERGENCY LIGHTING O o nei-4-,PfcM
FIRE EXTINGUISHERS IlAyQ
ARE ALARM SYSTEM (.JI Q 4 1
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM 1J0 ) CS
HOOD INSTALLATION v
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLERS
CLEARANCE TR HEATING UNITS
REQUIRED SIGNAGF, }'�{Q e'er•
CHIMNEY (( *,{,y✓1
WOOD STOVE
FIREPLACE-MASONRY
FIREPLACE-FACTORY BUILT
REMARKS: T OK TO THIS DATE
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mmMRPUB INS T R
FIRE MARSHAL
TOWN OF QUEENSBURY
;ri j OUEENSBURY, NY 12804
(518) 761-B205
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVED _ S Z 0
NAME Unkr 1-��-- 11 33o
LOCATION PERMIT# P1
•
SCHEDULE INSPECTION ON Z-7� a
A n I AM alo
APPROV7•
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AISLE WIDTHS
EXITXIT SIGNS
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FIRE EXTINGUISHE' Min
FIRE ALARM SYSTEM W,i-
FIRE SPRINKLER SNS Y -- �r�
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OOD SUPPRESSION SY.TEM —- �,l
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CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING UNITS ' TN.
M•:
REQUIRED SIGNAGE 'CALL' P •'
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FIREPLACE ❑MASONRY ❑FACTORY BLT. G
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REMARKS:
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ISA NEW YORK STATE UNIFORM FIRE PREVENTION AND BUILDING CODE e ,4 e,.c-e
aka FIRE INSPECTION REPORT 1 "ii J/
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761-8205 FIRE MARSHALS OFFICE 742 BAY ROAD, GUEENSBURY,NY 12804-5902 � �
Occupant s�� p Tele hone FD
P C(�U n1f ki C11�(.. AddressS13 ,J'YUjCQ K)- 1 C.Ilk n <I
Contact Person ! ReceN ByDal tiff/- Inspector
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S ❑Sprinkler E Wet ❑ Dry I�I Supr ss' ❑Detection ❑Heat ElAlarm ❑ Local
Y C ww1 ❑Smoke D Supervised
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FAILURE TO CORRECT CODE VIOLATI NS NOTED WITH AN"X" MAY RESULT IN APPROPRIATE
LEGAL ACTION AGAINST YOU OR YOUR ESTABLISHMENT AS DIRECTED BY LAW.
PART 1161 EMERGENCY ACCESS PART 1172 COMBUSTIBLE FIBERS
0. ( ) 1161.1 General Requirements 44. ( ) 1172.1 General Requirements
45. ( ) 1172.2 Loose Storage
PART 1162 MEANS OF EGRESS 46. ( ) 1172.3 Baled Storage
1. ( ) 1162.1 General Requirements PART 1173 DUST
3. ( ) 1162.2 Obstructions
3. ( ) 1162.2g Aisles 47. ( ) 1173.1 General Requirements
4. ( ) 1162.3 Elevator Warning
in Signs PART 1174 HAZARDOUS MATERIALS
5. ( ) 1162.4 Elevatorp blnming Signs 48. ( ) 1174.1 General Requirements
6. ) 1162.6 Openings E in Egress
Walls and Separations( 49. ( ) 1174.2 Corrosive Liquids
8. ( ) 1162.E Falerbr Egress 50. ( ) 1174.3 Flammable Solids
8. ( ) 1162.7 Facilities for the Handicapped 51. ( ) 1174.4 Highly Toxic Materials
Pan1163 EQUIPMENT AND SYSTEMS 52. ( ) 1174.5 Oxidizing Materials
9. ( ) 1163.1 Genera!Requirements �letn �/53. ( ) 1174.6 Poisonous Gases
J ', ( ) 1174.7 Radioactive Materials
10. ( ) 1163.2 FuelG Gast Systems (A -Co' J `1� ( ) 1174.8 Unstable Chemicals
11.2 ( ) 1163.3 LPG,Containers end Tanks IY 1
12. ( ) 1163.5 LPG,Tank Paint ACD (� RT 1175 COMPRESSED GASES
13. ( ) 1163.6 Fuel Oil Systems LeP �� Y4rif ( ) 1175.1 Genera Requirements
15. ( ) 11639 Chimneys. es,Gas Vents {cy(0ms �1 ( ( ) 1175.3 Hydrogen
16. ( ) 1163.10 Incinerator and Compactors { /`1I 58. ( ) 1175.4 Flammable Anesthetics
17. (X) 1163.11 Electrical Systems OC 1(� 59. ( ) 1175.5 Nonflammable Medical Gases
18. (X) 1163.12 Commercial Cooking Equipment x\ C PART 1176 EXPLOSIVES
19. ( ) 1163.13 WaterSupplySystem 11� L CkIDry' 60. ( ) 1176.1 General Requirements
21. ( ) 1163.13b SpMHa' ste (0 Q
21. ( ) 1163.13d Standpipe System PART 1178 MATERIAL FOR WELDING AND CUTTING
23. ( ) 1163.13de Fire Hydrantrs A
23. ( ) 1163.13e Yard System /10 62. ( ) 1178.3 Welding and Cutting
24. ( ) 1163.131 Portable Fire Extinguisher o �k.• AA,, 62. ( ) 1178.3 OxyElec Fuel WelclogWeldi and Cutting
• 25. ( ) 1163.13g Fire Alarm System q�OQ AQ-/ 63. ( ) 1178A Electric Arc,Wekfing and Cutting
26. ( ) 1163.13h Fire and Smoke Detectors d \ �O1)/ PART 11911191.1
1g1 FlRE SAFETY SAFEGUARDS
27. ( ) 1163.13i Foam and Chemical Extinguishing System 1 ,a PA_ ( ) 11 I.1 General Precautions
I
28. ( ) 1163.14 Elevator Equipment lei
5 ( ) 1191.2 Externr pmlecGOn
PART 1164 SPECIAL PROPERTY USES '`d(,O t At3 666. ( ) 1191.3 Interior Protection
29. ( ) 1164.2 Assembly Spaces I�+ C 67. ( ) 1191.3b Combustible Decorations
30. ( ) 1164.3 Self-Service,Regular Service,Garages 68. ( ) 1191.3d Portable heaters
31. ( ) 1164.5 Abandonment or Removal,Storage Tanks PART 1182 FLAME PRODUCING DEVICES q •
32. ( ) 1164.6 Dry terCle Yard Plank 69. ( ) 1192.1 General Requirements C`
34. ( ) 1164.9 Waiter ins 70. ( ) 1192.2 Asphalt Kethes or
a D
34. ( ) 1164.9 Tents andAir Supported
and
Yards
Structures 1•
35. ( ) 1164.11 Vehicle Wrecking and Junk Yards PART119] FIRE SAFETY EQUIPMENT os.�b�
36. ( ) 1164.14 Marinas and Boat Yards 71. ( ) 1193.1 General Requirements
PART 1171 FLAMMABLE AND COMBUSTIBLE UQUID5 PART 119/ FIRE SAFETY SIGNS AND INSTRUCTIONS38. ( ) 1171.1 General Tanksremenis 72. (X 1194.1 General Requirements 51(,SAGE. ¶oR.
38. ( ) 1171.2 Storagee Tanks L
39. ( ) 1171.4 Portable Tanks and Containers PART 1195 FIRE SAFETY TRAINING CpQ goiC • I a
40. ( ) 1171.5 Sprayip Finishing
Tanks 73. ( ) 1195.1 General Requirements 1 1 Ki-t�n
41. ( ) 1171.5 Spray FlnishiAp
42. ( ) 1171.6 Electrostatic Apparatus PART1196 FIRE DEPARTMENT NOTIFICATION
43. ( ) 1171.7 Dry Cleaning , .74. ( ) 1196.1 Generape°uirements
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