CO-0595-2022 CERTIFICATE OF OCCUPANCY ONLY Office Use Only
fm�jF. APPLICATION Permit#: �� "'��✓'—���
T0,,n 72_, rnsbun Permit Fee:$J i{i9,
742 Bay Road,Queensbury,NY 12804
Invoice#:
P:518-761-8206 or 518-761-8205 www.gueensbury.net
E C E t 11
"This application is for occu a r7SEPVS
no wo lure' uirin a building permit"
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CONTACT INFORMATION: �� I
TOWN OF QUEDISBUrV I
BUILDING&COOES�
• Applicant:
Name(s): SaIVS-e as
Mailing Address, C/S/Z:
Cell Phone: �_) Land Line:
Email:
• Business Owner(s):
Contact Name(s): ,,,Ae .
Mailing Address, C/S/Z: 11 'I-ar APC4::
Cell Phone: _( Sig, ) -(W- 5c7X Land Line: _( )
Email:
• Manager:
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: _( ) Land Line: _( )
Email:
• Property Owner(s):
Business Name: AD in, Ha,11 NcWcc-; LLC
Contact Name(s): Jas 'r {,-
Mailing Address, C/S/Z: shuL,j
Cell Phone: _( ) Land Line: _( VTR ) -79 �k7� X)6S
Email: SSsa�, vlen»�����ri� car,
Certificate of Occupancy Only Revised June 2017
'Town of C2ucrnsbun
742 Bay Road,Queensbury,NY 12804
P:518-761-8206 or 518-761-8205 www.gueensbury.net
BUSINESS INFORMATION:
Name of business: Lq k�
Address (including suite, space, etc.): Au,a�ion R✓, Q�e�ns6 � ���/dP�y
Type of business (i.e.: retail, car repair, etc.): Re-ho, l
Please provide an accurate layout of your store showing all walls, exits, stockrooms, rest
rooms, counters and fixtures 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: �n•� ��,n�,e
Applicant signature:
Date: 1A
Certificate of Occupancy Only Revised June 2017
Town ofczycensbuay
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:
Business Location (including suite,space,etc.): 7f V/«41,6 , Qoa.c- ns��na Sro
SPA /T'
Business Phone#:
1. Contact name: LTA 0/�Aromorn
Main Phone:_ 7 ) ono -3c-C/a :Secondary Phone:_( )
Coming from what town/village? Q t U1S�
2. Contact name: Rr, /px'�n2,e
Main Phone:_( 519 ) 7115f-66 7? ; Secondary Phone:_( )
Coming from what town/village? S6
TOWN OF QUEENSBURY FIRE MARSHAL'S OFFICE
P: 518-761-8206 F: 518-74S-4437
FI REMARSHAL@QUEENSBURY.NET
FIRE MARSHAL MIKE PALMER DEPUTY FIRE MARSHAL GARY STILLMAN
Certificate of Occupancy Only Revised June 2017
FIRE MARSHAL'S OFFICE
Town of Queensbury
742 Bay Road, Queensbury, NY 12804
"Home of Natural Beauty ... A Good Place to Live "
LAN REUIiE '
Trading Card Hub
578 Aviation Rd
CO-0595-2022
9/23/2022
I have reviewed the submitted drawings for the above project; and offer the
following comments:
1) Verify Fire extinguisher locations & inspection.
2) Locks / latches shall comply with 2020 NYSFC.
3) Verify operation of existing exit / emergency lights.
4) CO Detection
5) Verify Knox Box key.
6) Verify aisles & storage.
Deputy Fire Marshal
Tyson Converse
742 Bay Road
Queensbury NY 12804
518 761 8205
garys@queensbury.net
Fire Marshal 's Office . Phone: 518-761-8206 Fax: 518-745-4437
.fCremarshal@queensbunt.net - www.queensbum net
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302.5-1-92.11 CO-0595-2022
Trading Card Hub
578 Aviation Rd, Space 18
Certificate of Occupancy