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CO-0668-2022
CERTIFICATE OF OCCUPANCY ONLY office use only CO r APPLICATION Permit#: CA -O�la d - 2022 c wc� geN�ua i„y Permit Fee:$ Pr ® _ N'f� cv ��I8a�Road;Queensbury,NY 12004 Invoice#: i ® PadWi-761-8206 or S18-761-8205 wwwmueensbumnet C) a® obis application Is for occupancy only,with no work requiring a building permit" BUSINLS INFORMATION: Name of business: C=�1 Business Address(including suite,space,etc.): "q•e., . JA 1 AW 5 Detailed explanation of business(attach a separate piece of paper, if necessary): DLLs Cn AIA hp nn be �h�l��r �A1P InGO,(a,�y�(:ta MP S, ��ncl 'fUl1�i• *Please pro de an ACC rrate layout of Your tpate showhllg an walfir o ts, stockrooms, crest (rooms, toonteirs god ftaves on a s®pairate sheet of papeir*** 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: 56-nnvrt Uo-4S Applicant signature: .._ �� Date: 2-•2 Property Owner name• , �`j�r�, -„ � 4. Property Owner signature:--- �_ Date: i eertincate of ompaw oniy Revised September2M2 II I I w0atc.11C.0 742 Bay Road,Queensbury,My U804 P:S18-761-8206 ar=-761-8205 www.aueensbury.ne� CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Applicant: . - Name(s): Sba-y-wDn Wn� Malling Address,C/S/Z: (24(( 8LxA j e6n &-,6. -rX 717144 Cell Phone:!_ 1 Land Line: _r r� Email: S�a.+�+n©tnr„3@Ccirle �. a"�� • Business Owner(s): Contact Name(s): e r . Mailing Address,C/S/Z: "lk. Cell Phone:_(�rJ Land Line: _(!97,) Email: C_- -r�-� • Manager: Contact Name(s):KrLrun ecurvi rnx Mailing Address,C/S/Z: :�L$ R4-4 Cell Phone:_(51e )a�3 _42-$7 land Line: _( ) Email: • Property Owner(sh Business Name: L.a1`;,e. & Contact Name(s): fez rz n z S j Mailing Address,C/S/Z: ;Z"7M Age-,Slt q0'7,f O 7 Cell Phone:_( � Land Line: _(C1_ ig 6,500 Email: SS5 .ws®r'56n.�-3 c y6irw _onw1;k. cona Contact Person for Compliance in regards to this project: 5d ar'iklaI! IaLVWS Cell Phone:�_) Land Line: S(�)30 -6 1 U' Email:_ __4Glnnan re) @ ya-kr>x,ja r.5.c;b1,22 1 Certificate of Occupancy Only Revised September2022 ! I 7nunnff�ms ury 742 Bay Road,Queensbury,NY 12804 P:518-761-8206 or S18-761-820S www.nueensburv.net EMERGENCY CONTACT INFORMATION "THIS FORM IS.USED TO ASSIST EMERGENCY SERVICE PERSONNEL WHO MAY CALLED TO YOUR BUSINESS AFTER HOURS,PLEASE BE SURE THE CONTACTS LISTED BELOW ARE WILLING AND AVAILABLE TO REPSOND DURING OFF-HOURS TO ASSIST POLICE AND/OR FIRE PERSONNEL IN GAINING ENTRY TO YOUR BUILDING." PLEASE BE ADVISED THAT FAILURE TO ASSIST EMERGENCY SERVICE PERSONNEL MAY RESULT IN DAMAGE TO YOUR BUILDING BY POLICE AND/OR FIRE.PERSONNEL. Date: i y J3+ 19A Business Name: C }t Uev,d;n�r5 C'tr1V7V_% Z(%$ zX -s Business Location(including suite,space,etc.):_�l��� UPS 51 t.1e:) , L&Ice All 0-1645 Business Phone#; 5 i 1. Business contact name: 60,'Uvt Cx-,-6e-Lu4 Main Phone:_(51 )_A53- H 9-$7 ;Secondary Phone: Contact Is coming from what town/village? 5Iz1 n" Cae 2. Business contact name: (�lLt✓LA �r�S C i�LC� Main Phone:_ ;Secondary Phone:_( Contact is coming from what town/village? Lake, Oytar TOWN OF QUEENSIBURY FIRE MARSHAL'S OFFICE P:518-761-8206 F:51 B-745.4437 FIREMARSHAL@QUEENSBLJRY.NET i FIRE MARSHAI_MIKE PALMER DEPu`y FIRE MARSHAL TYSON CONVERSE I _ I Certificate of Oceupanq Only Revised September 2022 FIRE MARSHAL'S OFFICE Tozvn of Queensbury 742 Bay Road, Queensbury, NY 12804 "Home of Natural Beauty ... A Good Place to Live " ' LAN REVT�F Go! Calendars Games Toys Books 1424 State Route 9 CO-0668-2022 11/02/2022 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 -flremarshal@queensbuty.net • WWW.queensbunl.net ti ,i s W V v' '�� F- 4•� �y�7 G—�I'a �t-1-7 .r N'� �I'� e-4'7 �-1�� � n _E-I C1 i I r 41 7 F fal> Fy'> y'7 VNOVJF C-hah h a2 2022 288.16-1-1 CO-0668-2022 TOWN OF QUEENSBURY Go! Calendars Games Toys Books BUILDING a CODES 1424 State Rte 9, Ste 15 Certificate of Occupancy - name change