CO-0106-2023 CERTIFICATE OF CCUPA CCY ONLY o�ceUse Only
APPL I@ � (! Per it#: Co� 91 Q to - 20 2
]in+ir of(jirrcn.twn a mit Fee:$
HA 15 l�D
742 Bay Road,Queensbury,NY 12804 n oice#: �
P:518-761-8206 or 518-761-8205 www. u ensbu�r, tDFN01
�O��URY
"This application is for occupancy only, with no work requiring a building permit"
BUSINESS INFORMATION:
Name of business: &L67j da c k At-:on-del—A&
Business Address (including suite, space, etc.):,6 N, is 4, -;b r VA f =� �f /W
_'r L' �.�t�'!L�,f�// i ',? �.V •.tea'#.,�r.r `� Y���i l/ ��l'
Detailed explanation of business (attach a separate piece of paper, if necessary):
ScrLp rn c cCil/
Sc' cry r
***PI provide an accWate Iayoiut Oklr space showi ft
A walls, eidts, stoda vows, rest rooms, counters and fixtores
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: cbfvi &4b(_q0n_5tC/A
Applicant signature: 1`i Date:
Property Owner name: &.k' AAK/-►,t., c.o LL C
Property Owner signature: Date:
r 64WS G4_X 4 vv\
Certificate of Occupancy Only Revised February 2022
filhil/o tZmen-hun.
742 Bay Road,Queensbury,NY 12804
P:SIS-761-8206 or 518-761-820S www._queensbu[Y;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: l
Business Location(including suite,space,etc.): /
4V4' ) ATr)L/
Business Phone
1. Business contact name: 11 Nloccunsj&ol �i 1
Main Phone:_ Sj pS�� 3q�:Secondary Phone:_(�J C11
Coming from what town/village?--LD!R I ki Mj
2. Business contact name:
Main Phone:_ 1 _(f� 51 (LI3 ql ;Secondary Phone:_( ,_ �n S/
' V [}
Coming from what town/village? - C f /
TOWN OF QUEENSBURY FIRE MARSHAL'S OFFICE
P:518-761-8206 F: 518-745-4437
F IF;U MiARS1 1_L??QUEEN F,I.RY.NF7
FIRE MARSHAL MIKE PALMER DEPUTY FIRE MARSHAL TYSON CONVERSE
Certificate of Occupancy Only Revised February 2022
fcn.'it taF c jekrn.l+un
742 Bay Road,Queensbury,NY 12804
P:518-761-8206 or s18-761-8205 www.aueensbury.net
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s): 11`
Mailing Address, C/S/Z: � ��.
Cell Ph_
o e: (51 ) Land Lin ) LA Act
Email:
. I - — — -1 0\—./ J
• Business Owners
Contact Name(s):
Mailing-Address, C/S/Z:
Cell Phone:_( _i_e(o{� - S%�� _Land Line: _(�1 )
Email:
• Manager:
Contact Name(s): r
Mailing Address, C/S/Z:
Celf Phone:_(� _) Lan Line: _( ) Ld�U b qT—
Email:
• Property Owner s
Business Name: C
Contact Name(s): � �1- --
Mailing Address, C/S/Z: .Sr?�
Cell Phone:_( } Land Line:
Email: �OVK� !�41
Contact Person for Compliance in regards to this project: E4
Cell Phvn ) 510 Land Line:
Emafl: '
Certificate of Occupancy Only Revised February 2022
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302.5-1-92.11 CO-0106-2023
Adirondack'Aromatherapy
578 Aviation Rd,, Space 41
Certificate of Occupancy
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FIRE MARSHAL'S OFFICE
Town of Queensbury
742 Bay Road, Queensbury, NY 12804
"Howe of Natural Beauty ... A Good Place. to Live "
Adirondack Aromatherapy
578 Aviation Rd
CO-0106-2023
3/16/2023
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
firemarshal@queensbun/net 7V7VIV.queensburiil.net