CO-0268-2023 -�- CERTIFICATE OF OCCUPANCY ONLY office use only
` �� •2a
Permit#: CC) 2.
APPLICATION
Town afC rrcn.+bury Permit Fee:$
742 Bay Road,Queensbury,NY 12804 D is"e#:��
P:518-761-8206 or 518-761-8205 www. ueensbur n t
MAY 9 9 �.e02.3 €
"This application is for occupancy onl��'witki n"o:work requiring a building permit"
BUSINESS INFORMATION:
Name of business: CROCS
Business Address (including suite, space, etc.): 1424 U.S. 9, Suite 15, Lake George, NY 12845
Detailed explanation of business (attach a separate piece of paper, if necessary):
Temporary crocs shoe wear store. Painting walls white if not already. Installing wood blocking on the walls
for new fixtures. Assembling floor fixtures.
***Please provide an accurate layout of your space 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: Cynthia Beltran
Applicant signature: cynthia.3eltira in Date: 5/17/23
Property Owner name: Robin Genovese
Property Owner sign re: Date: 5/19/2023
Certificate of Occupancy Only Revised February 2022
f
Town or(-t"nsbun
742 Bay Road,Queensbury,NY 12804
P:518-761-8206 or 518-761-8205 www.gueensbury.net
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s): Cynthia Beltran
Mailing Address, C/S/Z: 100 Davids Dr Hauppauge NY 11788
Cell Phone: ( 631 ) 278-1640 Land Line:
Email: cbeltran@broadwaynational.com
• Business Owner(s):
Contact Name(s): Crocs
Mailing Address, C/S/Z: N/A
Cell Phone:_( ) Land Line: _( )
Email: cbutcher@crocs.com
• Manager:
Contact Name(s): N/A
Mailing Address, C/S/Z:
Cell Phone:_( ) Land Line: _( )
Email:
• Property Owner(s):
Business Name: Lake George Northway, LLC
Contact Name(s): hin .Genr\tagQ/,SaianP Shanuc
Mailing Address, C/S/Z: 75nn \n/estchester Ayenl le' 51lite 40�1 Purchase, my 10577
Cell Phone:_( 201 ) Q_7nR Land Line: _( 914 253_6,Fnn
Email: robin@rgenoveseandassociates.com/sshanus@shanus�mCaanagement.com
Contact Person for Compliance in regards to this project: Cynthia Beltran
Cell Phone: 6( 31 ) 278-1640 Land Line: �)
Email: cbeltranabroadwaynational.com
Certificate of Occupancy Only Revised February 2022
FIRE MARSHAL'S OFFICE
Town of Queensbunj
742 Bay Road, Queensbuny; NY 12804
"Home of Natural Beauty ... A Good Place to Live "
PLAN REVIEW
CROCS (Temp)
1424 Route 9, Suite 15
CO-0268-2023
5/22//2023
The following comments are based on a review of submittals:
• Verify fire extinguisher location and inspection
• Verify paths of egress
• CO detection is required
• Provide key for Knox Box
• Function test all Exit and Emergency lighting fixtures
• Provide square footage for retail sales and warehouse so max occupancy
can be calculated
Michael J Palmer
Fire Marshal
742 Bay Road
Queensbury NY 12804
firemarshal@queensbury.net
Fi r e M a r s h a l 's Off i c e P h o n e: 518-761-8206 F a x: 518-745-4437
firentarsltal@gtteensbicn .net zvzvzv.queensbun/net
1,11-�-') I Id I
CROCS TEMP STORES
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—4'7/16'04 4'7/16'0C —4'7/16'OC/4'7/16"OCR 4'7/16"OC—/-4'7/16'OC--4"7/lfi'OC —4'7/16'OC�4"7/16"OC/-4'7/16"OC 4'7/16'OC— 4'7/16'OC--4'7/16'OC
® ar ® a
FULL PRICE WALL verify ump ut wa s
locati n
verify b k wall FIXTURES COUNT:
verify an
(17)TEMP FLOOR FIXTURES
wire; -_w1r:.e±: -wires �inri�re!-
--I ca hwrap door to ation
bin;_._. `•bi:q_ _bin___ _Lhi.n ! TEMP PERIMETER UPRIGHTS
to c ation_ (36)
(6) FOLDING TABLES 96 X 30(NOT SHOWN)
(8)FOLDING CHAIRS(NOT SHOWN)
j, 14'7/16'0c (4)WIRE BINS
(2)TOWERS
W' 1
4-7/16-oc (1) EXTRA LARGE 10 STATION CHARM FIXTU
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u' '4'7/16'0'
' 'Q7/1,'OC
CLEARANCE WALL
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EQ 4'7/16'OC-,M7/16'0C-�4'7,116'OC-f-4'7/1VOC 4'7/1COC 4'7/16'OC 4'7/16'OCy�4'7/16-0Cf4'7/16-0C�-4'7/16'OC 4'7/16'OC 4'7/16'OC 4'7/16'OCII 7l1711 4'7WOC EQ-
Confidential,Copyright Quarter20,LLC,2023.Do not circulate. 288.16-1-1 CO-0268-2023
Crocs v
1424 State Rte 9
Certificate of Occupancy
CROCS TEMP STORES
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Confidential.Copyright Quarter20,LLC,2023.Do not circulate.
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LAKE GEORGE
CROCS TEMP STORES
TEMP PERIMETER UPRIGHTS
TO BE INSTALL 4' 7/16"OC
FROM EACH OTHER/REFER
TO THE PLAN ON PAGE 3 FOR
ADDITIONAL DIMENSIONS
• TEMP PERIMETER FULL PRICE FIXTURE TEMP PERIMETER CLEARANCE FIXTURE TEMP FLOOR FIXTURE
SHOWN WITH 7 UNIVERSAL FULL BAYS SHOWN WITH 6 CLEARANCE RSB SHOWN WITH 6
AND 35 HANG ARMS CLEARANCE RSB
Confidential.Copyright Quarter20,LLC,2023.Do not circulate.