CO-0319-2023 CERTIFICATE OF OCCUPANCY ONLY Office Use Only q
APPLICATION Permit#: ��� l • ��'�
ry Town Cf,��Cnsbu Permit Fee:$
742 Bay Road,Queensbury,NY 12804 invoice#:
P:518-761-8206 or 518-761-8205 www.gueensbury.net
**This application is for occupancy only, with no work requiri i err it**
IN
BUSINESS INFORMATION: '� V
Name of business: IRS Telecom Inc JVN 09?
Business Address (including suite, space, etc.):-509 Queensbury II D)Vlln - —
Queensbury, NY 12804 °�Fs
Detailed explanation of business (attach a separate piece of paper, if necessary):
We design, install and maintain microwave networks for Public Safety Communicaitons networks
***Pig provide an- accwate -layout of yow space showing
A wads -e
icks., stockroom, rapt room, countm and fnctwes
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: Robert Cornel
Applicant signature: Date: 5-11-23
Property Owner name: Prime Group Holdings, LLC
Property Owner signature _Eve- Date:
Certificate of Occupancy Only Revised September 2022
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Torn oCLzxrnsl�ury
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): Robert Cornell
Mailing Address, C/S/Z: 1603 RT 30 N Bomoseen,VT 05732
Cell Phone: )802-777-4662 Land Line: 1 )
Email:rstelecom@comcast.net
• Business Owner(s):
Contact Name(s): Robert Cornell
Mailing Address, C/S/Z: 1603 RT 30 N Bomoseen,VT 05732
Cell Phone:_( ) Land Line: _( )
Email:
• Manner:
Contact Name(s): Robert Cornell
Mailing Address, C/S/Z: 1603 RT 30 N Bomoseen,VT 05732
Cell Phone: _(802 )777-46672 Land Line: _( )
Email:rstelecom@comcast.net
• Property Owner(s):
Business Name: Prime Group Holdings, LLC
Contact Name(s): John A. Burke, Jr. 5yp—
Mailing Address, C/S/Z: 85 Railroad Place, Saratoga Springs, NY 12866
Cell Phone:_( ) Land Line: _( )518.615.0552 x7285
Email:John.burke@goprimegroup.com
Contact Person for Compliance in regards to this project: Robert Comell
Cell Phone: (( )802-777-4662 Land Line: � )
Email: rs ee ecom comcas .ne
Certificate of Occupancy Only Revised September 2022
Tosim or(!xcn'sbun'
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: 5-11-23
Business Name: RS Telecom Inc
Business Location (including suite,space,etc.): 509 Queensbury Ave, Queensbury NY 12804
Business Phone#: 802-777-4662
1. Business contact name: Robert Cornell
Main Phone:_(8021 777-4662 ; Secondary Phone:_( )
Contact is coming from what town/village? Bomoseen, VT
2. Business contact name: Mike AnusZeWski
Main Phone:_(518 )232-1066 ;Secondary Phone:_( )
Contact is coming from what town/village? Gansevoort, NY
TOWN OF QUEENSBURY FIRE MARSHAL'S OFFICE
P: 518-761-8206 F: 518-745-4437
FIREMARSHAL@QUEENSBURY.NET
FIRE MARSHAL MIKE PALMER DEPUTY FIRE MARSHAL TYSON CONVERSE
Certificate of Occupancy Only Revised September 2022
FIRE MARSHAL'S OFFICE
Town of Queensbunj
742 Bay Road, Queensbury, NY 12804
"Home of Natural Beauty ... A Good Place to Live "
PLAN REVIEW
RS Telecom Inc
509 Queensbury Ave
CO-0319-2023
6/9//2023
The following comments are-based on a review of submittals:
• Verify fire extinguisher location and inspection
• Verify paths of egress
• CO detection (if required)
• Function test all Exit and Emergency lighting fixtures
Michael J Palmer
Fire Marshal
742 Bay Road
Queensbury NY 12804
firemarshal@queensbury.net
Fire Marshal 's Office Phone: 518-761-8206 Fax: 518-745-4437
firemarshal fteensbum.alet - zuww.queensbunJ.net
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297.12-1-2 CO-0319-2023
RS Telecom Inc
509 Queensbury Ave
Certificate of Occupancy