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CO-0395-2023 E C E 0 V E JUL 0 7 2023 TOWN OF QUEENSBURY Ar-DVI-DINGM.TP T E O OCCUPANCY ONLY office Use{„ilk 9 APPLICATION Permit N: � � Z — 4 Tot.n of Qx•cn1bun, Permit Fee 742 Bay Road,Queensbury,NY 12804 Invoice it; Z — P:518-761-8206 or 518-761-8205 www.gueensburV.net "This application is for occupancy only, with no work requiring a building permit`* BUSINESS INFORMATION: Name of business: ' 14E (' M 51 LV /� Business Address (including suite,space, etc.): 6 V JgQU�j ON k4 /�/r�Z06 I`� Detailed explanation of business (attach a separate piece of paper, if necessary): j �RS�N�. 1�2P�►�lING Sti©�v I Please provide an accurate layout of your space showing all walls, exits, stockrooms, rest rooms, counters and factures 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. I Applicant name: lid f�faZOE�t/►.�1Jh.� Applicant signature: Date: ( L3 Property Owner name: i Property Owner sig Date: i i Certificate Of Occupancy Only Revised September 2022 i .r,t.,rr•v�a"4�=a=.i 3�a.�"3xr.�.'"'��:�.^8R* .. 031f, TIi ULrr.Trxtlf_rsael DOL9 MJT Cr'gnitJIEAWAIM'1T„"RV1?tLLMAIIC1f OF m,trn[titLvrA,ti .DAL71:JOtrgA!n[SGiI1tCE3TOeEFCIDVEr+a�DfT1'TUWR.ATLUi411( .-- .- tr�&tcrr'fo+uvrl ItCRLpruzCl.rraOnvtFr orALTLOUTKor3TOflt rrtDV1AiKD"TVY1[1. Trnen eJCZinrnehuq. 742 Bay Road,queensbury,NY 12804 P:518.761-8206 or518.761.8205 WIMqueensbury.net CONTACT INFORMATION:PLEASE PRINT LEGIBLY OR TYPE,PLEASE INCLUDE AN EMAIL • Applicant: Name(s): 'i?'4P,N Mailing Address,C/S/Z: Lululan ST S6'j- 11Jy ( 3 Cell Phone: S_ ( Iil Land Line: 1_) Email: • Business Owner(s)• Contact Name(s):_ -5&mc As "oyc Mailing Address,C/S/Z: Cell Phone:_( ) Land Line: _( ) Email: • Manager: Contact Name(s): Mailing Address,C/S/Z: Cell Phone:_( ) Land Line: _( ) Email: • Property Owner(s): Business Name: Contact Name(s): Mailing Address,C/S/Z: Cell Phone:_( ) Land Line: _( ) Email: t Contact Person for Compliance in regards to this project: cl,'h� 'I rr�r�E72 Mq,�, Cell Phone: 5( IV) ) Land Line: I Email:i 4y&ym 47 H e &-M41#-. C!M Certificate of Occupancy Only Revised September 2022 --Y— —'----y------ 7f4LE Tt:EDEMMU IERZEWI DOES?tot CO TIMNS TEAWARRANTY OR REPRESENIATMOF y -- - Afn"IIX ALL MEASURES,DuffNSIONS AIA DISTANCES TO BE FIELD VERPED BY TENANT.ALL UTLITY _ __ Il)CJ1TI017S SROhN kiE_A[tkI ARE APPR07coMTE,EXACT LOCATIONS TO BE F iELD VERfft¢1.B "ZI117- IfVAC SO EDU,E SPACE d:301 I O (I T-71 dfb clllboq• 742 Bay Road,queensbury,NY 12804 P:518-761-8206or518.761-8205 WWW.gUeensbury.net EMERGENCY CONTACT INFORMATION "THIS FORM IS USED TO ASSIST EMERGENCY SERVICE PERSONNEL WHO MAYBE 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: 7 R 3 Business Name: e.n u57/8 LL C Business Location(including suite,space,etc.): �/g /gVfyyZt7J �IDf 1.1 y 12 BCL, a2>n tri 'TT MA-Xyc Business Phone#: 1. Business contact name: Main Phone:_( 5 ) 95!'5 I ;Secondary Phone:_( ) Contact is coming from what town/village? 2. Business contact name: " Main Phone:_( ) :Secondary Phone:_(^) Contact is coming from what town/village? TOWN OF QUEENSBURY FIRE MARSHAL'S OFFICE P:518-761-8206 F:5 1 B-745-4437 F I R E M A R SFi A LGa Q U E E N S S U R Y.N ET FIRE MARSI IAL MIKE PALMER DEPUTY FIRE MARSI4AL TYSON CONVERSE CertiGote of Occupancy Only Revised September 2022 FIRE MARSHAL'S OFFICE Town of Queensbury 742 Bay Road, Queensbury, NY 12804 "Honte of Natural Beauty ... A Good Place to Live " PLAN REVIEW 518 Gym 578 Aviation Rd space 30 CO-0395-2023 7/10/2023 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. 7) Maintain 18" Clearance from ceiling for sprinkler system Deputy Fire Marshal Tyson Converse 742 Bay Road Queensbury NY 12804 518 761 8205 garys@queensbury.net Fi r e M a r s It a 1 's Off i c e - P It o it e: 518-761-8206 - F a x: 518-745-4437 {iremarshal@queensbuint.net - www.queensburil.net MM- THE DEPICTION tezEON DOES NOT CONSTITUTE A WARRAJ%rry OR REPRESE?fTAT*N OF AffYKIND ALL MEASURES,DDAENSjONS AND DISTANCES To 13E FIELD vEpiRED By TENANT.ALL UTILITY LOCAT"i�!R4�N -APPROXIMATE CT LOCATIONS TO BE FIELD VERIFMDj3Y HEREON ARE EXA RVAC SCHEDULE SPACE 0:30 U�TLp TYPE TONS). rismc MODEL 9 SERIAL n DATE 1 75 CA — ER 24C8aAR DT��330�� 211M 41) -6A(MS5 .II Z7-- .,.,-"--11 1, 41 -z 5 TIT Arl! K'U RTU—5--o 2005 'TU CARRIER TU 5.1 j31pVG5D826__ ___ 2008 ---- CAMER j50HJ0kG69RIW 1320813iN23 2008- ----- I E—tiko—il, —? LL-L C 75 —Nl'l "'m ir (�ET =7-= 0 ==n- &.xz C.T.a ZnDATA I .. I _. - I bl X=' cr LL U) c 7�- Lu z U i I;- az I I I 6W c�k LI- on no z Ln (D '-4 00 > < G) — k< cu 0 0 30 o co J%- r) r) c r= II W —% ,c) c) FLO cu R PLAN Q 0 DIMENSION CONTROL PLAN ..t � -- L011�-- TliE DEMMI HEREON DOES NOT CONSTITUTE A WARRANTY OR REPRESENTATION OF ANY IONO.ALL MEASURES,DIMENSIONS AND DISTANCES TO BE FIELD VERIFIED BY TENANT.ALL UTILITY LOCATIONS SHOWN HEREON ARE APPROXIMATE,EJ(ACT LOCATIONS TO BE FIELD VERIFUIBY TiiP 8W. SPACE N:30i • I - _ HVAC SCR IEDIJLE SQE(IN �— INSTALL I UNIT p TYPE-�-_TONS). RVOCE MODEL Of 5 SERIAL 9 DATE I �Tf, RTU 75 �C.ARfiIF.R 15011IXVIG63RIM __IMOC,11061 xm ma's "' T - RT11)20.0 (CARRIER I 024CBGAR 400BG35 3 2W8 i'_�n� NOX ICHA165135+; 5CMA00955 109E - L"I 5 RTU S.0 CARn1ER ,501iJGwGGu3'3T61_320GG5LG25 2GG0 r,:.� f � �[�• r� 5.0 CARRIER 1501 U00GGG63R7 i! 1320GG10422 2005 �` _ N ')1 - -6_- RTU_ Too— CARRIER, _ (50H.1-012"M_iY_31UGSW26 2008 0�'1��7•--, 'LRTU 5.1 CARRIER SRU-0OfG6RU _I5320 _ 200G RTU0 IENNOX CAIGOHNIG 0CG60280J 199E — n __ LFh'N�1X f1lA 1f N'.1_v1 ��5,11n 1(tfi7 Jnos - _ Q Ql + C•f7-. —_ „7_C SC-7 _� -7 ts.r :_0'irs-7 _I t+°•5• —h- r.r'•.r_r I Py .. ("i] r � -�- •� —j tta w _ 113 o- 1Fl:avi oru ^ j c � ,Sad. 5•,rad. I � �• U I � f �-0 V:C:rtR:msYir., i L ac u.+.tO m I a1" I 1�..1o1ro I I C 30 FLOOR PLAN DIMENSION CONTROL PLAN