CO-0562-2023 �— CERTIFICATE i CUPANCY LY office use only
A� Fir��rMI Permit#: yO5 - LO 2
3
Town of(twensbuq 3
Permit Fee:$
TOWN N OF QUEENSBURY Invoice#: Oy`l�`rS�`lP
742 Bay Road,Queensbury,NY 12804 BUILDING &CODES
P:518-761-8206 or 518-761-8205 www.clueensbury.net
"This application is for occupancy only, with no work requiring a building permit"
BUSINESS INFORMATION:
Name of business: Pizza Hut#41766
Business Address (including suite, space, etc.): 97/99 Main St.,Queensbury, NY 12801
Detailed explanation of business (attach a separate piece of paper, if necessary):
Change of ownership only-No other changes will be made to location or equipment
***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: Tasty.Hut Nprtheast LLC
Applicant signature: Neil Thomson-CFO Date: 9/7/23
Property Owner name: Tasty Hut Northeast LLC
Property Owner signature: Neil Thomson-CFO Date: 9/7/23
Certificate of Occupancy Only Revised September 2022
ToHn d'(twensbun
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): Tasty Hut Northeast LLC
Mailing Address, C/S/Z: 2205 W 136th Ave,Ste 106-209, Broomfield,CO 80023
Cell Phone:) Land Line: �_) 469-895-4450—Option 4
Email: permits@tastyrg.com
• Business Owner(s):
Contact Name(s): Courtney Mowry
Mailing Address, C/S/Z: 2205 W 136th Ave,Ste 106-209, Broomfield,CO 80023
Cell Phone:_( ) 303-669-2558 Land Line: _( ) 469-825-6532
Email: cmowry@tastyrg.com
• Manaeer•
Contact Name(s): Manager will be determined after change of ownership
Mailing Address, C/S/Z:
Cell Phone:_( ) Land Line: _( )
Email:
• Property Owner(s):
Business Name: Tasty Hut Northeast LLC
Contact Name(s): Courtney Mowry
Mailing Address, C/S/Z: 2205 W 136th Ave,Ste 106-209, Broomfield,CO 80023
Cell Phone:_( ) 303-669-2558 Land Line: _( ) 469-825-6532
Email: permits@tastyrg.com
Contact Person for Compliance in regards to this project: Courtney Mowry
Cell Phone:() 303-669-2558 Land Line: 469-825-6532
Email:_ cmowry@tastyrg.com
Certificate of Occupancy Only Revised September 2022
Town ofQucensbun-
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: 9/7/23
Business Name: Tasty Hut Northeast LLC dba Pizza Hut
Business Location (including suite,space,etc.): 97/99 Main St.,Queensbury, NY 12801
Business Phone#: (518)792-3698
1. Business contact name: Courtney Mowry
Main Phone:_( )303-669-2558 ;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: 518-745-4437
FIREMARSHAL@QUEENSBURY.NET
FIRE MARSHAL MIKE PALMER DEPUTY FIRE MARSHAL TYSON CONVERSE
Certificate of Occupancy Only Revised September 2022
l
-NAB ,,�,�