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CO-0650-2023 CERTIFICATE OF OCCUPANCY ONLY Office Use Only
APPLICATION Permit#: CJJ r 0(o 202-S
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Permit Fee:$ 1�� r
742 Bay Road,Queensbury,NY 12804 Invoice#: 2-E)
P:518-761-8206 or 518-761-8205 www.clueensburV.net
"This application is for occupancy only, with no work requiring a building permit"
BUSINESS INFORMATION: 1
Name of business: ��`
Business Address (including suite, space, etc.): V) r4_C3� pold
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Detailed explanation of business (attach a separate piece of paper, if necessary):
A�ej j S /,0-5 V 2456 e0lkc-4 bl
** *Please provide an accurate layout of your space showing
A walls, exits, stockrooms, rest rooms, counters and fihctures
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: BAQbR&,q_ C(
Applicant signature: Date: lo hI Idto
Property Owner name:
Property Owner signature: Date:
Certificate of Occupancy Only Revised February 2022
l' n Of
742 Bay Road,Queensbury,NY 12804
P:518-761-8206 or 518-761-8205 www.aueensbury.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: 0 13
Business Name: 14 01
A
Business Loc tion(includi g suite,space,etc.): Av)
IU I 206� I V
Business Phone#: "
1. Business contact name: T2ct r�Q rrt- k I ACAM
Main Phone:_( ) � ) 3 9)" NO � ; Secondary Phone:_(�/� ) 3o- 9d 37
Coming from what town/village?
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2. Business contact name: he
Main Phone:_(, / _?z)-7- Secondary Phone:_( )
Coming from what town/village?
TOWN OF QUEENSBURY FIRE MARSHAL'S OFFICE
P: 51 8-761-8206 F: 518-745-4437
FIREMARSHAL@QUEENSBURY.NET
FIRE MARSHAL MIKE PALMER DEPUTY FIRE MARSHAL TYSON CONVERSE
Certificate of Occupancy Only Revised February 2022
wvfy.
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): R A R b 0,4,a
Mailing Address, C/S/Z: 2 1k POi n w69 2V
Cell Phone: 1 ` 6 A Land Line:
Email: pal , P!
• Business Owner(s):
Contact Name(s): 'd 1
Mailing Address, C/S/Z: 7 14I C-H oo m 0
Cell Phone:_( _) f - Eog land Line: _( )
Email:
• Manager:
Contact Name(s): At
Mailing Address, C/S/Z:
Cell Phone: _( ) Land Line: _( )
Email:
• Property Owner(s):
Business Name: Ve.410A( 1l�
Contact Name(s): U
Mailing Address,.C/S/Z: �i�! o a, kv Z�0
Cell Phone: _( ) Lan Line: _( 3 ) 2 �/.3 9 oa
Email: ,�7A-Me3 Ykd4'i�M , com
Contact Person for Compliance in regards to this project:
Cell Phone: Land Line:
Email:
Certificate of Occupancy Only Revised February 2022
��. FIRE MARSHAL"S OFFICE
Town of Queensbury
742 Bay Road, Queensbury, NY 12804
"Home of Natural Beauty ... A Good Place to Live "
PLAN REVIEW
Gifts N Glamour
578 Aviation Rd space 42
CO-0650-2023
10/12/2023
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
tysonc@queensbury.net
Fire Marshal 's Office • Phone: 518-761-8206 Fax: 518-745-4437
-flrenzarshal@queensbury.net - www.queensbury.net
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ANn8SNEITIO=10 NMO.L --- -- --------___-- _- — -_--
CIE Z 1 130 302.5-1-92.11 CO-0650-2023
Gifts N Glamour
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H 578 Aviation Rd, Space 42
Certificate of Occupancy