CO-0145-2021 •
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Town c nsbun• BUILDING&CODES Permit Fee:$ 110
742 Bay Road,Queensbury,NY 12804 Invoice#: ��
P:518-761-8206 or 518-761-8205 www.queensburv.net
**This application is for occupancy only, with no work requiring a building permit**
BUSINESS INFORMATION:
Name of business: /tia`Ne,t6/ A/1./fe
Business Address (including suite, space, etc.): , 7k _z J.a.: ,:c. „) U 2i , 'J e -LGl
a ee-AYS �� f /mod
Detailed explanation of business (attach a separate piece of paper,if necessary):
t "is•)/1 /7e-94Le7ec-
PCnr 1r .
***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 dear 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.
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Applicant name: ZAP i 5 �,e4 !S �-,0C -*
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Applicant signature: r4� , Date:.. : ZUZ/
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Property Owner name; Jason Tyler
a o n Tyler r ° „Property :Owner signature: °=y �
Date: 3/23/21.
Certificate of Occupancy Only Revised December 2020
Town of Qircrns.ury
742 Bay Road,Queensbury,NY 12804
P:518-761-8206 or 518-761-8205 www.nueensburv.net
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant: l�-� / /
Name(s)://O/i ., !e, -) I` ,`geN '/. S .r) 0
Mailing Address, C/S/Z: D., Auk /27D it I s V- -'
Cell Phone: ( 6 57 r Lanyi Line: (�r� 7 ),24;5— ,99/
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Email: Neit%S fc,u P�cs- 7` S yah6d ,e_e/n
• Business Owner(sl: //��
Contact Name(s): 1f}J- j ' Lu ke:C. W/41/.s /
Mailing Address, C/S/Z: 9?1 ,� UJ�c.SL-i DAl- /0.6;., 1ii i,t) /2 // a?er- Ah/ft7 9i/2,:fd
Cell Phone:_( ) Land Line: _( )
Email:
• Manager:
Contact Name(s): //1/2
Mailing Address,.C/S/Z:S'�ZP10_5_5
i /�J4 A)/at I/,_,i/ avee,usia,yy /ON:' ''i
Cell Phone:_(5'/1 ) 0 S Land Line: (S/k ) 7%? DZX(.9
Email: //94). 9.? rc5 ara,cJs r�
• Property Owner(s):
Business Name: Aviation Mall NEWCO,LLC
Contact Name(s): Jason Tyler
Mailing Address, C/S/Z: 578 Aviation Rd Queensbury,NY 12804
Cell Phone: ( ) Land Line: _( 518 ) 793-8818
Email: JasonTyler@pyramidmg.com
Contact Person for Compliance in regards to this project: . 7�o i+ 7
Cell Phone:( ) Land.Li e: (46`7 )
Email: 7/D i t► c r�-o?4. t/►r.v5c., /s
Certificate of Occupancy Only Revised December 2020
•
Town of C3uccnsbury
742 Bay Road,Queensbury,NY 12804
P:518-761-8206 or 518-761-8205 www.queensburv.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: I
Business Name: 1l//JL/&)L( i d!e
Business Location(including suite,space,etc.);_ r�c9/ll ali e LJ )d2' /li A;/;1 /1
L B•Y .ScP
Business Phone#: �2-' 7cf
1. Business contact name: /L'2 9 v S S
Main Phone:_(, '/f ) ;Secondary Phone: (37f ) 77/
Coming from what town/village?
2. Business contact name:
Main Phone:_( ) ;Secondary Phone; ( )
Corning from what town/village?
TOWN OF QUEENSBURY FIRE MARSHAL'S OFFICE
P:518-761-8206 F:518-745-4437
FI REMARSHAL@QUEENSBURY.NET
FIRE MARSHAL MIKE PALMER DEPUTY FIRE MARSHAL GARY STILLMAN
Certificate of Occupancy Only ;Revised December 2020
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15' From building structure 41111114Exit Signage/Combo Pack
10' From main mall entrance 40 Fire Extinguisher
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1.THESE DRAWINGS COMPLY WITH CRAP1ER 31 OF 111E 2015 INIERIW11OAAL FEE CODE.3RD PRINTING AS AmatoFM LCCq
ADOPTED BY NW YORK STALE.
. S 2. ONS(1)TYPE 2-A FIRE DTINGUISHER SHALL DE PROM)FOR EVERY 3.000 S.F.OF FLOOR AREA AND SHALL Sam ATE
= tunA TRAVa.DISTANCE OF NO FURRIER THAN 75 MI. 20.%40.Mr
w 3. IN THE EVENT OF SUMMED HIND SPEEDS OF 5D LLP.H.OR GTEAIER.lEM SHALL BE I01EDPJ8.Y EVACUATED. O
ANCHOR WEIGHTS
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MIT OF 700
o Au � POUNDS.
DIAGRAM swear IS VAw FOR 1E115 51114 Wwu U HEIGHT(HEIGHTAT i LEG)OF B-6 ANCHORING PLANa
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CER.2771C/1 7-:E Of:F.Lilill RECISIA9VCE
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j REGISTERED APPLICATION NUMBER ISSUED BY
FiG�ST�44\Nimma,,,;„isiiel - q • , 1„:-
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SEATTLE TEXTILE COMPANY ``
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IIISVP. o 4ETP Seattle,WA 98134
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• .. -o This is to certify that the materials described below have been flame-retardant treated (or ..bl.
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-' '7 . are inherently nonflammable) and were supplied to:
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�-� .•` MORRIS TENT
For Manufacture Of: 20 X 20 White B.O. Frame Mid a.
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. 13 MECHANIC STREET Number: WFMB020X20 Made On: March 17, 2021
MORRIS,NY 13808 .
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, � v• Certification is hereby made that: � ill
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0 0 o 6 The articles described on. this certificate have been treated with aflame-retardant approved chemical and , o
4 that the.application of said.chemical was done in conformance with California Fire Marshal Code,a b...0
to or exceeds NFPA 701, CPAI-84,ULC 109. quall i �.
The Flame Retardant Process`Used WILL NOT Be Removed.By
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Washing And Is Effective For The Life Of The Fabric
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` AL 1_+ATT •Y+'TEXTIL • • 11' : ►e Signed: '
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':. a • Name of A. Jicator of FlErnie Resistant Finish Certificati••uS•ecialist—Scott Kaczmarek/'SeatdeTe :eCom.an I'
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