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CO-0708-2023 l / 00044 CERTIFICATE OF-OCCUP_AN.CY_QNLY Office Use Only O E Permit#: C O —070 3(--0 Al;P�L-IC—A- O _ iim:ofi mcus r$. NOV 0 6 2023Permit Fee:$ �9cS/. 6 0 742 Bay Road,Queensbury,NY 12804 Invoice#: C�7 l P:518-761-8206 or 518-761-820! vtraknrie'ensbu[yFiVetjiSBU`;Y BUILDING 8L CODES **This application is for occupancy only, with no work requiring a building permit** BUSINESS INFORMATION: Name of business: Creative Jam, LLC Business Address (including suite, space, etc.): 6 State Route 149, Lake George, NY 12845 Detailed explanation of business (attach a separate piece of paper, if necessary): open space for gallery/retail of artwork with tables, chairs and easels for creatives/artists to work. ***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: Darcy Leigh DarcyLeigh, Creative Jam:Digitally signed by Darcy Leigh,Creative Jam 1 1/3/2023 Applicant signature: 9 „ Date:2023.11.0420:03:03-04'00' Date: Property Owner name: AIJ, LLC (Jeff Goldberg) Jeffrey Goldberg for AIJ,LLC,'•p o i oa zo` , }Or AIJ,LLC 1 1/3/2023 Property Owner signature: oonar Date: Certificate of Occupancy Only Revised September 2022 2_ look Town ti t`1�recns:ua 742 Bay Road,Queensbury,NY 12804 P:518-761-8206 or 518-761-8205 www.queensburv.net CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Applicant: Name(s): Darcy Leigh Mailing Address, C/S/Z: 357 Ruggles Road, Gansevoort, NY 12831 Cell Phone: ( )518-596-6399 Land Line: ( ) Email:darcy.arwen@gmail.com • Business Owner(s): Contact Name(s): same as above Mailing Address, C/S/Z: Cell Phone:_( ) Land Line: _( Email: • Manager: Contact Name(s): same as above Mailing Address, C/S/Z: Cell Phone: ( ) Land Line: _( Email: • Property Owner(s): Business Name: AIJ, LLC Contact Name(s): Jeffrey Goldberg Mailing Address, C/S/Z: 814 Goggins Road, Lake George, NY 12845 Cell Phone: (518 )527-5117 Land Line: (518 )798-9203 Email:Jeff@fish307.com Contact Person for Compliance in regards to this project: Darcy Leigh Cell Phone: ( )518-596-6399 Land Line: ( Email: darcy.arwenggmail.com Certificate of Occupancy Only Revised September 2022 3 742 Bay Road,Queensbury,NY 12804 P:518-761-8206 or 518-761-8205 www.aueensburv.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: 11/3/2023 Business Name: Creative Jam Business Location(including suite,space,etc.): 6 State Route 149 Lake George, NY 12845 Business Phone#: 518-596-6399 1. Business contact name: Darcy Leigh Main Phone:_(518 )596-6399 ;Secondary Phone: Contact is coming from what town/village? Town of Wilton/Gansevoort 2. Business contact name: Jeff Goldberg Main Phone: (518 )527-5117 ;Secondary Phone: (518 )798-9203 Contact is coming from what town/village? Lake George or Wilton/Gansevoort TOWN OF QUEENSBURY FIRE MARSHAL'S OFFICE P:518-76 1-8206 F:518-745-4437 FIREMARSHAL@QUEENSBURY.NET FIRE MARSHAL MIKE PALMER DEPUTY FIRE MARSHAL TYSON CONVERSE Certificate of Occupancy Only Revised September 2022 Aft FIRE MARSHAL'S OFFICE Town of Queensbury 742 Bay Road, Queensbury, NY 12804 4111 "Home of Natural Beauty ... A Good Place to Live " PLAN REVIEW Creative Jam, LLC 6 State Route 149 CO-0708-2023 Certificate of Occupancy 11/13/2023 I have reviewed the submitted drawings for the above project, and offer the following comments: 1. Verify fire extinguisher locations and current inspection tag 2. Verify paths of egress 3. Verify storage 4. Verify clearances to electrical service panel 5. Verify work was completed to properly protect existing receptacle outlets, switch plates and junction boxes as discussed during previous walk through 6: Verify locations of and performance function test of all exit and/or emergency lighting 7. 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