CO-0765-2019 (2) CERTIFICATE OF OCCUPANCY ONLY Office. Uw 00
APPL
APPL
742 y 1 , ,
P. 18-761-8,2016,"art 1 - 61-920s WW . uee 5660 'et N
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"This application is for oc,cupancy o t no, work requiring a building in permit"
CONTACT I N FORMATI ON
o lic nt-
N ame(s):,Jo lle Timms
Kai fing ,Address, /$/Z 310 Past LaClair Street Hudson PaIIs New Fork 12839
Cell Ptim n .( i.' ) 681-1712 Land firma,
Erg aii,jr"" ll N8 liv .corwm
Business Owner(sj: SAME AS APPLICANT
Mailing Address, /51 . (11'�l or tap here tc, R racr tem.
Cell Phone: Land Line:
Ema:il:(
Manager* SAME AP' LICANT
Contact ga�rn ( ,�: Cfj('�J� co tap' here tc"gip'
Wiling,Addr ss, C/S/Z.- Click (:a,r 1,ap i°cn"cd"" to c '-m i.u
Cell Phone- Land Line:
ma rl,Cl lcdk c,r bvip 9""q,a_, t�, �°III w (1c x1,
Property Qw
Business, Name. Aviaition Mail N wccr L,L
Contact Narmm (s): James rii ith
Mail i'n Address, Aviation Road,, Queensbury, New fork 1
Cell Phone. Land Lire: 18-79 - 18
Email:jam s riffith pyres mldrng,,com
Contact Person for Building & Code Compliance: rm:°HIC], CQ' i�'ip, ht'R',, to entell [eel
Cell Phone, Land Line: �
Email. Cfick cff hr~i-e dext�
CertificaFc of Occupancy Only kevised F,pbruary 2019
AND ce(
742 Say Road,Queensbur , NY 128014
P„518-761-820 or 518-761®8 p5 r. ue rr qr jXj
BUSINESS INFORMATION:
l ame business: JO & Co Boutiques, Inc.
Address (including u.mit , space, etc.): Aviation Malk Store # D103
Click or tap Ii �e i,o enter text,
Type of business (Le.: retails, car repair, etc.): Clothing Boutique,
Please provide an accurate layout of your store showing ill walls„ exits, stockroorns, rest
roorns, counters and fixtures on a separate sheet of paper..
IMPORA qT, The business owner is responsible for keeping exits clear and maintaining exit
sigma and emergency lights. Fire extinguishers, fire sprinkler systems, and firs, al*m systems
require annual inspectionsan outside contractor and thecorresponding spondlin documentation
rrnu st be provided ed to the Town of Queensbury FireMarshal's office. Fire extinguishing systuem
found in kitchens and gas stations require 5em i-arnruual inspections. Any violations noted
during an inspection rpAuure im,meldiate corrective action sand a re-inspection.
Applicant rnarrne: c8h.i or iap �Ia..re tcc enter tglxt,
Applicant signature: niic : cntip iici e I,o �N�9w q q wit
Ceftifi+ale^iOtcupari y Ordy PeOwd Felbwary 2019
742 Bay Road,Q'u eensbuuryV NlY 2280
P,. 18-761-8,206,or519-76 -820 ul��r��bu� an t
EMERGENCY CONTACTINFORMIATION
"THIS FORM IS USED,TO ASSIIST EMERGENCY SERVICE PERSONNE'L'WHO, MAY RE CALLED TO YOUR
BUSINESS AFTER HOURS. PLEASE'E RF SURE THE CONTACTS LISTED, BELOW ARE WILUN N
AVAILABLE TO, REP ,C11ND DURING OFF-HOURS.TOASSIST POLICE AND/OR. FIRE PERSONNEL IN
AIN ING ENTRY TO OUR BUILDING.
PLEASE ICE ADVISED THATFAILLIRE TO ASSIST EMERGENCY SERVICE PERSONNEL MAY RESULT IN
DAMAGE CIE TO YOUR; BUILDING BY POLICE ANID/ I1 FIRE PERSONNEL.,
Date. 1 M/ / 0 .
Business Na , JO & Co. Boutiques, Inc.
Busin ss Location (Including SUfte, spia,ce, etc.,. Aviation Mlall —Store # D103
C k.u,r t'Sd.,u (tier t0 n8 r Iryxt
Business Phone H,, 18- R1-171
, Contact Haas:Joellle Tinim;s
Main Phone- ( 518 ) 8':I-1712;Secondary Phone
Coming from what town/village? Queeinsbury weekdays/ Hudson 'Falls weekends
. Coma t name: a";MHblk4 c�ur taii11 Nay ie to eritc.r text-
Main Phone: Secondary Phone:
Coniin f ro ni whial tow n/vi I I a ge? (Ji cl( t')r to 1,:) �Br pf" kcN e. r'V11 Rext,,
FIRE MARSHAL IMIKE f-'Af_,f+ R Dtpu t Y r 11HE M AFC lk-AL.G A R Y F-I LLM
cort flcate on Occupancy ciniv Rawlised IFp rvary 201.9
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PIC-
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302.5-1-92.11
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578 Aviation Rd