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2024-0354 CERTIFICATE OF OCCUPANCY ONLY Office Use Only ("111) V Permit#: 20 `6.JP .__. ,, APPLICATION Town 4;fCtrecns u�y Permit Fee:$ 742 Bay Road,Queensbury,NY 12804 Invoice#: P:518-761-8206 or 518-761-8205 www.queensbury.net **This application is for occupancy only, with no work requiring a building permit** BUSINESS INFORMATION: Name of business: 3/u� ��n .�� 017 i 1 ;1 - Business Address (including suite, space etc.): 9-g,.._ c .,: •' -t \d, O Detailed explanation of business (attach a separate piece of paper, if necessary): 12 ,d-cLr ;p ***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-ann..u.aLiriwspectaoris An,? i�l tions noted during an inspection require immediate corrective ail Minjsp c i• JUL 19 2024 " . Applicant name: _De/LAR ,eA r. — ct cli►{,Y TOM ur Cvq BUILDING MODES Applicant sig atn_- Date: 9/ " S� Property Owner name: f (nit-iA)41"- Property Owner signature: -4,r Date: Z/i` Certificate of Occupancy Only Revised September 2022 .rye Town of—Calgeenibiny 742 Bay Road,Queensbury,NY 12804 P:518-761-8206 or 518-761-8205 www.queensbury.net CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Applicant: Name(s): ss iY MbeArt -.De"( LA-P ee4-,a�� Mailing Address, C/S/Z: $ r.e,-)_< JJ,.erU4 j..e, c //p_5 Cell Phone: (5i ) 3713--?6,D1 Land Line: ( ) Emmail:Z ire a . /-42A.ea O /u-e. otssf t', , • Business Owner(s): Contact Name(s): Mailing Address, C/S/Z: Cell Phone: _( ) S Land Line: _( Email: • Manager: Contact Name(s):i Mailing Address, C/S/Z: q2 ,/ar.7r 019r�e_, / iiQ3 Cell Phone: _(.5n ) Land Line: _( ) Email:1.Z7 o H u,Se r 2/c Cc, ra4 s Q 3= C-'o.►Y, • Property Owner(s) Business Name: Av,a-ri Contact Name(s): 644-g $ 't'i Mailing Address, C/S/Z: 572? Ave.4 . Cell Phone: _( 37# ) 1'13 "i1212 Land Line: _( Y1n ) Email: .-% car 6 g`v3 Q ra J i0A.s • UNA., Contact Person for Compliance in regards to this projectlp Cell Phone: (57's )773--9Cc 4-/ Land Line: ( ) '/u-e C=1 4.�s I ', cetryin Certificate of Occupancy Only Revised September 2022 r: ik. "t Town of'Q ccnshury , 742 Bay Road,Queensbury,NY 12804 P:518-761-8206 or 518-761-8205 www.queensbury.net i 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//5/ 7/ Business Name: /J-Q Cre:r7-,?Eko1/4,‹S R Y .,?�, h Business Location (including suite,space,etc.): Business Phone#: C5> j)39 g"961-/ 1. Business contact name: cc_u42 l. :er.,..cie-71- Main Phone:_($7" ) ,39-S-'96„.D y ; Secondary Phone:_( ) ' Contact is coming from what town/village? ,2<_, Ol/ k 2. Business contact name:—70— /©v`S e r Main Phone:_(-51' ) 91/'"-1,5-0 ; Secondary Phone:_( ) Contact is coming from what town/village? flY,12.2"i// P 0^fi TOWN OF QUEENSBURY FIRE MARSHAL'S OFFICE P: 518-761-8206 ' F: 51 8-745-4437 FI REMARSHAL@QUEENSBURY.NET FIRE MARSHAL MIKE PALMER DEPUTY FIRE MARSHAL TYSON CONVERSE Certificate of Occupancy Only Revised September 2022 ? :1RV 035B Albany 4 I —_._2Q24 AV'I,ATO MA L 578 Aviation Road, parking lot Certificate of Occupancy H - - --�, , - 35"1 - 1 Roa'' 1 a Aviation-Roa 35` - Aviation Road ' 35' 41 35, I I- .■ -- - 35' • — — -j 1 RR. 35' 1 35' d -® ? - __■ ® ®1 * SE I' SSE _?J �SC I .-_ �- ■ CI i I I I I I I I I I I I oc ■ 35' -1 35' '1. 35, S ' 'I' MUM, MEW I ti----1:1 ■■ASIDE 1., ,se 'I ;Se is ,se _t. ,se - - _ I 1 4 1 1 I l i II y L i I I I ® � 35, I, iambi — N• • • III MU 1111111 • II • _ - ttt��� " ' O 'lik-- 1. MEOW 35' -MEW 35'■ I-1 I - 1 1 I--1 ( i 1• I I I _ ,- ■ ■■ I■■■I■ ■■■■■ 1' SE 41.5311. 4' ,SS ! - - ®! 35' '1-� ,". — __ i--- r'1 I f _I 1 1 1 _ —I 1 .G.i1 --- — ■`�■ �, — _ 1 _ I Ii1 — -- Aviation Ro aid — ! ( P�%��o��' — — IGa3Q. I— fit — — — — _ __ Q. p.-' 4 '►+s -- - - - - - 0 co O _1 i co c _ �_