CO-000052-2016 TOW.. 'M .Y, QUEENSBURY
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4 ` 742 Bay toad, QUeersbury,NY t2804 5904 (518)761-8201
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Conn Development - 13tti1�ling ,� Cocks (518) 761-825C�
CE-11RIFIFICATE N 01`—�� NCY
Permit NLIniber: CO-1 00052-2016 Date Issued: Thursday, March 24, 201
This is to certify that work requested to be clone as shown by Permit Number Cad-000052-201
has been completed.
Tax Map Number: 288,-1- 1
Location: 42 GURNEY L N
Owner: ''barren. Operations Associates, L.IC
Applicant: Lloyd Cote
This structure may be occupied as a: C/O only, Warren Center (former Westmount
Health Facility) By Order of']'oNvn Board
TOWN OF C7fJEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the
property owner of the responsibility for compliance with. Site Plan,
"variance, or other issues and conditions as a result of approvals by the Director olBuilding& Cade Enforcement
Planning Board or Zoning Board of Appeals.
Comrararrrlty Development Office
Town of Queensdrury • 742 dray Road Queenslrury, New fork -Td( 04
David d atin,Director of Budding Codes Michael ,Palmer, Fire Marshal
Cram Brourra,Zoning A draainistrator- 0 �
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IITEW BUSINESS CERTIFICATE OF 007UP�
APPLICATION
TAX MAP �'� �'a �� � BLDU. PERMIT FILE# ; C CO Q
It applicable
t •'ram*
Marne of Business; ,�1 1�
Address /—()C9 -86
of Business: -241 Gu(nr-( ,�, QUESTI4JN7 CALL
76126 OR
EMAIL codes D_gueensbury.net
VISIT OUR WESSITE FOR MORE �
Person in.Charge or Manager. �� INFORMATION
www,queenstrury.net
Business Phone Plumber:
Type of Business: !�
( ) � -6� � 0
Owner of Property: Phone Number( )
Home Cell
Owners C / p r�
Address: " ? ! /T �,��s Axn�i W l bl o
Please provide an accurate layout of your store showing all walls, exits, stockrooms, rest rooms,
counters and fixture layout on a separate sheet of paper.
,✓ � ...
Signature: � ./�..,_ G"" QEt4;'
Of person submMing this form
Notes 1 Comments:
FIRE MARSHAL'S OFFICE
Toaln of Qucensbury
742 Bay Road, Queensbury, NY12804
o fit e of N a t ii r a I Beauty — A (Goad P 1 (7 c e fir
PLAN REVIEW
Warren Center (Westmount)
42 Gurney Lane
2/8/2016
CO-000052-2016
* Verify placement and function of all exit and emergency lighting
fixtures
* Verify Fire extinguishers locations
# Provide current generator inspection report
* Provide current sprinkler system inspection report
9 Provide current record of inspection for range hood suppression
* Provide current cleaning report for Hood, duct and fan kitchen
systems
* Complete install of Knox Box and provide keys
* Evaluate / Install carbon monoxide detection
* Complete walk thru inspection of the facility will be required
* Placement of Blue FD signage
Michael J Palmer
Fire Marshal
742 Bay Road
Queensbury NY 12804
fire marsh a I@quee nsbury.net
Fi r c Mara s h as I's O.ff i e e 11 o ii,c: 518-761-8206 j-'a x: 518-745-4437
ftrei
EMERGENCY CONTACT UPDATE
Please print clearly
DATE: j
0 4 ?("I"Ih
BUSINESS NAME:
BUSINESS ADDRESS.AO
BUSINESS PHONE:
ra Lo
PHONE 1:
CONTACT 1: Rl� PHONE2. r-A -7 1
TOWN/VILLAGE RESPONDING FROM:
ur) Mam Cr PHONE 1:_7Ch C)03
CONTACT 2: 9'Cj-)e_ PHONE 2: qZa- sbf_)C:)
TOWN/VILLAGE RESPONDING FROM:
This form is used to assist Emergency Service personnel who may be called .to
your business offer hours. Please be sure that the persons listed on this form will
Lae willing and available to respond during off-hours tc assist Police and/or Fire
personnel in gaining entry to your building.
PLEASE BE ADVISED THAT FAILURE TO RESPOND TO ASSIST EMERGENCY SERVICE
PERSONNEL MAY RESULT IN DAMAGE TO YOUR BUILDING TO FACILITATE ENTRY BY
POLICE AND/OR FIRE PERSONNEL.
TOWN OF QUEENSBURY FIRE MARSHAL'S OFFICE
Phone: 518-761-8206 - Fax 518-745-4437
fi,remarshal.@queenisbur-net www.queensbury.net
Fire Marshal Michael j Palmer Deputy Fire Marshal Gary K Stillman
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EMERGENCY PHONE JACKS` `rb I 1 FIRE ZONE KEY
MEDICAL REFRIGERATORS
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SUCTION MACHINES / CPR ZONE 1,EAST VdING-
efa ( _ ZONE 2,NORTH
FACILITY CELL PHONE �\ ZONE 3 VICE WING.
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ZONE 4, .
e ZONE 5,SOUTH WING
ZONE 6,WEST WING--
sHx,<° # ZONE 7,MECHANICAL ROOM
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