2024-0500 Docusign Envelope ID:EA6A1F78-6CF4-401C-BB17-3F9309070563
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CERTIFICATE OF OCCUPANCY ONLY Office Use Only,
Ate.3', Permit II: 2S4•214 *
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.
APPLICATION
Permit F . 1 —
t(2- ..
Foot a ii Nur
742 BInvoiceay Road,Queensbury,NY 12804
P:518-761.8206 or 518-761-8205 wym,queensbury.rtet
**This application is for occupancy only,with no work requiring a building permit**
BUSINESS INFORMATION:
Name of business: 1—S (..) t .1_, UY
rc . 4
Business Address (including suite,space,etc.): -15- ( ,a), go.,..), ( ).....,4 Z.
Detailed explanation of business(attach a separate piece of paper, if necessary): p,,,j, ,1„,
c.---4,*CU e455, C4LLI ." i4418. 1 41144 prdi
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...1.:/:4, Lt.'s i'... cb GL.Wilyri%. .y61 p.4 dit , e.,..etieri suet 4 44....1....,;11 4...1,..,..44.4. rj,erb........•....4.- :I
*
4 . .3**Please provide an.aYwatrate layout of your space showing -,1
all walls, exits, stockrooms, rest rooms, countess 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.
1
.......,.........
Applicant name: C.-7 . Up•Lit, ill)/- A., ..-1...4.,..
,
Applicant signature: At d2... Date: el/(2120-1.,,i
04 P Property Owner name: ,'4.. ,-,,r,„-i,,e,1 LL6
p- Signed by: ...
Property Owner signati ,-- 4/ Date:
\--299BF2F3C4130431.
le e r&
IC 11 11,
Certificate of Occupancy On I ly Revised September 2022
SEp 1 u 0
2024 70
TO
"ME
DING&u, Satipt,
oDes,,r
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):
Mailing Address, C/S/Z: Kizs Ir�.l:o n�:K-- S��t� 26v, 0.01L 2,. MN Ss12c1
Cell Phone: ((,si ) -Sol zs s- Land Line: ( )
Email: kb`"PP,,4 e.4<per(' <o..
•
• Business Owner(s): _
Contact Name(s): Ry... , -1 5!._. 11` pi,Mailing Address, C/S/Z: yfzs g.J p t zoo, wo,.�1L. rho Ssrzq
Cell Phone:_( )(,ci -z3e-7 Land Line: (
Email: krotur s.4(),4ep---e,,,,.,.._,-,--Lr.,
• Manager:
Contact Name(s):
Mailing Address,C/S/Z: 2 3 Co(I.44, L (4-1c0.. F.11%, NY 12-83q
Cell Phone:_(Sf 8 ) -sit 37 Land Line: _(
Email: ur,t_4_.,y01...tc rei..-;k--• —
• Property Owner(s):
Business Name: Dec, hror-1.4 L.Lc-
Contact Name(s): eQ...,e.-
Mailing Address, C/S/Z: Po Rba 3Y G QY rzoYY
Cell Phone:_(S18 ) Rs 7— isss' Land Line: _(
Email: ZM;L.cvc.l i1..,,,.re—
Contact Person for Compliance in regards to this project: /-lu�W.
Cell Phone:( ) Sol 7„ 3c Land Line: ( )
Email: I,vs.fir4 _=-�=-h-4..._
I ,
Certificate of Occupancy Only Revised September 2022
lail:MWSEE' . t A'- n..r. .. .. - - - ---
7,e,P.
1 c4 C�:iti ii WIl'
Yr
t 742 Bay Road,Queensbury,NY 12804
P:51S-761-8206 or 518-761-8205 www.queensbury.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: 9/12/Z0LLf
Business Name: ETS u 4,_L DVY
Business Location(including suite,space,etc.): —7S C�,� o,.�� U.:.� Z
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Business Phone#: 5 (g- 83 - -S5c0
1. Business contact name: I1_41 11I,.r...,_
Main Phone:_(SI 8 ) 3't ;Secondary Phone:_(SIR ) 832 S -o Q
Contact is coming from what town/village? lufa„F I(t t IJ`f
2. Business contact name:
Main Phone:_( ) ;Secondary Phone:_(
Contact is coming from what town/village?
TOWN OF QUEENSBURY FIRE MARSHAL'S OFFICE
P:518-761-8206 F:518-745-4437
FIRE-MARSHAL@OUEENSf3URY.NE
FIRE MARSHAL MIKE PALMER DEPUTY FIRE MARSHAL TYSON CONVERSE
Certificate of Occupancy Only Revised September 2022
AMP --.,_-
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308.20-1-3.3 2024-0500
• ETS Upstate NY _
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75 Carey Road, Space 2 .
• Certificate of Occupancy
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LABORATORY TEST REPORT
I Report 0 tit CltB
9 Leta Teak N sSt�w481�x
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TLSTMATERIAL:
Deck§pds Data Material Received: Juno 16,2023
A s: 15 PsoeG'a Park Drive Suite 240 Natorlai T S taetc Turf w Machad Cushion
l andol lutA Q23-88 made w Condition: Excellent Now
Products GT48
To �lttETkltyAS�t�Qa STE@:
Tas Services ko,was instructed the client to test fair the fc1llorovin ...
laird. ASTM O28 16 2021 Test Method. Sfafllmlv Test Method Berl 'an Characteristics of Finished Tendrlo Ffoomr G�wo n MatarraCs
g PLAN,
Date.Wk
,
.. $aAwiIIY.VI"WIN:Is padorwIft ale WON de6atmad ai'ESI..
r The vursfiRp We d wdins.iA d.WM%od by 116 Wd MINN amaUAWEaAta.
• In boa mEAa spscft wgft'aaaw I*O"fW.a afim1MiI1sfim 94 b&MA&hudd WI PoLVA 19411N 0Mpenanam,and appwvW fw M bp'an autanad HLwW,
Ad UNOWaro utonidtw dm wApda mM1aa191®afBf,WIbm wf Iw*mft Wd 0014W.blattW
. µj ttl dd AalatllYN'AA%W'wGBd,'GpMWaaaa Gia GbG.40lp.lpa 1dp9 al�bq Alb Ilka Sl'WgIM�b Ipk fdaCWd
TES SCOPE., This testmethodpmvidas a matnod of defermining the flemmabRity cheraciertstres utilizing a small ignition source fmothenamine tablet)in a laboratory
anluironmsnt,Eight specimens,9RX 9,were taken from the sample lot and i nVed with the above listed infill recipe,Each sample was placed into a test chamber
floor and a steed framer 230mm X 230mm with 200mm diameter hots,placed on top of the pile surface.A methenam'ine tablet was placed centrically onto the
fiber surface.The pW was ignited using a lighted match,with the ignition flame and pmpagafed flame allowed to W-exthpish.
CRf rgRIA: The specimen passes,if the charred portion of the fast specimen did not extend to within 25mm(17 of the diameter hole of the steel frame.The U.S,Consumer
Product Safety Commission mquiies that at least seven of the eight specinaenspaw the test for acceptance as meeting the standard,
TtoiN FROM TSST,kt t"l OD&
Stater reasoIn for an DoWaWn frsa+n AddMans to or E=hIs ittrus Fmm Taaat4 eft,d.
Due to maCorlatcontent,speGfmens ware not pm-ondWoned oven dried 185'02 hours
T 19ATA:
TesttYadw Test amen UnchanvdAroa Result
M D2859.18(2021) Pass
PiN Flammability 2 Pa
3 y a
4 Pass
1 'R Pa
8 3,11" Pass
7 >I Q" Pass
tl y3.0P Pass
Test Summaq
8 out of 8 pass Passss,U.S.CPSC 16CFP 1630 FF1-70
via a�aaaeldanatwrwuaabaanabauaRaanesMrtsanmkdmasaeamaa«wwbwwwwddpmam�laaamar�daama.
Tsa ww�u+r'we�wwAm..{mlawa�sa +
4ldew. awdNdIre lMnxna1lVwrnu drNAmnaI.NaJR rreanM,.aa aaFR.aMeatiamnndErwarrydFmnrs xrafl w.PMRdmN mNMmBi.
stia Mina,Ilk Iamb puremtmr TaahaNg Samos ITSII LLC
'TSi ddadanr... Our 9abmras"is awediiad by ft US O"i.gat CaERIRPR aa�Naaanai Inattuta of$Wndarda and Techaaakrgi+.;ISC OEC 174e5IM6 Out nwade#c N'VLAP 1.00106.0,
I TB da an OrgamizationW Mambw OWN(Annadcan SodaV ASIr TestIns and MaWdAs).TSi is a eaatd'm3 imdapendoM WS*Waaa Wq by ha.STC(Syntl Tuad'CaauneB..
sda "4dl17yy
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100208-D
Testing,Services(T5t)LLC
817 Showalter Avenue
Page 1 of 1 PO Scrag 1343
patto n,GA 30721
tf4ut I.cFIExS'AND A FORTS APPLY ONLY TrTHE SAMPLE'TESrEaY AND ARE MY IADJATIAOF'UM OLAUIVES PP AFPAREEPfLC IOZWICAk OR UMIIAW PRODUCTS,TH13L LETTE'RSoANA REPORTS AN%FOR THE USE aNEY i(aFIHE CIANT 10 WHOM THEY ARE AWRt:4'SEp AND HEIR
COMiMWWCA'ra NTO AW ClrMERS OR THE USE,OF THE NAME TESEIMG SERVICEa,INC'..MUST RECEuvE OUR PRIOR WRn"TEN APPROVAL.OWN At PORTS,6ETiHR$,NAME SEALS,OR INSIGMA ARE NOT UNDER ANY CIRCUMSTANCES TO N USED IN AUVER SING TO THE GENERAL PUOuC.
i
S T I N G
NLABORTORY TEST
vi,10 B'a 847A1
W T
ifiElrrr, ftss t.aw Test slutubalr. SSt4BB7
Batas duae 23,
IW"WYt"itW.�`I@'S��IfSiLeTV��'ES.tPS � ^^�
afficeWestin serwrice's.ats
c TESTMATtERtAL.
t}rt tuck S s Date.Makdol d: .tune 16,2023
A ress: 15 Pacella Pads Drive Stab 240 materiat T S nthatic Turf w/Attachad Cushion
Rando ,MA 02368 Material Condiat a: Excellent New
Product, GTT48
TES G METHODS REQUESTED:
Testing Services 'was instructed Py the client to test for the toiitrwi ,...
lard": ASTM E644 NFPA 253 Test Method: Standard Test Method for Critical Radiant Flux of Floor Covering'Systems Using a Radiant Heat Energy Source
FTM Standard 372
SAMPLING PAN
S l)aft 40/2023
• Specimn sampftispeftconed fin Me samprrng depafte d of TTS1,,
• The sampungsireerspadmenaisdatenn0ad'byMeras method requirements.
in the event a speaks s'amppng sire is not caged for a derarmina6m wail be made based or previous tesb'ng oxpadems.and approved far use by an authodEzed manager,
r Allr samples are suboded ro the oidside envhwmentar conafficas of temparature and ralaeva hwmdtyr.
S ere lnarr ax ura to s ed anviromrier tat oevrvdd ons based on a edlLic tear metrnod„take sea in tt a a tenants rn 1vt1 ofn the a a seated
DS Tt4N FROM TE'STM
Stale reason for M Dartedon fro^Add tins to or Etrchrstons From Test Moffiod.
Noma
Tr*0 SCOPE: This test method measures the crftaf radiant flux of hodxontaty mounted flbor-covering systems exposed to a Naming sjffibn source positioned an a graded
radiant haat energy anvirtrnment wlthi n an enclosed chamber:The results are designed to pro vide a bests for estimating one aspect of Tire behavior of a tloorivrg
system..
T SUMMARY.•
TEST ME17fDD TESTDE'SICRtPTtDN TEST RESULT
Burn Dlstence Ttma'to Flame Out Crtdcat Radiant Flux^
AST E648-loaf Crdroal Radiant Flux Specimen,#f 11 fOf'cm 1:49:28 min 0.00 L'W.fcm'r
S cirnen tit 1 101 cm 1:24:34 min 0,00 WcmE
cllrfan#3 101 Cm 1:30..24 rain 0.00 itW,+dm2
NFPA CfassttPcattao NO Ctasstdcad"
SIDEW 0,00
COO Of v"erfab'tn coo
Mow
�nq
Board:Calcium Skate Board AdhesWc MuN-Purpose Tr"owet:WAnCanbring:96 hours @ 707 RH CdittraOon Cur":36aF w1ornow C 5356
YAM I
We ul all ee4mrorts for our siesta on a Deal ofiDd basia,Our findings and jadgments are based on Iftromason'bo us using rho wost rest rnaarods avabble.
'TSn a rewha rbr the apaalae sauna wated,
tnnl aeaarpuiaa rloud in'a4a dewiadau;aadons or tins report alb tests ace perloN ea atdr Red m owolan Stated test nwthad.
Test Fperq.Apprdtrak
Sdo Was,IN,Lab Duacbr Tasting Sa maaa CTSay LLC.
TS dlbfta: 0UraabO1;R p1..Xmdttadbydre USaapt.ar ,NaborWr n5ftWaMandardsand T40hHWAW 6$7 C1702500e.Ourear7a Cc NVLAP'10010",
T81 a5 an 00ganbalianan.Member of ASTM lArNR6$n:ocWy for Teadng and,naaenetal.
1 �(^!w}, {,ski.
V�A r
TESTINQ
Testing Services(TSI),LLC
817'Showalter Avenue
PO Box 1343
Dalton,GA 307Z1
OUR LETTERS AND R PCarT&APPLY ONLY TO THE SAMPLE TESTED AND ARE NOT NECESSAPrt.Y MOOCAInW,OF THE QUA TWS OF APPARENTLY Ya@kn'WAp 04 SIMtlLhR PRC➢MOn"I:'S.TUHL 11'nIMS AN'aR*P4M75 ME FOR THE.USE aN0Of THE CLIENT TO WHOM THEY ARE ADDRESSED Amp INEra
COMMUNICAT1 TO ANY OTHERS DR THE USE OF TPAE NAME TESTING sEEvx:E%niC MUST'a cim oua PR*R wwrnm APPROVAL OUR l vogTS.umERS,NAME,SEAL$,OR NNU5NrA ARE.NOT UNDEA ANY CARCU STANCES TO BE USED IN ADVEgnSING 70 THE eeN'ER&PUBLIC'..
BL
O""N DECK GT48 ARTIFICIAL TURF
10SPORTS. GT48 is our most popular artificial turf option
for indoor facilities.The polyethylene yarn
provides the softest feel while still holding up
to,heavy traffic.
No infill necessary,save yourself the time of
cleaning up the rubber pellets.GT48
Padded Artificial turf is designed to
withstand the rigors of daily use and high
traffic.
M MA
r' 1301yethyl e en Polypropylene
Pile Height 0.9,1 in.
c Olbr(s) Black
s
Primary Backing Polypropylene Cloth Non-Woven
coating Polyurethane,
Poll Size 15,X100,
...................................... ..................... .................................-
48ozW
Total Weight 74 oz/yd2
fight 5 oz
.................. -
Secondary Coating Weight 21 oz/yd2
T/ial biy,
PASSED ASTM D2859
Total Yarn linear Density 7100 stiches/sqrn
3/16 in.
Permeability > 180 Mm/h
<50pprn
8M 6S6171
info ca Ondecksports.corn
Ca)onic ecksports