2011-059 TOWN OF QUEENSBURY
w742 Bay} Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20110059 Date Issued: Friday, May 06, 2011
This is to certify that work requested to be done as shown by Permit Number P20110059
has been completed.
Location: 340 AVIATION Rd
Tax Map Number: 523400-301-008-0001-017-000-0000
Owner: DONALD & LUCYNA SOKOL
Applicant: NORTHLAND FRIENDSHIP CLUB
This structure may be occupied as a:
Certificate of Occupancy (COM) By Order of Town Board
TOWN OF QUEENSBURY
(Th
Issuance of this Certificate of Occupancy DOES NOT relieve the r,< , / wr
P Y r
property owner of the responsibility for compliance with Site Plan, '�✓
Variance, or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
011W.ET 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20110059 Application Number. A20110059
Tax Map No: 523400-301-008-0001-017-000-0000
Permission is hereby granted to: NORTHLAND FRIENDSHIP CLUB
For property located at: 340 AVIATION Rd
in the Town of Queensbury,to construct or place
at the above location in accordance with application together with plot plans and other information hereto filed
and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning
Ordinance. Type of Construction Value
Owner Address: DONALD & LUCYNA SOKOL
340 AVIATION Rd Certificate of Occupancy(COM)
QUEENSBURY,NY 12804-0000 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans &Specifications
2011-059
CO only-NORTHLAND FRIENDSHIP CLUB
$50.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Saturday, March 10, 2012
(If a longer period is require=d,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before:the expiration date.)
Dated at the T-ownt$Quee(/tiib , :Thursday, March 10, 2011
J /Yip;•JY
SIGNED BY C...1 G /4J
for the Town of Queensbury.
Director of Building&Code Enforcement
. T. Community Development Office •
Town of Queeenshury • 742 Bay Road • Queensbury; New York •12804 Date Stamp
• Daaid 1-latin, Director of Building&Codes
Craig Brown,Liming Administrator•Michael J. Palmer, Fire Marshal 20',1
NEW BUSINESS CERTIFICATE OF OCCUPANCY PERMIT
APPLICATION
1I • _ / - / 7
TAX MAP # BLDG. PERMIT FILE# /7-0c7
I If applicable
Name of Business: 1\1 l)�:`U�(J� �� (1 5 � C`0\C1
Address (�, � T.-43C-4_6\
(�
of Business: 340 1V1l�\-taf� \ c4 QUESTIONS? CALL 761-8256 OR
EMAIL codesqueensbury.net
VISIT OUR WEBSITE FOR MORE
Person in Charge or Manager: on- O\<<:, INFORMATION
www.queensbury.net
Business Phone Number: 1)12) -3°13�
Type of Business: C,-\0•'C�e,c- (loin- ee k- c,\..\ •
Owner of Property: nG\& Phone Number(s): 51$ - 79 3-1157t4 S i 9— 1 4 J-2,7 7
Home Cell
Owners
Address: IzR 'CV:)C\0R- I Q )- \S\D vc > N Please provide an accurate layout of your store showing jeweils, exits, stockrooms, rest rooms,
counters and fixture layout on a separate sheet of paper.
Signature: � w X Date: 3 9' \1
Of person submitti"Loral 1
Notes / Comments:
2611 -O5
EMERGENCY CONTACT UPDATE
TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 743-2502
PLEASE PRINT
DATE: 3 g `\
BUSINESS NAME: �n�w�1 -(nQ. �iC)t3b
(�aC nk�n,
BUSINESS ADDRESS: jL- 0 P\o'oc\--ic;(\ iL3 (),1/4 & ç 5
BUSINESS PHONE: Co3 Co" 3 c 3(
HOME
CONTACT 1: \ Mw13 �c� � PHONE 5� _7' 570
ADDRESS: 3a 4A3LA k'\\s \--)0 s Chi-ems ekC
HOME
CONTACT 2: \� S ' - PHONE `'‘'` -- lei' 13
ADDRESS: 3� `- Dc ( tQA.14kfila
1v
This form is used to assist Emergency Service personnel who may be called to
your business after hours. Please be sure that the persons listed on this form will
be willing and available to respond during off-hours to 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
Ph on e: 518-761-8206 • F a x: 518-745-4437
firenzarshal@queensbury.net • www.queensbury.net
Page 1 of 1
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The Town of Queensbury does not warrant the correctness or accuracy of this data or assume any
responsibility for any explicit or implied uses.
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r,-.."m 742 Bay Road
Queensbury,NY. 12804-5902
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Inspection Form
/2 //,1
Town of Queensbury Fire Marshal �Perfodic Inspection Date: -
742 Bay Road,Queensbury NY 12804 o Reinspection ) ) _v s/
518 761 8206/518 761 8205 --c,='CO Inspection Permit#: I I /
Fire Marshals Representative
_MJ Palmer Business Name: i�1'Li !Irnit ., I c(,,0
Location: /L ,,, 4' E
GK Stillman Contact: - �.;,i-,f
Type of Inspection N/A Yes No
EXITS: NOTES
Exit Access FC 1014
Exit Enclosure FC 1020
Exit Discharge FC 1024
Sign Normal FC 1011
Sign backup FC 1011.5.3
AISLES:
Main Aisle Width FC 1024/1025
Secondary Aisle Width FC 1025 , ,
FIRE EXTINGUISHER:
Hung FC 906 -
Insp of extinguisher FC 906
EVAC SIGNS IN R ooms FC 404.6 •
TRUSS ID SIGNAGE FC 505.3
EMERGENCY LIGHTING:
Interior FC 1006 ✓'
Exterior FC 1006
Clearance to Electrical FC 605.3
Compressed Gas FC 3003
Knox Box FC 506
F.D.Signage- FC 510 ,_ �-
,, , --)0
No Smoking Signs FC 310.3
Storage FC 315 �� '
Electric Wiring Enclosed/Labeled FC 605.3.1
Vehicle Impact Protection FC 312.1 // �/-.. / �'
Interior Finishes FC 803-804 - / Q2 J
Smoke Detectors FC 907 l \._6 - j
CO detectors FC 610 � ' 11
Clearance to Spr,/Ceiling FC 315.2.1
18"/24"
Exterior Storage FC 315.3 - "
Operating Permit
Vacant Buildings FC 311 i,,,-
REINSPECTION DUE APPROXIMATELY
21 DAYS
SYSTEMS: FC 901 lnsp OK NC - DATE: OK NC
Date
Generator Annual DATE: OK NC
Hood Installation /
Elevator Semi Annual \.
FIRE ALARM Annual DATE: OK NC
HVAC Shutdown
Sprinkler System Annual 4'
Sprinkler FDC
Kitchen Suppression Semi Annual ,, Fire`•. ;�i t, omrlpie
Fuel Island Suppression Semi Annual '. to } �'
Hood Cleaning 3-6
. 1411111F., 2) '1)f.!11
Inspection Form
Town of Queensbury Fire Marshal Periodic Inspection Date:
742 Bay Road,Queensbury NY 12804 Reinspection
518 761 8206/518 761 8205 CO Inspection Permit#:
Fire Marshals Representative
MJ Palmer Business Name:
Location: 34e)
GK Stillman Contact:
Type of Inspection N/A Yes No
EXITS: NOTES
Exit Access FC 1014
Exit Enclosure FC 1020
Exit Discharge FC 1024
Sign Normal FC 1011
Sign backup FC 1011.5.3
AISLES:
Main Aisle Width FC 1024/1025
Secondary Aisle Width FC 1025
FIRE EXTINGUISHER:
Hung FC 906
lnsp of extinguisher FC 906
EVAC SIGNS IN R ooms FC 404.6
TRUSS ID SIGNAGE FC 505.3
EMERGENCY LIGHTING:
Interior FC 1006
Exterior FC 1006
Clearance to Electrical FC 605.3
Compressed Gas FC 3003
Knox Box FC 506
F.D.Signage- FC 510
No Smoking Signs FC 310.3
Storage FC 315
Electric Wiring Enclosed/Labeled FC 605.3.1
Vehicle Impact Protection FC 312.1
Interior Finishes FC 803-804
Smoke Detectors FC 907
CO detectors FC 610
Clearance to Spr./Ceiling FC 315.2.1
18"/24"
Exterior Storage FC 315.3
Operating Permit
Vacant Buildings FC 311
REINSPECTION DUE APPROXIMATELY
21 DAYS
SYSTEMS: FC 901 lnsp OK NC DATE: OK NC
Date
Generator Annual DATE: OK NC
Hood Installation
Elevator Semi Annual
FIRE ALARM Annual DATE: OK NC
HVAC Shutdown
Sprinkler System Annual
Sprinkler FDC
Kitchen Suppression Semi Annual
Fuel Island Suppression Semi Annual
Hood Cleaning 3-6
Commercial Final Inspection Report // /2
Office No.: (518) 761-8256 Date Inspection request received:
Queensbury Building & Code Enforcement Arrive: am/pm Depart: am/pm
742 Bay R /(,' i
ad, Queens. ry, NY 12804 Inspector's Initials:
z_
NAME: 1 r� ` . r _ I r `/L� /'lg iJ ( PERMIT#: I 5 f
LOCATION: ., , �/ ) I DATE: 2/ /./
COMMENTS:
Y ` N NA
Chimney/°B"Vent/Direct Vent Location
Plumbing Vent Through Roof 6"/Roof Complete
Exterior Finish/Grade Complete 6"in 10'or Equivalent
Interior/Exterior Guardrails 42 in. Platform/Decks
Interior!Exterior Ballisters 4 in. Spacing Platform/Decks
Stair Handrail 34 in.—38 in. I Step Risers 7"I Treads 11"
Vestibules For Exit doors> 3000 sq. ft.
All Doors 36 in.w/l.ever Handles I Panic Hardware, if required
Exits At Grade Or Platform 36(w)x 44" (1)/Canopy or Equiv.
Gas Valve Shut-off Exposed& Regulator(18")Above Grade
Floor Bathroom Watertight I Other Floors Okay
Relief Valve, Heat Trap l Water Temp.110 Degrees Maximum
Boiler/Furnace Enclosure 1 hr. or Fire Extinguishing System
Fresh Air Supply for Occupancy/Ventilation Combustion
Low Water Shut Off For Boilers
Gas Furnace Shut Off Within 30 ft. or Within Line Of Site
Oil Furnace Shut Off at Entrance to Furnace Area
Stockroom/Storage/Receiving/Shipping Room (2 hr.), 1 1/2 doors
> 10% > 1000 sq. ft.
'/. Hour Corridor Doors&Closers
Firewalls l Fire Separation, 2 Hour, 3 Hour Complete/Fire
Dampers I Fire Doors
Ceiling Fire Stopping, 3,000 sq. ft.Wood Frame
Attic Access 30"x 20"x 30"(h), Crawl Space Access 18"x 24"
Smoke Vents Or Fan, if required
Elevator Operation and Signage I Shaft Sealed
Handica ed Bathroom Grab Bars!Sinks/Toilets
Handicapped Bath/Parking Lot Signage
Public Toilet Room Handicapped Accessible
Handicapped Service Counters, 34 in., Checkout 36"
Handicapped Ramp/Handrails Continuous/12 in. Beyond tBoth
sides)
Active Listening System and Signage Assembly Space
Final Electrical/Flex Gas Piping Bonded
Site Plan/Variance required
Final Survey, New Structure/Flood Plain certification, if req.
As-built Septic System Layout Required or On File
Building Number or Tenant Address on Building or Driveway 4'
Water Fountain or Cooler
Building Access All Sides by 20'/Driveable Surface 20'wide
Okay To Issue Temp. or Permanent CIO
Okay To Issue C/C
L:1Building&CodesForms\Building&CodesMnspection Forms\Commerc ial Final Inspection Report.doc Revised January 7,2008