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2011-244 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20110244 Date Issued: Tuesday, June 14, 2011 This is to certify that work requested to be done as shown by Permit Number P20110244 has been completed. Location: 1161 STATE ROUTE 9 Tax Map Number: 523400-295-008-0001-002-000-0000 Owner: MITCHELL A COHEN Applicant: THE SNACK SHACK This structure may be occupied as a: Certificate of Occupancy(COM) By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve they �Q 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 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518)761-8256 BUILDING PERMIT Permit Number: P20110244 Application Number: A20110244 Tax Map No: 523400-295-008-0001-002-000-0000 Permission is hereby granted to: THE SNACK SHACK For property located at 1161 STATE ROUTE 9 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: MUCHELL A COHEN Certificate of Occupancy(COM) PO BOX 21 Total Value LAKE GEORGE,NY 12845 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications 2011-244 THE SNACK SHACK $50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,June 07,2012 (If a longer period is required,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 To Queens rY a day,June 07,2011 A SIGNED BY li',.7 ®° for the Town of Queensb ury. ury. Director of:Building&.Code Enforcement Conimitnitly Development Office Town of Queensbury- 742 Bay Road - Queensbury, New York -12804 D lvlarilyn Ryba,Executive Director-David Hatin,Director of Building&Codes Craig Brown,Zoning Administrator■JWiclurel J.Palmer,Fire Marshal MAY 2'6 2011 NEW B USINESS CERTIFICATE OF O CC T O �Y APPLICATION TAX MAP# 2S, Y- 1-2_ BLDG. PERMIT FILE# 11-Z4 app ica e Me. v& I j t,►` LL�C. Name of Busines�4-Tkt_ 4( 1� rG� Address i 1 6 i of Business:J]69 Rbo4e o OAe� I N y 12,f;bq QUESTIONS? CALL 761-8256 OR EMAIL codes0gueensburv.net � a ` VISIT OUR WEBSITE FOR MORE Person in Charge or Manager: D� �CJ'1 INFORMATION www.aueensburv.net Business Phone Number. Type of Business:_ I—C6A Owner of Property: $eve CA LA Phone Number(s): 14 767 Home cell Owners C �v.I O(1 DC• (' .1�2h5bU , 121h 01 Address: �Peaseapfavtde an�accurate layout of yourstore'strow�nalv�al s ex�ts;stock�Qoms stvoms , ';coti�itersand��xture'layo_.u` `on.a'eParate••sll`eet of paperer�� q' ��'"`-�`�-�-�� y�� Signature: Date: Of person submitting this form Notes/Comments: W&vi ,may ofcyn' "Note: This application is for occupancy only, with no work requiring a building permit. No fee required for this permit r EMERGENCY .CONTACT UPDATE TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 743-2502 PLEASE PRINT DATE: BUSINESS NAME: 51 a_x BUSINESS ADDRESS: H 5gr ZAt q a&b)bL)n4, Nq J ZbO� BUSINESS PHONE: SEA 2,271-1 CONTACT 1: 5c NA&ial0( HOME PHONE g �I22�1 ADDRESS: rJ eri c,�f Dr. p;F-� ' � 1�`� 1�Z� CONTACT 2: V OLhC,� C�6 HOME PHONE S12 qSY' G-76-7 ADDRESS: CQ ��dyC �� L>h'��c��-� �2,M 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 Phone: 518-761-8206 Fax: 518-745-4437 firemarshal ft eensburil.net www.aueensNirii.net 1 1 24141 Inspection Fora 476 Town of Queensbury Fire Marshal O Periodic Inspection Date: U Time: `� 742 Bay Road,Queensbury NY 12804 o Re-Inspection 518 7618206/518 7618205 NCO Inspection Permit#: ire arshals Representative MJ Palmer Business.Name: ('�� Ic(� j1 4cf( Location: GK Stillman Contact: Type of Inspection N/A Yes No EXITS: Exit Access FC 1014&FC1029 NOTES Exit Enclosure FC 1020&FC1029 Exit Discharge FC 1024&FC1029 Locks and latches FC1008& FC1029.2 Sign:Normal FC 1011 &FC1029 Sign:backup FC 1011.5.3&FC1029.7.5 AISLES: Main Aisle Width FC 1024/1025&FC1029.11 Secondary Aisle Width FC 1025&FC1029.11 FIRE EXTINGUISHER: Hung FC 906 Inspection of extinguisher FC 906 EVAC Plan FC 404.6 TRUSS ID SIGNAGE FC 505.3 EMERGENCY LIGHTING: Interior FC 1006.3&FC1029.8 Exterior FC 1006.3 Clearance to Electrical FC 605.3 Electric Wiring Enclosed/Labeled FC 605.3.1 Combustibles in Equipment Rooms FC315.2.3 F.D.Si na e- FC 510 No Smoking Signs FC 310.3 Storage FC 315.2 Compressed Gas FC 3003 Vehicle Impact Protection FC 312.1 Interior Finishes FC 803-804 Smoke Detectors FC 907 CO detectors FC 610 Clearance to Sprinkler/Ceiling'FC 315.2.1 18" / 24" EVAC SIGNS IN Rooms FC 404.6 R1 &R2 Fuel Pump Warning Signs FC2205.6 Fuel Station Emer Procedures FC2204.3.5 Exterior Storage FC 315.3 REINSPECTION D UE APPROXIMATELY Vacant Buildings FC 311 21 DAYS SYSTEMS: FC 901.6 Insp 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 iF8 � �t Kitchen Suppression Semi Annual OK t0 l6SUe ica 0 o GCEIp Fuel Island Suppression Semi Annual Hood Cleanin 3—6-Annual Knox Box:installed/checked FC506 .I C Operating Permit, if required will be issued after FireM�rsh4! Completion of Inspection Chien u Inspection Form Town of Queensbury Fire Marshal . O Periodic Inspection Date: t / Time: A�L/ 74 Bay Road,Queensbury NY 12804 o e-Ins ectio�nn V(�� 5161 8206/518 7618205 CO Inspecti Permit#: Firs a shals Representative Palmer Business.Name: Location: GK Stillman Contact: Type of Inspection N/A Yes No EXITS: Exit Access FC 1014&FC1029 NOTES Exit Enclosure FC 1020&FC1029 Exit Discharge FC 1024&FC1029 Locks and latches FC1008& FC1029.2 Sign:Normal FC 1011 &FC1029 Sign:backup FC 1011.5.3&FC1029.7.5 AISLES: Main Aisle Width FC 1024/1025&FC1029.11 Secondary Aisle Width FC 1025&FC1029.11 p/ FIRE EXTINGUISHER: Hung FC 906 Inspection of extinguisher FC 906 EVAC Plan FC 404.6 TRUSS ID SIGNAGE FC 505.3 ,� < EMERGENCY LIGHTING: Interior FC 1006.3&FC1029.8 Exterior FC 1006.3 VE Clearance to Electrical FC 605.3 Electric Wiring Enclosed Labeled FC 605.3.1 Combustibles in Equipment Rooms FC315.2.3 G F.D.Si na e- FC 510 No Smoking Signs FC 310.3 Storage FC 315.2 Compressed Gas FC 3003 Vehicle Impact Protection FC 312.1 Interior Finishes FC 803-804 Smoke Detectors FC 907 CO detectors FC 610 Clearance to Sprinkler/,Ceiling'FC 315.2.1 s/ 18" / 24" EVAC SIGNS IN Rooms FC 404.6 R1 &R2 Fuel Pump Warning Signs FC2205.6 Fuel Station Emer Procedures FC2204.3.5 Exterior Storage FC 315.3 REINSPECTIONDUE APPROXIMATELY Vacant Buildings FC 311 21 DAYS SYSTEMS: FC 901.6 Insp OK NC DATE: OK NC Date Generator Annual DATE: OS NC Hood Installation Elevator Semi Annual FIRE ALARM Annual DATE: OIs; NC HVAC Shutdown Sprinkler System Annual S rinkler FDC Kitchen Suppression Semi Annual Fuel Island Suppression Semi Annual Hood Cleaning 3-6-Annual Knox Box:installed/checked FC506 Operating Permit, if required will be issued after Completion of Inspection 24' 7 9 Emergency Plan First Aid Kit Owl CPR Kit 35-' 11 I J 33 34 18 �� 5[,� 32 31 20 30 Dry food storage under counter 29 23 25 28 -� Outsi o e Counter Service Window 1 Service Window 2 Description Manufaturer 1 Ice Cream Freezer JAR 2 Hot Box Metro 3 Garbage Can 4 Drying Counter 5 Stainless Sink-Sanitizing 6 Stainess Sink-Rinse 7 Stainless Sink-Wash 8 PVC Sink-Mop/Can 9. Toilet Glacier Bay 10 Hot Water Tank GE 11 Stainless Sink-Hand Wash 12 Counter 13 Refridgerator/Freezer Frigidaire 14 Garbage Can . 15 Convection Oven GE Monogram 16' Microwave Oven Amana 17 Work Table 18 Beverage Cooler Powers 19 Stainless Cooler Star Metals Co. 20 Triple Head Milkshake Blender Hamilton Beach 21 Garbage Can 22 5 Bay Stainless Steam Table 23 Dipwell Dipwell 24 Ice Cream Freezer Hershey's 25 Hot Fudge Dispensor Server 26 Ice Cream Freezer Hershey's 27 Dipwell Dipwell 28 Nacho/Pretzel Warmer J8J Food Snacks 29 Triple Head Slush Machine Bunn 30 Duel Head Slush Machine Bunn 31 Hot Chocolate Machine Sysco 32 Coffee Machine Crystal Rock 33 Pizza Warmer Hatco 34 Cotton Candy Machine J8J Food Snacks 35 Popcorn Machine J8J Food Snacks 36 Fire Extinguisher First Alert 37 Fire Extinguisher First Alert