2011-567 TOWN OF QUEENSBURY
topro742 Bay Road, NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20110567 Date Issued: Tuesday, April 03, 2012
This is to certify that work requested to be done as shown by Permit Number P20110567
has been completed.
Location: 25 WILLOWBROOK Rd
Tax Map Number: 523400-296-012-0001-037-001-0000
Owner: SCHERMERHORN COMM. HOLDINGS, LP
Applicant: SCHERMERHORN COMM. HOLDINGS, LP
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 the property
owner of the responsibility for compliance with Site Plan, Variance, or
other issues and conditions as a result of approvals by the Planning Board
Director of Building&Code Enforcement
or Zoning Board of Appeals.
TOWN OF QUEENSBURY
tifiohi
vim742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20110567 Application Number: A20110567
Tax Map No: 523400-296-012-0001-037-001-0000
Permission is hereby granted to: SCHERMERHORN COMM. HOLDINGS, LP
For property located at: 25 WILLOWBROOK 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: SCHERMERHORN COMM. HOLDIl Certificate of Occupancy(COM)
536 BAY Rd Suite 2 Total Value
QUEENSBURY,NY 12804-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
BP 2011-567 SCI,LLC (Data Processing)
C/O Only 25 Willowbrook Road,No. 2
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,November 15,2012
(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 Town f Queg bui /Tu s a , : .mber 15,2011
44
SIGNED BY \ for the Town of Queensbury.
Director of Building&Code Enforcement
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At;:-:., r, Community Development Office t� f
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T{, ri of OC!oensbfir>, • 7.i2 fray RC:di' Over--ItJS irry, i'ou York •1280.1 D E.
Dowd Hatfrt, Du:icor of Building d Codes N ^
Cf.at Brown, Zc:!iiig Ardrnimstratcr• M!cI1 al„I Paltrier. Fire Marsn ii _ NOY, l L} 201
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TOWN OF QUEENSBURY
ESTABLISHMENT OFA NEW BUSINESS BUILDING & CODES
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION
'Note: This application is for occupancy only,with no work requiring a building permit. .,f. r "7
TAX MAP# cur's.IL -1 - 67 I BLDG. PERMIT FILE# NY.%
If applicf e
Name of Business: S-G Z L L
Address
of Business: c 14--/4 Co Lc/ 4 PG u i .2 d ..z QUESTIONS? CALL 761-8256 OR
EMAIL Ccdesidtpueensbww.not
�G t A VISIT OUR WEBSITE FOR MO
Person in Charge or Manager: INFORMATION N-
yr'lw.queensbury.net
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Business Phone Number: ,J S' - z/ -y - 1
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Type of Business: /�A 1 A Yn rbc O -s S/,U O
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Owner of Property:,..)(91i:'t'fTtr[tt (t;Lon6(0i41 FIDIA'Phone Numberts): J i 0, i -I (..)10 11'1 ceo a
name CMI / 1 O
ff -� 1 Or 16 J Al tl /ago 4-/ N
Owners Address:
�t� LJ�w. pr�2G itc r`i� ...4N J � �
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Provide an accurate layout of your store showing all walls, exits, stockrooms, rest roan: VNO
U) U
counters and fixture layout on a separate sheet of paper.
Signature: /�C// �--�� / �/
Date: /// v - -
Of on submitting this f rm
pers
Notes 1 Comments:
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EMERGENCY CONTACTU T C QaIE �
TO: WARREN COUNTY SHERIFF'S DEPT. FAX ,1133 1.11 4 2011 .6
TOWN OF QUEENSBURY
PLEASE PRINT BUILDING& CODES
DATE: / / 0/ //
BUSINESS NAME: S L
BUSINESS ADDRESS: 7 < <-6)&(___) .6700/‹ R O
BUSINESS PHONE: 5/ e- (v3 I�'
CONTACT I: 2 0 S (A C HOME PHONE 3 (4. / 3 0 ..)-9
ADDRESS: L ' 0/ /v ) LL (pC c, icy /J. `f
CONTACT 2: -) A V t T (A '0 0 3 HOME PHONE 7 cl/- /c ' c4
ADDRESS: c3 (i% C OOL/ (o 6-- A L / 6 C exi5
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 FACIUTATE ENTRY BY POLICE AND/OR FIRE
PERSONNEL.
Inspection Form
,1 2 ,
Town of Queensbury Fire Marshal O Periodic Inspection Date:�T`a '2 Time: o
742 Bay Road,Queensbury NY 12804 o Re-Inspection i( -5.4 7
518 7 1 8206/518 761 8205 CO Inspection Permit#:
xFir arshals Representative
MJ Palmer Business Name: S C.- OE-
Location: 26 w l I I hr06l C
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: .....--,'"
✓ ,`^^ )c"
Main Aisle Width FC 1024/1025&FC1029.11 l , _
Secondary Aisle Width FC 1025&FC1029.11 /�
FIRE EXTINGUISHER: Hung FC 906 .1'ti
Inspection of extinguisher FC 906 V'
EVAC Plan FC 404.6 AM.
TRUSS ID SIGNAGE FC 505.3
EMERGENCY LIG HTIN G: -•' ,
Interior FC 1006.3&FC1029.8 f
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.Signage- 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 DUE APPROXIMATELY
Vacant Buildings FC 311
21 DAYS
SYSTEMS: FC 901.6 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 AnnualI v., -
Sprinkler FDC `; =�i;i:i „ _ ;C •;
Kitchen Suppression Semi Annual - fi;;
Fuel Island Suppression Semi Annual t`
Hood Cleaning 3-6-Annual I
Knox Box:installed/checked FC506 i U I L
P 14
Operating Permit, if required will be issued after
t
Completion of Inspection ;-,�r; `T`f`_1 `
Inspection Form
Town of Queensbury Fire Marshal O Periodic Inspection Date: 2.17-1 I Time: /646
742 Bay Road,Queensbury NY 12804 o Re-Inspection 1
518 761 8206/518 761 8205 k CO Inspection Permit#:
Fire Marshals Representative ''
L4AJ Palmer Business Name: $C_-1
� ,,�� Location: R.5-G<),c-wr.)l� �.. ,('=`�
— K Stillman Contact: gob S`L4ck_
Type of Inspection N/A Yes No
EXITS: Exit Access FC 1014&FC1029 NOTES
Exit Enclosure FC 1020&FC1029 ./ '�'
Exit Discharge FC 1024&FC1029
Locks and latches FC1008& FC1029.2 .,, /
Sign:Normal FC 1011 &FC1029
Sign:backup FC 1011.5.3&FC1029.7.5
AISLES:
Main Aisle Width FC 1024/1025&FC1029.11
Secondary Aisle Width FC 1025&FC1029.11 �a � `5`' r`^ L�,r `/r' lam'
FIRE EXTINGUISHER: Hung FC 906 .-.'''' )7 C--4:t=1---t--C
Inspection of extinguisher FC 906 ,..•'''..
EVAC Plan FC 404.6 ,,..f r t_ p
TRUSS ID SIGNAGE FC 505.3 f ''' f#411 /K,,/j k/ , k.k '1
EMERGENCY LIGHTING: 1 / G
Interior FC 1006.3&FC1029.8 L&f
Exterior FC 1006.3 ,
Clearance to Electrical FC 605.3 / ry - fit,- ,b-fit...-AZ2-) ,F64 L 04
Electric Wiring Enclosed/Labeled FC 605.3.1
Combustibles in Equipment Rooms FC315.2.3
F.D.Signage- FC 510
No Smoking Signs ns FC 310.3 .-.-" ' 1
�G
(
Storage FC 315.2 �� /"r a ®r-4/1Y'l > ��/�r
Compressed Gas FC 3003 .c` ,,,� (-�'-./L.,.i _ k'... ,$' )
Vehicle Impact Protection FC 312.1 ./`* l�fr� i �
Interior Finishes FC 803-804 ..-/" ��
Smoke Detectors FC 907 ---''- 1 C,e, 4z1 c�4.-1 --7(r _,5-(
CO detectors FC 610 .00°-
Clearance
`Clearance to Sprinkler/Ceiling FC 315.2.1 7-
18" / 24"
EVAC SIGNS IN Rooms FC 404.6(R1 &R2) """ : Cr P[4 u e-Sc w-6.4e. in Ccnipainsa
Fuel Pump Warning Signs FC2205.6 .A.
Fuel Station Emer Procedures FC2204.3.5 ,,"'"e. gez)fri ~ "1(ca-
Exterior Storage FC 315.3
Vacant Buildings FC 311 ...•••-:.,„,r REINSPECTION DUE APPROXIMATED
21 DAYS
SYSTEMS: FC 901.6 Imp 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 Wand Suppression Semi Annual
Hood Cleaning 3-6-Annual
Knox Box:installed/checked FC506
Operating Permit, if required will be issued after
Completion of Inspection
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