2011-400 TOWN OF QUEENSBURY
Oggir 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20110400 Date Issued: Monday, August 29, 2011
This is to certify that work requested to be done as shown by Permit Number P20110400
has been completed.
Location: 1468 STATE ROUTE 9
Tax Map Number: 523400-288-012-0001-019-000-0000
Owner: KENNY-BROCK PARTNERSHIP
Applicant: SPIRIT HALLOWEEN
This structure may be occupied as a:
Certificate of Occupancy (COM) By Order of Town Board
TOWN OF QUEENSBURY
4 I/
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 of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
Ai 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20110400 Application Number: A20110400
Tax Map No: 523400-288-012-0001-019-000-0000
Permission is hereby granted to: SPIRIT HALLOWEEN
For property located at: 1468 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: KENNY-BROCK PARTNERSHIP
1454 STATE ROUTE 9 Certificate of Occupancy(COM)
LAKE GEORGE,NY 12845 Total Value
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2011-400
SPIRIT HALLOWEEN - CO only
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday, August 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 Toprrr- fgueensb try; 4 ,l olday,August 15, 2011
SIGNED BY ti " " for the Town of Queensbury.
Director of Building&Code Enforcement
E-CE-t-VbET
ommunity Development Office
glec'e NV { ti ,ems n . nr AUG (� Q (�
Towri or Quaansbo,y • i 42 Bay Road • C“.ie nsbury, !yaw York . ' U `� 8 2011
David Hatin, Director of Building& Codes
Craig Brown, Zoning Administrator• Michael J. Palmer, Fire Marsha TOWN OF QUEENSBURY;;
• BUILDING & CODES
ESTABLISHMENT OF A NEW BUSINESS
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION
*Note: This application is for occupancy only, with no work requiring a building permit.
TAX MAP # BLDG. PERMIT FILE#
n If applicable
Name of Business: 5P;R ;T 1-L A LLo L&i E E 'er
Address G
of Business: 'fL Vi 5_1 , r_E (T- 9 LA CLC I^ p QUESTIONS? CALL 761-8256 OR
11 ', - --y— f' VISIT OUR WEBSITE FOR MORE
Person in Charge or Manager: 1_1 A i A!K-O W`J(t INFORMATION
Business Phone Number: 6 IS - 71 Z - L15 L1
Type of Business: 5 EA-50A.) A L TA L H A l to W E e AI CT()P-_
Owner of Property: MI d F-e Al N)/ Phone Number(s):7933-3 I I
J -FE
/ Home Cell
Owners Address: '-15 ( SDk I E el-- q 9, LAKE •a SEI A Y
Provide an accurate layout of your store showin.- -i1 walls. exits. stockrooms. rest rooms.
counters and fixture layout on a separate sheet of paper.
Signature:/Coet cZ44t Date: 3a I I
Of person submitting this form
Notes / Comments:
/.,15 A 7A;lczW5 OE (1 Li/3 --SZY--0
EMERGENCY CONTACT UPDATE
TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 743-2502
PLEASE PRINT
DATE: -7/30/11
BUSINESS NAME: cel Q ; 1 1-!4 dC-d P /V
/
BUSINESS ADDRESS: I y (01-1 STATE. Ai , Lig 6 .(i-,26E
BUSINESS PHONE: _ 5 L
CONTACT 1: I-15 A 4V)5(4. ( HOME PHONE 11/3-5Z -657,),
ADDRESS: 525 Pock-64 51: 1 1/0Aa5bu6 7 N
CONTACT 2: HOME PHONE
ADDRESS:
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.
Inspection Form
Li()
Town of Queensbury Fire Marshal O Periodic Inspection Date: i Time: !'0
742 Bay Road,Queensbury NY 12804 o Re-Inspection , t
518 761 8206/518 761 8205 t CO Inspection Permit#: 11 -L4Q0
Fire Marshals Representative
MJ Palmer Business Name: t LA..c4-‘1 r ,r
Location: I t--! 1. 9
_ GK Stillman Contact: LA sc.
Type of Inspection N/A Yes No
EXITS: Exit Access FC 1014&7C1029 , .- NOTES
Exit Enclosure FC 1020&FC1029 f
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 37
_ 1
Secondary Aisle Width FC 1025&FC1029.11 �" `
FIRE EXTINGUISHER: Hung FC 906 r�
Inspection of extinguisher FC 906
nEVAC Plan FC 404.6
it
TRUSS ID SIGNAGE FC 505.3 /
EMERGENCY LIGHTING:
Interior FC 1006.3&FC1029.8
Exterior FC 1006.3 7 ' F
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 i /,R
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 7
Fuel Station Emer Procedures FC2204.3.5 /
Exterior Storage FC 315.3 1 REINSPECTION DUE APPROXIMATELY
Vacant Buildings FC 311 /
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 Fire Medal In4pecton Compi+:te
Kitchen Suppression Semi Annual OK to lastItt Iti Icate of Occupancy
Fuel Island Suppression Semi Annual
Hood Cleaning 3-6 -Annual
Knox Box:installed/checked FC506 AUG 23
Operating Permit, if required will be issued afterFire Me
Completion of Inspection jig m
„i.,1.