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2010-530 TOWN OFQ UEENSBURY v,01 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number. P20100530 Date Issued: Monday, November 15, 2010 This is to certify that work requested to be done as shown by Permit Number P20100530 has been completed. Location: 4 WESTERN Ave S Tax Map Number: 523400-309-011-0002-036-000-0000 Owner: HAYES & HAYES LLC Applicant DIRTY GOBLIN GAMES 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 � . . 01' xt 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. 1�` TOWN OF QUEENSBURY Wvt,TO 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20100530 Application Number. A20100530 Tax Map No: 523400-309-011-0002-036-000-0000 Permission is hereby granted to: DIRTY GOBLIN GAMES For property located at: 4 WESTERN Ave S 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: HAYES &HAYES LLC PO BOX 109 Certificate of Occupancy(COM) GLENS FALLS,NY 12801 Total Value Contractor or Builder's Name/Address Electrical Inspection Agency Plans &Specifications 2010-530 DIRTY GOBLIN GAMES LLC $0.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Tuesday,November 08,2011 (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 T of e'ensb}�'ry�,•ii o ovember 08,2010 Gam' SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement ,. o ;� -��t ) Viil5 l U 0 Community Development Office _ Town of Queensbury • 742 Bal/ Road • Queensbury, New York •12804 b)._ OTT-7-i Marilyn Rijha, Executive Director•David Hatin, Director of Building&Codes /71 � _._.w. f „ ,1 i Craig Brown, Zoning Administrator•Michael J. Palmer, Fire Marshal '''4; I Y • � r- ?--2.- 2 i1/ 1 NEW BUSINESS CERTIFICATE OF OCCUP CViipl ' , , w l APPLICATION Jt_ ,, F-s 1 ITAX MAP# -�O 9a if - a, - - C BLDG. PERMIT FILE# I ( S )` ' If applicable Name of Business: p , 1---E Go 6 I , ,- G R M 2< L' L C Address of Business: Atik Li£ T /A A-Ve. 5v:7 e D R Ve E t //v UESTIONS? CALL 761.8256 OR I Zo c �'� �Y / EMAIL codes a(�queensburv.net Person in Charge or Manager: Cl q�-7'h i L/ Eck M Q(nn Ply‘/!. 6u/7-ter VISIT OUR INFORMATION FOR MORE www.queensburv.net Business Phone Number: S f 2' - `o-3 G- ---SQ -/ 6 Type of Business: r-1-0'6 6 cn n d 0..a r~e. V' c ('t V Owner of Property: u `Q c 01-N(A. -e 5 C Phone Number(s):51 -T 9 -85.70... -(2� / 7 Home Cell Owners j Address: -.3 `1S B ' G 13`t t KD Rt/ �e n 5 5 fi vy / /At/ 1 Z7-O t- Please provide an accurate layout of your store showing alldwalls, exits, stockrooms, rest rooms. counters and fixture layout on a separate sheet of paper. Signature:mVA/U4 hbDate: r d)/- /01 0 Of person submitting this form Notes/Comments: • *Note: This application is for occupancy only, with no work requiring a building permit. No fee required for this permit c;__(2) — 3 6 EMERGENCY CONTACT UPDATE Please print clearly DATE: II - I- 10 BUSINESS NAME: D Goa (/'4 (c,nk BUSINESS ADDRESS: ‘1 S - 'r /41(e S�, aV tAS VAY Al ]Z� BUSINESS PHONE: PHONE 1: ' CONTACT 1: .11ck7' -- dentVon PHONE 2: SI$,32/1•01 TOWN/VILLAGE RESPONDING FROM: (o0/1 ! P \ f /I.� PHONE 1: CONTACT 2: Kc&/k (�v/TC�e � PHONE 2: 5f �6?: ^ S?G ? TOWN/VILLAGE RESPONDING FROM: Cof -'A l 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 P h a n e: 5.18-761-8206 . F a x: 518-745-4437 firefnarshal@queensbury.net www.queensbury.net Fire Marshal Michael j Palmer Deputy Fire Marshal Gary Stillman Inspection Form Town of Queensbury Fire Marshal CDPeriodic Inspection Date: II f 1 ICS 742 Bay Road,Queensbury NY 12804 o Reinspection 518 761 8206/518 761 8205 CO Inspection Permit ft: 1 U 5 3 6) Fi Marshals Representative MJ Palmer Business Name: c) p L, Cr,(44.4c. S Location: 1-1 S c1 •cr• _ GK Stillman Contact: pc,t6,4 rev:,n v„`; 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 APPROXIMATEL] 21 DAYS SYSTEMS: FC 901 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 s" 1 Sprinkler System Annual Sprinkler FDC Fire Mart Itl5�Q14610wWIe Kitchen Suppression Semi Annual OK tO Issue C rMTlc-'1C' i L.coi?#l1Cy Fuel Island Suppression Semi Annual Hood Cleaning 3-6 10 r __ _ fir hz, __� TvEOni QlbirL't1_ =�^z Inspection Form Town of Queensbury Fire Marshal (DPeriodic Inspection Date: i4JYiic) 742 Bay Road,Queensbury NY 12804 o Reinspection 518 761 8206/518 761 8205 '°CO Inspection Permit#: I C; 3(-) Fire Marshals Representative MJ Palmer Business Name: DIn4-1 °� if IN lnnt 5-- Location:Location: �..� S �;°.► �� ; _ GK Stillman Contact: v.k,r• tt Oc,v."5 Yk Type of Inspection N/A Yes No EXITS: NOTES Exit Access FC 1014 / Exit Enclosure FC 1020 / Exit Discharge FC 1024 ✓ rt it Sac r., ii i r. bo-N- Sign Normal FC 1011 / Sign backup FC 1011.5.3 / s�,OS .J��S 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 1 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 18724" Exterior Storage FC 315.3 / Operating Permit / Vacant Buildings FC 311 / REINSPECTION DUE APPROXIMATEL] 21 DAYS SYSTEMS: FC 901 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 Kitchen Suppression Semi Annual Fuel Island Suppression Semi Annual Hood Cleaning 3-6