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2010-254 TOWN OFQ UEENSBURY WON742 Bay RoadQueensbury,NY 12804-5902 (518)761-8201 Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20100254 Date Issued: Monday, June 21, 2010 This is to certify that work requested to be done as shown by Permit Number P20100254 has been completed. Location: 199 HUDSON POINTE Blvd Tax Map Number. 523400-315-000-0001-027-000-0000 Owner. HUDSON POINTE HOMEOWNERS Applicant PARTNERS IN CARE GIVING 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 theLa ! / property owner of the responsibility for compliance with Site Plan, f ` Variance, or other issues and conditions as a result of approvals by the Director of Building&Coderc` ent Planning Board or Zoning Board of Appeals. ��` TOWN OF QUEENSBURY Fvteorilif 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20100254 Application Number. A20100254 Tax Map No: 523400-315-000-0001-027-000-0000 Permission is hereby granted to: PARTNERS IN CARE GIVING For property located at: 199 HUDSON POINTE Blvd 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 Queens bury Zoning Ordinance. Type of Construction Value Owner Address: HUDSON POINTE HOMEOWNERS ASSOC., INC. Certificate of Occupancy(COM) P.O. BOX 526 Total Value GLENS FALLS,NY 12801 Contractor or Builder's Name/Address Electrical Inspection Agency Plans &Specifications 2010-254 PARTNERS IN CARE GIVING - C/O ONLY $50.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Friday, May 27,2011 (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 To Queens ry; ,,T u.sday, May 27, 2010 SIGNED BY for the Town of Queensbury. Director of Building Code nforcement Community Development Office ([n (; Town of Queensbury • 742 Bay Road • Queeshury, New York •12804 Marilyn Ryba, Executive Director•David Hatin,Director of Building&Codes MAY `�*�j� "`20i0p Craig Brown,Zoning Administrator•Michael J.Palmer,Fire Marshal / • ToTANZra7-1fIZif C.1714 NEW BUSINESS CERTIFICATE OF OCC I' • " ,s n APPLICATION TAX MAP# 3/s` / is , 1 BLDG. PERMIT FILE# /O— ttappbcable Name of Business: ?o r4-ne-rs Zn crre C;u:n7, TnC . Address /� of Business: I R'9 N'-'cP S"n �6; ^+e 3 luc9 ( ;/ t P e/is`7u lU y QUESTIONS? CALL 7614256 OR y EMAIL codesOqueensbury.net IWESSITE �d�f Person in Charge or Manager: (---?c-k- r' ') kt�p VISIT OUR INFORMATION FOR MORE www.queensbury.net Business Phone Number. „5-7 e 3 - 7 t 9 6 Type of Business: $ o c. r c ID a ...5.�r s C t-414) /11v -i (J-r _O Cc�;.y�✓ntcn/ // Seev,'Ce , (c>re - ur, - nurses seri)�`c�s f o V t9 a +6 A.)“,-.x C 03A; (1 a.. f vrn,-. (rD 2.Yn e rk t.) ea e s /I ere �Qrl� I4,)y row ery n � Owner of Property: 4/t,6/.s r, A.„le A 4 scc. 13-n c, Phone Number(s): 5/k 7 9 r 2 3 a y h u c-lc tya Home ear Owners Address: Po C X S a(, G / IV ) Sol Please provide an accurate layout of your store showing all walls, exits, stockrooms, rest rooms, counters and fixture layout on a separate sheet of paper. Signature: ( 1 GL C21,-1-‘29 Date: S p'/v 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 /0- 254/ EMERGENCY CONTACT UPDATE TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 743-2502 DATE: cr/d s /i v BUSINESS NAME: Ger (0.ers Zr, Coge �; u;As Lk BUSINESS ADDRESS: t 4 4c4cPSdr, V'd h+e 6 ( _ e-t)u cc,,s /1// BUSINESS PHONE: 3a/ / 7F3- 9359 HOME CONTACT 1�ks.-5-iu� PHONE G 31- c 7 Va ADDRESS: 3-14 4 i D s root r4) ry a N ofl r)(4 5164..4) HOME CONTACT 2: C YY1dPHONE 1 q 8 - 3 ADDRESS: "6 f�u�Ds�„ r.� /3 hid 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. TOWN OF Qt1EEN4Bt1RY FIRE MARSHAL'S OFFICE P It o tt e: 518-761-5206 F a x: 518-745-4437 fire rrrrrr slrrrlt«;'�1rr� r rrshrrr�.rrf f 111111 1.gliCerrshr.rr y,IWI Inspection for Permit to Occupy Fire Marshal's Office Request Reed Permit No. Town of Queensbury 742 Bay Road ID C° Queensbury,NY 12804 Scheduled Inspection Date: l Time: Phone: (518)761-8206 Business Name: 61►�kt 1 Al 0 4 r ( 1--L v Fax: (518)745-4437 Location: ?11 Type of Inspection N/A Yes No EXITS: Exit Access Exit Enclosure COMMENTS Exit Discharge AISLES: Main Aisle Width Secondary Aisle Width EXIT Signgn-normal Jl Sign-battery ^ EVAC signs in rooms v \ TRUSS ID SIGNAGE EMERGENCY LIGHTING 11-\ A c V_1 9 FIRE EXTINGUISHER: a/A I Hung 0 Inspection of extinguisher FIRE ALARM SYSTEM CIL Fan Shutdown Fire Sprinkler System (FDC) Fire Suppression-kitchen Fire Suppression-Gas Ilan Generator Hood Installation Elevator i Fire Mar `4l 1 ••, . _. .rl Interior Finishes OK to Issue C- i ate of Oc. agcy Storage Compressed Gas Clearance to Sprinklers ,l�o Clearance to Bectrical N : Electric Wiring Enclosed/Labeled Combustible Waste e ` Vehicle Impact Protection •.n+ ' Knox Box G n`I �uleellspu F.D.Signage-Willy Rooms No Smoking Signs Maximum Occupancy Sign ©I[._ Emergency Evacuation Plan Approved (If no other approvals apply.the B&C Office will:� - the C •- «) :of Occupancy) o Denied /call for Recheck Inspected By: L:\F1reMarshal\FM Forms Masters\perniitto occupyform_doc Inspection for Permit to Occupy Fire Marshal's Office Request Rec'd Permit No. Town of Queensbury 742 Bay Road Queensbury,NY 12804 Scheduled Inspection Date: Time: Phone: (518) 761-8206 Business Name: Fax: (518) 745-4437 Location: Type of Inspection N/A Yes No EXITS: Exit Access Exit Enclosure COMMENTS Exit Discharge AISLES: Main Aisle Width Secondary Aisle Width EXIT SIGNAGE Sign-normal Sign-battery EVAC signs in rooms TRUSS ID SIGNAGE EMERGENCY LIGHTING FIRE EXTINGUISHER: Hung Inspection of extinguisher FIRE ALARM SYSTEM Fan Shutdown Fire Sprinkler System (FDC) Fire Suppression-kitchen Fire Suppression-Gas Islan Generator Hood Installation Elevator Interior Finishes Storage Compressed Gas Clearance to Sprinklers Clearance to Electrical Electric Wiring Enclosed/Labeled Combustible Waste Vehicle Impact Protection Knox Box F.D.Signage-Utility Rooms No Smoking Signs Maximum Occupancy Sign Emergency Evacuation Plan u Approved (If no other approvals apply,the B&C Office will issue the Certificate of Occupancy) u Denied / call for Recheck Inspected By: L:\FireMarshal\FM Forms Masters\permitto occupyform.doc - ..Cn ," " , _ I 1 I 1.C1) _ , , Ail entrances 39' — are t Dining 39' 14'6" handicapped 22' . -.) 10' All doorways TV Room (34 �°°m are at least 36" wide u.A-l,raom r"-- --.) 10' 01 N 5' Activity Room Hail 10' 24' j , — Not an exit I I — L j Foyer To Floor Plan PARTNERS IN CARE GIVING 0► Basement 199 HUDSON POINTE BLVD. ,A QUEENSBURY, NY 12804