2010-033 AllSaki TOWN OFQUEENSBURY
Ba
742 Queensbury,y Road,Qu NY 12804-5902 (518)761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number. P20100033 Date Issued: Wednesday, March 03, 2010
This is to certify that work requested to be done as shown by Permit Number P20100033
has been completed.
Location: 357 BAY Rd
Tax Map Number. 523400-296-019-0001-029-000-0000
Owner. OLD SCHOOL HOUSE L.L.C.
Applicant: ALLSTATE INSURANCE COMPANY
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 (----. 4trAP 4/,,rt
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
Fo' Y d,Queensbury,742 Ba RoaNY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20100033 Application Number. A20100033
Tax Map No: 523400-296-019-0001-029-000-0000
Permission is hereby granted to: ALLSTATE INSURANCE COMPANY
For property located at: 357 BAY 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: OLD SCHOOL HOUSE L.L.C. Certificate of Occupancy(COM)
ATTN: JOHN &DIANE MATTHEW Total Value
2546 STATE ROUTE 9L
QUEENSBURY,NY 12804-0000
Contractor or Builder's Name/ Address Electrical Inspection Agency
Plans &Specifications
2010-033
C/O only- ALLSTATE INSURANCE COMPANY
$0.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Saturday, February 12,2011
(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 •f Quee r, ay, February 12,2010
SIGNED BY for the Town of Queensbury.
Director of Building&Code nforcement
....„..,.....z.r 1 IWrEFT
# Community Development Office ,
1,--Y-F ., Town of Queensbury • 742 Bay Road • Queensbury, New York •12804 "s"
aBt
1i
. • •David Hatin,Director of Building&Codes _ �E y ��� � ,
Craig Brown,Zoning Administrator-Michael J. Palmer,Fire Marshal
T47 ►`i -GF.0 tri- PJBRpt"
BUILDING & CODES
ESTABLISHMENT OF A NEW BUSINESS
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION
TAX MAP# 2 7 ./7 - /- Z 7 BLDG. PERMIT FILE# ( (/\*
IfaOar—lie3
Name of Business: 4//.y-jgi,c ito 0144vc E (o k' "Aug/
Address
of Business: 3 S7 ,iv UESTIONS? CALL 761-8256 EMAIL codeseaueensburvmetR
�� VISIT OUR WEBSITE FOR MORE
Person in Charge or Manager: k ,�J� Cobs 17(.1 INFORMATION
www.aueensburv.net
Business Phone Number: 7(1S— Z0 0
Type of Business: Q`(6ci 1 rv)u 4-Ay( Acie,,u�
Owner of Property: QV 5r t{,,, (itioC L L t_ Phone Number(s): t(,Y-TeX'( 7 V., -35-i r
Home Cell
Owners
Address: 2 SYS AZT qt 1, &✓ffG_S 6Jt1 Nii t zo-uy
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.
Signatur . - 444.0J,„ Date: /f/a0%p
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
EMERGENCY CONTACT UPDATE
TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 743-2502
PLEASE PRINT
DATE: Ali (got o
BUSINESS NAME: 4115TA76 1wJi(/60J 4p .
BUSINESS ADDRESS: 3 57 o3A� 1-4 SU t T w
Sys — gza0
BUSINESS PHONE:
HOME
CONTACT 1: Ktui1 Cie vs 6 PHONE ?ea SI 30
ADDRESS: 17 Q.vilw5 t,� j ( i-is t v t 1
HOME CONTACT 2: 7511.0. Alive/ PHONE �(� 4'5-IL
ADDRESS: - 4.: .i"
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 o n e: 518-761-8206 • F a x: 518-745-4437
fireniarsluil@queensbury.net • www.queensbury.net
Inspection for Permit to Occupy
Fire Marshal's Office Request Rec'd Permit No. Obi o - C) T3
Town of Queensbury
742 Bay RoadLO
Queensbury,NY 12804 Scheduled Inspection Date: 3// be) Time: _92
Phone: (518)761-8206 Business Name: ----1---os.1%.4v4v-e
Fax: (518)745-4437 Location: 35-7 c2-7 Co
Type of Inspection N/A Yes No
EXITS:
Exit Access r/i
Exit Enclosure I/ COMMENTS
Exit Discharge /
AISLES:
Main Aisle Width ../,
Secondary Aisle Width ,/
EXIT SIGNAGE
Sign-normal V '
Sign-battery /
EVAC signs in rooms /
TRUSS ID SIGNAGE ki
CJ 0
EMERGENCY UGHTING /
Or\
FIRE EXTINGUISHER:EXTINGUISHER:
Hung .,
Inspection of extinguisher -
03111(k)/
// TI-5-
FIRE ALARM SYSTEM V -
Fan Shutdown /
Fire Sprinkler System (FDC) Vr
Fire Suppression-kitchen
Fire Suppression-Gas Islan ./
Generator
Hood Installation /,
Elevator /
Interior Finishes
i Storage /7
Compressed Gas /
Clearance to Sprinklers
Clearance to Electrical 04////, "r:tn..'Sia ,'. ;Ii (i i n
wiring _,Q,lip,ip-va !
Electric ring Enclosed/Labeled
;
i ss,A--, A
Gig-tit-v..4,t-i Citcorlfitt'y t i
Combustible Waste
Vehicle Impact Protection /
Knox Box /
F.D.Signage-Utility Rooms /
• ,
No Smoking Signs //,
Maximum Occupancy Sign /z
.--...,_ -- --
Emergency Evacuation Plan / I , Air) ,,„-rf-.1- ,,
•
..E!.
Approved (If no other approvals apply,the B&C Office .. - .. r. •te of Occupancy)
ci Denied /call for Recheck
Inspected By: Illat—
LARreMoshal\FM Forms Masters\pennitto occupyform_doc
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