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2010-243 TOWN OF QUEENSBURY **WI742 Bay Road Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20100243 Date Issued: Friday, June 11, 2010 This is to certify that work requested to be done as shown by Permit Number P20100243 has been completed. Location: 668 STATE ROUTE 149 Tax Map Number. 523400-279-000-0001-062-000-0000 Owner. GGV, LLC Applicant: BISTRO LEROUX 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, aviPIf: I Variance, or other issues and conditions as a result of approvals by the Director of Building&Code nforce ent Planning Board or Zoning Board of Appeals. TOWN OF QUEENSBURY 0,0 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20100243 Application Number. A20100243 Tax Map No: 523400-279-000-0001-062-000-0000 Permission is hereby granted to: BISTRO LEROUX For property located at: 668 STATE ROUTE 149 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: GGV, LLC 20 SWEET Rd Certificate of Occupancy(COM) STILLWATER,NY 12170-0000 Total Value Contractor or Builder's Name/Address Electrical Inspection Agency Plans &Specifications 2010-243 BISTRO LEROUX- C/O only $50.00 PERMIT FEE PMD- THIS PERMIT EXPIRES: Saturday, May 21,2011 (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 Quee u , 6F is ay 21,2010 SIGNED BY aitlY \ for the Town of Queensbury. Director of Building&Code Enforcement . lis. Community Development Office - Town of Queensbury • 742 Bay Road • Queensbury, New York ••128p4' • •David Hatin,Director of Building&Codes i 0 Craig Brown,Zoning Administrator•Michael J.Palmer,Fire Marshal f , f / ESTABLISHMENT OF A NEW BUSINESS CERTIFICATE OF OCCUPANCY PERMIT APPLICATION TAX MAP# 27 5 - / BLDG. PERMIT FILE# / — 24(3 I If applicable Name of Business: 6 is -1" 1 e-I 0(A- - Adress o f Business: (9 ( 8 &+ -I e !e-c IV , �j L „ 4./y QUESTIONS? CALL 761-8256 OR t 1 EMAIL codesaatteensburv.net Person in Charge or Manager: f`'''1).4-v- G— L/J I w/Q-- VISIT OUR N INFORMATION FOR MORE / www.aueensburv.net Business Phone Number: 7 q 8 - 2-9 2- CC ii - 92-1/- Z23 2_ Type of Business: 54 A1t- -441 1— Owner of Property: k bid"7 t• 6'47 Phone Number(s): 7 78-3 Eatf z— v24/-7_Z8 L— / Home Cell Owners y Address: . 73 �/�Lis-0/I t ' A- / / r 44/ /U / /2_6,2_7 Please provide an accurate layout of our store showing all walls, exits, stockrooms, rest rooms, counters and fixture layout .1 a separate sheet of paper. Signatur-t 1 14 „ A, Date: 3h5//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 EMERGENCY CONTACT UPDATE TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 743-2502 PLEASE PRINT DATE: S�/ 1 U BUSINESS NAME: j I�S !� C) Le_ eok_x BUSINESS ADDRESS: 6 6 7 S / , / 4" BUSINESS PHONE: 5/8 P-Cj 81 HOME CONTACT 1: kb G-EA /1'y PHONE 7 2 7— C121/ qzz-{ ADDRESS: 5-1) 7 3 N S-' i- ori-4/Liv /V-) h L7 HOME 7 0 CONTACT 2: G� C`'"`�"y PHONE 798 — y� ADDRESS: 7 'M 971 4-Y 471 /1-- 2 :7 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 Ph on e: 518-761-8206 • F a x: 518-745-4437 firenuzrshal@queensbury.net • www.queensbury.net Inspection for Permit to Occupy Fire Marshal's Office Request Rec'd Permit No. Town of Queensbury r, 742 Bay Road 10(°4 Ito ,�,• Queensbury,NY 12804 Scheduled inspection Date: r Time: �(, Phone: (518)761-8206 Business Name: -6(S Lif 0.J Fax: (518)745-4437 Location: t t 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 v�j \ TRUSS ID SIGNAGE EMERGENCY UGHTING ori\c)I FIRE EXTINGUISHER: Hung Inspection of extinguisher 6((..• FIRE ALARM SYSTEM Fan Shutdown Fre Sprinkler System (FDC) Fire Suppression-kitchen 0)C.- Fire Suppression-Gas Islan Generator ----- --- -.�.., Hood installation C,c.1 twws n i FI0 Ma _.,al In rt Co+npis?ie Elevator SCK to issLsc.,Cart late f Occupancy Interior Finishes Storage Compressed Gas el Clearance to Sprinklers Clearance to Electrical • Electric Wiring Enclosed/Labeled [ . �---�— Combustible Waste Fife. M. Vehicle Impact Protection Trj, Qiae rst U Knox Box F.D.Signage-Utility Rooms No Smoking Signs Maximum Occupancy Sign Emergency Evacuation Plan Approved (If no other approvals apply,the B&C Office will - -C •to of Occupancy) o Denied /call for Recheck Inspected By: L-\FireMarshal\FM Forms Masters\permltto occupyfomtdoc Inspection for Permit to Occupy Fire Marshal's Office Request Rec'd Permit No. Town of Queensbury 742 Bay Road C. (3 ! Queensbury,NY 12804 Scheduled Inspection Date: Time: b Phone: (518)761-8206 Business Name: c 'yam Fax: (518)745-4437 Location: Type of Inspection N/A Yes No EXITS: Exit Access Exit Enclosure COMMENTS Exit Discharge AISLES: Main Aisle Width } ,W f A w�Fi Secondary Aisle Width r TAt� I" 9 'tc� EXIT SIGNAGE cl c 'i-vr t-- Cr Sign-normal r� Sign-battery 1 G 4 4 V EVAC signs le rooms TRUSS ID SIGNAGE EMERGENCY LIGHTING c s1 N r.4 FIRE EXTINGUISHER: Met c li 5 CZ 0 Hung Inspection of extinguisher FIRE ALARM SYSTEM {.•zN C( t f Qr - Fan Shutdown Fire Fire Suppresssiiont� (FDC) L,c)p S Sc c`- 9' Fire Suppression-Gas Islan Generator Hood Installation Elevator Interior Finishes Storage h�� ('t 1 Ym 1n� tl,�` Compressed Gas Clearance to Sprinklers c1 1 ck Clearance to Electrical b. Electric Wiring Enclosed/Labeled CC Combustible Waste Vehicle Impact Protection Knox Box F.D.Signage-Utility Rooms No Smoking Signs Maximum Occupancy Sign Emergency Evacuation Plan ❑ Approved (If no other approvals apply,the B&C Office wi issue the Certificate of Occupancy) o Denied /call for Recheck lnspec`ed By: L:\FreMarshal\FM Forms Masters\permitto occupyform doc Inspection for Permit to Occupy Fire Marshal's Office Request Rec'd_. Permit No. a-13 Town of Queensbury 742 Bay Road �/1y Queensbury, Y 12804 Scheduled Inspection Date: I� /tJ Time: `' 0 A �\ Phone: (518)761-8206 Business Name: 13 f5`tiNr) 1.--C '-,‹ Fax: (518)745-4437 Location: z-1 Z'n Type of inspection N/A Yes No EXITS: Exit Access Exit Enclosure COMMENTS Exit Discharge AISLES: Main Aisle Widtht k'c U Secondary Aisle Width t. 0,(%kg ���JJJ EXIT SIGNAGE k A___/••.Sttc.-r-<'- �' �( �"`; Sign-normal -!v r k4j r 2r:. y Sign battery- 1 1 EVAC signs in rooms TRUSS ID SIGNAGE EMERGENCY LIGHTING FIRE EXTINGUISHER: N� - ?c-t-t' '- Hung Inspection of extinrher rN I 2,,„estik. ' i *7 _;c.t. FIRE ALARM SYSTEM ' Cm Fan Shutdown -� Fire Sprinkler System (FDC) X. f `-- 'p r" r'�*' Fire Suppression-kitchen Fire Suppression-Gas Wan Generator ---/ , Hood Installation . O I t te f ' I- ,...., Elevator l Interior Finishes k ©"L/ Storage Compressed Gas Clearance to Sprinklers �-- Clearance to Electrical t I cti--1).0 .�..fi , , Electric Wring Enclosed/Labeled ...F..- t Combustible Waste (� t Vehicle Impact Protection @._ l Gi1�lam` � )r,�L' Q 1 Knox Box , F.D.Signage-Utility Rooms ......._ No Smoldnq Signs Maximum Occupancy Sign Emergency Evacuation Plan ❑ Approved (If no other approvals apply,the B 8.C Office will issue the Certificate of Occupancy) ❑ Denied / call for Recheck Inspected By: Ai � L:\FlreMarshal\FM Forms Masters\permitto occupyfomr..doc . = rr'(- c-C S" >? .l ti' Lit-1 4 �,E; i; . �N.�, � -5 ( cl k.. r, r� — t� i t,,,-/ 0 W /s:DIVG Oar..a NAAeaa 0 4 ,8I1 :3lHoS SN V d C N - -- ----- -_ -- - __ _ --- -- .b-.9L— —_. _yµ.... —.— ..____„Z.SZ. �t AJNWIH� } Al r, ,> 1 �I f j t � A I � I , Tom.' � •} ir I i I l ;- iv , - i 4, I-------- -- LI-- 1 t t - 1 r� 1 --------------F -- -- - ----- ---- --- --� n'I I I r-- — _— ------- -.- I