2010-284 TOWN OFQ UEENSBURY
742 BayRoad,Queensbury,NY 12804-5902 (518)761-8201
vpzio Qu may,
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number. P20100284 Date Issued: Tuesday, July 06, 2010
This is to certify that work requested to be done as shown by Permit Number P20100284
has been completed.
Location: 395 BIG BAY Rd
Tax Map Number. 523400-309-017-0001-014-000-0000
Owner: HAYES & HAYES, LLC
Applicant ADIRONDACK WINERY LLC
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 ( 4
f'
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
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20100284 Application Number. A20100284
Tax Map No: 523400-309-017-0001-014-000-0000
Permission is hereby granted to: ADIRONDACK WINERY LLC
For property located at: 395 BIG 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: HAYES & HAYES, LLC Certificate of Occupancy(COM)
PO BOX 109
GLENS FALLS,NY 12801-0000 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans &Specifications
$0.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Tuesday,June 28, 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 rofi�ueens , , 111,a une 28, 2010
SIGNED BY Li)
i 00) for the Town of Queensbury.
Director of Building&Code Enforcement
Jul Li0 .10 07: 10a Sasha Pardy 518-480-3768 P. 1
T A UPDATE
Please print clearly
DATE:
BUSINESS NAME: n ► r tj C"
BUSINESS ADDRESS: � U 1✓
Qu-ceo
BUSINESS PHONE:
.. PHONE I:
CONTACT 1: ffl ,c (` PHONE 2: fi'� - a 60 - V6 3
TOWN/VILLAGE RESPONDING FROM: u�_80:5 b,j f
PHONE 1: ���� -14'&c - 376?
CONTACT 2: ck. h ��� PHONE 2: $ d 60 -� V 6
TOWN/VILLAGE RESPONDING FROM: _e Q5J r
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.
T'O WN OF QLUE-ENSBUR Y FIRE M�ARSHA.L'S O FT
P h o n e: 518-761-8206 51 8-7415-44t5
�t•e�tz(.?s's�f�l@cJZ(ee.ts�c.(rE .=?2T � zvzoze?.��(.(e�ti�Sb1•tY�!.net
F-Im- A'tnrsh.,gtl Michael J Palmer Detarlij/ F iii•e Allar�shal G m y S-11nua
I
Community Development Office
Town of Queensbury • 742 Bay Road • Queensbury, New York •12804
,
Marilyn Rt/ba, Executive Director•David Hatin, Director of Building&Codes
Craig Brown, Zoning Administrator•Michael 1. Palmer, Fire Marshal
► '- = = CERTIFICATE OF OCCUPANCY PERMIT
[�7 - APPLICATION
TAX MAP # BLDG. PERMIT FILE#
/0::cat4r949
Name of Business: ICA i c-C) ()A Ct C kL
Address Q
of Business: 3 c(�� Vck,.1 c.2•J •
QUESTIONS? CALL 761-8256 OR
(1/� 1 EMAIL codes(c�queensbury.net
Person in Charge or Manager: 1 I I t _VI Ckp -� VISIT OUR WEBSITE FOR MORE
INFORMATION
rwvw.queensbury.net
Business Phone Number: 51 • - Co S- - ct 1-
Type of Business: L i/1.-r�
Owner of Property: 0..1 4 5 6 C,.J y9 CSL. Phone Number(s):
Home Cell
Owners
Address:
3 C15 ��
B (� ,t• �-t'/� e
S
u2 ?li>
r Y--at'rlhvy � Li' ?lit/
Please provide an accurate layout of your store showing fall walls, exits, stockrooms, rest rooms,
counters and fixture layout on a separate sheet of paper.
Signature: /14/4
Date: /7 1(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
Inspection for Permit to Occupy
Fire Marshal's Office Request Recd Permit No. I U ' a e 4
Town of Queensbury GO
742 Bay Road C)
Queensbury,NY 12804 Scheduled Inspection Date: Time: U
Phone: (518) 761-8206 Business Name: 4 t.
ul 11 ' \ME&
Fax: (518)745-4437 Location: 0
Type of Inspection N/A Yes No
EXITS:
Exit Access J
Exit Enclosure / COMMENTS
Exit Discharge /
AISLES:
Main Aisle Width ✓
Secondary Aisle Width /
EXIT SIGNAGE --
Sign-normal Q.) °
Sign-battery ,/ v�
EVAC signs in rooms / I� t i►
TRUSS ID SIGNAGE / CCY `/
EMERGENCY UGHr1NG /
FIRE EXTINGUISHER:
Hung /
Inspection of extinguisher
FIRE ALARM SYSTEM
Fan Shutdown / _
Fire Sprinkler System (FDC) / ; Fire Mart*nwec ilurt Cortlple e
Fire Suppression-kitchen OK to Issue Crirti li cate of Otwpm
Fire Suppression-Gas Islan `
Generator /
Hood Installation
lu
Elevator /
____4p4" ''
Interior Finishes
Storage /
Compressed Gas ,/ I fire)lfarshc-4
Clearance to Sprinklers / / t`.._.... p_QUeel�fjuly,..._....._.
Clearance to Electrical �/
Electric Wiring Enclosed/Labeled )
Combustible Waste /
Vehicle Impact Protection /
Knox Box
ED.Signage-Utility Rooms , T1
No Smoking Signs Plan .�
Maximum Occupancy Sian
Emergency Evacuation
Approved (If no other approvals apply,the B&C O •. issue - C ', . e of Occupancy)
o Denied / call for Recheck
'
Inspected By: ‘
L:\FireMarshal\FM Forms Masters\perrnitto occupyform.doc