2015-266 iAeffilbkiTOWN OF QUEENSBURY
too742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20150266 Date Issued: Tuesday, July 07, 2015
This is to certify that work requested to be done as shown by Permit Number P20150266
has been completed.
Location: 123 QUAKER Rd
Tax Map Number: 523400-296-019-0001-002-000-0000
Owner: MRK COMMUNITY COLLEGE HOUSING, LLC
Applicant: MR B'S BEST - GLEN LAKE SERVICE CORP.
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 ( 44,0 1 16/lt
owner of the responsibility for compliance with Site Plan, Variance, or
other issues and conditions as a result of approvals by the Planning Board Director of Building&Code Enforcement
or Zoning Board of Appeals.
016` TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20150266 Application Number: A20150266
Tax Map No: 523400-296-019-0001-002-000-0000
Permission is hereby granted to: MR B'S BEST- GLEN LAKE SERVICE CORP.
For property located at: 123 QUAKER 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: MRK COMMUNITY COLLEGE HO1
6 CHELSEA P1 Certificate of Occupancy(COM)
CLIFTON PARK,NY 12065-0000 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2015-266
C/O only for Office
Mr. B's Best- Glen Lake Service Corp.
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,June 24,2016
(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 e : ra i on date.)
Dated at the Town I 'Qu.-n%r ' ' doe say,June 24,2015
SIGNED BY /✓moi , i/1A / for the Town of Queensbury.
� r
: - . . Building& ode Enforcement
1
Office Use Only
Town of Queensbury Fire Marshal
Received:
ESTABLISHMENT OF A NEW BUSINESS Tax Map ID:
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION Permit No.: 2oi5 - 2te(0
Permit Fee: �� - ,
*Note: This application is for occupancy only,with no work requiring a building permit.
Name of Business 40A a_ T2. (A.-QnL.o ke_ S2ry i -C, Co cc .
Address b 24, +2 C(
Type of Business FH C.2
Manager L 2 v v
OR Person in chargeRECEir'd
Business Phone No. _ -Q 3- S l t14 2 2 2U15
Property Owner K- 16 12 --Cl I f C o -e-tr4 Rv
Address (o S 2 Q v �. 0.C-e- � � � `F'
Phone 3 7 / - O S&L(
/Provide an accurate layout of your store showing all walls, exits, stockrooms, rest rooms, counters, and fixture layout on a
separate sheet of paper.
Print Name: R- ( ' Pe \L
g cC `` CilZQZ,
Signature: �� 3 - 2
�
Date: W. 2:2-1 2 t7/ .S
Notes I Comments: -Cc hGcrt S? race ; .s /' c - 1 Oc / /2_ Cat a.LQr-
°' d t,,-e ens 6 to r v AN, @ '7' 30 ac ry SS S',".S',". tt-1Q re 7L.
J--QA5`eri+ �-t,V-t 1- t-t S 6 o r rt gra I phi C
0 rrer u-V-I"ors .
IMPORTANT: The business owner is responsible for keeping exits clear and maintaining exit signs and emergency lights. Fire
extinguishers,fire sprinkler systems, and fire alarm systems require annual inspections by an outside contractor and the corresponding
documentation must be provided to the Fire Marshal's office. Fire extinguishing systems found in kitchens and gas stations require
semi-annual inspections. Any violations noted during an inspection, require immediate corrective action.
CONTACT NUMBERS:
Director, Building and Codes-761-8253 Zoning Administrator-761-8218 Zoning-761-8238
Fire Marshal-761-8206 Planning-761-8220
Town of Queensbury Fire Marshal—New Business Permit 518-761-8206
EMERGENCY CONTACT UPDATE
TO: Warren County Sheriff's Department
1. 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.
2. 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. �
•=•-_-_- -�-
LD� c� � o -T� ,
PLEASE PRINT .�U�d 2 2 2015
DATE: (o '/%2-- Z p TOWN OF QUEENSBURY
BUILDING&CODES
BUSINESS NAME: i_a l p rd #7 ek- Rea l Pryer-1-y
LL C
;di a 2 f10 1.4-, c Z— — Ci( 0/50— y'52-
BUSINESS ADDRESS: L Ck 5,ea ‘q . et ; c v- lC N) 12-0(4.5
373 — 4/ Sib
BUSINESS PHONE:
CONTACT 1: 01 I Chi Ci-e,( ICI i rn1Ce 14HOME PHONE
ADDRESS: C L S •eG tiP l • c P I�CONTACT2: e 0 n e HOME PHONE 7 ` 62367
ADDRESS:
Town of Queensbury Fire Marshal—New Business Permit 518-761-8206
Inspection Form
30
Town of Queensbury Fire Marshal O Periodic Inspection Date:/h1` 1 Time: / •
742 Bay Road,Queensbury NY 12804 (11.Re-Inspection (� d�o
518 761 8206/518 761 8205 CO Inspection Permit#:
Fire Marshals Representative
MJ Palmer Business Name: (nom"` CS`' 'i or
Location: 1X13 fa/ltan It 6°-
GK Stillman Contact:
Type of Inspection N/A Yes No
EXITS: Exit Access FC 1014&FC1029 - NOTES
Exit Enclosure FC 1020&FC1029
Exit Discharge FC 1024&FC1029
Locks and latches FC1008& FC1029.2
Sign: Normal FC 1011 &FC1029
Sign:backup FC 1011.5.3&FC1029.7.5 y
AISLES: '� �� /
Main Aisle Width FC 1024/1025&FC1029.11
Secondary Aisle Width FC 1025&FC1029.11
FIRE EXTINGUISHER: Hung FC 906 � �\"n�� �
Inspection of extinguisher FC 906
EVAC Plan FC 404.2
TRUSS ID SIGNAGE FC 505.3
EMERGENCY LIGHTING:
Interior FC 1006.3&FC1029.8
Exterior FC 1006.3 DL
Clearanc
e to Electrical FC 605.3
Electric Wiring Enclosed/Labeled FC 605.3.1
Combustibles in Equipment Rooms FC315.2.3
F.D.Signage- FC 510
No Smoking Signs FC 310.3
Storage FC 315.2
Compressed Gas FC 3003
Vehicle Impact Protection FC 312.1
Interior Finishes FC 803-804
Smoke Detectors FC 907
CO detectors FC 610
Clearance to Sprinkler/Ceiling FC 315.2.1
18" / 24"
EVAC SIGNS IN Rooms FC 404.6(R1 &R2)
Fuel Pump Warning Signs FC2205.6
Fuel Station Emer Procedures FC2204.3.5
Exterior Storage FC 315.3 REINSPECTION DUE APPROXIMATELY
Vacant Buildings FC 311
Emergency Disconnect FC 2203.2 21 DAYS
3rd Party Electrical
SYSTEMS: FC 901.6 lnsp OK NC DATE: OK NC
Generator Annual
FM Type Suppression Semi Annual DATE: OK NC
Elevator Semi Annual
FIRE ALARM Annual DATE: OK NC
Paint Booth Suppression Semi Annual
Sprinkler System Annual
Sprinkler FDC rrr
Kitchen Suppression _ Semi Annual ;i / c �`" �' ' _,v
Fuel Island Suppression Semi Annual I f 0"r'4
Hood Cleaning 3-6-Annual J
Knox Box:installed/checked FC506 �G
JUL O r I ;
Operating Permit, if required will be issued after • -
Completion of Inspection - , .)
Inspection Form _
Town of Queensbury Fire Marshal O Periodic Inspection Date: 6 A Time: !4
742 Bay Road,Queensbury NY 12804 o'te-Inspection `�-2
518 761 8206/518 761 8205 �- CO Inspection Permit#: r��t
Fire Marshals Representative f 7----(r41)
� /'f
Business Name: /0h• f .1,‘ / O
Location: ��3 i ��
'PalmerStillman Contact: 100/1
Type of Inspection N/A Yes No
EXITS: Exit Access FC 1014&FC1029 / NOTES
Exit Enclosure FC 1020&FC1029 �,,
Exit Discharge FC 1024&FC1029 ' ►��/�
Locks and latches FC1008& FC1029.2 41r- 176
Sign: Normal FC 1011 &FC1029
Sign:backup FC 1011.5.3&FC1029.7.5
AISLES:
Main Aisle Width FC 1024/1025&FC1029.11 3
Secondary Aisle Width FC 1025&FC1029.11 ✓/
FIRE EXTINGUISHER: Hung FC 906
Inspection of extinguisher FC 906 �'�CA ,,409 41.W
EVAC Plan FC 404.2 r
TRUSS ID SIGNAGE FC 505.3
EMERGENCY LIGHTING: 7 !///ii
Interior FC 1006.3&FC1029.8 %%��!!//��
Exterior FC 1006.3
Clearance to Electrical FC 605.3 .,...°"''. /I__ _
4-
Electric Wiring Enclosed/Labeled FC 605.3.1 -� /`y�/(
Combustibles in Equipment Rooms FC315.2.3
F.D.Signage- FC 510 r
No Smoking Signs FC 310.3 ;/
Storage FC 315.2
/Ri
57 Compressed Gas FC 3003 �/ 6) 4-' fiptr./`�
Vehicle Impact Protection FC 312.1
Interior Finishes FC 803-804
Smoke Detectors FC 907 .�„.
CO detectors FC 610
Clearance to Sprinkler/Ceiling FC 315.2.1 /
18" / 24"
EVAC SIGNS IN Rooms FC 404.6(R1 &R2)
Fuel Pump Warning Signs FC2205.6
Fuel Station Emer Procedures FC2204.3.5
Exterior Storage FC 315.3 ..
Vacant Buildings FC 311 REINSPECTION DUE APPROXIMATELY
Emergency Disconnect FC 2203.2 �j 21 DAYS
3rd Party Electrical „/
SYSTEMS: FC 901.6 Insp OK NC DATE: OK NC
Generator Annual
FM Type Suppression Semi Annual DATE: OK NC
Elevator Semi Annual
FIRE ALARM Annual
Paint Booth Suppression Semi Annual DATE: OK NC
Sprinkler System Annual
Sprinkler FDC C
KitchenSuppression Semi Annual
Fuel Island Suppression Semi Annual grt/te
* C /(//41/
Hood Cleaning 3-6-Annual
Knox Box:installed/checked FC506 46,
Operating Permit, if required will be issued after
Completion of Inspection4
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