CO-000004-2016 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development- Building& Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: CO-000004-2016 Date Issued: Friday, May 20, 2016
This is to certify that work requested to be done as shown by Permit Number CO-000004-2016
has been completed.
Tax Map Number: 302.5-1-38
Location: 527 AVIATION RD
Owner: HESS RETAIL STORES LLC
Applicant: Speedway, LLC
This structure may be occupied as a: CO only- Speedway
gas station/convenience store By Order of Town Board
527 Aviation Rd. TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the
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 12804-5904 (518)761-8201
Community Development-Building&Codes (51.8)761-8256
BUILDING PERMIT
Permit Number: CO-000004-2016
"fax Map No: 302.5-1-38
Permission is hereby granted to: Speedway,LLC
For property located at: 527 AVIATION 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
Owner Name: )"'LESS RETAIL STORES LLC Certificate of occupancy
$0..00
Owner Address: I Hess Plaza Total Value $0.00
Woodbridge,NJ 07095
Contractor or Builder's Name 1 Address Electrical Inspection Agency
Plans&Specifications
CO only-Speedway
gas station/convenience store
527 Aviation Rd.
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES:
(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 piration eat .}
Elated at the Town of Qucc ry; T r January 7,2016
tM
SIGNED BY: for the'rown of Queensbury.
Director of Building&Code Enforcement
Office Use QDniy
Town of Queensbury Fire Marshal
Received;
ESTABLISHMENT OF A NEW BUSINESS Tax Map ID:
CERTIFICATE 4F OCCUPANCY PERMIT APPLICATION Permit No.:
Permit Fee:
*Note: This application is for occupancy only,with no work requiring a building permit.
Name of Business
Address
Type of Businessr: hy
Manager
A () 6 201
OR
Person in charge C II Lee M� r Lb/NG, C�P� �) LVA C o C or,)STtA CO
Business phone No. l t,62—
Property
2—Property Owner
,Address . CG) .5=
Phone
,"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: V AT6 t t_biN C,% CarµPAr "-f
Signature:
Date: i 61s,
Notes P Comments:
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,re uire immediate corrective action.
CONTACT NUMBERS:
Director,Building and Codes-761-8253 Zoning Administrator-761-8218 Zoning-761-8238
Fire Marshal-761-8266 planning-761-8220
Town of Queensbury Fire Marshal-New Business Permit 518-761-8205
EMERGENCY CONTACT UPDATE
TO: Warren County Sheriffs 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.
PLEASE PRINT
DATE: 121 30 1 15
BUSINESS NAME: .5 4pj�!Eh VXIA�j
BUSINESS ADDRESS: 52.1 A%A A noQ P—D , O,A-F OSS , 2�j Ny
BUSINESS PHONE: SIR-- -745 — AIRD
CONTACT 1: HOME PHONE
ADDRESS:
CONTACT 2: HOME PHONE
ADDRESS:
Town of Queensbury Fre Marshal—New Business Permit 518-761-8206
FIRE MARSHALS OFFICE
742 Pay Rowl, QiiecnStniry, NY 12804
of N a t it r a I B e a it f y — A G o o d P 1 a c e to L i v e
PLAN REVIEW
Speedway #7789
527 Aviation Road
1/7/2016
CO-000004-2016
• Fire extinguisher locations to be determined
• All egress door hardware shall comply with Chapter 10 of the NYS
Fire Code
• Verify operation of all exit and emergency lighting fixtures,
• Verify aisle and storage
• Carbon monoxide detection is required
• Verify emergency fuel disconnect is still accessible and proper
signage is affixed to the same
• Verify cashier line of sight to dispensing area
Michael J Palmer
Fire Marshal
742 Bay Road
QUeensbury NY 1280,4
firemarsha]
,queensbury.net
flhone518-761,5200
?(,tvuu
G=
John O'Brien
January 5, 2O15
Code Enforcement Office
74ZBay Rd,
Queensbury, NYI28O4 / y 6 �0��
~=^o
/
Re: Speedway-Hess Remodel Project ^
�
Subject Building Permit Application
Speedway Gas Station/Convenience Store No.7789-5Z7Aviation Rd.
]oho:
Per our recent discussion, enclosed please find our application for a Certificat of Occupancy Permit for
the Speedway gas station remodel 1obedone at527Aviation Rd. Included |nthis submission are the
following documents:
1) Certificate ofOccupancy Permit Application
2) (l)copy ofthe project documents
3) Check for Fifty Dollars ($SO.0])
Should you have any questions or require any additional information, please do not hesitate to contact
me.
Sincerely,
\.
Kate Casey
Project Engineer W
Gi|baneBuilding Company
(518) 258-3532