CO-000057-2016 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-000057-2016 Date Issued: Tuesday, February 9, 2016
This is to certify that work requested to be done as shown by Permit Number CO-000057-2016
has been completed.
Tax Map Number: 309.11-2-36
Location: 4 WESTERN AVE
Owner: Hayes& Hayes
Applicant: Jill White
This structure may be occupied as a: CIO only,space 93
Wynter Haven Quilt Studio 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, ,
Variance,or other issues and conditions as a result of approvals by the Director of Building&Code Ent,
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
: Community Development- Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: CO-000057-2016
Tax Map No: 309.11-2-36
Permission is hereby granted to: Wynter Haven Quilt Studio
For property located at; 4 WESTERN AVE
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
Tvoe of Construction
Owner Name: Hayes&Hayes Certificate of occupancy $0.00
Owner Address: 297 Saratoga AVE Total Value $0.00
South Glens Falls,NY 12803
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
CIO only,space#3
Wynter Haven Quilt Studio
$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 ury before a ex 'ration e.)
Dated at the T of Q ee u ay,February 9,2�016
SIGNED BY: YY for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
Town of Queensbury Fire Marsha!
Received:
ESTABLISHMENT OF A NEW BUSINESS Tax Map ID: -50 - 11- 2-510
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION Permit No.: GD- `��""�41 1p
Permit Fee:*15-0 >Y1V 01c St.. Zbc�
*Note: This application is for occupancy only,/with no work requiring a building permit.
Name of Business
Address (,(,YPj _� "c� F,
Type of Business r t 411 /1')l� f7J P CSCZ/Qs y y(-
Manager
OR
Person in charge 7 f
Business Phone No.
Property Owner � `f 41 Z4.0 5- e .Z!
a �Address L-Fa - -442-1 e ( 7. Lj ,ll Alj( 4,790-3
Phone --� �' / i� • ��f
✓Provide an accurate layout of your store showing all walls,exits,stockrooms,rest rooms,counters,and fb ture layout on a
separate sheet of paper.
Print Name:
Signature: /�.. /,1/
Date:
Notes/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
semiannual inspections. Anv 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 518-76M206
EMERGENCY CONTACT UPDATE
Please print clearly
DATE: ,2-� /r
BUSINESS NAME: )zvl)k r 7�/1-�►'✓ r7` �f�] ! ()
BUSINESS ADDRESS: -V SU GOZ(Sl°r7 all G��'�'�Sr��C�' /
VY
BUSINESS PHONE: �+� �/ e�wo 7-7
f ,+ l��r / PHONE I:
CONTACT 1: t /rG(� �T�� PHONE 2:
TOWN/VILLAGE RESPONDING FROM: Yy,)A5� (�����c� 7'``�l� //1
/'`�
PHONE 1:
CONTACT 2: PHONE 2:
TOWN/VILLAGE RESPONDING FROM:
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
Phone: 518-761-8206 - Fax. 518-745-4437
flrenmrshal@queensbutynet - www.aueensbul-It.net
Fire Marshal Michael I Palmer Deputy Fire Marshal Gant K Stillman
Wynter Haven Quilt Studio 4 So.Western Ave,Queensbury,NY 12804 518-792-2077
Wynter Haven Quilt Studio Emergency Exit Procedure:
• In the event of an emergency, all customers will be directed to
exit through the nearest exit.
• Assigned person will call 911.
• North Parking Lot is the assigned meeting Place in the event of
an emergency.
• Trained Staff will assist in the evacuation of customers from the
front of the store, to exit through the front emergency exit and
be directed to the North Parking Lot.
• Trained Staff will assist in the evacuation of customers from the
back of the store, to exit through the rear emergency exit and be
directed to the North Parking Lot.
• Assigned Staff Member will verify that all customers have been
safely removed from the premises.
• Assigned Person will meet emergency responders.