2012-150 '` TOWN OFQ UEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20120150 Date Issued: Monday, April 16, 2012
This is to certify that work requested to be done as shown by Permit Number P20120150
has been completed.
Location: 578 AVIATION Rd HI #1
Tax Map Number: 523400-302-005-0001-092-011-0000
Owner: AVIATION MALL NEWCO LLC
Applicant: KERRY LYN'S BOUTIQUE
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, Variance, or J ,
other issues and conditions as a result of approvals by the Planning Board
Director o :uilding&Code ! .rce .-nt
or Zoning Board of Appeals.
01.h`
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20120150 Application Number: A20120150
Tax Map No: 523400-302-005-0001-092-011-0000
Permission is hereby granted to: KERRY LYN'S BOUTIQUE
For property located at: 578 AVIATION Rd HI #1
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: AVIATION MALL NEWCO LLC
4 CLINTON Sq Certificate of Occupancy(COM)
SYRACUSE, NY 13202-0000 Total value
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2012-150
CO only Kerry Lyn's Boutique Space B l O 1
$50.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Tuesday, April 09, 2013
(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 Town of Queensbury; Monday, April 09, 2012
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
D _. _ 4
Community Development Office
Town of Queensbury - 742 Bay Road • Queensbury, New York -1'8 Date
David Hatin, Director of Building& Codes
Craig Brown, Zoning Administrator- Michael J. Palmer, Fire Marshal ¢UI l 14.3
ESTABLISHMENT OF A NEW BUSINESS
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION
*Note: This application is for occupancy only, with no work requiring a building permit.
TAX MAP # _3n /- , l I BLDG. PERMIT FILE# • / 't
tt If applicable
Name of Business: kecc6 1 s �,�-ti ty(,� •Q
Address a/1'64A // r Qof Business: / �`+Ui 1_01
QUESTIONS? CALL 761-8256 OR
EMAIL codesequeensbury.net
(��. VISIT OUR WEBSITE FOR MORE
Person in Charge or Manager: k 7� -eXI LA-)rse-AVN INFORMATION
www.queensbury.net
Business Phone Number: S v 37. .37c
Type of Business: ` r '( 5 u {.j,IGS') yam
Owner of Property:\t4rC) /ii2tget�14- Phone Number(s):77 -88-
`J Home Cell
Owners Address: 57 kl`Ct47di1
Provide an accurate layout of your store showing all walls, exits, stockrooms, rest rooms,
counters and fixture layout on a separate sheet of paper.
Signature: b Date: i b /oZ-
Of -rson sufttlrrg this form
Notes / Comments:
EMERGENCY CONTACT UPDATE1319i� _ 5�
TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 743-2502
PLEASE PRINT
DATE: qi& )c?---
i 1
BUSINESS NAME: kf'(CLtu�
I 6 & (((..t
BUSINESS ADDRESS: 'its ' k 77`Gtn/\ CJ J. . • Lct( LI Y
BUSINESS PHONE: �I P -376-
CONTACT
37 CONTACT 1s 'gCP4(10."1 V\YA HOME PHONE 5I )-5/0-3a5T
ADDRESS: Vd - • • \11.J a.3
CONTACT 2: Gate, DitsWz HOME PHONE 576.6 % 'aS i7
ADDRESS: 10/1/4 Or \'A,SEC-1_y y
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.
Inspection FormO
I' Ip
Town of Queensbury Fire Marshal O Periodic Inspection Date: Time:
742 Bay Road,Queensbury NY 12804 o Re-Inspection / ��
518 761 8206/518 761 8205 .9 'CO Inspection Permit#:
Marshals Representative
Fie
MJ Palmer Business Name: a ' - _ . , r R A
Location: -40'10ifori 111�t( ,. Q aiol
GK Stillman Contact: Arw,lclr>i<c> Li) re.n✓1
Type of Inspection N/A Yyc No
EXITS: Exit Access FC 1014&FC1029 NOTES
Exit Enclosure FC 1020&FC1029 /
Exit Discharge FC 1024& FC1029 l
Locks and latches FC1008& FC1029.2 7
Sign:Normal FC 1011 & FC1029
Sign:backup FC 1011.5.3& FC1029.7.5
AISLES:
Main Aisle Width FC 1024/1025&FC1029.11 `<^ C4
Secondary Aisle Width FC 1025&FC1029.11 -X `v
FIRE EXTINGUISHER: Hung FC 906 Y
__ Inspection of extinguisher FC 906 7
EVAC Plan FC 404.6 // , 0
TRUSS ID SIGNAGE FC 505.3 I
/
EMERGENCY LIGHTING: `'t
Interior FC 1006.3&FC1029.8 / ,f C\N'
� (
Exterior FC 1006.3
Clearance 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) Z
Fuel Pump Warning Signs FC2205.6 �'
Fuel Station Emer Procedures FC2204.3.5 /
Exterior Storage FC 315.3 f REINSPECTION DUE APPROXIMATELY
Vacant Buildings FC 311 / 21 DAYS
SYSTEMS: FC 901.6 Insp OK NC DATE: OK NC
Date _
Generator Annual DATE: OK NC
Hood Installation
Elevator Semi Annual
FIRE ALARM Annual DATE: OK NC
HVAC Shutdown
Sprinkler System Annual .-------- ,;
Sprinkler FDC t Fire Mar`.; .et insoec I..n Car iote 1
p • ,OK L)iSSue Corti!.rtf-?c}f Ocr t:,'•8f1"1
Kitchen Suppression Semi Annual
Fuel Island Suppression Semi Annual
Hood Cleaning 3-6-Annual I -
Knox Box:installed/checked FC506 i r-„ l� iZ
4,1
•
Operating Permit, if required will be issued after �� ��
Fire 3
Completion of Inspection Town of Ci:A.r 'i,?......___� ,
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