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2012-277 4111111hi TOWN OF QUEENSBURY vero742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY { Permit Number: P20120277 Date Issued: Friday, August 17, 2012 This is to certify that work requested to be done as shown by Permit Number P20120277 has been completed. Location: 123 QUAKER Rd Tax Map Number: 523400-296-019-0001-002-000-0000 Owner: MRK COMMUNITY COLLEGE HOUSING, LLC Applicant: MRK COMMUNITY COLLEGE HOUSING, 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 property 4 41,5t 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. TOWN OF QUEENSBURY IF 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518)761-8256 BUILDING PERMIT Permit Number: P20120277 Application Number: A20120277 Tax Map No: 523400-296-019-0001-002-000-0000 Permission is hereby granted to: MRK COMMUNITY COLLEGE HOUSING, LLC 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 HOU Certificate of Occupancy(COM) 6 CHELSEA P1 Total Value CLIFTON PARK,NY 12065-0000 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications 2012-277 Suites 106 & 107 CO Only- Roof&Restoration Services of America, LLC $50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,June 06,2013 (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 ensbury; Wed e d ,June 06,2012 SIGNED BY4 for the Town of Queensbury. Director of Building&Cod Enfo\ment :a.-•/.1).-/"-p--(24-1" .i\_. �,,,,�. Community Development Office Town of Queensbury • 742 Bay Road • Queensbury, New York •128041 ,v� 1 l J ,,.: J David Ha tin, Director of Building& Codes Craig Brown, Zoning Administrator• Michael J. Palmer, Fire Marshal • -T= i 4 r icv s ESTABLISHMENT OF A NEW BUSINESS ,Z., JT ,,rs CERTIFICATE OF OCCUPANCY PERMIT APPLICATION �� vi--- ,et':-"1-1 � �' 0l� *Note: This application is for occupancy only, with no work requiring a building permit. (pr- TAX MAP # 2 vl Co - 1 1 v ' — Z BLDG. PERMIT FILE# I .% ---e:;\ c (2 . ( (� If applicable Name of Business: � ' 0 A S1--%3v- I-1 ', . ., �,t' J b c l T 1 ) f"'-7 Pr' c n , 1,Ce... Address of Business: l 1.1 q u n k(.,.,/ 2 )ti i �, /v/, 6 4---/07 QUESTIONS? CALL 761-8256 OR �,{ / EMAIL codes(a queensbury.net t" i Lkae� VISIT OUR WEBSITE FOR MORE Person in Charge or Manager: 1 ( r In C? I I I b 1 )'/� INFORMATION 1 l� t ll,Ke P; Z O www.queensbury.net Business Phone Number: 50 LI I 3 Z 1 c 3 "V' SSSS-ci5�v� Type of Business: S A-0 r, WI 'R 1.S I-0 f'(9 1 3 n Owner of Property: 0-1(Z << I`i, I Qr'9€r Phone Number(s): 3 3 L1 t 0 F(..\ g- 9.12- D Home �) Cell Owners Address: 6 C e `I L1 n a Y' i c l i _f'!",^ T(�nrI< (o il 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: -) • )lam Date: .1/?/ Z Of person submitting this form Notes / Comments: EMERGENCY CONTACT UPDATE TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 743-2502 PLEASE PRINT DATE: f/ // Z BUSINESS NAME: ° ° / EJ T O fa �h SerIf v I 4/97e,--• BUSINESS ADDRESS: / Z 3 (Qvn / /2c 1-itr /i2 '� Jo? BUSINESS PHONE: " L/ / Z F3 I CONTACT 1: 076,r ( // h CI•HOME-PHONE 5-61-) 9/ 3 z ADDRESS: CONTACT 2: (0C 1(' W) /1 H E-PHONE Prk 9 s Z ADDRESS: Cit( / ,/ C/ I/A 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 Form Town of Queensbury Fire Marshal o Periodic Inspection Date: f) I16412--Trme:1 '> /7T 742 Bay Road, Queensbury NY 12804 o Re-Inspection 518 761 8206/518 761 8205 COl4 Inspection Permit#: 42— 7 77 Fire Marshals Re resentative /' - 2-- MJ Palmer Business Name: �- { es 'z.-a, _ __ , Ah4-,) Location: /2-6 Ode—,, ,.L 26, '. /4GK Stillman Contact: 7/ e.,.- G-//i,i$ 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 Locks and latches FC1008& FC1029.2 /'j Sign:Normal FC 1011 & FC1029 Sign:backup FC 1011.5.3&FC1029.7.5 -------- AISLES:AISLES: Main Aisle Width FC 1024/1025&FC1029.11 Secondary Aisle Width FC 1025&FC1029.11 /f FIRE EXTINGUISHER: Hung FC 906 Inspection of extinguisher FC 906 EVAC Plan FC 404.6 TRUSS ID SIGNAGE FC 505.3 /- EMERGENCY LIGHTING: Interior FC 1006.3& FC1029.8 / Exterior FC 1006.3 Clearance to Electrical FC 605.3 .f Electric Wiring Enclosed/Labeled FC 605.3.1 Combustibles in Equipment Rooms FC315.2.3 ------ F.D. F.D. Signage- FC 510 No Smoking Signs FC 310.3 ./ -r Storage FC 315.2G(� Compressed Gas FC 3003 �� Vehicle Impact Protection FC 312.1 ----- �� Interior Finishes FC 803-804 Smoke Detectors FC 907 1. CO detectors FC 610 ,------ Clearance Clearance to Sprinkler/Ceiling FC 315.2.1 --------.- 18" 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 _—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 Kitchen Suppression Seml Annual Fuel Island Suppression Semi Annual Hood Cleaning 3-6-Annual Knox Box:installed/checked FC506 Operating Permit, if required will be issued after Completion of Inspection a`; )i . i'Ci4, Inspection Form Town of Queensbury Fire Marshal O Periodic Inspection Date: 1.' 4,10 742 Bay Road, Queensbury NY 12804 o Re-Inspection Z-Z� -7 518 761 8206/518 761 8205 ,- CO Inspectio _ Permit#: / / Fire Marshals Representative J _ MJ Palmer Business Name: �6O . 1- r'?�) '-y'A1),1 , W../4 G /Leviie:-,,1 Location: i 2-.3 �%�<. K.. '(.4...z,(2_ . ,, its, 1 )�7 /'K Stillman Contact: /-77�';-='f �'///r2s' 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 AISLES: Main Aisle Width FC 1024/1025& FC1029.11 ----"-- Secondary Secondary Aisle Width FC 1025&FC1029.11 FIRE EXTINGUISHER: Hung FC 906 ----""/ Inspection of extinguisher FC 906 EVAC Plan FC 404.6 TRUSS ID SIGNAGE FC 505.3 -- ---- •• EMERGENCY LIGHTING: / r j - k\L Interior FC 1006.3& FC1029.8 i-f �G / /��t jJ' f`�- J Exterior FC 1006.3 / a t.r>cs5-1 t C PA ,''r`r�vc Clearance to Electrical FC 605.3 • Electric Wiring Enclosed/Labeled FC 605.3.1 ��lC� hive / ''—( e- 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 /CO detectors FC 610 Clearance to Sprinkler/Gelling FC 315.2.1 .----------- 18" /18" / 24" EVAC SIGNS IN Rooms FC 404.6 (R1 &R2) ..----"e _ 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 2I DAYS SYSTEMS: FC 901.6 lnsp 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 Kitchen Suppression Semi Annual Fuel Island Suppression Semi Annual Hood Cleaning 3-6 -Annual Knox Box:installed/checked FC506 Operating Permit, if required will be issued after Completion of Inspection