2012-343 TOWN OF QUEENSBURY
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742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20120343 Date Issued: Wednesday, December 19, 2012
This is to certify that work requested to be done as shown by Permit Number P20120343
has been completed.
Location: 543 QUEENSBURY Ave
Tax Map Number: 523400-297-008-0001-026-000-0000
Owner: 543 QUEENSBURY AVE., LLC
Applicant: HEADRUSH APPAREL
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
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
` ••••••••••••01••J 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
. 4,
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20120343 Application Number: A20120343
Tax Map No: 523400-297-008-0001-026-000-0000
Permission is hereby granted to: 543 QUEENSBURY AVE., LLC
For property located at: 543 QUEENSBURY 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. Type of Construction Value
Owner Address: 543 QUEENSBURY AVE., LLC Certificate of Occupancy(COM)
543 QUEENSBURY Ave Total Value
SUITE 1
QUEENSBURY, NY 12804-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2012-343
CO Only-Headrush Apparel
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,July 19,2013
(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 o nsbury; Thu s a a,July 19, 2012
SIGNED BY (4 1 _ for the Town of Queensbury.
Director of Building& Co.e Enfo ement
lir Community Development Ofce
Town of Queensbury • 742 Bay Road - Queensbury, New York -12804
David Hatin, Director of Building& Codes JJ L 1. 2012
Craig Brown,Zoning Administrator- Michael J. Palmer, Fire Marshal o p
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# ,21 1-c) Ir BLDG. PERMIT FILE# /.1"3 (!2
If applicable
Name of Business: �-7/4i4,O/?tISh' , ?PPP'ee L ,j-k1 C
Address / /± q QUESTIONS? CALL 761-8256 OR
ofBUslness: -5- 2 (47/�l 'hShU��j' ,eive� ���� EMAIL codes(CALL 61-82 .net
J /G L L/1M77 VISIT OUR FORMWEBSITE FOR MORE
Person in Charge or Manager:
INFORMATION
www.queensbury.net
Business Phone Number: 7 ?'330 0
Type of Business: /7PFP t t/J /Ri hLi 7/Q rtl f- OFF/CLf
Owner of Property: ( [( 4/C/Ow Phone Number(s): 5W`Zqs2-0c03
('� Home cep
Owners Address: 5L�z6/ ' .f l�U Ate S G%;
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: �► Date:
Of person bmitting this form
Notes/ Comments:
EMERGENCY CONTACT UPDATE
TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 743-2502
PLEASE PRINT
DATE: (9 ?6 eO J Z
BUSINESS NAME: / tp ,2ucN /D7g?._j c
BUSINESS ADDRESS: 56/ S C/e 3l), I/fry A/�; (rte' 1/
I
BUSINESS PHONE: 5/?- 7f2L50O
CONTACT 1: I� 1 L f Jf J HOME PHONE ?9(9"qv(.0 2
ADDRESS: 6 Aitne-ovcs--/ t2. /( '�� vI ?-
rrf� ��L1 ?I6. -9s7
CONTACT 2: Z__. HOME PHONE ,' - 5'
ADDRESS: L/
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 QueensburyFire Marshal o On r f�
Periodic Inspection Date: Time:
742 Bay Road,Queensbury NY 12804 o Re-Inspection
518 761 8206/518 761 8205 "�CO Inspection Permit#: �7 � ) _
Fir Marshals Representative
MJ Palmer Business Name: 11-sk
Location: 6c-Pm t) - +--\Q t~.
GK Stillman Contact: •
; 1 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
Sign:Normal FC 1011 &FC1029
Sign:backup FC 1011.5.3& FC1029.7.5
AISLES:
Main Aisle Width FC 1024/1025&FC1029.11 (�
Secondary Aisle Width FC 1025&FC1029.11 � � l� 5
FIRE EXTINGUISHER: Hung FC 906 �( �\
Inspection of extinguisher FC 906
•
EVAC Plan FC 404.6 (J
TRUSS ID SIGNAGE FC 505.3
EMERGENCY LIGHTING:
Interior FC 1006.3&FC1029.8
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 41.
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 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 Semi Annual
Fuel Island Suppression Semi Annual OFririe0ASuSuS:'a'in"iJ 1G.0r n(U1'-1?.'81rEG
j
Hood Cleaning 3-6 -Annual
Knox Box:installed/checked FC506 „ 1
Operating Permit, if required will be issued after • ---- Fire
Completion of Inspection Town of 7a<<eark?-. r'� r •s
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NEW WINDOWS TOTAL NEW SECOND FLOOR AREA - Z032 SF
TOTAL OCCUPANCY
OFFICE - 1 PER 100 SF = 21 PEOPLE
ONE EXIT ALLOWED IF < 30 PEOPLE - OKAY
ONE EXIT ALLOWED IF TRAVEL DISTANCE IS 75' OR LESS - OKAY
SECOND FLOOR PLAN ALL NEW CONSTRUCTION TO BE TYPE 2A PARTIAL FIRST FLOOR PLAN
1/8" = 1'-0" METAL STUD AND 5/8" GYP. BD.
NEW FLOOR STRUCTURE TO BE STEEL COLUMNS
OPEN WEB STEEL JOISTS WITH METAL PAN & �®
PLYWOOD DECKING SIMILAR TO EXISTING
CAD FILE NAME
ACM\V & H\WMCAN PAINTBALL\A-1.1
SCALE AS NOTED
DRAWN BY
DRAWING TITLE
CONCEPTUAL
INTERIOR
RENOVATION
PLANS
DRAWING No.
A-1