2012-593 0111111K TOWN OF QUEENSBURY
742 BayRoad,Queensbury,NY 12804-5902 (518) 761-8201
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Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20120593 Date Issued: Monday, December 31, 2012
This is to certify that work requested to be done as shown by Permit Number P20120593
has been completed.
Location: 357 BAY Rd
Tax Map Number: 523400-296-019-0001-029-000-0000
Owner: OLD SCHOOL HOUSE L.L.C.
Applicant: LAW & LEOMBRUNO, LLP
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 c- a G
43:t
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 COIL EENSBURY
742 Hs.v K(ad,Quvcnsburv,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (5 8) 761-8256
BUILDING PERMIT
Permit Number. P20120593 Application Number. A20120593
Tax 11i1a No: 523400-296-019-0001-029-000-0000
Permission is hereby granted to: LAW & LEOMBRUNO, LLP
1^or property located at: 357 BAY Rd
in die l'own of Queensbury,to construct or place
at the above location in accordance with application together with plot plans and other information hereto filed
and approvuland in compliance with the NYS Uniform Building Codcs and the Quce,nsbury Zoning
Ordi'111,111cc. Type of Construction Value
Owncr.\ddress: OLD SCHOOL HOUSE L.L.C. Certificatc of0ccupancy(CON4)
ATTN: JOHN & DIANE MATTHEW l'otal Value
2546 STATE ROUTE 9L
QUEENSBURY, NY 12804-0000
Contractor or Builder's Maine, / z\ddress Electrical Inspection Agency
Plans& Specifications
'2012-593 Suite 8
CO Orfly LAW & LEOMBRUNO, LLP
PERMIT FEE PAID -THIS PERMIT EXPIRES: Saturday, December 28, 2013
(1fa longer period is required,an application for an extension intist be made to the code J."riforcenlent Officer
of the'ro-,vn of Qucciisbtiry before the expiratioidale)
Dated at the Town of Queensbury; Friday, December 28, 2012
S K;N L',I)BY for the Town of Queensbury.
Director of Building&Code E'nforcernent
,
g Community Development Office
•' Town of Queensbury • 742 BayRoad •
, yQueensbury, New York •12804
Date
David Hatin, Director of Building& Codes ;
Craig Brown, Zoning Administrator• Michael J. Palmer, Fire Marshal SVP A
r. )
L.9)C
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 # ! 1 e , I (4-1-" Ci BLDG. PERMIT FILE# / pk- 23
Name of Business: LA-IA1 4-- L0 rr\ b(-RA1M t 1-LP
Address /�,� {� j c Q
of Business: 351 B �i &dL J R.(k V QUESTIONS? CALL 761-8256 O
EMAIL codes{cr�queensbury netR
. 0. 1 VISIT OUR WEBSITE FOR MORE
M
Person in Charge or Manager: I l t ict INFORMATION
www.queensbury.net
Business Phone Number: 51-'1 Gi t - t i l t
/{ /� p44( vi i 1'
Type of Business: l_-PA - A-c.c0 Ltnrin1 Q
00
_.._ 4 „,
t--), ,,, ,)Owner of Property: B L0 SC-11.00 1 h0 U.S e 1.1_c Phone Number(s): b 6F -5-z4 I
Q vo„,l Citi i' u S Home Cell
Owners Address: t D �OA"& 491-
LA-Ke_ Ge ore_ N 1 12.545
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: ' qCd,+il.1 Date: i?i 2-4I (1/
Of person submitting this form
Notes / Comments:
P S 9,3
EMERGENCY CONTACT UPDATE
TO; WARREN COUNTY SHERIFF'S DEPT. FAX: 743-2502;... ..
v
PLEASE PRINT
DATE:
BUSINESS NAME: 1---91,0 " rr b P-(4"-)0 LL P
1
BUSINESS ADDRESS: 351 t /4 S - S
Que ios b = , N.y . /220Lf
BUSINESS PHONE: SSS- 1b I 'I L`E 8`
CONTACT 1: ��'`�-� LAAAJ HOME PHONE tit
? GRAN AIL
ADDRESS: (WQfAJS b.4r? NI I LTC
CONTACT 2: HOME PHONE
ADDRESS:
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: L2 f 31112Tlme: 19Sl.1M(11
742 Bay Road,Queensbury NY 12804 ,p Re-Inspection
518 761 8206/518 761 8205 CO Inspection Permit#: /2.---5
Fi�:Marshals Representative /
>,i MJ Palmer Business Name: L?'.€) 4-Leery) bPL)nV, GLP
Location: ��7
'.1 1Z � \S-� 0
../" GK Stillman Contact: 1/1 is cte.� kd
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 ..------11
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 .�`
Electric Wiring Enclosed/Labeled FC 605.3.1 -----"'
Combustibles in Equipment Rooms FC315.2.3 c------
F.D.Signage- FC 510
No Smoking Signs FC 310.3 t
Storage FC 315.2 ./
Compressed Gas FC 3003 tJ
0
Vehicle Impact Protection FC 312.1
Interior Finishes FC 803 -804
Smoke Detectors FC 907 .----- r
CO detectors FC 610 ,�
Clearance to Sprinkler/Ceiling FC 315 .2.1 /
18" / 24" ) , -,.
EVAC SIGNS IN Rooms FC 404.6 (R1 & R2) ___...--
Fuel
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:1:43( OK `C
Date
Generator Annual r 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 f
Knox Box:installed/checked FC506
-1
Operating Permit, if required will be issued after
Completion of Inspection
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