2013-074 TOWN OF QUEENSBURY
`FO S 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20130074 Date Issued: Thursday, March 14, 2013
This is to certify that work requested to be done as shown by Permit Number P20130074
has been completed.
Location: 108 MAIN ST.
Tax Map Number: 523400-309-014-0001-012-000-0000
Owner: PATRICK MERRILL
Applicant: S & J CELLULAR
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.
1� TOWN OF QUEENSBURY
`1431742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20130074 Application Number: A20130074
Tax Map No: 523400-309-014-0001-012-000-0000
Permission is hereby granted to: C &J CELLULAR
For property located at: 108 MAIN St
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: PATRICK MERRILL Certificate of Occupancy(COM)
108 MAIN St Total Value
QUEENSBURY,N.Y. 12804
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2013-074 S & J Cellular
CO Only
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday, March 14,2014
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town of Qu sbu T • r arch 14, 2013
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
. _ s— _ _
" ea Community Development Office I i!', r i'1 r
, , Town of Queensbury- 742 Bay Road • Queensbury, Nein', •12804 I
. in, ; ®ate
David Hatin, Director of Building& Codes I J II ; FEB 2 1; 201 tamp
Craig Brown,Zoning Administrator• Michael J. Palmer, Fire Marshal L
J TO
I ri 'IL ' 'a", . c m-s i r
ESTABLISHMENT OF A NEW BUSINESS C' - =`
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION
*note: This application is for occupancy only, with no work requiring a building permit.
TAXMAP# 30q,Il -I-1a . . BLDG. PERMIT FILE# I 3 -0941
41
If applicable
SName of Business: J t T Ce\\y`cur
Address CZ,)GGIncV rl t I•31
of Business: ktY% Vint n 'C Q:\ `a€O e` ,QUESTIONS?EMCALL 761-6256 OR
AIL codesCo)queensbury.net
VISIT OUR WEBSITE FOR MORE
Person in Charge or Manager.1fiSet �R\ucy y Sam \ecot )p INFORMATION
www.aueensburv.net
aza
Business Phone Number: (_S-1i) .2a$"a 3 ',f.
Type of Business: Cc11sskes(- Nis,cvtc - mica:,
Owner of Property: y I ;/ Phone Number(s):7?o/j/f?
t / 5��
Owners Address: ,( !��/ l
Provide an accurate layout of your store showing all walls, exits, stockrooms, rest moms,
1 ' counte/ an•• xture layout on a sep rate s eet of paper.
�•
Signature: I /lit!` 1_/At..., Date: 2 2 (3
Of.< . bm t(ng this form
Notes I Comments:
EMERGENCY CONTACT UPDATE a F 0()1
TO: WARREN COUNTY SHERIFF'S DEPT FAX: 743-2502
PLEASE PRINT f
DATE:a /
;t '� a 0 13
BUSINESS NAME: S F S C.e_t. l o 1 c,.C-
BUSINESS ADDRESS: IOS Aar3 1-. Oticensbatie Ivy /arPDy
BUSINESS PHONE:(f/R) 222-o?376
CONTACT 1: 6c071 /7ClA4C HOME PHONES/ a-2
ADDRESS: o d Sea/ntn ra sic FT, .d 47 Ago;
a8
CONTACT 2 Sase1\ A- V3Ln HOME PHONE -0709
SSS ��age Si- APt- 3
ADDRESS: G le.h s cca t se, !`1i 1
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 s�
Town of Queensbury Fire Marshal 0 Periodic Inspection Date:411 f 13 Time:
742 Bay Road,Queensbury NY 12804 °Re-Inspection
518 761 8206/518 761 8205 ®CO Inspection Permit#: 13 OIL/
Fire Marshals Representative
AMJ Palmer Business Name: SS CL.=LLJIna_
Location: ieu Mora St'
GK Stillman Contact: ��a
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 Wdth FC 1024/1025&FC1029.11
Secondary Aisle Width FC 1025&FC1029.11 ./z7w\ /t
FIRE EXTINGUISHER: Hung FC 906 _` ,..44\14)1/
Inspection of extinguisher FC 906 C (WeIa°
EVAC Plan FC 404.2
TRUSS ID SIGNAGE FC 505.3
EMERGENCY LIGHTING:
Intenor FC 1006.3&FC1029.8
Extenor FC 1006.3 \
Clearance to Electrical FC 605.3 K_ t U
D
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 air
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 { Fire Marse:oI Inspeciir n Comple
Kitchen Suppression Semi Annual EE OK to Issue Corti cafe of Occupancy
Fuel Island Suppression Semi Annual t
Hood Cleaning 3-6-Annual
Knox Box:installed/checked FC506 ; ! � 251.3
Operating Permit, if required will be issued after
Completion of Inspection i FI°1 s' l