2014-196 TOWN OF QUEENSBURY
icoN742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20140196 Date Issued: Friday, June 13, 2014
This is to certify that work requested to be done as shown by Permit Number P20140196
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: CHEESEWICH...GRILLED CHEESE CONCOCTTIONS
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 f
owner of the responsibility for compliance with Site Plan, Variance, or f
other issues and conditions as a result of approvals by the Planning Board Director of Building&Co.: nfor _ ent
or Zoning Board of Appeals.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20140196 Application Number: A20140196
Tax Map No: 523400-302-005-0001-092-011-0000
Permission is hereby granted to: CHEESEWICH...GRILLED CHEESE CONCOCTTIC
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 CO( M)
SYRACUSE,NY 13202-0000 Total Value
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2014 -196 Cheesewich ...Grilled Cheese Concoctions
CIO Only Unit 53
550.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,June 03,2015
(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 To• • i •u -nsbu ; Tu• i ./ June 03,2014
i
SIGNED BY ars-. for the Town of Queensbury.
Director of Building&Code Enforcement
l..
I Office Use Only
Town of Queensbury Fire Marshal jRec 'o d:2 8 2014
�
ESTABLISHMENT OF A NEW BUSINESS SO �r1-�cniSB 'Rv ,b - ��, II
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION T —
^SPetp`Iiitistb'VG.8 CGDES
Permit Fee:
*Note: This application is for occupancy only,with no work requiring a building permit.
Name of Business �hY� ��e�-�,c� , , Cc'1 \L Ck'1deSe- CvAC oc`fonS
Address 5 7 e- To,. <1 Lti ct Si
Type of Business -1 cx,�� ��:� r L ,11 k.0 r
Manager
OR11
Person in charge btrfi er t L\
Business Phone No. 5 I iQ 4-437
Property Owner L i ct±Io A. Ma it NL w c a ,
Address /1/14/ (( /2 ok,Grr
Phone s---/e- 7137- style
,(Provide an accurate layout of your store showing all walls, exits, stockrooms, rest rooms, counters, and fixture layout on a
separate sheet of paper. /i
'6
Print Name: =("i' LA- [t b 6er`fI
Signature: ti 1
Date: Y f�
Notes/Comments:
IMPORTANT: The business owner is responsible for keeping exits clear and maintaining exit signs and emergency lights. Fire
extinguishers,fire sprinkler systems, and fire alarm systems require annual inspections by an outside contractor and the corresponding
documentation must be provided to the Fire Marshal's office. Fire extinguishing systems found in kitchens and gas stations require
semi-annual inspections. Any violations noted during an inspection, require immediate corrective action.
CONTACT NUMBERS:
Director, Building and Codes-761-8253 Zoning Administrator-761-8218 Zoning-761-8238
Fire Marshal-761-8206 Planning-761-8220
Town of Queensbury Fire Marshal-New Business Permit 518-761-8206
EMERGENCY CONTACT UPDATE
TO: Warren County Sheriff's Department
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.
2. 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.
PLEASE PRINT
DATE: (z8)r
BUSINESS NAME: �n'. WtGn. . (.Art tLei c��- v� c6c (pi 5
BUSINESS ADDRESS: K- A u i afi a.4 Ma i
BUSINESS PHONE: CIS' 46FO- `((� 3.S
CONTACT 1: fi' 114.6-6Cr f HOME PHONE -Sic? f2 'Oil Y 3
ADDRESS: 20 t,us /Slue,. 104 1( It//
CONTACT 2: HOME PHONE
ADDRESS:
Town of Queensbury Fire Marshal—New Business Permit 518-761-8206
Inspection Form +` �
3
Town of Queensbury Fire Marshal 0 Periodic Inspection Date: Time:
/ Y Time:
742 Bay Road,Queensbury NY 12804 o Re-Inspection / -
1 A.
518 761 8206/518 761 8205 G'CO Inspection Permit#: `��
Fire Marshals Representative
-XMJ Palmer Business Name: Ch- .1'Se✓w< (-I-1
Location: '7 8 A-,j•-'r w.-)
GK Stillman Contact: v b c^'c-}-j 0COG ei'?r
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 7-
Sign:Normal FC 1011 &FC1029 \
Sign: backup FC 1011.5.3&FC1029.7.5 / SUPPI1 'SSr° 3 (S IJ140
AISLES: 'L?04'S1-- --rte -„,,,, .,
Main Aisle Width FC 1024/1025&FC1029.11 /'--
Secondary Aisle Width FC 1025&FC1029.11
FIRE EXTINGUISHER: Hung FC 906 �/
Inspection of extinguisher FC 906 /
EVAC Plan FC 404.2
TRUSS ID SIGNAGE FC 505.3 7- / -� -• f‘4)
EMERGENCY LIGHTING:Interior FC 1006.3&FC1029.8 l Cay4-1
Exterior FC 1006.3 7-
Clearance to Electrical FC 605.3 /f
Electric Wiring Enclosed/Labeled FC 605.3.1 /�
Combustibles in Equipment Rooms FC315.2.37
F.D.Signage- FC 510 /r r C Q
No Smoking Signs FC 310.3 /
Storage FC 315.2 7 C21-C---
Compressed Gas FC 3003 7”'
Vehicle Impact Protection FC 312.1 7 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
Emergency Disconnect FC 2203.2 21 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 nn IDATE: OK NC
HVAC Shutdown ' r ` (��
Sprinkler System Annual
Sprinkler FDC r Fire Marshal llon Complete
Kitchen Suppression Semi Annual OK to Issue Cert ,of Occupancy
Fuel Island Suppression Semi Annual
Hood Cleaning 3-6-Annual
Knox Box:installed/checked FC506
JUN 11201
Operating Permit, if required will be issued after t
Completion of Inspection Firs Marshal
.,t • '.,,:.
1 THE CHEESEWICH: 4-3-14 _1 — r — —c
FOOD SERVICE EQUIPMENT PLAN
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