CO-000778-2016 TOWN OF QUEENSBURY
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742 Bay Road,Queensbury,NY 12804-5904 (518)761.8201
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Community Development-Building&Codes (518)761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: CO-000778-2016 Date Issued: Friday, January 20, 2017
This is to certify that work requested to be done as shown by Permit Number CO-000778-2016
has been completed.
Tax Map Number: 301.8-1-17
Location: 340 AVIATION RD
Owner: Matt Sokol,DLS Enterprises
Applicant: Matt Sokol
This structure may be occupied as a:C/O only
Tenant:The Tavern Restaurant By Order of Town Board
TOWN OF QUEENNSSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the �,1- (/
property owner of the responsibility for compliance with Site Plan, ��JJ��
Variance,or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
742 Bay Road.Queensbury,NY 12804-5904 (518)761-8201
GL Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: CO-000778-2016
Tax Map No: 301.8-1-18
Permission is hereby granted to: Tavern Restaurant
For property located at: 340 AVIATION 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
Owner Name: Matt Sokol Certificate of occupancy $0.00
Owner Address: 340 AVIATION RD Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
C/O only
Tenant:The Tavern Restaurant
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday,November 14,2017
(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!7D-4;
nday, ov her 14,2016
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
Town of Queensbury Fire Marshal
Received:
ESTABLISHMENT OF A NEW BUSINESS Tax Map ID:
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION Permit No.: C — 000 ?
Permit Fee: 5�
'Note: This application Is for occupancy only,with no work requiring a building permit.
Name of Business r 1Y�✓�'
Address �i r�7ta ✓� �^t 1 u t
Type of Business
ManagerOR
Person in charge
Business Phone No. 5 l k J(J,3 'Fe iNOV 09 2011, L`1�
VYYWl' f:=VJ `
Property Owner Dc
Address
Phone
✓Provide an accurate layout of your store showing all walls,exits,stockrooms, rest rooms,counters, and fixture layout on a
separate sheet of paper,
Print Name: a�–
Signature:
Date: 101
Notes 1 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
Please print clearly
DATE: c. Z.d!(e D G C C OV
NOV 0 9 2016 D
BUSINESS NAME: s Ize- r
URY
�,� / BUILDING & CODES
BUSINESS ADDRESS: 3L+ rtV�c/1�7 n-J
BUSINESS PHONE: C7'
l PHONE I:
CONTACT 1: OA-C�- �i�l�-csZ PHONE 2:
TOWN/VILLAGE RESPONDING FROM:
(�, / . \ PHONE I: 5-7f, 37.f�(11S'3 /'
CONTACT 2: 0t*fJ � � &AA) PHONE 2:
TOWN/VILLAGE RESPONDING FROM: C( �,✓tG cf�
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.
TOWN OF QLIEENSBLIRY FIRE MARSHAL'S OFFICE
Phone: 518-761-8206 • Fax: 518-745-4437
fCremarshal®gueensburi net - zozuzu.queensburt/.net
Fire Marshal Michael J Palmer Deputy Fire Marshal Gary K Stillman
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