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CO-000188-2015 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 -- Community Development-Building&Codes (518)761-8256 CERTIFICATE OF OCCUPANCY Permit Number: CO-000188-2015 Date Issued: Friday, December 18, 2015 This is to certify that work requested to be done as shown by Permit Number CO-000188-2015 has been completed. Tax Map Number: 296.19-1-42 Location: 79 GLENWOOD AVE Owner: Prime Glenwood,LLC Applicant: E5 Support Services,LLC This structure may be occupied as a:CO only E5 Support Services LLC By Order of Town Board First Floor 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 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 QL Community Development-Building&Codes (518)761-8256 BUILDING PERMIT Permit Number: CO-000188-2015 Tax Map No: 296.19-1-42 Permission is hereby granted to: E5 Support Services,LLC For property located at: 79 GLENWOOD 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 Owner Name: Prime Glenwood,LLC Certificate of occupancy $0.00 Owner Address: 621 Columbia ST Total Value $0.00 Cohoes,NY 12047 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications CO only E5 Support Services LLC First Floor $50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: (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 ueensb • [ / on 2015 SIGNED BY: (-yVjYj/ 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.: PermitFee:4f5o^ )Y)\ `bb *Note: This application is for occupancy only,with no work requiring a building permit. Name of Business F5 c 11agorl Seey%�"5, LLC Address �( Gzl eatJocd A t , (�r LrM 56✓�y, W tar Type of Business Sd ar , rj rcu C` ✓1 — _ ((_-. _(_._„ __� ManagerOR ' 1 D Person in charge NG o [aS c OCT 2 2 2015 UUU Business Phone No. 0 �1 d TOWN OF QUEENSBURY Property Owner P i e ( etirtLroc ej L C n DING i ODES Address 4)-I Cerl U%,htr,_ Phone G l f — 7 ?.5 —MOO ✓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: G Signature: —� Date: 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 T0: 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: C L5 BUSINESS NAME: E, 5 �5-0 c" Serx/,`cPS BUSINESS ADDRESS: / 1 Gil ei, W o o d /t"nVe, I�UeCn3d�y�#Y BUSINESS PHONE: Jr/ `3G CONTACT 1: `�gv4 I��d�^ �h HOME PHONE 51 Sr—Z g3—y�G� ADDRESS: 3 TV T' I-e, ✓ood S) r i�w, 04 e* yk&v,, NY � qq 5 r Ss — 3c t —t�3�� CONTACT 2: �—c$� /i✓ HOME PHONE SI i '—Igy—y��J ADDRESS: �� i7 KCl.�Oo r fie, Town of Queensbury Fire Marshal—New Business Permit 518-761-6206 �a�� pjs aaw . ya. -.•...._•-------- ................... ••. ............. � z � I'1Ni u g VwLr m+t arzn'.sz1 .r w it HEM 5 nary a 1Boon ns ; Y b 1 � .........._•......••_................................... .-..•..................•..--.�, PROPOSED FIRST FLOOR.OFFICE FLOOR PLAN awn uv.r S-4 i OCT 2 2 2 015 TOWN OF aUEENSBURY BUILDING&CODES 6 � 3 � G a �n 0 Zf 9� 3 6 L � �