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CO-000354-2017 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-000354-2017 Date Issued: Wednesday, July 12, 2017 This is to certify that work requested to be done as shown by Permit Number CO-000354-2017 has been completed. Tax Map Number: 309.9-2-7 Location: 106 LUZERNE RD Owner: 106 Luzeme Road,LLC Applicant: Dejana Truck&Utility Equipment Company,LLC This structure may be occupied as a: C/O Only Name Change:Dejana Truck&Utility Equipment Company,LLC By Order of Town Board Type of Business: Mfg.&upfit truck bodies,components and parts 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-000354-2017 Tax Map No: 309.9-2-7 Permission is hereby granted to: Dejana Truck&Utility Equipment Company,LLC For property located at: 106 LUZERNE 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 Tvoe of Construction Owner Name: 106 Luzeme Road,LLC Certificate of occupancy $0.00 Owner Address: 443 West Mountain RD Total Value $0.00 Queensbury,NY 12804 Contractor or Builders Name/Address Electrical Inspection Agency Plans&Specifications C/O Only Name Change:Dejana Truck&Utility Equipment Company,LLC Type of Business: Mfg.&upfit truck bodies,components and pans $50.00 PERMIT FEE PAID-TFBS PERMIT EXPIRES: Saturday,June 23,2018 Of 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 ofens r j priday J no 3 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 OF OCCUPANCY PERMIT APPLICATION Permit No.: act -7 Permit Fee: 'Note: This application is for occupancy only,with no work requiring a building permit. �/ f q S-gl } Name of Business ZA0 A JP i4c 9 e GLri6i ry EQL41'Ax}uJT&AipAi y• SLG Address /o& I'uzEwE Roa/5, Qu#rA/sBuRy,,JY ia8©y Type of Business Mrd*uiFiT TAuCII ®clviEs r'omQou a,+4 7ART5 C E 0 �n Manager UJ/A4/441 ZT, €i4LIAT, Tit. v OR D Person in charge Business Phone No. SIQ�' ?93- 1?z(.s TOWN OF QUEENSBURY _ COMMUNITY DEVELOPMENT Property Owner y)j k,_iAd4 z. 9&,eAr, ,TP, - Address M6 L l t.2,rLQNE &o, Qu, i lE 5Duxy I C Y /;L Phone (S70 M -a945— ✓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: WA l k&l lT' (OT-CK-1 Signature: Date: Notes I Comments: A/l !.' L / — Al 014e4d 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 p ECEOVE EMERGENCY CONTACT U192 TE D Please print clearly COMM NTO NaTYDEVELOPMENTFQUNS DATE: 41110 - BUSINESS NAME: Df_,T4,,,4 I'u:CK � ttT'tc.iTy&ajj 2tEAJr 660wy BUSINESS ADDRESS: iy�, bt;zrAZ jrz_ komb BUSINESS PHONE: —/ -57 -' PHONE I: 512' 341"033% CONTACT 1: D, �I �h�Qr� PHONE 2:_ c i 19) - 793 1Gyp TOWN/VILLAGE RESPONDING FROM: 1IWJl 19 7 1"W15 PHONE 1: �✓Ic�" 338"iS99 CONTACT 2: COW-\] 5��fi A' oc) PHONE 2: TOWN/VILLAGE RESPONDING FROM: < ?� FA 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 QUEENSBURY FIRE MARSHAL' S OFFICE Phone: 518-761-8206 • Fax: 518-745-4437 {iremarshal@queensburp.net • www.queensbury.net Fire Marshal Michael J Palmer Deputy Fire Marshal Gary K Stillman 6/15/17 106 LUZERNE RD QUEESBU E C� E Q V E TOWIV OF=()UEENSBURY OOMMUM" r DEVELOPMENT Moa a3110G _ 3OIdd0 S1aVd AVG AVG AVG AVB X-W1 V3aV NOUVDIaGV.4 309.9-2-7 CO-000354-2017 Dejana Truck & Utility Equip. Co. LLC AVG NouvOlaevd 106 Luzerne Road C/O Only Change of Name AVG NOI1VOIaGVd AVG NOUOMOad AVG NOI10naOUd