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CO-000453-2017 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-000453-2017 Date Issued: Wednesday, August 30, 2017 This is to certify that work requested to be done as shown by Permit Number CO-000453-2017 has been completed. Tax Map Number: 302.12-1-31 Location: 238 BAY P-D Owner: Kubricky Construction Corp Applicant: Kassia's Play Dates,LLC This structure may be occupied as a: C/O only Tenant: Kassia's Play Dates, LLC By Order of Town Board Suite 2 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 OL Community Development-Building&Codes (518)761-8256 BUILDING PERMIT Permit Number: CO-000453-2017 Tax Map No: 302.12-1-31 Permission is hereby granted to: KassiWs Play Dales,LLC For property located at: 238 BAY 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 Tvce of Construction Owner Name: Kubricky Construction Corp Certificate of occupancy $0.00 Owner Address: 269 Ballard RD Total Value $0.00 Wilton,NY 12831 Contractor or Builders Name/Address Electrical Inspection Agency Plans&Specifications C/O only Tenant:KassWs Play Dates,LLC Suite 2 $50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,August 4,2018 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the Town ofueensb nda 17 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement 4iLCERTIFICATE OF OCCUPANCY ONLY office Use Only APPLICATION Permit#: /o �s3d17 loun.d cLnrnQ,un- Permit Fee:$ ,,Go 742 Bay Road,Queensbury,NY 12804 Invoice#: Lv O P:518-761-8206 or 518-761-8205 www.gueensbury.net "This application is for occupancy only, with no work requiring a building permit" CONTACT INFORMATION: C ( WPE • Applicant: \n TOWN OF t Name(s): l 11� 1�1J� COf�nNWNi1Y I JE ELOPI`ENT Mailing Address, C/S/Z: Cell Phone: (519�_) — Land Email: SGS ry,,QLT • Business Owner (s): �� Contact Name(s): Mailing Address, C/S/Z: r Cell Phone: ?)) Land Line: _( ) Email: (a 1 • Manager: Contact Name(s): Mailing Address, C/S/Z: Cell Phone: _(�) Land Line: _( ) Email: KCG&Sj G m . C • Property Owners -. Business Name: Contact Name(s): f) v Mailing Address, C/S/Z: Cell Phone: _(S ) — Land Line: _(SI& ) 5 Email hS, brn Certificate of Occupancy only Revised June 2017 4WL 1,,.n d(tac mb., 742 Bay Road,Queensbury,NY 12804 P:518-761-8206 or 518-761-8205 www.gueensbury.net BUSINESS INFORMATION: Name of business: LQsskat,(�, P10.y VakS , L. C. Address (including suite, space, etc.): c�?> p IJ(XV K©(� � ,tel A Ljt / U�acts)shuLA . NA 1a �UL1 Type of business (i.e.: retail, car repair, etc.): PaA Please provide an accurate layout of your store showing all walls, exits, stockrooms, rest rooms, counters and fixtures on a separate sheet of paper. IMPORANT: 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 Town of Queensbury 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 and a re-inspection. Applicant name: das 0 16, P(Q Applicant signature: Date: "j���� l� Certificate of Occupancy Only Revised June 2017 QL Tarn oI(Juav 'bun 742 Bay Road,Queensbury,NY 12804 P:518-761-8206 or 518-761-8205 www.gueensbury.net EMERGENCY CONTACT INFORMATION "THIS FORM IS USED TO ASSIST EMERGENCY SERVICE PERSONNEL WHO MAY BE CALLED TO YOUR BUSINESS AFTER HOURS. PLEASE BE SURE THE CONTACTS LISTED BELOW ARE WILLING AND AVAILABLE TO REPSOND DURING OFF-HOURS TO ASSIST POLICE AND/OR FIRE PERSONNEL IN GAINING ENTRY TO YOUR BUILDING." PLEASE BE ADVISED THAT FAILURE TO ASSIST EMERGENCY SERVICE PERSONNEL MAY RESULT IN DAMAGE TO YOUR BUILDING BY POLICE AND/OR FIRE PERSONNEL. Date: I c I Business Name:kla� c, i r-A f.0 hyo, ,1 l .&,S C . Business Location(including suite,space,etc.): 2( (1 \�1_}.�1 2aacATS l A ak ktrns"x t, � I�. LA Business Phone#: 519 9qu "1 1 1. Contact name: C Q±he r-1 Iy. ( kusS, C6 1 V\a Main Phone:_( )�- I�DJ�� ; Secondary Phone:_( ) Coming from what ttowwn/villa1ge? 2. Contact name: 6 ( k js j n Main Phone: D ) — �;Secondary Phone:_(_) Coming from what town/village? Nn TT Yl TOWN OF QUEENSBURY FIRE MARSHAL'S OFFICE P: 518-761-8206 F: 518-745-4437 FIREMARSHAL@QUEENSBURY.NET FIRE MARSHAL MIKE PALMER DEPUTY FIRE MARSHAL GARY STILLMAN Certificate of Occupancy Only Revised June 2017 EXHIBIT A SAYROAD NO PARKING IN FRONT-TEMPORARY DROP OFF AND DELIVERY ONLY z z — r V rL LL n Q Suite 1 O Z E Suite 4&5 Z >- r Z O Q u Y C1 n3 Q6 x Suite 3 Z Z v O Z O O yCGSS`[�, IC[ n Overhang ^� A `- s �' Z m To Be NO PARKING _ suite LLC_ O Z Removed a NO PARKING O of 1 Z NO PARKING u '. a xxx— x : XX it, 4 3 m u v 'o 0 0 m x a O 302.12-1-31 CO-000453-2017 Kassia's Play Dates, LLC 238 Bay Road, Suite 2 C/O only `NPRREN Suite 5-Second Floor Above South End of Suite 4 Property Exhibit A 238 Bay Rd.Qby NY