CO-000216-2017 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
_ Community Development-Building.&Codes. (518)76.1'8256
CERTIFICATE. OF OCCUPANCY
Permit Number: CO-000216-2017 Date Issued:
This is to certify that work re4uested to be done as shown by Permit Number CO-000216-2017
has been completed.
Tax Map Number: 302.5-1-92.11
Location: 578 AVIATION RD
Owner: Valerie Haynes,AVIATION.MALL NEWCO LLC.
Applicant: Valerie Haynes
This structure may be occupied as a:Certificate of Occupancy Only
Aviation Mall,Space#34 - By Order of Town Board
Tenant:Play It Again 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)161-8201
Community Development-Building&Codes (518)-761--8256
BUILDING PERMIT
Permit Number: CO-000216-2017
Tax Map No: 302.5-1-92.11."
Permission is hereby granted to: Play It Again
For property located at: 578 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 incompliance with the NYS Uniform
Building Codes and the Queensbury Zoning Ordinance
'Type of Construction
Owner Name: Valerie Haynes Certificate of occupancy $0.00-
Owner Address: 120 Ballard RD,418 Total Value $0.00
Gansevoort,NY 1.2831
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
Certificate of Occupancy Only
Aviation Mall,.Space#34
Tenant:Play It Again
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,May 12,2017
(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 ry; Frid , 12 17
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
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Office Use'Only
Town of Queensbury Fire Marshal
Received: i
ESTABLISHMENT OF A NEW BUSINESS Tax Map ID: �.5-/=9�. 11
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CERTIFICATE OF OCCUPANCY PERMIT APPLICATION Permit No.:
Permit Fee: `
*Note: This application is for occupancy only,with no work requiring a building permit.
Name of Business '' ?"`�
Address S 79 ,A-vjar-nn nj a 4-t,3q (Weeasb L)Ec( i
Type of Business 12e.-t)_o mb�)t eS Y-n u_s'i G ')C)to r S i C , I
Manager
OR
Person in charge V :A-q,�t�5
Business Phone No. `S f 4
Property Owner Mg a- i
i Address CL1fyTiynJU.A2C ��2� c �JSc� J,1Tj3,9, 02
Phone l"5 i 81 5bc- R r g
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✓Provide an accurate layout of your store showing all walls, exits, stockrooms, rest rooms, counters, and fixture layout on a
separate sheet of paper.
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Print Name: yA Le_g-i C7j. j t'wl f-)e S
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Signature: �/�� 0 n ,�,Z)
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Date: S I Lill r7
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I Notes./Comments: 2317
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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 i
semi-annual inspections. Any violations noted during an inspection, require immediate corrective action.
CONTACT NUMBERS: i
Director, Building and Codes-761-8253 Zoning Administrator-761-8218 Zoning-761-8238
Fire Marshal-761-8206 Planning-761-8220
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Town of Queensbury Fire Marshal—New Business Permit 518-761-8206
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EMERGENCY CONTACT UPDATE I
302.5-1-92.11 CO-000216-2017
Play It Again
TO: Warren County Sheriff's Department 578 Aviation Road, Space 34
C/O Only i.
1. This form is used to assist Emergency Service person,_. -iu-yuui-i)usiness-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 Err ( _,
DATE: 5I y f1-7
BUSINESS NAME: PL-Ate )--r A 6 A i V
BUSINESS ADDRESS: 2d ,L( nS bo r-
BUSINESS PHONE: 5 i$ o - g3
CONTACT I: t1'AiP2iE I-Jae_S--H OM E PHONE
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ADDRESS:
CONTACT 2: HOME PHONE
ADDRESS:
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Town of Queensbury Fire Marshal-New Business Permit 518-761-8206 I
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