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CO-000796-2017 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-000796-2017 Date Issued: Friday, June 8, 2018 This is to certify that work requested to be done as shown by Permit Number CO-000796-2017 has been completed. Tax Map Number: 303.20-2-41 Location: 146 RIVER ST Owner: Youssef Chaaben, Robinson & Son, LLC Applicant: Youssef Chaaben This structure may be occupied as a: Certificate of Occupancy Only Tenant: Black Tie Cafe LLC By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the property owner of the responsibility for compliance with Site Plan, 4t Variance, or other issues and conditions as a result of approvals by the Planning Board or Zoning Board of Appeals. Director of Building&Code Enforcement TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development- Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: CO-000796-2017 Tax Map No: 303.20-2-41 Permission is hereby granted to: Black Tie Cafe LLC For property located at: 146 RIVER ST 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: Youssef Chaaben Certificate of occupancy $0.00 Owner Address: Total Value $0.00 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications Certificate of Occupancy Only Tenant:Black Tie Cafe LLC $ 50.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Friday, January 11,2019 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury befjthexpiration that .)Dated at the Town o Queen hu ry 11,2018 SIGNED BY: �d for the Town of Queensbury. Director of Building&Code Enforcement f3 CERTIFICATE OF OCCUPANCY ONLY Office Use Only APPLICATION Permit#: co —000 7 }`3 Permit Fee:$ 5) 0- 742 Bay Road,Queensbury,NY 12804 !r C E 9 V E Invoice#: 12 1�q P:518-761-8206 or 518-761-8205 www. I�ury.net DEC 202017M, "This application is for oc up �i td$ o requiring a building permit" l B ILDIN&CODES CONTACT INFORMATION: "''` • Applicant: Name(s): Mailing Address, C/S/Z: -1'J e '314 Cell Phone:) (oS1 -013`3 Land Line: —( l ) '531 - H49 Email: 'HCl (hcia L,) '_V1 E GrY_� Y�t' I 1 ftm • Business Owner(s): Contact Name(s): YOLk Mailing Address, C/S/Z: Cl`19 `C LtnN Rhe . 11 CnwyuI Cell Phone:_( '3 ) ( I - CI 33 Land Line: _( -I ) 531 - H4C1(c Email: d - ch C c • Manager: Contact Name(s): )L, H<Se1 C km, ben Mailing Address, C/S/Z:_ iA 1 eenwliC N` ' 334 Cell Phone: _( I S ) (off( -0, I33 Land Line: _( `)-I Email: • Property Owner(s): Business Name: Q ` .Y Contact Name(s): , n Mailing Address, C/S/Z: P , RV .WCe h 5 I aZ0 Cell Phone: _( � I )_( '3 Land Line: _( fl S Email:. Contact mail:TContact Person for Building & Code Compliance: Cell Phone: Land Line: � ) Email: Certificate of Occupancy Only Revised December 2017 roun oft 742 Bay Road,Queensbury, NY 12804 P:518-761-8206 or 518-761-8205 www.gueensbury.net BUSINESS INFORMATION: Name of business: 1:51 RCL-F I Uft, LU�, Address (including suite, space, etc.): ( 44 i-t V-f SICef t H L 2,K)n Eh(�tS t4 l 2Z-3q Type of business (i.e.: retail, car repair, etc.): re fz'tt ( fC.rd SfYV de— 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: Applicant signature: -a � Date: � Certificate of Occupancy Only Revised December 2017 w w Y { l,rKtt,�t�tx'�'tr.bur} 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: � � ct �1—I Business Name: Business Location (including suite, space, etc.): 114q ki Vey- 1)Wt'f+ kdscri F(lS a y (3 3q Business Phone#: 1. Contact name: 1 C"� Ltsse f Ck(,abe n Main Phone:_( ) ; Secondary Phone:_( Coming from what town/village? k d". _-n Eb t 6 2. Contact name: Main Phone:_( ) ; Secondary Phone:_( ) Coming from what town/village? 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 December 2017 INSPECTION WORKSHEET (001933-2018) Town of Queensbury - Building and Codes - Fire Marshal 742 Bay Road - (518) 761-8256 Building (518) 761-8206 Fire Marshal Case Number:CO-000796-2017Case Module:Permit Inspection Date:03/22/2018Inspection Status:Passed Inspector:Gary StillmanInspection Type:General (Fire Marshal) Job Address:146 RIVER STParcel Number:303.20-2-41 Hudson Falls, NY 12839 Contact TypeCompany NameName ApplicantChaaben, YoussefChaaben, Youssef Granted Permission\[Black Tie Cafe LLC\], Business Name\[Black Tie Cafe LLC\], Property Owner\[Robinson & Son, LLC\], Primary OwnerChaaben, YoussefChaaben, Youssef Checklist ItemPassedComments Fire Marshal NotesYES Exit AccessYES Exit EnclosureYES Exit DischargeYES Locks and LatchesYES Sign: NormalYES Sign: backupYES Main Aisle WidthYESReturn to verify Secondary Aisle WidthYES Fire Extinguisher HungYESHang the front door as discussed 3/21/18 ok Inspection of ExtinguisherYESCurrent inspection required 3/21/18 ok Energency Lighting InteriorYES Clearance to ElectricalYES Electric Wiring EnclosedYESClose up all electrical, provide electrical inspection 3/21/18 electrical inspection 2/18/18 Combustibles in Equipment RoomsYES StorageYESok Interior FinishesYES CO DetectorsYESPlug-in with battery back up provided Clearance to Sprinkler/CeilingYES Mar 22, 2018Page (1) INSPECTION WORKSHEET (001933-2018) Checklist ItemPassedComments Knox Box: Installed/checkedYESInstall Knox box at front door as discussed 3/21/18 install Knox Box as discussed 3/22/18 Knox Box installed, key placed inside for front door Stillman, Gary (Inspector) Mar 22, 2018Page (2) a Town of Queensbury-Building and Codes-Fire Marshal 742 Bay Road-(518)761-8256 Building(518)761-8206 Fire Marshal Case Number: CO-000796-2017 Case Module: Permit Inspection Date: 03/22/2018 Inspection Status: Passed Inspector: Gary Stillman Inspection Type: General(Fire Marshal) Job Address: 146 RIVER ST Parcel Number: 303.20-2-41 Hudson Falls,NY 12839 Contact Type Company Name Name Applicant Chaaben,Youssef Chaaben,Youssef Granted Permission [Black Tie Cafe LLC] Business Name [Black Tie Cafe LLC] Property Owner [Robinson&Son,LLC] Primary Owner Chaaben,Youssef Chaaben,Youssef Checklist Item Passed Comments Fire Marshal Notes YES Exit Access YES Exit Enclosure YES Exit Discharge YES Locks and Latches YES Sign:Normal YES Sign:backup YES Main Aisle Width YES Return to verify Secondary Aisle Width YES Fire Extinguisher Hung YES Hang the front door as discussed 3/21/18 ok Inspection of Extinguisher YES Current inspection required 3/21/18 ok Energency Lighting Interior YES Clearance to Electrical YES Electric Wiring Enclosed YES Close up all electrical,provide electrical inspection 3/21/18 electrical inspection 2/18/18 Combustibles in Equipment Rooms YES Storage YES ok Interior Finishes YES CO Detectors YES Plug-in with battery back up provided Clearance to Sprinkler/Ceiling YES Mar 22,2018 Page(1) Checklist Item Passed Comments Knox Box:Installed/checked YES Install Knox box at front door as discussed 3/21/18 install Knox Box as discussed 3/22/18 Knox Box installed,key placed inside for front door Stillman,Gary(Inspector) Mar 22,2018 Page(2) Town of Queensbury-Building and Codes-Fire Marshal 742 Bay Road-(518)761-8256 Building(518)761-8206 Fire Marshal Case Number: CO-000796-2017 Case Module: Permit Inspection Date: 03/21/2018 Inspection Status: Partial Pass Inspector: Gary Stillman Inspection Type: General(Fire Marshal) Job Address: 146 RIVER ST Parcel Number: 303.20-2-41 Hudson Falls,NY 12839 Contact Type Company Name Name Granted Permission [Black Tie Cafe LLC] Applicant Chaaben,Youssef Chaaben,Youssef Primary Owner Chaaben,Youssef Chaaben,Youssef Business Name [Black Tie Cafe LLC] Property Owner [Robinson&Son,LLC] Checklist Item Passed Comments Fire Marshal Notes YES Exit Access YES Exit Enclosure YES Exit Discharge YES Locks and Latches YES Sign:Normal YES Sign:backup YES Main Aisle Width YES Return to verify Secondary Aisle Width YES Fire Extinguisher Hung YES Hang the front door as discussed 3/21/18 ok Inspection of Extinguisher YES Current inspection required 3/21/18 ok Energency Lighting Interior YES Clearance to Electrical YES Electric Wiring Enclosed YES Close up all electrical,provide electrical inspection 3/21/18 electrical inspection 2/18/18 Combustibles in Equipment Rooms YES Storage YES Return verify Interior Finishes YES CO Detectors YES Plug-in with battery back up provided Clearance to Sprinkler/Ceiling YES Knox Box:Installed/checked NO Install Knox box at front door as discussed 3/21/18 install Knox Box as discussed Stillman,Gary(Inspector) �Mar 21,2018 ����� ���� Page(5) Town of Queensbury-Building and Codes-Fire Marshal 742 Bay Road-(518)761-8256 Building(518)761-8206 Fire Marshal Case Number: CO-000796-2017 Case Module: Permit Inspection Date: 01/16/2018 Inspection Status: Failed Inspector: Gary Stillman Inspection Type: General(Fire Marshal) Job Address: 146 RIVER ST Parcel Number: 303.20-2-41 Hudson Falls,NY 12839 Contact Type Company Name Name Primary Owner Chaaben,Youssef Applicant Chaaben,Youssef Business Name Black Tie Cafe LLC Property Owner Robinson&Son,LLC Granted Permission Black Tie Cafe LLC Checklist Item Passed Comments Fire Marshal Notes YES Exit Access YES Exit Enclosure YES Exit Discharge YES Locks and Latches YES Sign:Normal YES Sign:backup YES Main Aisle Width NO Return to verify Secondary Aisle Width YES Fire Extinguisher Hung NO Hang the front door as discussed Inspection of Extinguisher NO Current inspection required EVAC Plan YES Energency Lighting Exterior YES Energency Lighting Interior YES Clearance to Electrical YES Electric Wiring Enclosed NO Close up all electrical,provide electrical inspection Combustibles in Equipment Rooms YES Storage NO Return verify Interior Finishes YES CO Detectors YES Plug-in with battery back up provided Clearance to Sprinkler/Ceiling FC 18'/24" YES Knox Box:Installed/checked NO Install Knox box at front door as discussed Stillman,Gary(Inspector) Jan 16,2018 Page(1) 1H JAN 11 2018 { n� V � �LA rC---, AY$ y Yy \- 303.20-2-41 CO-000796-2017 Black Tie Cafd LLC 146 River Street Certificate Of Occupancy Only F 'D z- G) v�� U�uv 'l WI) 0 0 L---j pCC� EOWE DEC 2 0 2017 TOWN OF QUEENSBURY BUILDING&CODES 14' 01-1 First Floor 336 ft: 15' ry First Floor 210 ft, -� ' AJOA MSN SN3V KUM ke 71*P% 41UN01 r�tVtb�`d� tv��# OVOt!183M U ., N39N3t'N313d"d N 1 N3i4J- _ `fi b` I Q i�3.L OD N o-1 w;)N:3 '4 L I Pd t7 .,.,. ..., ,.,,..•t�giEua�►eW ruuo�>+d4�atl ��t1g f t�r��M.1,.� :mak"t�?�'3� i IQ� 3�gb�^�J-3 �,�! `�'-`1 � -l.. 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