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CO-0057-2018 4ill 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-0057-2018 Date Issued: Wednesday, February 14, 2018 This is to certify that work requested to be done as shown by Permit Number CO-0057-2018 has been completed. Tax Map Number: 309.10-1-88.2 Location: 53 LUZERNE RD Owner: A& Q Holdings Inc., MPW Industrial Services Inc Applicant: MPW Industrial Services Inc This structure may be occupied as a: C/O Only (using front office of building only) By Order of Town Board MPW Industrial Services, Inc. TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the /� property owner of the responsibility for compliance with Site Plan, �d 4�t 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 Community Development - Building & Codes (518) 761-8256 BUILDING PERMIT Permit Number: CO-0057-2018 Tax Map No: 309.10-1-88.2 Permission is hereby granted to: MPW Industrial Services Inc For property located at: 53 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 Type of Construction Owner Name: MPW Industrial Services Inc Certificate of occupancy $0.00 Owner Address: 53 Luzerne RD Total Value $0.00 Queensbury,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications C/O Only(using front office of building only) MPW Industrial Services,Inc. $ 100.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Tuesday,February 12, 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 before the expiration d e.) Dated at the Town uee ury; �Mo ruary 12,2018 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement -57i L .: 5 3 ' u�'etw pct . �4�s S CERTIFICATE OF OCCUPANCY ONLY office use only APPLICATION Permit#: co 57-.),o lGt g Tawe ofCtixrnshary Permit Fee:$ 742 Bay Road,Queensbury,NY 12804 Invoice#: 1717 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: • Applicant: Name(s): M,PW Industrial Services Inc I" , Mailing Address, C/S/Z: r 9711 Lancaster RD Hebron,Ohio 43025 L'd+�pa+c tc d % ���l�l z et-i e Cell Phone: ( 511 4 ) 3 Sro - 14Zyo Land Line: 800) 827-8790 (SZ u-eeAc AJX Email: Mpf,64a @ m?w/ 5ervi cc 5 tom • Business Owner(s): Contact Name(s): S'AJKeG Mailing Address, C/S/Z: Cell Phone:_( ) Land Line: _( ) Email: • Manager: Contact Name(s): David Cronk Mailing Address, C/S/Z: 53 Luzerne rd,Queensbury, NY 12804 Cell Phone:_( 51�. 796-1755 Land Line: _( ) Email: dcronk@mpwservices.com • Property Owner(s): Business Name: A&Q Holdings Contact Name(s): Adrienne Mailing Address, C/S/Z: 31 edgewood drive Queensbury,NY 12804 Cell Phone:_( ) Land Line: _( 518 ) 745-9879 Email: Contact Person for Building&Code Compliance: Adrienne Quirion <adrienne.ar425@gmai1.com> Cell Phone:_�_) Land Line: 518 ) 745-9879 Email: adrienne.ar425@gmail.com D a , FEB 1 2X818 Certificate of Occupancy Only Revise J Decem TOWN OF UJE1=1 SLIURY COMMUNi,Y DEVELOPIAR,.I` Town ofCAwensbuzy 742 Bay Road,Queensbury,NY 12804 P:518-761-8206 or 518-761-8205 www.gueensbury.net BUSINESS INFORMATION: Name of business: I MPW Industrial Services, INC Address (including suite, space, etc.): 9711 Lancaster Road, Hebron, OH 43025 5�!) /Rd Type of business (i.e.: retail, car repair, etc.): Industrial cleaning 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: Stefanie C MPW Secretary & General Counsel Applicant signature: Date:_ �-- Certificate of Occupancy Only Revised December 2017 %Qtx"Vnsbriyr 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: 2/7/2018 Business Name: MPW Industrial Services inc Business Location(including suite,space,etc.): 53 Luzerne rd, Queensbury, NY 12804 Business Phone#: 518-796-1755 1. Contact name: David Cronk Main Phone:_( 518 ) 796-1755 ;Secondary Phone:_( ) Coming from what town/village? South Glens Falls 2. Contact name: Mike Otruba Main Phone:_(____518) 380-4740 ;Secondary Phone:_( ) Coming from what town/village? Queensbury TOWN OF QUEENSBURY FIRE MARSHAL'S OFFICE P: 518-761-8206 F:518-745-4437 FIREMARSHALeQUEENSBURY.NET FIRE MARSHAL MIKE PALMER DEPUTY FIRE MARSHAL GARY STILLMAN Certificate of Occupancy Only Revised December 2017 Page 1 of 1 x s s gym,w ar ��Suwburw L4tr.ar• },fiCw t �:N fix? *��? � �9�xaY � R AITPI.OT PLAN I I IAVE PEUR� NALLY fA ASUrED THE DISTANCE PP "' INES TO THE U TuRc(S)OR SIGNS) TE L'I 67 309.10-1-88.2 CO-0057-2018 MPW Industrial Services Inc. 53 Luzerne Road C/O only (front office space only) httpJ/gby2svr/output/QBURY QBY2SVR.23041164353.jpg 5/2/2011