CO-0323-2018 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
-t—`o Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: CO-0323-2018 Date Issued: Friday, June 15, 2018
This is to certify that work requested to be done as shown by Permit Number CO-0323-2018
has been completed.
Tax Map Number: 302.8-1-7
Location: 309 BAY RD
Owner: Monica Rozell,Natalie Granati
Applicant: Monica Rozell
This structure may be occupied as a: Certificate of Occupancy Only
Tenant: Monica Rozell LLC By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the 4 �ot
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
Community Development - Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number: CO-0323-2018
Tax Map No: 302.8-1-7
Permission is hereby granted to: Monica Rozell LLC
For property located at: 309 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
Type of Construction
Owner Name: Monica Rozell Certificate of occupancy $0.00
Owner Address: 30 MASTERS CMN SOUTH Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
Certificate of Occupancy Only
Tenant: Monica Rozell LLC
$ 100.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Saturday, June 15, 2019
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queens before th xpiration e.
Dated at the Town Quee 4Fri a ne 15, 2018
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
_ CERTIFICATE OF OCCUPANCY ONLY Office Use Only
APPLICATION Permit#: C U r 3�3 - �
Permit Fee:$ 1 Q :. ll
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742 Bay Road,Queensbury, NY 12804 a �nvoace#:
P:518-761-8206 or 518-761-8205 www.gueensburynpti1 .y .d ..
JUN Q 6 2Q1 t 10
"This application is for occupancy on ',with no work requiring a building permit"
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CONTACT INFORMATION: ►°'
• Applicant:
Name(s): f100tLC—k- o-z-f
Mailing Address, C/S/Z: *2�6 (Aas- v--s 5b r Z2,5
Cell Phone: ( 5(S ) 32Z( - 03a�3 Land Line: (5(2 ) -7`E5
Email: rnY &z.0 l(L�q (vAfti< -cz
• Business Owner(s): �aclSi ASS //4�
Contact Name(s): 01 �(i 0.4 � 1�'� 0
Mailing Address, C/S/Z: # 3 U c cci, As
Cell Phone: _(S 1 ) -1 G 4 - Land Line: _( (
Email: q Om
• Manager:
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: _( ) Land Line:
Email: S `l )K4., I �6 fi r
• Property Owner(s):
Business Name: e's r ��l
Contact Name(s):
Mailing Address, C/S/Z: ' rz1L - 12 `ft(
Cell Phone: _( 5/ ) Z-ZZ - 6 `7 33 Land Line: _( )
Email: I , C e M
Contact Person for Building & Code Compliance:
Cell Phone: _� ) "7 2 `� —y 0 7- Land Line: � )
Email: -Z.:7L i Al 64 1 ✓+'�
Certificate of Occupancy Only Revised December 2017
302.8-1-7 CO-0323-2018
Monica Rozell LLC
309 Bay Road
742 Bay Road,Queensbury,NY 12804 Certificate of Occupancy Only
P:518-761-8206 or 518-761-8205 www.gueensbury.net
BUSINESS INFORMATION:
N m f
a e • Musiness. � �-
Address (including suite, space, etc.): ��� Q00
, 1
Type of business (i.e.: retail, car repair, etc.):
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:
Date:
Certificate of Occupancy Only Revised December 2017
302.8-1-7 CO-0323-2018
Monica Rozell LLC
309 Bay Road
Certificate Of Occupancy Only
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:
Business Name: I r 6Q��LCA
Business Location (including suite, space, etc.): G{ O
Business Phone#: 5 C)_-2)DO
1. Contact name: I y I O 77 1
Main Phone:_( )� ® b() ; Secondary Phone:
Coming from what town/village? �1�1f'ee�,�
2. Contact name: naL(� �YZz lrc
Main Phone:_( ) G (`, —�c��(]"n ; Secondary Phone:_( )
Coming from what town/village? �Q�LSI�y lvG
TOWN OF QUEENSBURY FIRE MARSHAL'S OFFICE
P: 518-761-8206 F: 51 8-745-4437
FIREMARSHAL@QUEENSBURY.NET
FIRE MARSHAL MIKE PALMER DEPUTY FIRE MARSHAL GARY STILLMAN
Certificate of Occupancy Only Revised December 2017