CO-0217-2018 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-0217-2018 Date Issued: Tuesday, May 15, 2018
This is to certify that work requested to be done as shown by Permit Number CO-0217-2018
has been completed.
Tax Map Number: 309.10-2-28
Location: 52 MAIN ST
Owner: Erbessd Reliability LLC
Applicant:
This structure may be occupied as a: Certificate of Occupancy Only
Tenant: Erbessd Reliability LLC By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the 4 .
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.
y TOWN OF QUEENSBURY
`-c 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
�_ Community Development - Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number: CO-0217-2018
Tax Map No: 309.10-2-28
Permission is hereby granted to: Erbessd Reliability LLC
For property located at: 52 MAIN 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: Michael Howard Certificate of occupancy $0.00
Owner Address: 131 Feeder Dam RD Total Value $0.00
South Glens Falls,NY 12803
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans& Specifications
Certificate of Occupancy Only
Tenant: Erbessd Reliability LLC
$ 100.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Wednesday, May 8, 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 date.)
Dated at the Town ueen ury; 4Tue . ; , 2018
.14.
SIGNED BY: if \, for the Town of Queensbury.
Director of Building&Code Enforcement
CERTIFICATE OF OCCUPANCY ONLY Office Use Only
APP I�p-r o P rmit#: e
P rmit Fee:$ /V U• b D
Cl Town of n_.ui_yVI] MAY 0 3 2018 I voice#: D N[�r/
742 Bay Road,Queensbury,NY 12804
P:518-761-8206 or 518-761-8205 www.• ,,. OF QUEENSBURY
BUILDING& CODPS
**This application is for occupancy only, with no work requiring a building permit**
CONTACT INFORMATION:
• Applicant:
Name(s): 1-10k ii L
Mailing Address, C/S/Z: 13► 'F£tD i e °D„,,,w (d 5. VoAs t2.2O3
Cell Phone: (Ni6 )oics- Land Line: ( 5%0 )019 i oc
Email: IIYICI.o-vul 4 e to ssd �`a(ca-�i i l c /. L_ow l
• Business Owner(s):
Contact Name(s): kt c� + 1 \-\-ot,* _p
Mailing Address, C/S/Z: %St f tsobtz. Dti► ad. S. Wavas Fr,A1.> f;3 r,3
Cell Phone: _( 5 )C1 SSc.ft4 .-f- Land Line: (S]g__) 4 -7.2 e c
Email: VA6Akkcict q f ija sac, 10► 1 t��. cn&.
• Manager:
Contact Name(s): 100 cv,.4t-1
Mailing Address, C/S/Z: l3\ Dt_�1�$ QA. S. lole.at -115 L3,1 I`teo3
Cell Phone: _(este ) o1.cc 9144-4 Land Line: ('$ )
Email:
• Property Owner(s):
Business Name: 5 t0, tJ « r ails Li—C.--
Contact Name(s): Sir, 1D®1Da r—[
Mailing Address, C/S/Z: y210 C- (44 \-v t La l‘tq Noj
Cell Phone:_( dt'�-o ) sg ` �-$vS Land Line: _( ) •l
Email: SA-tan t` (2.x 5e, 1cz.s c oo-i
Contact Person for Building & Code Compliance: Co 4)k-VQ
Cell Phone: j ) Land Line: (
Email:
Certificate of Occupancy Only Revised December 2017
309.10-2-28 CO-0217-2018
Erbessd Reliability, LLC
,? 52 Main Street
Certificate of Occupancy Only
Town of brccn ua •
742 Bay Road,Queensbury,NY 12804
P:518-761-8206 or 518-761-8205 www.queensbury.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: S - — )
Business Name: CA' G.-5S of (Le\ itAD L (d c- '✓ �—' ��
11 ,
Business Location (including suite,space,etc.): S
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S o . (U At 03 1 >
Lav Asbur / l7 4-
Business Phone#: i 8 8-Lf 2_2 C7
1. Contact name: t•-.V.
Main Phone:_( 5-to, ) B 1-41-100 ;Secondary Phone:_(S 1 ' )1 SS,O--1
14+
Coming from what town/village? 614, y'l S 1-cj,i.s
2. Contact name: E a.r 1 C,w
Main Phone: (. "1 g ) 1416 (.(t4Sle ; Secondary Phone:_{ ) -
Coming from what town/village? i�.9.Yl 5 0$$
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
309.10-2-28 CO-0217-2018
Erbessd Reliability, LLC
`' 52 Main Street
Town orQtrcenibury Certificate of Occupancy Only
742 Bay Road,Queensbury,NY 12804
P:518-761-8206 or 518-761-8205 v,ww.queensbury.net
BUSINESS INFORMATION:
Name of business: '�cbg55d (Z_¢ \, hti VL L( _C_
Address (including suite, space, etc.): Ti' G1iru Q ) k- 14Z e \ '--1 \S
, 2$3® i
s�
Type of business (i.e.: retail, car repair, etc.) C nc�►ne-e-r d'� Pro d�(-4-s a b�f�t.cq,S ,�
MonuF'o�� c- CC �g�cazse..`��t ,. - J
t
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: to, imo
� �hA4 � � e � a
Applicant signature: r vc"
Date: S- -5 1€'
Certificate of Occupancy Only Revised December 2017