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2009-177 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 (2t Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20090177 Application Number. A20090177 Tax Map No: 523400-302-008-0001-045-000-0000 Permission is hereby granted to: GRJH, INC. For property located at: 234 QUAKER 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 Value Owner Address: GRJH, INC. 323 USHERS Rd Certificate of Occupancy(COM) CLIFTON PARK, NY 12065-0000 Total value Contractor or Builder's Name/Address Electrical Inspection Agency Plans &Specifications 2009-177 QUAKER SUNOCO - C/O only $50.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Friday, May 21, 2010 (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 wn o ee ury, ,May 21, 2009 SIGNED BY * t4 for the Town of Queensbury. Director of Building&Code Enforcement TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20090177 Date Issued: Tuesday, May 26, 2009 This is to certify that work requested to be done as shown by Permit Number P20090177 has been completed. Location: 234 QUAKER Rd Tax Map Number: 523400-302-008-0001-045-000-0000 Owner: GRJH, INC. Applicant: GRJH, INC. This structure may be occupied as a: Certificate of Occupancy (COM) 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, `' 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. U]/UD/LUUy xuls I7: 31 raA tsbu3b4ubYu w(un Inc ---+ titm x mis'1xz, nurnz r`xa WJuu1/ UUZ. •r; t Im L Coiniittrtrihj Development OfficeTown of Queensbury • 742 Bay Roars • Queensbury, New York -128C I17yLe � Marilyn Ryba, Executive Director• David Hatin,Director of Building&Codes Craig Brown,Zoning Administrator•Michael 1. Palmer, Fire Marshal TOWN OF QUEENSBURY % %BUJLDING&-CO.DES. NEW BUSINESS CERTIFICATE OF OCCUPANCY PERMIT APPLICATION C)___7 I Z'� TAX MAP# BLDG, PERMIT FILE# app tca Name of Business: Q� fi�l �H'&'-0 t t? Address /+ of Business o2 3 QL4/4-lSds f7 y Cf` QUESTIONS? CALL OR EMAIL cotiesC�gueensburnsbur y.nei VISIT OUR WEBSITE FOR MORE Person in Charge or Manager: 0'7,e f /"jPf7 INFORMATION www.gueensbury.net Business Phone Number: Type of Business: C o"-y t i1-t .c (AJ Owner of Property: Phone Number(s): 660 Hume cell Owners Address: P-o . 322'° "7 X 8 S 0,1 ^'". - ? , 0 6 c 6 r Please provide an accurate layout of your store showing all walls, exits, stockrooms, rest rooms, counters and fixture layout on a separate sheet of paper. Signature: Date: Of person submitting this form Notes/Comments: 'Note: This application is for occupancy only, with no work requiring a building permit. No fee required for this permit 05/11/2009 19:14 FAX 191002 05/0512009 TUE 15. 39 FAX 8603640690 GRJH zac --- JIMMY METZ HOME FAX �ooa/aa2 ALA-�ow�. _l EMERGENCY CONTACT UPDATE TO: WARREN COUNTY SHERIFF'S DEPT_ FAX: 743-2502 PLEASE PRINT DATE: (c j�g BUSINESS NAME: BUSINESS ADDRESS: 3 `1 BUSINESS PHONE: HOME S��P''6°►�-1 CONTACT 1: G o _ >'a-��� PHONE ST/ ADDRESS: LouajA v-((e _ HOME CONTACT 2: PHONE Sf 5f'f" ADDRESS, This form is used to assist Emergency Service personnel who may be called to your business 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. 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. TOWN OF QLIEENSBURY FIRE MARSHAL'S OFFICE P It a n e. 518-761-8266 y T a x. 518-745-4437 fireniars>' a1@gueensbuDj.nef - zuunugueensbun�.net Inspection for Permit to Occupy Fire Marshal's Office Request Rec'd Permit No. Town of Queensbury t V 742 Bay Road T I �} A- Queensbury,NY 12804 Scheduled Inspection Date: t` ` Time: ' Phone: (518) 761-8206 Business Name: Fax: (518) 745-4437 Location: 0_Y Type of Inspection N/A Yes No EXITS: Exit Access Exit Enclosure COMMENTS Exit Discharge AISLES: Main Aisle Width Secondary Aisle Width EXIT SIGNAGE _ Sign-normal 1 N Sign-battery ,��PoOVVI �e 60 EVAC signs in rooms TRUSS ID SIGNAGE EMERGENCY LIGHTING FIRE EXTINGUISHER: " Hun Inspection of extinguisher v FIRE ALARM SYSTEM t v� Fan Shutdown Fire Sprinkler System FDC Fire Suppression-kitchen Fire Suppression-Gas Islan Generator Hood Installation Elevator 2iC1 ' Interior Finishes V Storage --- Compressed Gas Fite Ma1Q'�a)In ec o Cim�pl Clearance to Sprinklers OK to Issue Cwti Clearance to Electrical Electric Wiring Enclosed/Labeled Combustible Waste Vehicle Impact Protection Knox Box g l F.D.Si na e-Utility Rooms t -�- No SmokingSigns �ti$ <t�Sh."r Maximum Occupancy Sin is a... t7t�E:eilEt''J Emergency Evacuation Plan f it Approved (If no other approvals apply,the B&C Office will is ue th e ific e of Occupancy) ❑ Denied / call for Recheck Inspected By: L:\FireMarshal\FM Forms Masters\permitto occupyform.doc Inspection for Permit to Occupy Fire Marshals Office Request Rec'd Permit No. © ?- Town of Queensbury 742 Bay Road )I C 6 Queensbury,NY 12804 Scheduled Inspection Date: ` Time: Phone: (518)761-8206 Business Name: Fax: (518) 745-4437 Location: T of in c*m N/A Yes No EXITS: Exit Access Exit Enclosure ,i COMMENTS Exit Discharge AISLES: Pp I`CCIt Main Aisle Width _ 5econda Aisle Width i� V,,�� Cy EXIT SIGNAGEf'J)j1 Sign-normal Si -batter EVAC signs in rooms TRUSS ID SIGNAGE EMERGENCY LIGHTING FIRE EXTINGUISHER: Hun Inspection of extin uisher V✓�Cr-1��_. -�� � � ��/�� w- j�PC-trC,r V1 — FIRE ALARM SYSTEM - Fan Shutdown Fire Sprinkler System (FDC) Fire Suppression-Vitchen Fire Suppression-Gas Islan Generator Hood Installation Elevator Interior Finishes Stora a —� Compressed Gas Clearance to Sprinklers Clearance to Electrical Electric Wiring Enclosed/Labeled Combustible Waste Vehicle Impact Protection Knox Box F.D.Si na e-Utility Rooms No Smoking Signs , ^ Opi i Maximum Occupancy Sin Emergency Eme[gency Evacuation Plan 1C.,ro 6.t—d1L IML ❑ Approved (If no other approvals apply,the B&C Office ill issu th Cert icate of Occupancy) ❑ Denied / call for Recheck Inspected By: L:\FireMarshal\New Folder\permitto occupyform.doc -19 1 of 1 l a http://gby2svr/GIS/RPSPT000039/523400302008000104500000000001.JPG 5/14/2009 Page 1 of 1 .. z r✓/ � o� f d� 3���� r fj/ � � v/ �io \ � ..,r,- S�'�Gr� //✓. /z�//i� ��3 r %�/�l/// \�„<. :- \� G,�„yIIL'�'�'�'r� �� / �/ ,.: a \� ,.,,. ,;;' G�,if/,.�, r �s��,�� .° r!�✓ 3�/ice/� �� � � ��/�i'�\ a, f /� http://gby2svr/GIS/RPSI/T000040/523400302008000104500000000002.JPG 5/14/2009 z Y J 1 {