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2009-192 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 (zt Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number. P20090192 Date Issued: Thursday, October 22, 2009 This is to certify that work requested to be done as shown by Permit Number P20090192 has been completed. Location: 410 BAY Rd Tax Map Number. 523400-296-016-0001-016-011-0000 Owner HANSON VENTURES, LLC Applicant: HANSON VENTURES, LLC 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 t� Z�� 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 IMMi'ng'&Code E em Planning Board or Zoning Board of Appeals. TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20090192 Application Number. A20090192 Tax Map No: 523400-296-016-0001-016-011-0000 Permission is hereby granted to: HANSON VENTURES, LLC For property located at: 410 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. Tyne of Construction Value Owner Address: HANSON VENTURES, LLC P.O. BOX 809 Certificate of Occupancy(COM) BOLTON LANDING, NY 12814- Total value Contractor or Builder's Name/Address Electrical Inspection Agency Plans &Specifications 2009-192 TWO CHEFS DELI C/O ONLY $50.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Thursday,June 03, 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 T of ee ry�j� r y,June 03,2009 SIGNED BY ` for the Town of Queensbury. Director of Building&Code Enforcement c��9 /9C-)-- ------------- �Towl011n m111"i{Development Office ( l�of Queensbury - 742 Bay Road - Queensburu,. New York -1280. f David Hatin,Director of Building&Codes MAY 1o�� / Craig Brown, Zoning Administrator-Michael J.Palmer,Fire Marshal J s TOWN QU ESTABLISHMENT OF A NEW B G BODES CERTIFICATE OF OCCUPANCY PERMIT APPLICATION TAX MAP# /(o �t��/ `/ • ( � BLDG. PERMIT FILE# If© applichbler Name of Business: u�e�3 Address t.! of Business: LO I QUESTIONS? CALL 761-8256 OR EMAIL codes(daueensburV.net VISIT OUR WEBSITE FOR MORE Person in Charge or Manager: INFORMATION www.aueensburv.net Business Phone Number:- �� "- Type of Business: Owner of Property: �`�' W Phone Number(s): ,�/V— �`7 ( f, 6 d-00 Home Cell Owners Address: Please provide an accurate layout of your store showing all walls, exits, stockrooms, rest rooms, counters and fixture layout o e sheet of paper. C 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 EMERGENCY CONTACT UPDATE TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 743-2502 PLEASE PRINT DATE: �J BUSINESS NAME: C,�a BUSINESS ADDRESS: BUSINESS PHONE: .2 � HOMEE-7�� - cGU7 }� ' n n CONTACT 1: ` w V ` �' PHON ADDRESS: 6C-3 _ o HO CONTACT 2: � ( J N ��'"" PHO w _?V ADDRESS: This form is used to assist Emergency Service personnel who may b 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 QUEENSBURY FIRE MARSHAL'S OFFICE P h o n e: 5.18-761-8206 F a x: 518-745-4437 ireniarshal@queensbu e .net wwzt7.queensbu!2L net Inspection for Permit to Occupy Fire Marshal's Office Request Rec'd Permit No. Town of Queensbury742 Road II q 1 Q eeansbury NY 12804 Scheduled Inspection Date: `� d-k 10 / Time: ��`l Phone: (518) 761-8206 Business Name:`VWc- VE5 Fax: (518) 745-4437 Location: L41'� RR�--j an Type of Inspection N/A Yes No EXITS: Exit Access Exit Enclosure - COMMENTS Exit Discharge AISLES: Main Aisle Width Secondary Aisle Width vlv EXIT SIGNAGE Sian-normal Sign-battery EVAC signs in rooms kit TRUSS ID SIGNAGE EMERGENCY LIGHTING FIRE EXTINGUISHER: Hun ,,, w Inspection of extinguisher FIRE ALARM SYSTEM 01) Fan Shutdown 1�1 Fire Sprinkler System FDC Fire Suppression-kitchen Fire Suppression-Gas Islan N - Generator Hood Installation Elevator Interior Finishes FIw Mari, eC ..n C ) Storage o OK to jSStl� rti Of pccw� Compressed Gas Clearance to Sprinklers Clearance to Electrical Electric Wiring Enclosed/Labeled t '� 1 206 Combustible Waste p Vehicle Impact Protection `1 Knox Box € Fire F.D.Si na e-Utility Rooms - T Of No Smoking Signs —"�-----� � Maximum Occupancy Sign Emergency Evacuation Plan Approved (If no other approvals apply,the B&C Of e ill issue the ertific e of Occupancy) ❑ Denied / call for Recheck Inspected L:\FireMarshal\FM Forms Masters\permitto occupyform.doc