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2009-270 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20090270 Application Number. A20090270 Tax Map No: 523400-303-020-0002-018-000-0000 Permission is hereby granted to: DAVID DYMINSKI For property located at: 39 BOULEVARD 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: DAVID DYMINSKI 27 LEPERE Dr Certificate of Occupancy(COM) PITTSFORD,NY 14534 Total value Contractor or Builder's Name/Address Electrical Inspection Agency Plans &Specifications 2009-270 c/o only- SID HARVEY INDUSTRIES $50.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Friday,July 09, 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 thof Qu e b ry; f ay,July 09,2009 SIGNED BY `1 for the Town of Queensbury. ury. 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 0CCUP-A-NCY Permit Number. P20090270 Date Issued: Thursday, September 23, 2010 This is to certify that work requested to be done as shown by Permit Number P20090270 has been completed. Location: 39 BOULEVARD Tax Map Number. 523400-303-020-0002-018-000-0000 Owner. DAVID DYMINSKI Applicant: DAVID DYMINSKI This structure may be occupied as a: Certificate of Occupancy (COM) By Order of Town Bowl 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. F C E_0 I __ / Q�ommunity Development Officeown of Queensbury • 742 Bay Road - Queensbury, New York •12 0 F 0 J Marilyn Ryba, Executive Director-David Hatin,Director of Building&Codes 0 , Craig Brown, Zoning Administrator•Michael j.Palmer, Fire Marshal i TO N OFQUEENSBURY B1tYLD'iN�� _ ___ NEW BUSINESS CERTIFICATE OF OCCUPANCY PERMIT APPLICATION TAX MAP # BLDG. PERMIT FILE# '� IT applicable Name of Business: Address of Business: O C � �s C'( \o �-Ly � QUESTIONS? CALL 761-8256 OR EMAIL codesftueensburv.net 0. � ` VISIT OUR WEBSITE FOR MORE Person in Charge or Manager. C`�l �C C� INFORMATION www.aueensburv.net Business Phone Number: i a Type of Business: Owner of Property: ��� _C i1 �`! TMc s��r�r�r��r Phone Number(s): }come !j , yt eye Cell Owners Address: W-S �Oc r,fit- `SAT'.'-' Eyl 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: L�. � �. Date: J� 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 Inspection for Permit to Occupy Fire Marshal's Office Request Rec'd Permit No.'7'��! `0 Town of Queensbury . -7 17/lJel _ 742 Bay Road 3 v Queensbury,NY 12804 Scheduled Inspection Date: - Time: !t© Phone: (518)761-8206 Business Name: o � !4 tilt q- Fax: (518) 745-4437 Location: Type of kapection N/A Yes Ho EXITS: Exit Access Fait Enclosure COMMENTS Exit Discharge AISLES: Main Aisle Width 'Se6bnclary Aisle Width EXIT SIGNAGE Sign—normal Sign-bae ell EVAC signs i n rooms TRUSS ID SIGNAGE EMERGENCY LIGHTING FIRE EXTINGUISHER: Hun Inspection of extinguisher eD FIRE ALARM SYSTEM Fan Shutdown Fire S rinkler System FDC Fire Suppression—kitchen r Fi Fire Suppression—Gas Islan 0�(tp rg� C�IITI'i Generator Hood Installation Elevator ZQ Interior Finishes Storage Compressed Gas Clearance to Sprinklers Clearance to Electrical Electric Wring Enclosed/Labeled Combustible Waste Vehicle Impact Protection Knox Box LCerfi�flc F.D.Si na e—Utilit Rooms No Smokin Si ns Maximum Occu anc SinEmer enc Evacuation PlanApproved (If no other approvals apply,the B&C Offic❑ Denied / call for Recheck Inspected By: L:\FireMarshal\New Folder\permitto occupyform.doc Town of Queensbury Fire Marshal 742 Bay Road Queensbury NY 12804 518 7618206 phone 518 745 4437 fax firemarshal@queensbury.net COMMERCIAL INSPECTION REPORT NAME: LOCATION: a DATE: TIME: it`�-' m INSPECTOR: I' Fire Alarm Sprinkler Elevator FDC Generator Range Hood Fuel Island Fire Pump 209U Other Enter to o inspection Receipt of Inspection: CODE SECTION DESCRIPTION OF VIOLATION VIOLATIONS MUST BE CORRECTED IMMEDIATELY. A RE- INSPECTION WILL BE CONDUCTED IN A TIMELY MANNER C <----17- Ic JAN f 2000 C c