2008-073 111111644
TOWN OF QUEENSBURY
ET 742 BayRoad, ueensb NY 12804-5902 (518) 761-8201
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Community Development - Building& Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20080073 Date Issued: Tuesday, April 08, 2008
This is to certify that work requested to be done as shown by Permit Number P20080073
has been completed.
Location: 87 MAIN St
Tax Map Number: 523400-309-010-0001-037-000-0000
Owner: COTE'S CORNER, LLC
Applicant: PHIILIP P. COTE
This structure may be oc AlY SCE CREAM SHOPPE
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 Drr etor o Building e orcernent
Planning Board or Zoning Board of Appeals.
Mii
TOWN OF QUEENSBURY
ta-3" 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
•
BUILDING PERMIT
Permit Number: P20080073 Application Number: A20080073
Tax Map No: 523400-309-010-0001-037-000-0000
Permission is hereby granted to: PHILIP P. COTE
LEFTY'S ICE CREAM SHOPPE
For property located at: 87 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 Value
Owner Address: COTE'S CORNER, LLC
27 MAPLE Dr Certificate of Occupancy(COM)
QUEENSBURY, NY 12804-0000 Total Value
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2008-073 C/O only
Lefty's Ice Cream Shoppe
$0.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Wednesday,April 08, 2009
(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 Queen �{ / 7Oriar-,-April 08, 2008
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
r
Community Development Office .
; Town of Queensbury • 742 Bay Road - Queensbury, New York -1280r
6.11' . 11 ig
•David Hahn,Director of Building&Codes F
Craig Brown,Zoning Administrator•Michael I.Palmer,Fire Marshal TOWN OF QUEENSBURY
r-BU.IEB+N�&-GOOEi S`--/ `
ESTABLISHMENT OF A NEW BUSINESS
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION
TAX MAP # .10 —1 ^? BLDG. PERMIT FILE# (,' �(���/ I
Irapplicable
Name of Business: 1--Z't' l-s C.Q. Crkem an �ko e .
Address
t QUESTIONS? CALL 761-8256 OR
O
of Business: --)M � i r-, Si • j tRu, _,„,s I it,e1 , , rxeo "f EMAIL cadestu(?aueensburv.net
i (J VISIT OUR WEBSITE FOR MORE
Person in Charge or Manager: INFORMATION
www.aueensburv.net
Business Phone Number: (51 6 II a-a95D
Type of Business: Z tt C M rn .Sh®f
csitia-:--wit1-4:teta
Owner of Property: r 0,p Po C5"f'e)�(L. Phone Number(s): 6'12...)9 3a. - sa
as
Home Cell
Owners
Address: cp2 7 0"-AlPke / , `f.etris L k ram,1, • L L c LI
Please provide an accurate layout of your store showing all walls, exits, stockrooms, rest rooms,
counters and fixture layout on a se arate sheet of pa er.
Signature:
x
S. I ‘1UR
Of person subm' ' g this Date:form
Notes /Comments:
*Note: This application is for occupancy only, with no work requiring a building permit. No fee required for this permit
8--- k
E ERGENCY CONTACT UPDATE
TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 743-2502
PLEASE PRINT
DATE: izi) a 3 ,.1.)0
BUSINESS NAME: LQ- ` 's CeAm c
BUSINESS ADDRESS: In q1kRkrts
BUSINESS PHONE: S 18 -'14a -A9`0
HOME
CONTACT 1: 1 1'p C PHONE -
A� I _)/q1-( -•73��{
ADDRESS: ACT hf g. GIev>s c11s, N•t+ /3 oI
HOME
CONTACT 2: �}�'�l� P fie �. PHONE( ii)4.3.1.-5.);It.3
ADDRESS: c)7 Pi _ ,k quAg_rattel 1v , ► ,2w-1
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 QUEENSBURY FIRE MARSHAL'S OFFICE
Ph o n e: 518-761-8206 • F a x: 518-745-4437
firemarshal@queensbury.net • www.queensbury.net
Inspection for Permit to Occupy
Fire Marshal's Office Request Rec'd Permit No ' Cr }9
Town of Queensbury
742 Bay Road �7�f' i sc11
Queensbury,NY 12804 Scheduled Inspection Date: 1 —(� t1 Time: j, t�
Phone: (518)761-8206 Business Name: LJ 1 CqC 't -
Fax: (518) 745-4437 Location: ['YVAty...`'jr
Type of kapeclon N/A Yes No
EXITS:
Exit Access COMMENTS
Exit Enclosure
Exit Discharge
AISLES:
Main Aisle Width /
Secondary Aisle Width /
EXIT SIGNAGE /
Sign-normal `
Sign-battery / /
EVAC signs in rooms /
TRUSS ID SIGNAGE /
EMERGENCY LIGHTING /
FIRE EXTINGUISHER:
Hung /
Inspection of extinguisher
FIRE ALARM SYSTEM
Fan Shutdown
Fire Sprinkler System 7
Fire Suppression-kitchen Fire Marshal inspecon Comp""'
Fire Suppression-Gas Islan OK to Issue Certificate of Occupancy
Generator /
Hood Installation
Elevator APR v 72 i 18
Interior Finishes J
Storage ]
Compressed Gas ,j
Clearance to Sprinklers / / Fire Marsh l
Clearance to Electrical ,! Tow Of ueensbu
Electric Wiring Enclosed/Labeled
Combustible Waste /
Vehicle Impact Protection /1 Knox Box
F.D.Signage-Utility Rooms
No Smoking Signs
Maximum Occupancy Sign //
Emergency Evacuation Plan
Acikpproved (If no other approvals apply,the B&C Office w' issue the ' edifice e of Occupancy)
o Denied / call for Recheck
"fli ,
Inspected By: 1.
L:\FireMarshal\New Folder\permitto occupyform.doc
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