2008-178 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE (.3"F7 OCCUPANCY
Penn it Number. P20080178 Date Issued: Monday, June 23, 2008
This is to certify that work requested to be done as shown by Permit Number P20080178
has been completed.
Location: 71 OHIO Ave
Tax Map Number. 523400-309-009-0001-08 1-000-0000
Owner. MARY JANE CANALE
Applicant: MARY JANE CANALE
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.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20080178 Application Number. A20080178
Tax Map No: 523400-309-009-0001-08 1-000-0000
Permission is hereby granted to: MARY JANE CANALE
For property located at: 71 OHIO Ave
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: MARY JANE CANALE
28 FOX HOLLOW Ln Certificate of Occupancy(COM)
QUEENSBURY,NY 12804-0000 Total Value
Contractor or Builders Name/Address Electrical Inspection Agency
Plans &Specifications
2008-178
CERTIFICATE OF OCCUPANCY - ADIRONDACK DELI
$50.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Saturday, May 09, 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 Quee r' ay 09,2008
'Ity
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
"oiiiuihjtnn Development Office rou n of Queensbury - 742 Bat/ Road - Queensbury, Neal York -12
David Hatin,Director of Building&Codes
Craig Brown, Zoning Administrator-Michael J.Palmer, fire Marshal 7-O f-a.,.,
UkF
ESTABLISHMENT OF A NEW BUSINES oQeuRy
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION
TAX MAP# `/5 ��� l BLDG. PERMIT FILE# It
(� applicable
Name of Business:
Address
of Business: QUESTIONS? CALL 761-8256 OR
EMAIL codes(ftweensburv.net
VISIT OUR R MORE
Person in Charge Mana er: S INFORMATION
www.aueensbury.net
Business Phone Number:
Type of Business: v V--p 5 tt cv:�v
cu - SA
Owner of Property:B tdl �� � Phone Number(s): 1 L`�:�.. -��`1 S
Home Cell
Owners
Address: Liz-.YN
Please provide an accurate layout of your store showing all walls, exits, stockrooms, res ooms,
counters and fixture layout on a s arate sheet aper.
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
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EMERGENCY CONTAC ' '
CODES RY
TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 743-2502
PLEASE PRINT
DATE: 4 /3 C � O x
BUSINESS NAME:
BUSINESS ADDRESS: cm e ('ttt-� ?•� +�S�V.rtr
BUSINESS PHONE: CA ar0
HOME
CONTACT 1: 49e_o i PHONE
ADDRESS: 1 [.L..m CS Lc:.rQ 0Ya C—d cick.-ccl
T
HOME 3
CONTACT 2: "� �` PHONE �
ADDRESS: t 0 C-1�+r o t—CY L cr%G Qx� 6 V_r iA �j
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
P h o n e: 518-761-8206 F a x. 518-745-4437
firemarshaMqueensbunj et wwzv.queensbun .i� zet
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Inspection for Permit to Occupy
Fire Marshcd's Office Request Rec'd Permit No.
Town of Queensbury
742 Bay Road
Queensbury,NY 12804 Scheduled Inspection Date: i Time:
Phone: (518)761-8206 Business Name: AD Ihy^�'d��- ��2.•
Fax: (518) 745-4437 Location: QH 112% Ad 16IW6—
TWO Of Ilropecom NIA US No
EXITS:
Exit Access
Exit Enclosure COMMENTS
Exit Discharge
AISLES:
Main Aisle Width
Secondary Aisle Width
EXIT SIGNAGE
Si -normal
Si -batter
EVAC signs in rooms
TRUSS ID SIGNAGE
EMERGENCY LIGHTING
FIRE EXTINGUISHER:
Hun
Inspection of extin uisher
Fir MIt � I�w
i
FIRE ALARM SYSTEM , U approval
Fan Shutdown
p J
Fire Sprinkler System JUN A
Fire Suppression-kitchen /
Fire Suppression-Gas Islan
Generator
Hood Installation Fi MatStl8i
Elevator T f bu
Interior Finishes
Storage
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 p�
Maximum Occupancy Sin �d
Emergency Evacuation Plan
Approved (If no other approvals apply,the B&C Office issue the icate ccupancy)
❑ Denied /call for Recheck
Inspected By:
L:\FireMarshai\New Folder\permitto occupyform.doc
FIRE MARSHAL'S OFFICE
Town of Queensbury
742 Bay Road, Queensbury, NY 12804
"Home of Natural Beauty ... A Good Place to Live "
PLAN REVIEW
Adirondack Deli
2008 178
5/12/2008
1 have reviewed the submitted plans for the above project, and offer the
following comments:
1) Provide floor plan showing aisles widths and exit access dimensions
2) Provide details for exit and emergency lighting
3) Provide complete kitchen appliance layout, including hood, UL 300
compliant extinguishing system and alarm notification devices
4) Provide (1) 5# minimum ABC extinguisher in main area and "K" style in
kitchen
,p.�4 --:� L
Fire Marshal
Michael J Palmer
742 Bay Road
Queensbury NY 12804
518 761 8205
firemarshal@queensbury.net
Fire Marshal 's Office - Phone: 518-761-8206 • Fax: 518-745-4437
firetnarshal@queensburi .net • w7mv.queensbury.net