2008-224 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: P20080224 Date Issued: Tuesday, May 20, 2008
This is to certify that work requested to be done as shown by Permit Number P20080224
has been completed.
Location: 360 QUAKER Rd
Tax Map Number: 523400-303-005-0001-086-000-0000
Owner: NORTHGATE ENTERPRISES INC
Applicant: NORTHGATE ENTERPRISES INC
This structure may be ocp4k"I�-'AL SUPPLY W 5te —40U�f
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&Co Enfo ment
Planning Board or Zoning Board of Appeals.
D E C E o M _-
Coinninnity Developiiren.t Office
a ZIf 2 atoTown crf Queenshuri/ • 742 Bay Roa • C}Pcee VRd�,1''ark "1
•Davits Hatin, Director of Building v OF QUEENSBUR?'%
Craig Brown, Zoning Administrator•Michael J. Palmer,Fire MarsEI LD I NG & CODES ----------------
ESTABLISHMENT OF A NE W B USINTI N
CERTIFICATE OF OCCUPANCY PERMIT APPL _zz
TAX MAP # � �1 BLDG. PERMIT FILE# appica e
Name of Business:
Address QUESTIONS? CALL 761-8256 OR
of Business: cv— - EMAIL codes 9ueensbur--net
11 .�
�µ.rZPis'+g W w iL� i/ DL VISIT OUR WEBSITE FOR MORE
GCS _ INFORMATION
Person in Charge or Manager: www nueensbury.net
Business Phone Number:
S'/ �- 7ySo � 5S�
Type of Business: �-� 0 LC
----- — -
1.a
Owner of Property: �','b1 —Phone Number(s): cell
Home
Owners ti S �rn,,
Address: 3� �'�n �i 1�Please provide an accurate layout of your store showing all walls, exits, s , rest rooms;
counters and fixture layout on a separate sheet of paper.
Date:
Signature:
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: 3'} �- 0 e
BUSINESS NAME: A "YY1 L4
BUSINESS ADDRESS: 3,S'� �Yyc�►�Z�fL tteemS�Gc�ti JV J
BUSINESS PHONE:
��++
HOME
CONTACT 1: ►� � ' me ea, PHONE,1'/g-7IALL 'T
�+ vY) -P 2 .
ADDRESS:
LfLHOME
CONTACT 2:Cy li45 �d1�Ou' � ONE�Jf� 7Z/ 4 Lo�
ADDRESS: L'' S Fc A� es IV'
i
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
Phone: 5.18-76.1-8206 Fax: 518-745-4437
{ireniarsha gueen.shury.net wwzv.queensbuLymet
OCCUPY
Permit to Oc
n�pectton
Permit No.
We Marshed's Office Request Rec'd___- 3 V
Town of QueensburY Time:
742 Bay Road Scheduled Inspection Date:
Queensbvey,NY 12804 y/'Y\ ct
Phone: (518) 761-8206
Business game: ����
Fes; (51 8) 745-4437
location:
�� � I
T of cWon
N/A Yes
EXITS: COMMENTS
Exit Access
Exit Enclosure
F)dt Discharge
AISLES:
Main Aisle Width
Secondar Aisle Width
EXIT SIGNAGE
Si-n-normal
-batter
EVAC si ns in rooms
TRUSS ID SIGNAGE
EMERGENCY LIGHTING
FIRE EXTINGUISHER:
Hun G�--
In ection of extin uisher
FIRE ALARM SYSTEM
Fan Shutdown
Eire S rinkler S stem
Fire Su ression-kitchen fg a* �i)lml lif
Fire Su ression-Gas islan 0 twoSOIL} AI Due of $MY
Generator
Hood Installation
Elevator MAY ( ��
interior Finishes
Stora e
Com ressed Gas
Clearance to S rinklers Town of atiombury
Clearance to Electrical
Electric Whin Enclosed/labeled
Combustible Waste
Vehicle im act Protection
Knox Box
F.D.Si na e-Utility Rooms
No Smokin Si ns
L.
Maximum Occu anc Si n
Emer enc Evacuation Plan
DApproved {if no other approvals apply.the B&C office will issu e C rtifi ate of Occupancy?
Denied / call for Recheck
o
inspect
ed 8y: ,
I.:\FireMarshal\New Folder\permitto occupyform.doc
Page 1 of 1
F
ad �
��* a
a.
r,.
y
u
k
t 7 --22
F i
!i
E
CA
A