application ^¢ CERTIFICATE OF OCCUPANCY ONLY Office Use Only
Permit#: CO- �2- j- Zo 1c)
\�' = r� APPLICATION
Permit Fee:$ foo
Invoice#: t�0
742 Bay Road,Queensbury,NY 12804
P:518-761-8206 or 518-761-8205 www.queensbury.net
**This application is for occupancy only, with no work requiring a building permit**
CONTACT INFORMATION: ^ ,r,i) E. . ...Wit n�.�..1 �., .
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• Applicant: �s 1
Name(s): July 4 Ever Fireworks Inc J _ 9 I ii
382 Rock Cut Rd,Walden, NY 12586 A��a---• I I
Mailing Address, C/S/Z: ir'tr` i oi� QuEENSBU Y
Cell Phone: ( )917-468-9142 Land Line: i ) RLIII l� i r.; P r--. z
Email:camille@july4ever.net €-....�.�...�..�._....�.=.�_....�,,...,.,._._,..,....., `._-.... ....�....3
• Business Owner(s):
Contact Name(s): Anthony Esposito
Mailing Address, C/S/Z: 382 Rock Cut Rd,Walden, NY 12586
Cell Phone: _( )917-468-9145 Land Line: ( )845-564-0184
Email:camille@july4ever.net
• Manager:
Contact Name(s): Camille Esposito
Mailing Address, C/S/Z: 382 Rock Cut Rd,Walden, NY 12586
Cell Phone: ( )347-466-0393 Land Line: ( )845-564-0184
Email:camille@july4ever.net
• Property Owner(s):
Business Name: 1606 First Avenue LLC
Contact Name(s): Ronald Striegel
Mailing Address, C/S/Z: Meadowbrook Plaza at 324 Quaker Road Suite 6 Queensbury NY 12804
Cell Phone:_( ) Land Line: ( )772-341-5145
Email:ronsuzy@netzero.net
Contact Person for Building & Code Compliance: Ronald Striegel
Cell Phone: ( ) Land Line: ( )772-341-5145
Email:ronsuzy@netzero.net
Certificate of Occupancy Only Revised December 2017
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742 Bay Road,Queensbury,NY 12804
P:518-761-8206 or 518-761-8205 www.queensbury.net
BUSINESS INFORMATION:
Name of business: July 4 Ever Fireworks Inc
Meadowbrook Plaza at 324 Quaker Road Suite 6 Queensbury NY 12804
Address (including suite, space, etc.):
Type of business (i.e.: retail, car repair, etc.): Retail sales
Please provide an accurate layout of your store showing all walls, exits, stockrooms, rest
rooms, counters and fixtures on a separate sheet of paper.
IMPORANT: The business owner is responsible for keeping exits clear and maintaining exit
signs and emergency lights. Fire extinguishers, fire sprinkler systems, and fire alarm systems
require annual inspections by an outside contractor and the corresponding documentation
must be provided to the Town of Queensbury Fire Marshal's office. Fire extinguishing systems
found in kitchens and gas stations require semi-annual inspections. Any violations noted
during an inspection require immediate corrective action and a re-inspection.
Applicant name: Camille Esposito
Applicant signature:
Date: 6/04/2019
Certificate of Occupancy Only Revised December 2017