2008-659 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. P20080659 Date Issued: Friday, January 16, 2009
This is to certify that work requested to be done as shown by Permit Number P20080659
has been completed.
Location: 730 GLEN St
Tax Map Number. 523400-302-006-0001-054-000-0000
Owner. L.P. DECOGLEN LP
Applicant: PAULIE C'S VICTORY LANE SPORTS ZONE
This structure maybe 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: P20080659 Application Number. A20080659
Tax Map No: 523400-302-006-0001-054-000-0000
Permission is hereby granted to: PAULIE CS VICTORY LANE SPORTS ZONE
For property located at: 730 GLEN 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: DECOGLEN LP
25 CORPORATE Cir Certificate of Occupancy(COM)
ALBANY,NY 12203 Total value
Contractor or Builders Name I Address Electrical Inspection Agency
Plans &Specifications
2008-659
Paulie C's Victory Lane Sports Zone- CIO only
$0.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Saturday,December 19, 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 Towxr4,Queensb ry; Friday,December 19, 2008
SIGNED BY for the Town of Queensbury.
Director of Buildin nforcement
"Tooulll,n7711
itty Development Office
ueensburl/ - 742 Bail Road - Queensbury, Neon York -12804
-David Hatin,Director of Building&Codes
Craig Brown, Zoning Administrator-Michael i.Palmer Fire A4.arshal ;
ESTABLISHMENT OF A NEW BUSINESS
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION
TAX MAP # BLDG. PERMIT FILE#-
it
applicable
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Name of Business:AtIll� �/ {r � h
Address 7 r� /i��� s /� ,Yr
of Business: / �v �jt7 o c r�l/I� /✓vf��i� I& QUESTIONS? CALL 761-8256 OR
EMAIL codeso-gueensburV.net
//►► VISIT OUR WEBSITE FOR MORE
Person in Charge or Manager: INFORMATION
www.aueensbury.net
Business Phone Number: z--76( — ( 2 S
Type of Business:_ SP-P h G,yv6lJ C Aril e4l , 4 1-6
Owner of Property: �� Phone Number(s):5(cr7y7 776 I
Home cell
Owners [/ ^ L �^
Address: I-( mC'�/Nar�J 7fr" H ��'ol,.� Fir,((f
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: 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
EMERGENCY CONTACT [UPDATE
TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 743-2502
PLEASE PRINT
DATE: 2 u
BUSINESS NAME: / '� �// l�G�r✓� ✓ a✓A zwe
BUSINESS ADDRESS: Wo S--//- `''
BUSINESS PHONE: Y 7 W l Z 5-3
/ HOME
CONTACT 1:_T✓'`l/� �C,�� �UGG y PHONE ��'-7�i/-6� 21
Ct/a - 57Y-
ADDRESS: �'Z S/ �I� L�✓ U/� ��11 �,.�1 i,�riY
HOME
CONTACT 2: hd PHONE 51�— 7c��
ADDRESS: ` 1 �'I �'� rC� �t�C�S'� ���-- �J y l Z&3 9
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. 518-761-8206 Fax. 518-745-4437
rremarshal@queensbunj.net www.queensburj.net
Inspection for Permit to Occupy
Fire Marshal's Office Request Rec'd Permit No.
Town of Queensbury
742 Bay Road
Queensbury,NY 12804 Scheduled Inspection Date:^ i L'/ Time:
�5
Phone: (518)761-8206 Business Name:
Fax: (518) 745-4437 Location:
TWe of InWection N A Yes ft
EXITS:
Exit Access COMMENTS
Ex;t Enclosure
Exit Discharge
AISLES:
Main Aisle Width
SecoridaAisle Width
EXIT SIGNAGE
Sign—normal Sign-battery
EVAC signs in rooms
TRUSS ID SIGNAGE
EMERGENCY LIGHTING
FIRE EXTINGUISHER: 24
Hun
Inspection of extinguisher
FIRE ALARM SYSTEM
Fan Shutdown
Fire Sprinkler System FDC
Fire Suppression—kitchen
Fire S ession—Gas Islan
Generator
Hood Installation
Elevator
Interior Finishes
Storage
Compressed Gas
Clearance to Sprinklers 41
Clearance to Electrical
Electric Ming Enclosed/Labeled
Combustible Waste
Vehicle Impact Protection
Knox Box
F.D.Si na e—Utility Rooms
No Smoking Signs
Maximum Occupancy Sign
E m ergency Evacuation Plan
ApproVed (If no other approvals apply,the B&C Office wi issue the Certificate O cuponcy)
o Denied / Cali for Recheck
Inspected By:
L:\FireMarshal\New Folder\permitto occupyform.doc
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