2007-385 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
(zt Community Development- Building &Codes (518) 761-8256
CERTIFICATE ('3'"VE OCCUPANCY
Permit Number. P20070385 Date Issued: Friday, November 23, 2007
This is to certify that work requested to be done as shown by Permit Number P20070385
has been completed.
Location: 6 STATE ROUTE 149
Tax Map Number. 523400-288-012-0001-014-000-0000
Owner. FIVEASIDE, LLC
Applicant: FIVEASIDE, LLC
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: P20070385 Application Number. A20070385
Tax Map No: 523400-288-012-0001-014-000-0000
Permission is hereby granted to: FIVEASIDE, LLC
For property located at: 6 STATE ROUTE 149
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: FIVEASIDE, LLC
Certificate of Occupancy(COM)
C/O SILVER BUILDERS, INC.
3109 STIRLING Rd Suite 200 Total value
FT. LAUDERDALE, FL 33312-0000
Contractor or Builders Name/Address Electrical Inspection Agency
Plans &Specifications
2007-385
Lake George Timber Crafted Homes certificate of occupancy NOTE: mailing address is 10 State Route 149
ther are two buildings on this property
$0.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Thursday,July 17,2008
(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 To o ;7w 07
SIGNED BY Z2=r
the Town of Queensbury.
Director of Building Code orcement
JUN-21-2007 05 :30 AM LANG CUSTOM HOMES S187823439 r. ni
•David Hatin,Director of Building&Codes
Craig Brown,Zoning Administrator-Michael 1, Palmer, Fire Marshal
_ESTABLISHMENT OF A NEW B USIN�EUI...
CERTIFICATE OF 0 CCL1PAN9qERM1T APPLICATION
�..3 1 S
,l
TAX MAP# 'o� ��'�' . PA?DM FILE#
— ap
Name of Business: &4Z 67'evae
Address G�e�^ 9 4UE8 nONS? CALL 781-8259 0R
of Business: EMAIL coduaginnaburig.riat
Person in ChergO or Manager; �'I�a� MIA r ��� ial 1� �SR ou NwetMA71�MORE
Business Phone'Number: J-1G- 7� - lla 7
Type of Buslne= 4rKe
Owner of Property: 6Ve^A IG'e Phone Numbegs): ? —w Arw
Owners 3/�j 51 i �'� P pe
Address: ---
Please provide an accurate layout of your store showing all walls, exits, stockrooms, rest rooms,
counters and fixture layout on a s to sh r.
Signature: Date:
a per, a+is tom,
Notes/ Comments:
*Note: This application is for occupancy only, with no work requiring a building permit. No fee required for this permit
JUN-21-2007 05 :31 AM LANG CUSTOM HOMES 518Y�zJ +a�
CnncK%jrctV% , T ur i/Ai c
TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 743-2502
PLEASE PRINT
-3�
DATE:
BUSINESS NAME:
BUSINESS ADDRESS• V sib �i 441 •!�+ /
BUSINESS PHONE:
/ �'P�Y HOME
CONTACT 1: PHONE CP
ADDRESS: 0��9 ..5-D� ��• �� 1 �� � /2.,���
HOME _F
CONTACT 2:_44te 3d'�z.-, rG y
'��A PHONE
ADDRESS: CFi✓,�d/lJ SG, -.� i��.�C✓'"' ,/✓y� �i�..30�
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
firerruarshal fteensburu.get www,yueensbujij feet
Inspection for Permit to Occupy
Fire Marshals Office Request Rec'd Permit No. 0-7-3 57
Town of Queensbury
742 Bay Road
Queensbury,NY 12804 Scheduled Inspection Date: / '-W/y7 — Time: �Z
Phone: (518) 761-8206 Business Name:
Fax: (518) 745-4437 Location:
Type of Ins ectlon N/A Yes No
EXITS:
D Access
DO
it Enclosure COMMENTS
Exit Discharge
EVAC Plan -
AISLES:
Main Aisle Width
Secondary Aisle Width
Fire Marshal Ins tion Complete
EXIT SIGNAGE OK to Issue Cal
of Occupancy
Sign-normal
Sion-batter
EVAC signs in rooms JUL 3 Q ?�d7
TRUSS ID SIGNAGE
EMERGENCY LIGHTING
Fire Marshal
FIRE EXTINGUISHER: Town of Queensbury
Hun
Inspection of extinguisher
Hydro extinguisher
FIRE ALARM SYSTEM
Fan Shutdown
Fire Sprinkler p System /"' ,_�—
Fire Suppression
ression-kitchen
Fire Suppression-Gas Island !�,✓l
Hood Installation
Interior Finishes
Storage
Compressed Gas
Clearance to Sprinklers
Clearance to Electrical
Electric Wiring Enclosed
Combustible Waste
Vehicle Impact Protection
Fire Lane
F.D.Si na e-Utility Rooms
No Smoking Signs
Maximum Occupancy Sign
Emergency Evacuation Plan
Approved (If no other approvals apply,the B&C Office will issue the Certificate of Occupancy)
❑ Denied
❑ Call for Recheck
Inspecte BY:
L:\FireMarshal\insptopermitto occupyform.doc
Inspection for Permit to Occupy
Fire Marshal's Office Request Rec'd Permit No. y, J&
Town of Queensbury
742 Bay Road `
Queensbury,NY 12804 Scheduled Inspection Date: �� Time:
Phone: (518)761-8206 Business Name: LL
Fax: (518) 745-4437 Location: E a
Type of Ins ecfion N/A Yes No
EXITS:
Ut Access COMMENTS
Exit Enclosure
Fait Discharge
EVAC Plan
AISLES:
Main Aisle Width
Secondary Aisle Width
EXIT SIGNAGEQ� -
Sign-normal L 7`- S/�h A0t,1 c 1'rr CGJ�-1
Sign-batter / [
EVAC signs in rooms
TRUSS ID SIGNAGE
EMERGENCY LIGHTING
FIRE EXTINGUISHER: G}�V I P
Hun
Inspection of extinguisher
Hydro extinguisher
FIRE ALARM SYSTEM 1� J
Fan Shutdown
Fire Sprinkler System
Fire Suppression-kitchen
Fire Suppression-Gas Island
Hood Installation
Interior Finishes
Storage Ir
Compressed Gas
Clearance to Sprinklers
Clearance to Electrical
Electric Wirina Enclosed
Combustible Waste �J
Vehicle Impact Protection
Fire Lane
F.D.Si na e-Utility Rooms
No Smoking Si ns
Maximum Occupancy Sin .-
Emergency .4-
Emergency Evacuation Plan
❑ Approved (If no other approvals apply,the B&C Office will issu the Certificate of
Denied
❑ Call for Recheck
Inspected By:
L VIreMarshaNnsptopermitto occupyform.doc
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