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2007-435 (2) TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 (E)w Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20070435 Date Issued: Monday, July 16, 2007 This is to certify that work requested to be done as shown by Permit Number P20070435 has been completed. Tax Map Number: 523400-303-005-0001-083-000-0000 Location: 384 QUAKER Rd Owner: DEMETRIOS KOLIOS Applicant: DEMETRIOS KOLIOS 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 their~!a- .. ,� 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. 0 0 . -- Community Development Office < Town of Queensbury • 742 Bay Road • Queensbury, New York •12804 ' ; 1 Marilyn Ryba, Executive Director•David Hatin,Director of Building&Codes Craig Brown,Zoning Administrator•Michael J. Palmer,Fire Marshal ', 0 NEW BUSINESS CERTIFICATE OF OCCUPANCY PERMIT APPLICATION TAX MAP # BLDG. PERMIT FILE# If applicable jj' 7 Name of Business: [/ G Z J Address of Business: (Q(fSw QUESTIONS? CALL 761-8256 OR EMAIL codes@gueensburv.net ��`�r^ VISIT OUR WEBSITE FOR MORE Person in Charge or Manager: �'�'C2 /Y !(/ INFORMATION www.gueensbury.net Business Phone Number: S `Z Type of Business: Owner of Property: � %� � �qLf%c9 S Phone Number(s): Home Cell Owners Address: ��'i�} Of (��- ST/LC V l�L a 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: 7 Z o 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: 24 — 7 BUSINESS NAME: ® BUSINESS ADDRESS: �60zlel &14A� rp BUSINESS PHONE: HOME V CONTACT 1: D� �� P ONE 7 77� ADDRESS: // HOME CONTACT 2: f� 0�� -S t�l 2 HONES(� A7 7--oi 17 ,� /�¢ � � ADDRESS.: ieKw � 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 firemarshal@gueensburu.net www.queensbury net S o� q � Q ----------------- Inspection for Permit to Occupy Fire Marshal's Office Request Rec'd Permit No. en— `i 1` Town of Queensbury 742 Bay Road -7 f J!A 16 a-� Queensbury,NY 12804 Scheduled Inspection Date: l WG Time: Phone: (518) 761-8206 Business Name: ens Fax: (518) 745-4437 Location: ��w t Type of Inspection N/A Yes No EXITS: Exit Access COMMENTS Exit Enclosure Exit Discharge EVAC Plan - AISLES: Main Aisle Width Secondary Aisle Width EXIT SIGNAGE Sign-normal Sign-batter EVAC signs in rooms TRUSS ID SIGNAGE ' EMERGENCY LIGHTING FIRE EXTINGUISHER: Hun Inspection of extinguisher Hydro extinguisher FIRE ALARM SYSTEM Fan Shutdown Fire Sprinkler System Fire Suppression-kitchen Fire Suppression-Gas Island Hood Installation Fire Marshal Inspection Complete Interior Finishes OK to(SSUe CeCtificate of Occupancy Storage Compressed Gas Clearance to Sprinklers JUL 1 2007 Clearance to Electrical Electric Wiring Enclosed Combustible Waste Fire Marshal Vehicle Impact Protection ToWn Of sbU Fire Lane F.D.Si na e-Utility Rooms No Smoking Signs Maximum Occupancy Sign Emergency Evacuation Plan �pproved (If no other approvals apply,the B&C Office will issue t e Certifi to of O upancy) ❑ Denied ❑ Call for Recheck Inspected By: L:\FireMarshal\insptopermitto occupyform.doc Inspection for Permit to Occupy f Fire Marshal's Office Request Rec'd Permit No. © 7- `'/3 Town of Queensbury 742 Bay Road Queensbury,NY 12804 Scheduled Inspection Date: ���0 Time: Phone: (518)761-8206 Business Name: 0OC40 R Z2,4 - ! Fax: (518) 745-4437 Location: aBY ker plali&� Type of Inspection N/A Yes No EXITS: Exit Access COMMENTS Exit Enclosure Exit Discharge XI EVAC Plan AA AISLES: Main Aisle Width pp Secondary Aisle Width 12 EXIT SIGNAGE Sign-normal Sign-batter EVAC signs in rooms TRUSS ID SIGNAGE EMERGENCY LIGHTING -!' FIRE EXTINGUISHER: Hun Inspection of extinguisher Hydro extinguisher ,(f FIRE ALARM SYSTEM Fan Shutdown Fire Sprinkler System Fire Su L Suppression-kitchen C2� r o-1 �� 44 Fire Suppression-Gas Island `4? Hood Installation 61/Jv r7 Interior Finishes Storage Compressed Gas 4- Clearance to Sprinklers Clearance to Electrical Electric Wiring Enclosed Combustible Waste 411 vehicle Impact Protection A- Fire Lane F.D.Si na e-Utility Rooms No Smoking Signs �) Maximum Occu anc Sin �� L I`�' Emergency Evacuation Plan .e, ❑ Approved (If no other approvals apply,the B&C Office will issue the Certificate of Occupancy) --< Denied ❑ Call for Recheck Inspecte y: L:\FireMarshai\insptopermitto occupyform.doc