2007-516 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. P20070516 Date Issued: Monday, November 26, 2007
This is to certify that work requested to be done as shown by Permit Number P20070516
has been completed.
Location: 69 CONNECTICUT Ave
Tax Map Number. 523400-309-009-0001-080-000-0000
Owner. MARY JANE CANALE
Applicant: MARY JANE CANALE
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 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: P20070516 Application Number. A20070516
Tax Map No: 523400-309-009-0001-080-000-0000
Permission is hereby granted to: MARY JANE CANALE
For property located at: 69 CONNECTICUT Ave
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. Tyne of Construction Value
Owner Address: MARY JANE CANALE
Certificate of Occupancy(COM)
28 FOX HOLLOW Ln
QUEENSBURY,NY 12804-0000 Total vane
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2007-516 Certificate of Occupancy
IT'S ALL IN THE DETAILS - AUTO DETAILING
$0.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Thursday,August 21, 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 eensb Zty�ugust 21, 2007
SIGNED BY for the Town of Queensbury.
Director of Building& de Enforcement
Q7�To0lttl1n
rcriity Development Officef Queensbury • 742 Bat/ Road - Queensbury, New York -12804 Date Stamp
•David Hatin,Director of Building&Codes
Craig Brown,Zoning Administrator•Michael J. Palmer,Fire Marshal ;
ESTABLISHMENT OF A NEW BUSINESS
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION
TAX MAP# BLDG. PERMIT FILE# r�,>60'7
,^ ^ it pplicanle
Name of Business: s
Address
of Business: G,to o.,;y r [! r', .t_. QUESTIONS? CALL 761-8256 OR
V EMAIL codes(ftueensburV.net
VISIT OUR R MORE
Person in Charge or Manager: ; ` , r1i ,.. / INFORMATION
www.aueensburv.net
Business Phone Number:
Type of Business:
Owner of Property: fn' , Phone Number(s): S 5,1`t
Home Cell
Owners
Address: CCU /. L_ �c� c. : _ 1„ ^✓, C :�-3r, -i'
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'. �! f
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:
BUSINESS NAME: -I-
BUSINESS ADDRESS: IJL,, v
BUSINESS PHONE:
HOME
CONTACT 1: PHONE � `Zt
ADDRESS:
HOME
CONTACT 2: C2.i I Cz,V-/A t1 PHONE x
ADDRESS: y-
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
•firemarsha1@queensburj/ tie wwzvqueensbunj net
Inspection for Permit to Occupy ,
Fire Marshal's Office Request Rec'd Permit No. 0
Town of Queensbury
742 Bay Road
Queensbury,NY 12804 Scheduled Inspection Date: Time:
Phone: (518) 761-8206 Business Name: c.,,A-
Fax: (518) 745-4437 Location
IV - -
Type of Inspection N/A Yes No
EXITS:
Exit Access A COMMENTS
Exit Enclosure
Exit Discharge
AISLES:
Main Aisle Width
Secondary Aisle Width
EXIT SIGNAGE
Sign-normal Fire miarsta inspectop Complete
Sign-battery OK to Issue Ceffikate Of Occupancy
TRUSS ID SIGNAGE /1,f
EMERGENCY LIGHTING
FIRE EXTINGUISHER:
Hung Town of_Qg@nbg!l
Inspection of extinguisher
Hydro extinguisher
FIRE ALARM SYSTEM
Fan Shutdown
Fire Sprinkler System
Fire Suppression-kitchen
Fire Suppression-Gas Island
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.Signage-Utility Rooms
No Smoking Signs
Maximum Occupancy Sign
Emergency Evacuation Plan
- u Approved (If no other approvals apply,the B&C Office will issue the Certificate of Occupancy)
0 Denied
El Call for Recheck
Inspected By:
L:\Sue Hemingway\Fire Marshals Office Inpsection 08.17.2005.doc
Inspection for Permit to Occupy
Fire Marshal's Office Request Rec'd Permit No. Q! �
Town of Queensbury
742 Bay Road ( r L
Queensbury,NY 12804 Scheduled Inspection Date: Z/ I`"1 Time:
Phone: (518) 761-8206 Business Name: �,ZF
Fax: (518) 745-4437 Location: !�
Type of Inspection N/A Yes No
EXITS:
Exit Access -r COMMENTS
Exit Enclosure
Exit Discharge Al
AISLES:
Main Aisle Width a.,
Secondary Aisle Width
Fire Marshal Inspection Complete
EXIT SIGNAGE OK to Issue Certificate of Occupancy
Sign-normal
Sign-battery
A G 14�2007
TRUSS ID SIGNAGE
EMERGENCY LIGHTING re Marshal
Town of ueensbu
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 /fir
Interior Finishes /
Storage
Compressed
essed 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 t4-
Maximum Occupancy Sign
Emergency Evacuation Plan
x 'approved (If no other approvals apply,the B&C Office will issue the Certificate of Occupancy)
o Denied
❑ Call for Recheck
Inspect CdBy-::
L:\Sue Hemingway\Fire Marshals Office inpsection 08.17.2005.doc
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