2005-139 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: P20050139 Date Issued: Wednesday, March 30, 2005
This is to certify that work requested to be done as shown by Permit Number P20050139
has been completed.
Tax Map Number: 523400-303-016-0001-062-000-0000
Location: 430 DIX Ave
Owner: WESLEY & VICKI VEYSEY
Applicant: ARC DAY REHAB
This structure may be occupied as a:
By Order of Town Board
Certificate of Occupancy (COM) ov�v o QUEENS R
Director of Building&Code Enforcement
BP File# ZS-(
New I3us�un�.ess
Dept of Community Development Ct'Y't11Ca►tE� Of
Town of Queenshwy occupancy Z��erlriit
742 Bay Road
Queensbwy,NY 12804
(518) 761-8256
For occupancy only, with no work requiring buildingpermit. no fee required for this permit.
Name of Business:
Address: �82 az4
4v-el
Person in Charge or Manager.
Business Phone Number: 7 9S'V2G-/-/
Type of Business: (i.e.,mercantile,restaurant,hobby shop,plumbing store):
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Owner of Property: ve vse .
Address:
Phone-Number:
PYease provide an accurate layout of your store showing all walls,cras,stockrooms,rest rooms,
counters and f rture layout on a sep ate sheet of aper.
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Signature:G' Date.• 6� �
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Property Tajo Map No,3�2
Notes/Comments:
Town of Queensbury
Fire Marshal's Office
742 Say Road
Queensbuiry, NY 12804
Phone (518) 761-8205 Fax(518)745-4437
Fire Marshal's In pection Report
Request SCHEDULE Q'
Received: Penmit# D S-./ INSPECTION ON: 0 r
Name: ! _ AIZOA M NYTIME
Location: Lcy
APPROVED
N/A YES NO COMMENTS
EXIT ACCESS
EXIT ENCLOSURE
EXIT DISCHARGE
MAIN AISLE WIDTH
SECONDARY AISLE WIDTH
EXIT SIGN-NORMAL 10A /�O�XA
EXIT SIGN-BATTERY
EMERGENCY LIGHTING
FIRE EXTINGUISHER HUNG
FIRE EXTINGUISHER (/�, ✓
INSPECTION
FIRE EXTINGUISHER HYD O
FIRE ALARM SYSTEM
FIRE ALARM -FAN SHUTDOWN
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION-KITCHEN
FIRE SUPPRESSION-GAS l
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 EVAC PLAN
OK THIS DATE OK FOR R O NOT OK
NS EC ED BY
COMDEV/CHMSJNVORDILETTERS2001/FiREMARSHALINSPECTIONR ORT11022001
WHITE-BUILDING DEPARTMENT COPY YELLOW-OCCUPANT COPY
ROD�) 793-8307/ 3
W£ SL£ Y Co V£YS £Y �-
BUILDING CONTRACTOR
Remodeling — Additions 61 MacARTHUR DRIVE
New ConstructionGLENS FALLS, N. Y. 12801
2q
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