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2005-638 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: P20050638 Date Issued: Sunday, November 20, 2005 This is to certify that work requested to be done as shown by Permit Number P20050638 has been completed. Tax Map Number: 523400-309-014-0001-006-000-0000 Location: 107 MAIN St RAMSY Owner: G.R.J.H., INC Applicant: GOLDEN PETROLEUM, INC 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 k7 owner of the responsibility for compliance with Site Plan property P tY P 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. �y BP File# � ATe�az S�si�ness Dept of Community Development Ce]C't1lCa►t " Of Town of Q"eewbwy OCciipallcy'Pet-malt 742 Bay Road Queensbury,NY 12804 (518) 761-8256 =P For occupancy only, with no work requiring buildingpermit. no fey required for this permit. Name of Business: 'r� / 'h Address: 4 Lti4 Person in Charge or Manager. _� l �2 ��/CIA L� Business Phone Number: Type of Business: (i.e.,mercantile,restaurant,hobby shop,plumbing store): Owner of Property: ' -_ Address: Phone Number: 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• ,V�.- of aubmu ingthisfor Property Tax Map No. Notes/Comments: Town of Queensbury Fire MarshaPs Office EMERGENCY CONTACT UPDATE LMS 2000 TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 743-2502 PLEASE PRINT DATE: BUSINESS NAME: n d_44,v BUSINESS ADDRESS: ./0 7 ' v BUSINESS PHONE: /- ��i Z _ 4 l HOME CONTACT 1: Z, PHONE ADDRESS: a� '��2 HOME CONTACT 2 - PHONE 7 — ADDRESS: 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 - - g]&][;tb->ON NET . - -_ -- - Fire Marshal Steve Smith, Deputy Fire Marshal Make Palmer Phone 761-8205, FAX 745-4437 Inspection for Permit to Occupy Fire Marshal's Office Request Rec'd Permit No. Y Town of Queensbury 742 Bay Road ii� I Queensbury,NY 12804 Scheduled Inspection Date: l_ 7 Time: Phone: (518) 761-8206 Business Name: Fax: (518) 745-4437 Location: VV t t oN 5j Type of Inspection N/A Yes No EXITS: Exit Access COMMENTS Exit Enclosure Exit Discharge AISLES: Main Aisle Width Secondary Aisle Width EXIT SIGNAGE Sign-normal Sign-battery TRUSS ID SIGNAGE EMERGENCY LIGHTING FIRE EXTINGUISHER: Hun Inspection of extin uisher Hydro extinguisher FIRE ALARM SYSTEM Fan Shutdown Fire Sprinkler System Fire Suppression-kitchen Fire Suppression-Gas Island Hood Installation Interior Finishes Stora e Compressed Gas Clearance to Sprinklers Clearance to Electrical Electric Wiring Enclosed Combustible Waste Vehicle Impact Protection Fire Lane P i F.D.Si na e-Utility Rooms No Smoking Signs 3 Maximum Occupancy Sin Emergency Evacuation Plan ❑ Approved (If no other approvals apply,the B&C Office will issue)thertifi ate of Occupancy) Denied ❑ 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. Town of Queensbury Bay Road Qu r ! Queensbury,NY 12804 Scheduled Inspection Date: �1 '�� Time: ( Phone: (518) 761-8206 Business Name' _ Fax: (518) 745-4437 Location: ��- S Type of Inspection N/A Yes No EXITS: Exit Access COMMENTS Exit Enclosure Exit Discharge AISLES: Main Aisle Width Secondary Aisle Width EXIT SIGNAGE Sign-normal Sign-battery 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 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 r AppCOVed (If no other approvals apply,the B&C Office wilk.Kwe the ertifica of Occupancy) ❑ Denied o Call for Recheck Inspected By: L:\Sue Hemingway\Fire Marshals Office Inpsection 08.17.2005.doc Town of Queensbury Q Fire Marshal's Office 742 Bay Road Queensbury, NY 12804 Phone (518) 761-8205 Fax(518) 745-4437 Fire Marshal's Inspection Report Request SCHEDULE Received: Permit# ' INSPECTION ON: Name: -C 1 ��`` `'� � M NYTIME Location: APPROVED N/A YES NO COMMENTS EXIT ACCESS EXIT ENCLOSURE EXIT DISCHARGE _ 4 K` S-t U Lt h L V , MAIN AISLE WIDTH xj SECONDARY AISLE WIDTH EXIT SIGN-NORMAL EXIT SIGN-BATTERY _ EMERGENCY LIGHTING _ FIRE EXTINGUISHER HUNG `'n FIRE EXTINGUISHER INSPECTION FIRE EXTINGUISHER HYDRO 11`�`� r``t� 1M�` N C(jam FIRE ALARM SYSTEM FIRE ALARM -FAN SHUTDOWN FIRE SPRINKLER SYSTEM FIRE SUPPRESSION-KITCHEN L FIRE SUPPRESSION-GAS ISLAND c HOOD INSTALLATION I Yl 4 INTERIOR FINISHES STORAGE _ COMPRESSED GAS _ CLEARANCE TO SPRINKLERS CLEARANCE TO ELECTRICAL ELECTRIC WIRING ENCLOSED COMBUSTIBLE WASTE VEHICLE IMPACT PROTECTION FIRE LANE U-``► + F.D.SIGNAGE-UTILITY ROOMS �� NO SMOKING SIGNS _ MAXIMUM OCCUPANCY SIGN_ EMERGENCY EVAC PLAN^ _ li OK THIS DATE FOR CO T OK ^-Y, n� ` v : INSPECTED BY COMDEVIC HRISJIW ORDILETTERS20011F IREMARS HALINS PECTIONREPORT 11022001 WHITE-BUILDING DEPARTMENT COPY YELLOW-OCCUPANT COPY FROM :EXIT 18 _ FAX NO. :15187986614 Aug. 16 2005 01:13AM P1 tb .; T� paJbl@S�RDcC =; � �v s�fi L a 5 � d � ci } rck b =fPo w PROTECTION SYSTEM NEW YORK.FIRE�&SECURITY INSPECTION REPORT 4 Glens Fails Technical Park e'DATE OF Glens Falls,NY 12801-3802 ORDER ORDERED BY (51$)798-9551 ORDER TAKEN BY PHONE Fax(518)792-5199 P.O.NO. JOB NAMEMO. LOCATM WSTALLATION DATE LAST NJSPE INVOICE DATE JOB PHONE INSPECTION SYSTEM EQUIPMENT MANUFACTURE INFORMATION p SYSTEM INSTALLER — _, R.O.R. /-Fixed Heat SYSTEM APPLICATION PtatoeleGW f v r GP TYPE OF SYSTEM Ian 1 Dud ' MA VTENANCE PROGRAM BY Fknw CALL LIST UP TO DATE Yes No Manual tx= �. crow Zore REMARKS - Sir4ezone c Contacts Mo6wis Pholoheem - Water Flow Low Air s s A.C.Voltage Weight A.C.Voltage spfinwer Tamper ': _ D.C.with Load Last Hydro Q.C.Voltage D.C.without Load Gauge Pressure D.C.without Load Ak Hasa. .; Serial# Door Release -70 Z -f 0 G4 0 E**wd nt Shuwmn "" 6 -, l C/ 3 D.C.vAW y, 1'9 71 Debatloo Quit Auawle Csrwlt Renate Ammon Aut"DOOM vw.w Devices PIe.Diadw" Signs As Needed somcw Jews Pitt Fb:slee Tiny rasPEcroR Tbr" Gouges P%W Aamvawr ;STEM FUNCTIONAL solenoid of the above deaedDsa wok tilws,ei Basses SYS f EM -FUNCTIONAL Titus Delay ReIrd"SUN=Trom CREPANCIES DOW Dislor NOTED ABOVE volm olmor Phone um tT ) oe�