2005-946 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE (31.'U' OCCUPANCY
Permit Number. P20050946 Date Issued: Tuesday, March 28, 2006
This is to certify that work requested to be done as shown by Permit Number P20050946
has been completed.
Tax Map Number. 523400-309-007-0001-014-000-0000
Location: 10 HOLDEN Ave
Owner. W& T ENTERPRISES, LLC
Applicant: RM MASONRY
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: P20050946 Application Number: A20050946
Tax Map No: 523400-309-007-0001-014-000-0000
Permission is hereby granted to: RM MASONRY
For property located at: 10 HOLDEN 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. Type of Construction Value
Owner Address: W& T ENTERPRISES, LLC
10 HOLDEN Ave Certificate of Occupancy(COM)
Total Value
QUEENSBURY, NY 12804-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2005-946 RM MASONRY
CERTIFICATE OF OCCUPANCY
$0.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday, January 09, 2007
(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 of Que bu nday, January 09, 2006
SIGNED BY for the Town of Queensbury.
Director of Builduig&Co,e Enforcement
Sent By: Adirondack P&M, Inc; 1' 51B 793 4114; Dec-15-05 7:59AM; Page 2/3
BP File It
New l�tusi�ess�;
.Dept. of Community Development (�® �. 'LC�#,'�8 p�r
Town oJQueensbury Ocoup�ncy hex- zit
742 Bay Road
Queensbury,NY 12804
(518) 761-8256
For occupancy only, with no work requiring buildingpermit: no fee required for this permit.
Name of Business:
Address: J1 44`)CAJ✓1 ALIC
Person in Charge or Manager: I )�� �( ►' �`��-
Business Phone Number: �:2
Type of Business: (i.e.,mercantile, restaurant,hobby shop,plumbing store):
Owner of Property: yx�e� LLL-
Address: f �L GI _ V& / Id
Phone Number: 7 I Y 3 O D 3
Pleaseprovide are accurate layout ofyour store showing all walls, exits, stockrooms, rest rooms,
counters and fWnre layout on a separate sheet of paper.
Signature: Date:
ofperson submittingthisform:
Property Tax Map No. / !
Notes/Comments:
Sent By: Adirondack P&M, Inc; 1 518 793 4114; Dec-15-05 7:58AM; Page 1 /3
Town of Qu.eensbury q
Fir@ Marshal a Office
E-MERGENCY CONTACT UPDATE
Lnzs 2000
TO: WAKEN COUNTY'SHERIFF'S DEPT. FAX: 761-6210
- - ---- PLEASE PRINT
DATE: �a ►S 0
BUSINESS NAME: Wj -T F6k�C
BUSINESS ADDRESS: �� %0 x
BUSINESS PHONE:_
11 HOME
CONTACT i: 1 u.� PDow. 3 6 9-3 3
s
TOWN RESPONDING FROM:. G-") 61, 1t-5
CONTACT 2: -_- SCA �eck�eCPHONE DOME -� 1-3 33
TOVN RESPONDING FROM:
DOME
CONTACT S., �Ncz � PIXONE ?L I U y0�C
TOWN RESPONDING FROM: �� �
Mre Marshal Steve Smith, Deputy Fire Marshal Mike.Palmer
Phone 76I-8205,PAX 745-4487
Inspection for Permit t® Occupy
Fire Marshal's Office Request Rec'd Permit No. vs L16
Town of Queensbury
742 Bay Road
Queensbury,NY 12804 Scheduled Inspection Date: 3 //; `f�� Time: �
Phone: (518) 761-8206 Business Name: T�h--\
Fax: (518) 745 4437 Location: I��� A�4L3c.l�
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
i
Approved (If no other approvals apply,the B&C Office will issue the C rtificate of Occupancy)
❑ Denied
❑ Cali for Recheck
Inspected By: �
L:\Sue Hemingway\Fire Marshals Office Inpsection 08.1 7.2005.doc
Inspection for Permit to Occupy
Fire Marshal's Office Request Rec'd Permit No. _qq
6
Town of Queensbury
742 Bay Road 94 / 2
Queensbury,NY 12804 Scheduled Inspection Date: �� �y Time:
Phone: (518) 761-8206 Business Name: k?jrn
Fax: (518) 745-4437 Location:
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 \cJ
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
o Approved (If no other approvals apply,the B&C Office will issue the Ce ificate of Occupancy)
Denied
❑ Call for Recheck
Inspected By:
L:\Sue Hemingway\Fire Marshals Office Inpsection 08.17.2005.doc