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2005-947 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. P20050947 Date Issued: Monday, March 27, 2006 This is to certify that work requested to be done as shown by Permit Number P20050947 has been completed. Tax Map Number. 523400-309-007-0001-014-000-0000 Location: 10 HOLDEN Ave Owner. W& T ENTERPRISES, LLC Applicant: CLARKE'S COMPLETE CARE This structure maybe occupied as a: Certificate of Occupancy(COM) By Order of Town Board T WN OF QLgENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the P Y 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: P20050947 Application Number: A20050947 Tax Map No: 523400-309-007-0001-014-000-0000 Permission is hereby granted to: CLARKF'S C;OMWLETF, CARE 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 wide 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: W& T ENTERPRISES, LLC 10 HOLDEN Ave Certificate of Occupancy(CO1V) Total Value QUEENSBURY,NY 12804-0000 Contractor or Builder's Name /Address Electrical Inspection Agency Plans&Specifications 2005-947 CLARKE'S COMPLETE CARE 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 urZr77r January , 2006 SIGNEDBY y the Town of Queensbury. Director of Building&Code Enforcement Sent By: Adirondack P&M, Inc; f1 518 793 4114; Dec-15-05 7:59AM; Page 3/3 BP File# S Dept. of Community Development CGl' 10sx-t4e OAr Town ofQueensbury QCCAxJall(3�p8�'riCllt 742 Bay Road Queembury,NY 12804 (518) 761-8256 For occupancy only, with no work requiring building permit: no fee required for this permit. Name of Business: C•��C `S ✓''}�'2 , Address: Ci ( Y\yv10����� �Ce-1 y `i �/-J- 1 Person in Charge or Manager. a`rC j eK� Business Phone Number: Type of Business: (i.e.,mercantile,restaurant,hobby shop,plumbing store): a--�K Owner of Property: -T EAk&eo n Address: y o X �;I DS I ei J1) /�'7_ Z Phone Number: j 3 Please provide an accurate layout of your store showing all walls, exits, stockrooms, rest rooms, counters andfibdure layout on a separate sheet of paper. Signature: Date: of parson submitting this form, 7-- 1 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.eensbui.ry5F4 aw 7 Fire Marshal's Office EMERGENCY CONTACT UPDATE LMS 2000 TO: WARREN COUNTY'SHERIFF'S DEPT. FAN: 761-6210 _ PLEASE PRINT DATE: a 5 0 BUSINESS NAME: T LbL BUSINESS ADDRESS: Qa to y 56 a Fe, It) :tAl IOU }BUSINESS PHONE: �l ���� n 3 11 f 5 CONTACT 1.. sus- 3 �r- 7l01-090k I 1 �t.c,�Cs- PRONE sus- 361--3, 3 �f TOWN RESPONDING FROM: - 3 3 �e� ��-� kIOME 1 CONTACT 2• c. C _-- -PHO_TM 3 6 _ F TOWN RESPONDING FRONT: C> HOME CONTACT 3: :-'S�ns PRONL �O��U 0 TOWN RESPONDING FROM: �� � Fire Marshal Steve Smith, Deputy Fire Marshal Mike.Palmer Phone 76I-8205, FAX 745-4487 Inspection for Permit to Occupy Fire Marshal's Office Request Rec'd Permit No. Town of Queensbury 742 Bay Road Queensbury,NY 12804 Scheduled Inspection Date: J �� U v Time: yI Phone: (518) 761-8206 Business Name: L n,� rs vni 1 Fax: (518) 745-4437 Location: i o 4-,(,9C-DS / 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 i 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 <`°< Approved (If no other approvals apply,the B &C Office will issuLtherflificate of Occupancy) o Denied ❑ Call for Recheck Inspected By:\[-"\-� L:\Sue Hemingway\Fire Marshals Office Inppection 08.1 7.2005.doc Inspection for Permit to Occupy Fire Marshal's Office Request Rec'd Permit No. Town of Queensbury OG 742 Bay Road Queensbury,NY 12804 Scheduled Inspection Date: 1 Time: Phone: (518) 761-8206 Business Name: Fax: (518) 745-4437 Location: 10 61 dlv-- 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 t 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 3� Storage Compressed Gas Clearance to Sprinklers Clearance to Electrical Electric Wiring Enclosed Combustible Waste Vehicle Impact Protection X, Fire Lane F.D.Si na e-Utility Rooms No Smoking Signs Maximum Occupancy Sign Emergency Evacuation Plan ❑ Approved (If no other approvals apply,the B&C Office will is e the Ce ficate Occupancy) Denied Call for Recheck Inspected By: i L:\Sue Hemingway\Fire Marshals Office Inpsection 08.17.2005.doc