2004-300 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 _.,P20.0.40300 D.at_e Issued: Thursday, June 17, 2004
This:is:.to:certify-that=work requested to be:done as shown by.Permit Number _ f P20040300
has been completed.
Tax Map Number: __- - . ... 523400-302-006-0001-054-000-0000
Location: 730 GLEN St
Owner: DECOGLEN LP
Applicant: JACK'S AMERICAN BISTRO
This structure may be occupied as a: -
By Order of Town Board
Certificate -of Occupancy (COM) TOWN OF QUEENSBURY
Director of Building&Code Enforcement
T TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
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Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040300 Application Number: A20040300
Tax Map No: 523400-302-006-0001-054-000-0000
Permission is hereby granted to: JACK'S AWRICAN BTSTRO
For property located at: 730 STATE ROUTE 9
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: DECOGLEN LP
25 CORPORATE Cir Certificate of Occupancy(COIvi)
Total Value
ALBANY, NY 12203
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2004-300 JACK'S AMERICAN BISTRO
CERTIFICATE OF OCCUPANCY
$0.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday, June 04, 2005
(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 f Queens Wry; iday, June 04, 2004
SIGNED BY A. for the Town of Queensbury.
Director of Building&Code nforcement
BP File#
Ne�z SuSi11eSS
Dept. of Community Development Certificate of
Town of Queensbury Occupancy Permit
742 Bay Road
Queensbury,NY 12804
(518) 761-8256
For occupancy only, with no work requiring building permit: no fee required for this permit.
Name of Business: JCLc `S r4'►'l'►zVC*'n ��(s t-V-C)
Address: -73o VgA!2Rem'. S-r
Person in Charge or Manager:
Business Phone Number:
Type of Business: (i.e.,mercantile,rest urant,hobby shop,plumbing store):
Owner of Property: 1 1 fl-
Address: 2s (°cSLP�t u�C� �,�Q. �Q s
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.
-r
Signature: UI Date: �16�/ o !�
p on submitting his form:
Property Tax Map No.
Notes/Comments:
ow
Town of Queensbury
Fire Marshal's Office
742 Bay Road
Queensbury, IVY 12804
Phone (518) 761-8205 Fax(518) 745-4437
Fire Marshals Inspection Report
1,
Request �1�, SCHEDULE j'�
Receiver: Permit# d� Q0 INSPECTION ON: ��
Name: � � !` � �L�G � AM PM NYTIME
Location:
APPROVED _
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EXITS
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EXIT SIGNS—_NORMAL
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CLEARANCE TO SPRINKLERS
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CLEARANCE TO ELECTRICAL
REQUIRED SIGNAGE
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MAXIMUM OCCUPANCY SIGN
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----_�__ _ I CTED BY
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_ COMUEVICHR1SJNVORDILETTERS20011FIREMARSHALINSPECTIONREPORT11022001
\ WHITE—BUILDING DEPARTMENT COPY YELLOW—OCCUPANT COPY
Town of Queensbury C'
Fire Marshal's Office 5�
742 Bay Road
i Queensbury, NY 12804
LP� 11-8205e 18)1 Fax(518) 745-4437
I
Fite Marshal's Inspection Report
Request ��0 SCHEDULE -�
Received: _,_,_Permit# �- INSPECTION CAN:
Name: ��pl c c� AM PM ANYTIME
Location:
APPROVED
-- _.—_--- N/A- YES No {tn� I 't-� � TF,'Lf S : f N9r.
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CLEARANCE TO SPRINKL1RS P tr�l�(�r ��c,- tr• l�'r n S
UNITS CLEARANCE TO HEATING
CLEARANCE�O ELECTRICAL 2r ( '
REQUIRED SIGNAGE
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MAXIMUM OCCUPANCY SIGN
CHIMNEY
MASONRY ROUGH IN _—
_ FINAL �✓
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___ COMUEVICHRISJtWORD/LETTERS2001lFIREMARSHALINSPECTIONREPORT11022001
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