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2007-207a~ ~ ~ v O Q '~' ~~ w N c'V a •b ~ W ~ N ~~~' ~ V °' ~` "~ a w a ~ ti ow b w~ C~ b~ t~ ~ ~ ~ oA ~ ~ ~ ~ ~ ~ .~ '~ ~ A ~ h ~ ~ ~ ~ V N ~ ~ .~. ~ ~ ° ~ ° ~ °~ ~ ~ (~ ° b O m a~ o ~ v~ y~ o ~, ~'' o ~ ~ py U v .n °o Q Q a~ ~; ~ W ~ ~ w A ~ ~ ~ ~ ~~~ W ~ .~ ~, z w ~/ ~ ~ ~ ~ ~ ~ ~ zap V z ~ ~ ~ ~ ~' ~~~ ~' ~ ° °o ~ ~3 W u, '~" ~ ~ ~ b ~ O ~~ o a ~ a a A c ~ ~~ U v~ .•, ~~~ o V N ~ N ~ ~ ~~ ~:: •~' ~ v, a~ O O ~ v ~ O ~ ~ ^ o ~ ~ U o ° ~ ~ U t~ 7.a .~ ~ L.i ~ U ~ W i. i. ~ .~ ~ O V O ~ o ~ ;~ -~ ~ ~• ~, b W " ~ ~ +~ '~a°,o ~ v O Z ~ ~; w 3 0 ~ ~ ~ ~ ~ ~ ._ ~ I~~ ~ I~ ~ O ~a H v ~ a ~ a TOWN OF QUEENSBURY 742 Bay Road, Queensbury, NY 12804-5902 (518) 761-8201 Community Development -Building & Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20070207 Application Number. A20070207 Tax Map No: 523400-302-007-0001-044-000-0000 Permission is hereby granted to: MICHAEL & SUSAN KAIDAS For property located at: 154 QUAKER Rd in the Town of Queensbury, to constrict 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 Constnution Value Owner Address: MICHAEL & SUSAN KAIDAS PO BOX 268 CLEVERDALE, NY 12820-0000 Contractor orBuilder shame /Address Certificate of Occupancy (COM) Total Value Electrical Inspection Agency Plans & Specifications 007-207 AMILY DENTISTRY OF DR. JESSICA SHIN $0.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Sunday, May 25, 2008 (If a longer period is requited, an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before' the expiration date.) Dated at the To of Qu nsb ~ F i ~A 25, 2007 SIGNED BY for the Town of Queensbury. Director of Building & Code Enforcement ,~ -~-- Community Development Office ~ ~" ~ ~~! ~ ; Town of Queensbury • 742 Bay Road •Queensbury, New York •12804 ~ ~Y Marilyn Ryba, Executive Director • David Hatin, Director of Building £~ Codes ; ~ . '. ~ - r ~~ ~ ; Craig Brown, Zoning Administrator • Michael J. Palmer, Fire Marshal TO~~ ~~ ,,,,,..~,~t~~CSvRY BOTCQIN'~ ATtD L'ODE` ` ` `"~ NEW BUSINESS CERTIFICATE OF OCCUPANCY PERMIT APPLICATION ~©Z TAX MAP #_ Name of Business: Address of Business: BLDG. PERMIT FILE# Q~~ ~ . If applicable Person in Charge or Manager: ~L. JP55/ca _ ~Lt/.~ Business Phone Number: ~S/~ 791- .~ 9~0 GIUESTIONS? CALL 761=8256 OR EMAIL codes~queensbury.net VISIT OUR WEBSITE FOR MORE INFORMATION www.gueensburv.net Type of Business: ~ L9 ~ ~ ~ ~`7~C Owner of Property: ~ " 1~C ~ ~ .SlLS4 H ~~~ C Phone Number(s): ~9/a ~ 7/~ d ~S ~ 3 ~ y~ Home Owners Address: Cell Please provide. an accurate layout of your store showing all walls, exits, stockrooms, rest rooms, counters and fixture layout on a sepa to sheet of paper. Signature: Date: 30 L C+f person submitting this form Notes /Comments: a-i-~i4 *Nofe: This application is for occupancy only, with no work requiring a building permit. No fee required for Phis permit 0-20; . EMERGENCY CONTACT UPDATE TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 743-2502 PLEASE PRINT DATE: y ~3 0 ~a 7 BUSINESS NAME: BUSINESS ADDRESS: ~oy BUSINESS PHONE: ~SI ~ ~ 7R$- ~2r'~ HOME CONTACT 1: .SfPI/r Bnn~le /.]rSS%rq _ry~~ PHONE Sao -l/t ~ y ADDRESS: //,, HOME CONTACT 2: ~i1i~~lav~ d S c4h~q~~('4S PHONE ~9T~ 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 Fisted 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 PERSONNEL. „_ ._,. TOWN OF QUEENSBLIRY FIRE MARSHAL'S OFFICE Phone: 518-761-8206 Fax: 518-745-4437 fcremarshal~queensburu.net www.queensburu net Inspection for Fire Marshal's Office Town of Queensbury 742 Bay Road Queensbury, NY 12804 Phone: (518) 761-8206 Fax: (518) 745-4437 Permit to Occupy .. Request Recd Permit No. 1% Time: ..~~ Scheduled Inspection Date: Business Name: .~ ~ ~~ Location: T e of Ins action N A Yes No EXITS: ~ Exit Access Exit Enclosure Exit Dischar e EVAC Plan AISLES: Main Aisle Width Secondar Aisle Width EXIT SIGNAGE Si n -normal Si n -batter EVAC si ns in rooms TRUSS ID SIGNAGE EMERGENCY LIGHTING FIRE EXTINGUISHER: Hun Ins action of extin uisher H dro extin uisher FIRE ALARM SYSTEM Fan Shutdown ' Fire S rinkler S tam Fire Su ression -kitchen Fire Su ression -Gas Island Hood Installation Interior Finishes Stora e Com ressed Gas Clearance to S rinklers Clearance to Electrical Electric Wirin Enclosed Combustible Waste Vehicle Im act Protection CC Fire Lone ~ F.D. Si na e - Utifit Rooms ' No Smokin Si ns Maximum Occu anc Sin ~'C Emer enc Evacuation Plan COMMENTS P ~ \ ~~ Z ~~`~ ~~f s ~ Q f ~c~-uP ~ ~. ~~ s R c.P~c,~. ~,~ on Qwt i'~ l.c.~4~ C~s~''to"- ~~~~ ~~~, ~~~,CF~-, l~or 1 ~ ~~ !~~ ~OC+'L OY1 ~~ o Approved (If no other approvals apply, the B & C Office will issue the Certificate of Occupancy) `Denied Call for Recheck Inspected y: L:\RreMarshal\insptopermitto occupyform.doc Inspection for' Permit to Occupy ~` Fire Marshcl's OffIC@ Re uest Recd Permit No. `~ ~~ '^ O v a Town of Queensbury 742 Bay Road ~y ~/? G~ ~V Queensbury, NY 12804 Scheduled Inspection Date: Time: .~' Phone: (518) 761-8206 Business Na e: / Fax: (518) 745-4437 Location:~~ ~~:Glti. - T e of Ins action N A Yes No EXITS: Exit Access Exit Enclosure Exit Dischar e EVAC Pian AISLES: Main Aisle Width Secondar Aisle Width EXiT SIGNAGE Si n - normgl Si n -batter EVAC si ns in rooms TRUSS ID SIGNAGE EMERGENCY LIGHTING FIRE EXTINGUISHER: Hun Ins action of extin uisher H dro extin uisher FIRE ALARM SYSTEM Fan Shutdown Fire S rinkler S tam Fire Su ression -kitchen Fire Su ression -Gas Island Hood Installation Interior Finishes Stora e Com ressed Gas Clearance to S rinklers Clearance to Electrical Electric Wirin Enclosed Combustible Waste Vehicle Im act Protection Fire Lane F.D. Si na e - Utilit Rooms No Smokin Si ns Maximum Occu anc Si n Emer anc Evacuation Plan COMMENTS Fire Marshal Ins~ppeeclion Complate OK to Issue Certiificate of Occupancy N 14 2007 ~pproved (If no other approvals apply, the B s, C Office will issue the Certificate Occupancy) ^ Denied ^ Call for Recheck Inspect d By: L:\FireMarsha{\insptopermitto occupyform.doc