2004-985 TOWN OF QUEENSBUIRY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development Building & Codes (518) 761-8256
CERTIFICATE OF _OC UPANCY
Permit Number: P20040985
- -. ..Date Issued: Tuesday, February 22, 2005
This is-to certify thatw.ork requested to be done as shown by Permit Number P20040985
has been completed.
Tax Map Number: 523400-302-007-0001-045-001-0000
Location: 138 QUAKER Rd
Owner: . . . GARY & SUSAN HIGLEY
Applicant; KERRY V. GIRARD, CPA
- This structure may be occupied as a:
- By Order of Town Board
Certificate of Occupancy (COM) TOWN'OF QUEENSBURY
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040985 Application Number: A20040985
Tax Map No: 523400-302-007-0001-045-001-0000
Permission is hereby granted to: KF,RRY V. Cr1RARD- CPA
For property located at: 138 QUAKER Rd
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. Tyne of Construction Value
Owner Address: GARY& SUSAN HIGLEY
31 CHESTNUT Rd� Certificate of Occupancy(COlvl)
Total Value
QUEENSBURY, NY 12804
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2004-985 KERRY V GIRARD, CPA
CERTIFICATE OF OCCUPANCY
$0.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Thursday, January 05, 2006
(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 Queen n y, January 05, 2005
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
BP File#
] evv 10uSi11eSS
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@th®is permit.
I @/ E®
DEC 2 :3 2004
I TOWN OF QUEENSBURY
Name of Business: I e-rr`j V. G iV-Cur ILDING AND CODE
Address: 3 � C>
Person in Charge or Manager:
Business Phone Number:
Type of Business: (i.e., mercantile,restaurant,hobby shop,plumbing store):
y1
Owner of Property: o o -5 C f"-; �" -t' "� 'k ck� .
Address: '� er Rd. G&ke er `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 ofpaper.
Signatur Date: 12 CA Co)
of person submitting t is form:
Property Tax Map No.
1
Notes/Comments:
c;�b�RNS
Town of Queensbury RECEIVED
Fire Marshal's Office
D W C 2 3 20C4
EMERGENCY CONTACT UPUW uRv
LTRS 2000
TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 143-2502
PLEASE PRINT
DATE: I�W6
I
?-S-
BUSINESS NAME:
BUSINESS ADDRESS:
BUSINESS PHONE: S'1?__111 - -t-2)402-
-HOME
CONTACT 1: Eerr\jV. Grard PHONE q �
ADDRESS: :3 Q OIL Ave,, .Ue r-96 r\1 N
s a
HOME
CONTACT 2: C-Tor\ ! ', PHONE 19 o - H9 1
ADDRESS: Chelcs nu
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
PERSONNEL.
Fire Marshal Steve Smith, Deputy Fire Marshal Mike Palmer
Phone 761-8205, FAX 745-4437
Town of Queensbury
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# ��`Q B INSPECTION ON: '�
Name: "�'�'�`� �� - �%3v AM PM ANYTIME
e
Location: uq,5 Cbfw`�
APPROVED
N/A. YES NO COMMENTS
EXIT ACCESS
EXIT ENCLOSURE
EXIT DISCHARGE
MAIN AISLE WIDTH C /
SECONDARY AISLE WIDTHEXIT SIGN-NORMAL
_
EXIT SIGN-BATTERY Pe C Qc,i� A4u--S�-1 4 A
EMERGENCY LIGHTING
FIRE EXTINGUISHER HUNG IS G✓���
FIRE EXTINGUISHER x
INSPECTION
FIRE EXTINGUISHER HYDRO
FIRE ALARM SYSTEM
FIRE ALARM -FAN SHUTDOWN
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION-KITCHEN
FIRE SUPPRESSION—GAS
ISLAND �C
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.SIGNAGE—UTILITY ROOMS
NO SMOKING SIGNS
MAXIMUM OCCUPANCY SIGN
EMERGENCY EVAC PLAN
OK THIS DATE OK F O NOT OK
INSPECTED BY
COMDEV/CHRISJNVORDILETTERS2001IFIREMARSHALINSPECTIONREPORT11022001
WHITE—BUILDING DEPARTMENT COPY YELLOW—OCCUPANT COPY
Town of Queensbury f�
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:
I �t
Name: � (1'n � I Nah �� A PM ANYTIME
Location: 6%, `Qv
APPROVED
N/A YES NO COMMENTS
EXIT ACCESS
EXIT ENCLOSURE
EXIT DISCHARGE
MAIN AISLE WIDTH
SECONDARY AISLE WIDTH rJ�
EXIT SIGN-NORMAL 1 ' `
EXIT SIGN-BATTERY Ttv\-
EMERGENCY LIGHTING
FIRE EXTINGUISHER HUNG J
FIRE EXTINGUISHER
INSPECTION
FIRE EXTINGUISHER HYDRO
FIRE ALARM SYSTEM
FIRE ALARM -FAN SHUTDOWN
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION-KITCHEN
FIRE SUPPRESSION-GAS
ISLAND
HOOD INSTALLATION C -F( C,
� n -.
INTERIOR FINISHES 1 Y 0)
STORAGE (�
COMPRESSED GAS
CLEARANCE TO SPRINKLERS �ll I v
CLEARANCE TO ELECTRICAL \�Cf
ELECTRIC WIRING ENCLOSED w
COMBUSTIBLE WASTE
VEHICLE IMPACT PROTECTION
FIRE LANE
F.D.SIGNAGE-UTILITY ROOMS
NO SMOKING SIGNS
MAXIMUM OCCUPANCY SIGN
EMERGENCY EVAC PLAN
OK THIS DATE- O OR CO OT OK
INSPECTED BY
COMDEVICHRISJIWORDILETTERS2001/FIREMARSHALINSPECTIONREPORT11022001
WHITE-BUILDING DEPARTMENT COPY YELLOW-OCCUPANT COPY
Town of Queensbury
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:
1l` ti h h L o w AM PM ANYTIME
/\
Location: i. �� (C- ,V � f
APPROVED
N/A YES NO COMMENTS
EXIT ACCESS
EXIT ENCLOSURE
EXIT DISCHARGE
MAIN AISLE WIDTH
SECONDARY AISLE WIDTH
EXIT SIGN-NORMAL
EXIT SIGN-BATTERY
EMERGENCY LIGHTING
FIRE EXTINGUISHER HUNG
FIRE EXTINGUISHER
INSPECTION
FIRE EXTINGUISHER HYDRO
FIRE ALARM SYSTEM
FIRE ALARM -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.SIGNAGE-UTILITY ROOMS
NO SMOKING SIGNS
MAXIMUM OCCUPANCY SIGN
EMERGENCY EVAC PLAN _
J
OK THIS DATE O F R CO NOT OK
INSPECTED-BY'
COMDEV/CHRISJIWORD/LETTERS20011F IREMARSHALI NSPECTIONREPORT11022001
WHITE-BUILDING DEPARTMENT COPY YELLOW-OCCUPANT COPY
2ba ti '
RECEIVE
TOWN(J� '3BURY
BUILDING AND C,'ODE
Ao
o �
5 MD u�M.
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