Application CERTIFICATE OF OCCUPANCY ONLY Office Use Only
APPLICATION Permit CD — 0(04FL
iu.vll"Q,..vlUhllfl Permit Fee:$ Ilt�`
742 Bay Road,Queensbury,NY 12804 Invoice#:
P:518-761-8206 or518-761-8205 www.gueensbury.net
"This application is for occupancy only, with no work requiring a building permit**
BUSINESS INFORMATION:
Name of business: T;1f, star.,•
Business Address (including suite, space, etc.)y3�736 Upper Glen Street,Queensbury,New York 12804
Detailed explanation of business (attach a separate piece of paper, if necessary): Thewholesaleand
ret,-' sales of crystals,gemstones,minerals,rocks,fossils,and jewelry,or any other product related to the miinn r l�
whole. l{w l`li E
AUG 16 2021
***Please provide an accurate layout of your space showing TOWBUILDING a COD ES
all walls, exits, stockrooms, rest rooms, counters and fixtures
on a separate sheet of paper***
IMPORANT: The business owner is responsible for keeping exits clear and maintaining exit
signs and emergency lights. Fire extinguishers, fire sprinkler systems, and fire alarm systems
require annual inspections by an outside contractor and the corresponding documentation
must be provided to the Town of Queensbury Fire Marshal's office. Fire extinguishing
systems found in kitchens and gas stations require semi-annual inspections. Any violations
noted during an inspection require immediate corrective action and a re-inspection.
brow6/C�
Applicant name:
Applicant signature: Date: 312oz j
Property Owner name:'P.,,J—C/—Nq,�bro03f"-
Property Owner signature: o�"f Date: Yl/
:3 z,0C'(
Certificate of Occupancy Only Revised December 2020
742 Bay Road,Queensbury, NY 12804
P:518-761-8206 or518-761-8205 www.aueensburv.net
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s): Paul Dombrowski for Hoffman Enterprises
Mailing Address, C/S/Z: 25 Corporate Circle.Suite 100,Albany,New York 12203
Cell Phone: (518)265-4083 Land Line: (518)690-4313
Email: pauld@hoffmanenterprises.com
• Business Owner(s):
Contact Name(s): Toler Poquette.Steven Pugh,and Ashley Poquette d/b/a as The Stone Stash(collectively."Tenant').
Mailing Address, C/S/Z: 730&736 Upper Glen Street,Queensbury,Newyork 12804
Cell Phone: (585)743J144 Land Line:
Email: Thestonestash@gmail.com
• Manager:
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email:
• Property Owner(s):
Business Name: Hoffman Enterprises Contact Name(s): Paul Dombrowski Mailing Address, C/S/Z: 25
Corporate Circle,Suite 100,Albany, New York 12203
Cell Phone: (518)265-4083 Land Line: (518)690-4313
Email: pauld@hoffmanenterprises.com
Contact Person for Compliance in regards to this project:Paul Dombrowski Cell Phone:(518)265-4083 Land
Line: I513) 670-4 13
Email: pauld@hoffmanenterprises.com
Certificate of Occupancy only Revised December 2020
/]n.n d t Lxrn.hnri
742 Bay Road,Queensbury, NY 12804
P: 518-761-8206 or518-761-8205 www.gueensbury.net
EMERGENCY CONTACT INFORMATION
"THIS FORM IS USED TO ASSIST EMERGENCY SERVICE PERSONNEL WHO MAY BE CALLED TO YOUR
BUSINESS AFTER HOURS. PLEASE BE SURE THE CONTACTS LISTED BELOW ARE WILLING AND
AVAILABLE TO REPSOND DURING OFF-HOURS TO ASSIST POLICE AND/OR FIRE PERSONNEL IN
GAINING ENTRY TO YOUR BUILDING."
PLEASE BE ADVISED THAT FAILURE TO ASSIST EMERGENCY SERVICE PERSONNEL MAY RESULT IN
DAMAGE TO YOUR BUILDING BY POLICE AND/OR FIRE PERSONNEL.
Date:August 3,2021
Business Name:The Stone Stash
Business Location (including suite,space,ett.): &736 Upper Glen Street,Queensbury,Newyork 12804
Business Phone#:
1. Business contact name: Tyler
Main Phone:(518)585-7144 ; Secondary Phone:
Coming from what town/village? Hartford
2. Business contact name: Steve
Main Phone: (518)795-0395 ;Secondary Phone:
Coming from what town/village?Queensbury
TOWN OF QUEENSBURY FIRE MARSHAL'S OFFICE
P: 518-761-6206 F: 518-745-4437
=1REMARSHAL1@QUEENSBURY.NE7
FIRE MARSHAL MIKE PALMER DEPUTY FIRE MARSHAL GARY STILLMAN
Certificate of Occupancy Only Revised December 2020
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736 Glen St
Certificate of Occupancy m retail space
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MAP REFERENCES LANDS N/F OF 8
BUILDINGJ ROARING BROOK,LLC �IPF
1 _ ° °
MAP OF LANDS TO BE ms N50°O2'O:O"� /A, +//
EXCHANGEDBETWEEN 6 162.11'; % i N
LEWIS R.DeANGELIS AND
ABRAHAM RUDNICK „ / i / / =tip j LANDS N/F OF N
BY:COULTER BMcC0RMACK / �'�� / NIAGARAMOHAWK
DATED:FEBRUARY 12,1981 I� z / /'- !� -" / / ! POWER CORPORATION
I �\
s /
GLENS FALLS-LAKE GEORGE
S.H.No.417
MAP No.157 PARCEL No.192
ABRAHAM RUDNICK - f zs :•' `J�
BY:COULTER 3 MCCORMACK
DATED:FEBRUARY 12,1981 AREA
63,752.26 Sg. }1. 9T�pfq�gNs�6,�
_ r\ Nc Ff a
1.46 acres ASPHALT !foN00
L <o SURFACE "\i" js p9s�N
BOLLARDS 54 d >
a�za 1 STORY @ -.
® = 3 CONCRETE BLOCK P�4 i
r`, \ASPHALT -CONCRETE �' n
� �f! }
T o o\S U R FA C E /p`!O 1 2021 jJJJiii
l�1 • RAMP a �Ld fj
TO!/{jLtl OF QUEbVS
2B-B POST BUILDING PROPOSED °�°\ IPF BUILDING 0 CODE
NT AREA ASPHALT \°
TENA ,_`� \ SURFACE
oo
20'WIDE VEHICULAR AND PEDESTRIAN
EIiSEMENi AS PER DEED BODII 6b6 0
/ AT PAGE 251 It,
194.41 9.J5 / O E � � p500 Do
NOTE:CROSS-HATCHED AREAS INDICATE 5 / S50°020Q. N
AREAS OF CROSS EASEMENTS GRANTED IN / /f� ! ,\ ��'. 0 2.79' SHED //
EASEMENT AGREEMENT IN BOOK 6660F J / 1 \\\• '/3.31'
DEEDS AT PAGE 251. •/l \ - \ / ° / IPF
PROPOSED \ 173.73' o
TENANT AREA ,:/ / ' s5o°oa' I
/ 00 ° N/F OF
I ° -
lBUILDING �� LAN CANALS
I - LANDS N/F OF -
I HEREBY CERTIFY THAT THIS MAP WAS PREPARED , DECOGLEN
FROM AN ACTUAL FIELD SURVEY. /
THIS CERTIFICATION SHALL RUN ONLY TO THE PERSONS '
FOR WHOM THE SURVEY WAS PREPARED,AND ON THEIR
BEHALF TO THE TITLE COMPANY,GOVERNMENTAL AGENCYj-
AND LENDING INSTITUTION LISTED HEREON. -
CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL � -'" "• '' :;'� ��
INSTITUTIONS OR SUBSEQUENT OWNERS.
CERTIFIED TO: 736 UPPER GLEN STREET,LLC
THE ADIRONDACK TRUST COMPANY,IT'S SUCCESSORS AND/OR ASSIGNS - r/
UNITED GENERAL TITLE INSURANCE COMPANY _ - 111VVV J
ABRAHAM RUDNICK _ / - - — LEGEND
/ L-1 IPF®=IRON PIPE FOUND
-' NFO =NAIL FOUND
CERTIFIED BY: - ". =LAMP POST
MATTHEW C.STEVES,LLS NYS 50135 --�=UTILITY POLE
DATED:JANUARY 3,200 C=MANHOLE
--0 °—JANUARY 12,2006 ---��----- - =METAL FENCE LINE
m=GAS VALVE
OL "I a o xa DSDa sE x — -- -- — --_ -- ----- — Date January c. 2007--
"E�'CENEDL""D Map of a Survey made for m'DF SED,��,,._Dp.SpB—q„„Dx52. rxEa Scate 1"=30'
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TO„ME PERSDx EDR WHOM 11E 5D 1 13 --__--
169 Haviland Road Queensbur New York 12804 D aS0EES0E,„-,„D,ND,xs`D"`"°""" „D I Town of __ _
y - „a, Queensburg, Warren County, New York CROSS EASEMER TS SHEET 1 OF 1
518 792-8474 1 1 1112106 CEP TS. 736 Glen St,LLC
New York Lic. No. 50135
N0. BATE DESCRIPTION DWG.N0.06314 C1965
302.6-1-53/103-1-24