2003-057 ` 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: P20030057 Date Issued: Wednesday, August 06, 2003
This is to certify that work requested to be done as shown by Permit Number P20030057
has been completed.
Tax.Map Number: 523400-297-008-0001-026-000-0000
Location: "« 5af QUEENSBURY Ave
Owner: ADIRONDACK IP, L.L.C.
Applicant: COUNTRY KITCHEN
This structure may be occupied as a:
By Order of Town Board
Certificate of Occupancy (COM) TOWN OF QUEENSBURY
4 4t
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: P20030057 Application Number: A20030057
Tax Map No: 523400-297-008-0001-026-000-0000
Permission is hereby granted to: COI JNTRY KITCHF,N
For property located at: 537 QUEENSBURY Ave
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: ADIRONDACK IP, L.L.C.
4 WALKER Way Certificate of Occupancy(COM)
Total Value
ALBANY,NY 12205-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2003-057 COUNTRY KITCHEN
CERTIFICATE OF OCCUPANCY ONLY.NO STRUCTUAL WORK TO BE DONE
$0.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Sunday,March 07,2004
(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 Town of Qu nsbury; riday,March 07,2003
SIGNED By
^ for the Town of Queensbury.
1G
Director of Buil g&dolde Enforcement
r
Town of Queen.sb y
Fare MarshvXs Office
EMERGENCY CONTACT UPDATE
LM 2000
TO: WARREN COUNTY SHE RIFTS DEPT. FAM 761-6210
DATE:. PLFASE PRINT
BUSINESS NAME.
BUSINESS ADDRESS: rT
T,
BUSINESS PHONE:
CONTACT PgONE
�/�
TORT RESPONDING FROM:
HOME
CONTACT 2• PHONE
TOWN RESPONDING FROM:
ROME
CONTACT 3r PHONE
TOWN RESPONDING FROM
Fire Marshal Steve ,Smith, Deputy.Fire Marshal Mike Pahner
Phone 761-8205,PAX 74"487
Bp pile#r;003i
Dept. of Community,Development ��� � '�' CENED
Town ofQueensbury 4314ne-CLIPS M40-Y IL3'45x' *4 2003
742 Bay Road
Queensbury,NX 12804 TOWN OF OUEENSBURY
(518) 761-8256 BUILDING AND CODE
For occupancy only, with no work requiring building permit: no fee required for t
MAD,
0 3 26G
TOWN OF QUEENS Y
PLANNING OFFICE
Name of Business: L
Address: 6- 3 Q U9-& ►t Y y E SSE Cr1o,ti
Person in Charge or Manager: CAI? w 7-E 6C
Business Phone Number: 7 5/5-= 7 6,
Type of Business: (i.e.,mercantile,restaurant,hobby shop,plumbing store):
61ST* 1130TZax-) G�ti
Owner of Property: 1j lb I iq ON t1_fg Cj.0 f. L-L c
Address: a93,4 W fi E F w L<A9.4 fit-6111UY iQY 1 aaOS"
Pbone Number:
Please provide an accurate layout of your Store showing all walls,exits,stockrooms, rest rooms,
counters andf future layout on a separate sheet of paper.
Signature- Date:
ofper submittingthisform:
Property Tax Map No.c�q 7 r
Note-/Comments:
1
- Town of Queensbury
Fire Marshal's Office l
742 Bay Road
Queensbury, NY 12804
Phone (518) 761-8205 Fax(518) 745-4437
Fire Marshal's Inspection Report � u 6
Request U -7 SCHEDULE
Received: Permit# r 3- INSPECTION ON: WSMOMMM
Name: f C F/ �� L�/Q{�h0Y, e , AM M I YTIME
Location: ,N U ��-
APPROV D
N/A YE NO COMMENT
EXITS - L 1/`(1`l f�'Eu wG� L I U/-1 � ��L CS`U, Y! L�
AISLE WIDTHS
EXIT SIGNS-NORMAL
- BATTERY
EMERGENCY LIGHTING
FIRE EXTINGUISHERS �� ��- ems} Yam. ��� N `�•me h�i
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM V I
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION
INTERIOR FINISHES5 C
STORAGE V
COMPRESSED GAS x \
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING
UNITS
CL �-O ELECTRICAL
REQUIRED SIGNAGE
EMERGENCY PLAN
MAXIMUM OCCUPANCY SIGN
CHIMNEY
MASONRY ROUGHIN
FINAL
CHIMNEY
FACTORY BUILT ROUGH IN
FINAL
WOOD
STOVE ROUGHIN
FINAL
VENTED GAS
APPLIANCE ROUGH IN
/FIREPLACE FINAL LPT
MASONRY ROUGH INOK TEAS DATE OK �(3 C NOKFINALFIREPLACE
FACTORY BUILT ROUGHIN
INSPECTED BY
FINAL
COMDEV/CHRISJ/WORD/LETTERS2001/FIRE MARS HALT NS PECTIONREPORT11022001
WHITE-BUILDING DEPARTMENT COPY YELLOW-OCCUPANT COPY
-6
RECEIVED
MAR p 4 2003
Bu L®NG AN®CODE
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