CO-0176-2022 Apr 12 22 07:25a Todd Heym 5183383M p.3
CERTIFICATE OF OCCUPANCY ONLY office Use only
APPLICATION permit#: C4-_01 I-b - Zo 2-2—
Permit Fee:
ronv W(twoulwry
742 Bay Road,queensbury,NY 12804 Invoice le• _4���
P:518-761-82Q6 or S18-761-8205 www.aueensburv.net
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"This application is for occupancy only, with no work requiring a building permit"
BUSINESS INFORMATION: { -
Name of business:
Business Address (induding suite,space,etc.): 1 ua.lf.•� (�saal �
SwAp—
Detailed explanation of business(attach a separate piece of paper, if necessary):
ur .SGt)OC1 -
--.-- Plame provide an wAwaW Iayolult of yow space dWWhp
A waft, cats, stockrooms, Est rooms, COVISters and MUMS
on a separate sheet of paper
IMPORANT:The business owner is responsible for keeping exits dear 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 MarshaPs 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.
Applicant name: 1 OAci �^^^"
Applicant signature: Date: G4Z-
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Property Owner name: LZ + n�Ewu�s✓2 L �-
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Property Owner signature;. . : — :. . y ' Date:
CertiE'icate of occMancy_Oniy �V10 :i;- _ Revised Febmary2022
Apr 12 22 07:25a Todd Heym 5183383649
p.3
CERTIFICATE OF OCCUPANCY ONLY office use only
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APPLICATION permit#:f-o1 i-lo • Zo 22 .
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r4H'71 Ld(,hMCA+lW►Y
Permit Fee:$
742 Bay Road Invoice
,Queensbury,NY 12804
P:518-761-aZ06 or 518-761-8Z05 www.aueensbury.net
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"This application is for occupancy only, with no work requiring a building permit"
BUSINESS INFORMATION: 0
Name of business: f�
T a►/1eird�b
Business Address (including suite, space, etc.): jk uk (�ao� c�• y
Detailed explanation of business (attach a separate piece of paper, if necessary):
*' *Please provide an wxwate Iayont of yow space showing
A wags, exks, stockrooms, rest rooms, comtters and tktu res
on a separate sheet of paper***
1MPORANT: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.
Applicant name: -7d&U 6A'\
Applicant signature: 9Date: 4� ZL—
Property Owner name: k
Property Owner signature: ; _F .. tir,�.,<�^� ri Date:
certificate of Dccupancy OnV TOWN! OF( 8 .+,+ ,� �� Revised February 20Z2
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Apr 12 22 07:25a Todd Heym
5183383649 p 4
!«aTi of c Za eu>hun
742 Bay Road,Queensbury,NY 128Q4
P:518-761-8206 or 518-761-8205 www.gueensbury.net
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
r
Name(s): I Od + T6tyrin r'1
Mailing Address,C/S/Z: 'is- L-warvf 7ra"t G-Krs"04-t
Cell Phone: ( SW Cob- 1g5Z1 Land Line. i VK
Email:_ +r-h.E4M IQ .04.00. LD&IN
• Business Ownerts
Contact Name(s): A-L,.
Mailing Address, C/S/Z:
Cell Phone:_( ) Land Line: _(
Email:
• Manager:
Contact Name(s): �tcrl�e„
Mailing Address, C/S/Z:
Cell Phone:_( ) Land Line: _(�)
Email:
• Property Owneds):
Business Name: ctriydi Qcir}s
Contact Name(s):
Ida i I i� add,�s .._.�j_..��r�Wt Jan 60mItvArd
Apr 12 22 07;26a Todd Heym 5183383649
p.5
Town 4d'(kgmcn.%l1ur.
742 Bay Road,Queensbury,NY 12804
P:518-761-8206 or 518-761-8205 www.gueensbuty.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: 1I ZOz�
Business Name: Lo �d;de 4at-r 6 D
Business Location (including suite,space,etc.): l I -a ICI '4"- n- ecA
Business Phone#: S( k— g�
1. Business contact name:.
Main phone:_( 51V ) a{yp 1yL-14 :Secondary Phone:_( SIB'_ } 2*0 S97`�
Comingfrom what town/village? &Las
2. Business contact name: �7rrygp .
Main Phone:_(_� ;Secondary Phone:
Coming from what town/village?
TOWN OF QUEENSBURY FIRE MARSHAL'S OFFICE
P:51&761-6206 F: 518-745.4437
F1 REMARSHAL@QUEENSFiURY.NE-r
FIRE MARSHAL MIKE PALMER DEPUTY FIRE MARSHAL TYSON CONVERSE
Certificate of occupancy only Revised February 202-2
FIRE MARSHAL'S OFFICE
Tozon of Queensbury
742 Bay Road, Queensbury, NY 12804
"Home of Natural Beauty ... A Good Place to Live ,'
PLAN REVIEW
En Pointe Hair
118 Quaker Road
CO- 0176-2022
4/12/2022
The following comments are based on a review of submittals:
• Verify fire extinguisher location and inspection
• Verify location of exit/Emergency lighting. Function test will be required
• Lock/ latches shall comply with Chapter 10 of 2020 IFC.
• Verify paths of egress
• Verify storage
• Verify clearances to electrical service panels
• CO detection is required, if source is present
• Knox Box key is required
Michael J Palmer
Fire Marshal
742 Bay Road
Queensbury NY 12804
firemarshal@queensbury.net
Fire Marshal 's Office - Phone: 518-761-8206 Fax: 518-745-4437
.firemarshal fteensbui2j net - zvww.queensbury.net
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Apr 12 22 07:25a Todd Heym 5183383649 p.2
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En Pointe Hair Studio
118 Quaker Rd TOWN OF QuEENCertificate of Occupancy �u��a« c'
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