2011-119 4111114ki TOWN OF QUEENSBURY
742 BayRoad,Queensbury,NY 12804-5902 518 761-8201
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Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20110119 Date Issued: Wednesday, May 25, 2011
This is to certify that work requested to be done as shown by Permit Number P20110119
has been completed.
Location: 430 DIX Ave
Tax Map Number: 523400-303-016-0001-062-000-0000
Owner: WESLEY & VICKI VEYSEY
Applicant: LOOKS BY LACEY
This structure may be occupied as a:
Certificate of Occupancy (COM) By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the
property owner of the responsibility for compliance with Site Plan,
Variance, or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
` 742 Ray Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20110119 Application Number: A20110119
Tax Map No: 523400-303-016-0001-062-000-0000
Permission is hereby granted to: LOOKS BY LACEY
For property located at: 430 DIX 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: WESLEY &VICKI VEYSEY
61 MC ARTHUR Dr Certificate of Occupancy(COM)
QUEENSBURY,NY 12804 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2011-119
LOOKS BY LACEY - CO only - HAIR SALON
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday, April 20, 2012
(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 T(wn of ueert ry)/ / nesday, April 20, 2011
BY "vv
�, `a` for the Town of ueensbu
SIGNED Q ry
Director of Building&Code Enforcement
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Community Development Office
Town of Queensbury • 742 Bal/ Road • Queensbury, New York •12804 Date_Stamp
l.7apid 11atin, Director of Building&Codes
Craig Brawn,Zoning Administrator•Michael J. Palmer, Fire Marshal
NEW BUSINESS CERTIFICATE OF OCCUPANCY PERMIT
APPLICATION
TAX MAP # 7--;)3 �'. �Q BLDG. PERMIT FILE#
If appl le
Name of Business: Lcfl VL Lac /
AOfdBsIsneSS: - 3U 2 ve, t)4-4 N Jy QUESTIONS? CALL 761-8256 OR
EMAIL codes@queensburv.net
R WEBSITE
Person in Charge or Manager: Wu, �,I I VISIT OU INFORMATION FOR MORE
JJJJ www.queensburv.net
Business Phone Number: LQv2)2_483� — '
Type of Business:
Owner of Property: (1.)QS Ie VQ( �( Phone Number(s): `i 2.—(03(14 (gq— 89 2-2.
Home Cell
Owners
Address: C t Olcturty--hur br, CLvS 10,6
Please provide an accurate layout of your store showing all walls, exits, stockrooms, rest rooms,
counters and fixture layout CkI7 a separate sheet of paper.
Signature: U.I1 1 1W Date: ,2) 1 Of person submng this form
Notes/ Comments:
/7-/ I ?
EMERGENCY CONTACT UPDATE
TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 743-2502
PLEASE PRINT
DATE: 3 I 1 < <
BUSINESS NAME: l 00 K3 O l CIC-et
BUSINESS ADDRESS: L� L, )c V`2. Ut % I V I j '2Bv l
BUSINESS PHONE: ly SQ - 32i 8
�nn /� NOj ) HOME �CONTACT 1: 1\ Vk 1 O^ r PHONE 22Z- 3 Q 5
ADDRESS: 511 2- FI n\Vse.) wy( U fton N,l 122z/
HOME
CONTACT 2: PHONE
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 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.
TOWN OF QUEENSBURY FIRE MARSHAL'S OFFICE
P 1r o n e: 518-761-8206 • F a x: 518-745-4437
firemarshnl@queensbury.net • www.queensbury.net
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Inspection Form
Town of Queensbury Fire Marshal O Periodic Inspection Date: Time: ICJ
742 Bay Road,Queensbury NY 12804 o Re-Inspection
518 761 8206/518 761 8205 'ms.CO Inspection Permit#:
irearshals Representative
- MJ Palmer Business Name:entatS 67 L c j
Location: -! 3c) `D i(Y P1/4.i
_ GK Stillman Contact: L--PC I c&ED
/
Type of Inspection N/A Yes No
EXITS: Exit Access FC 1014&FC1029 NOTES
Exit Enclosure FC 1020&FC1029
Exit Discharge FC 1024&FC1029
Locks and latches FC1008& FC1029.2
Sign:Normal FC 1011 &FC1029
Sign:backup FC 1011.5.3&FC1029.7.5
AISLES:
Main Aisle Width FC 1024/1025&FC1029.11 , (,
Secondary Aisle Width FC 1025&FC1029.11 >♦' \_ ._. .--N--`---- .'C
FIRE EXTINGUISHER: Hung FC 906 r
Inspection of extinguisher FC 906
EVAC Plan FC 404.6 C6w 11 1 5 T rrll
TRUSS ID SIGNAGE FC 505.3
EMERGENCY LIGHTING:
Interior FC 1006.3&FC1029.8
Exterior FC 1006.3
Clearance to Electrical FC 605.3
Electric Wiring Enclosed/Labeled FC 605.3.1
Combustibles in Equipment Rooms FC315.2.31-_ / j0
F.D.Signage- FC 510 l L
No Smoking Signs FC 310.3
Storage FC 315.2
Compressed Gas FC 3003
Vehicle Impact Protection FC 312.1
Interior Finishes FC 803 -804
Smoke Detectors FC 907
CO detectors FC 610
Clearance to Sprinkler/Ceiling FC 315.2.1
18" / 24"
EVAC SIGNS IN Rooms FC 404.6(R1 & R2)
Fuel Pump Warning Signs FC2205.6
Fuel Station Emer Procedures FC2204.3.5
Exterior Storage FC 315.3 REINSPECTION DUE APPROXIMATELY
Vacant Buildings FC 311
21 DAYS
SYSTEMS: FC 901.6 Insp OK NC DATE: OK NC
Date
Generator Annual DATE: OK NC
_ Hood Installation -
Elevator Semi Annual
FIRE ALARM Annual , DATE: OK NC
HVAC Shutdown
Sprinkler System Annual
Sprinkler FDC
Kitchen Suppression Semi Annual 1 Fire Mamba!In ori Conipie
Fuel Island Suppression Semi Annual OK to)ssue Cprtl icate of Occupancy
Hood Cleaning 3-6 -Annual
Knox Box:installed/checked FC506
MAY - i 1
Operating Permit, if required will be issued after si
Completion of Inspection . -----4-
Fire Marsha,
c,....,. tea •. 0 ueensbu
Inspection Form
Town of Queensbury Fire Marshal Periodic Inspection Date: 4///
742 Bay Road,Queensbury NY 12804o Reinspection
518 761 8206/518 761 8205 , CO Inspection Permit#: 2,41/7- /7/-
Fire Marshals Representative
MJ Palmer Business Name: 5 �y/G/r-
V; Location: j2 U-1--, 7---
r
GK Stillman Contact: /,',//1 /
Type of Inspection N/A Yes No
EXITS: NOTES
Exit Access FC 1014
Exit Enclosure FC 1020
Exit Discharge FC 1024 t,,
Sign Normal FC 1011 ,,
Sign backup FC 1011.5.3 ,
AISLES:
Main Aisle Width FC 1024/1025
Secondary Aisle Width FC 1025 •
FIRE EXTINGUISHER:
Hung FC 906
Insp of extinguisher FC 906
EVAC SIGNS IN Rooms FC 404.6 -✓
TRUSS ID SIGNAGE FC 505.3
EMERGENCY LIGHTING:
Interior FC 1006 ,
Exterior FC 1006
Clearance to Electrical FC 605.3
Compressed Gas FC 3003
Knox Box FC 506 }
F.D.Signage- FC 510
/
No Smoking Signs FC 310.3 � l v
Storage FC 315 t,- - t1"i/��.,, ri Vd 571 1/
Electric Wiring Enclosed/Labeled FC 605.3.1H4-,1/1"1•
P.2 _ )
Vehicle Impact Protection FC 312.1 l
Interior Finishes FC 803-804
Smoke Detectors FC 907 ) KO
CO detectors FC 610 '- �(� 1 1G C_71,�; 4 I! y&.71L.�i�,�
Clearance to Spr./Ceiling FC 315.2.1
18"/24" ) v7-5 O e" d iSW 2
Exterior Storage FC 315.3 „-
Operating Permit
Vacant Buildings FC 311
REINSPECTION DUE APPROXIMA TEL Y
21 DAYS
SYSTEMS: FC 901 Insp OK NC DATE: OK NC
Date
Generator Annual DATE: OK NC
Hood Installation
Elevator Semi Annual
FIRE ALARM Annual V DATE: OK NC
HVAC Shutdown
Sprinkler System Annual
Sprinkler FDC
Kitchen Suppression Semi Annual
Fuel Island Suppression Semi Annual
Hood Cleaning 3-6
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