2010-405 TOWN OFQ UEENSBURY
For." 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number. P20100405 Date Issued: Friday, September 10, 2010
This is to certify that work requested to be done as shown by Permit Number P20100405
has been completed.
Location: 52 MAIN St
Tax Map Number. 523400-309-010-0002-028-000-0000
Owner. 52 MAIN ST. WEST GLENS FALLS, L.L.C.
Applicant: APEX MFG.
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 rSDAtiP 4
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 nforcement
Planning Board or Zoning Board of Appeals.
��� TOWN OF QUEENSBURY
E. 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20100405 Application Number. A20100405
Tax Map No: 523400-309-010-0002-028-000-0000
Permission is hereby granted to: APEX MFG.
For property located at: 52 MAIN St
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 Queens bury Zoning
Ordinance. Type of Construction Value
Owner Address: 52 MAIN ST. WEST GLENS FALLS
52 MAIN St Certificate of Occupancy(COM)
QUEENSBURY,NY 12804 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans &Specifications
2010-405
Apex Mfg. - C/O only
$0.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Friday, September 09,2011
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the To' • . eensb , Ta a r`a a eptember 09, 2010
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
pp: ,
1 t
f
Community Development Office ,
Town of Queensbury - 742 Bay Road- Queensbury, New York -12804 Date Stamp `
David Hatin,Director of Building&Codes ,'
Craig Brown,Zoning Administrator•Michael J. Palmer,Fire Marshalo
f
ESTABLISHMENT OFA NEW BUSINESS
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION
TAX MAP#3D1 IV-2 , Z3,7 BLDG. PERMIT FILE# 6
If a licab e
1
Name of Business: M i t.LC.
Address 1�A
of Business: c'1, _`ki vt 5$ Q V ee S w N r QUESTIONS? CALL 7614256 OR
EMAIL codesaaueensburv.net
VISIT OUR WEBSITE FOR MORE
Person in Charge or Manager: STYr 14 INFORMATION
p www.aueensburv.net
Business Phone Number: q7-0.53I .1-8 SS
Type of Business: 515 Ftitliittftri'llA bei1 v 51 Li
51
Owner of Property. ,5 po f, i Phone Number(s): t 1.0.S3 I i 7-8Cr
Home Cell
Owners � f Z
Address: 1174
I4 601 PI: II t MI*, AJt'
l 8/
Please provide an accurate layout of your store showing all walls, xits, stockrooms, rest rooms,
counters and fixture layout on441t-
a separate sheet of paper.
Signature: 44-
A'
Date: • 17. IU
Of persthis form
Notes / Comments:
*Note: This application is for occupancy only, with no work requiring a building permit. No fee required for this permit
i -- 1
EMERGENCY CONTACT UPDATE
TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 743-2502
PLEASE PRINT
DATE: CQ
BUSINESS NAME: 4iiN ,
BUSINESS ADDRESS: 204-4,0Av- Queects LAI AA
BUSINESS PHONE: R? . �31 . J!
HOME
CONTACT 1: 5Th1i 841.14--
ONE j'To 531- 1 9-rs'
Tile
604
t;f. 1-j A4 12 8 /1ADDRESS: lu(
� �� HOME
CONTACT 2: rVS'I1lvE- 14`I PHONE q 70.5'31 27-0 7
ADDRESS: 5 - A-1361
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 h o n e: 518-761-8206 • F a x: 518-745-4437
firemarshal@queensbury.net • wwzv.queensbury.net
1
Inspection for Permit to Occupy
Fire Marshal's Office Request Rec'd Permit No.a LOC
Town of Queensbury
742 Bay Road
Queensbury,NY 12804 Scheduled Inspection Date: 1,0 Time:
Phone: (518) 761-8206 Business Name: ')PO( IN‘i'q^
Fax: (518)745-4437 Location: 5-a- 'r`�'N ' ' 4kt
Type of Inspection N/A Yes No
EXITS:
Exit Access a
Exit E closure Vg- COMMENTS
Exit Discharge l.k--
AISLES:
Main Aisle Width OK
Secondary Aisle Width oc(
EXIT SIGNAGE
Sign-normal OIL--
Sign-battery T-
EVAC signs in rooms ---
TRUSS ID SIGNAGE --'
EMERGENCY LIGHTING .--, ; Fire Mel, ificarcf
FIRE EXTINGUISHER: e�of pp(
I JK t0 Issue Oari
Hung 010
Inspection of extinguisher , :r�
0 942,
FIRE ALARM SYSTEM t
Fan Shutdown ! flre Men
el1SbU
Fire Sprinkler System (FDC) L,....--- T -t�-�
Fire Suppression-kitchen
Fire Suppression-Gas Islan
Generator ^^
Hood Installation
Elevator —
Interior Finishes
Storage b
Compressed Gas —. _
Clearance to Sprinklers --
Clearance to Electrical e I,L
Electric Wiring Enclosed/Labeled 0 C.
Combustible Waste et-
Vehicle Impact Protection —
Knox Box
F.D.Signage-Utility Rooms
No Smoking Signs — ,
Maximum Occupancy Sign
Emergency Evacuation Plan '�
Approved (If no other approvals apply,the B& Office wi issue t'e Ce ificate of Occupancy)
o Denied / call for Recheck
Inspected By: ,di,
L:\FireMarshal\FM Forms Masters\permitto occupyform.doc
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1WIV OF QUEENSBURY 1 M. STA-opt bt&EW
WIRE MARSHAL'S OFFICE
REVIEWED BY ryit 5 1 mx (v - c. - TeutP 0
DATE -) (3. 1 0
COMMENTS - - ; CI.2.1n Ufp,15burtt , N`( (A.0.1