2010-348 t1
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20100348-37025 Date Issued: Tuesday, August 3, 2010
This is to certify that work requested to be done as shown by Permit Number P20100348-37025
has been completed.
Tax Map Number: 303.16-1-61 FILE C
op y
Location: 438 DIX#32391 AVE
Owner: Maplewood Ice Co Inc
Applicant: Looks by Lacey
This structure may be occupied as a:
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 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
I ON
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20100348 Application Number. A20100348
Tax Map No: 523400-303-016-0001-061-000-0000
Permission is hereby granted to: LOOKS BY LACEY
For property located at: 438 DIX Ave #32391
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: MAPLEWOOD ICE CO., INC.
#32391 Certificate of Occupancy(COM)
PO BOX 62 Total Value
WHITEHALL,NY 12887-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans &Specifications
2010-348
LOOKS BY LACEY - C/O only for salon
$0.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Wednesday,July 20, 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 T y6o eens)9ry;>Q ftjhei. , my 20,2010
SIGNED BY L4),„/:14/7Y tl J/ for the Town of Queensbury.
&
Director of Building Code Enforcement
fip,;o /0 -3,1
-17", Community Development Office
Town of Queensbury ' 742 Bay Road • Queensbury, New York •12804
ate
Stamp
•David Hahn,Director of Building&Codes
Craig Brown, Zoning Administrator-Michael J. Palmer, Fire Marshal
ESTABLISHMENT OF A NEW BUSINESS
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION
303 -61
TAX MAP # BLDG. PERMIT FILE# ��' rlqk
applicable
lic ble
I y� I-,
Name of Business: F 1� ,f�/1 LU CL V)
Aof Buddresinessss: 1.1 31R
X��\/
wortbolvt. N_9
I QUESTIONS? CALL 761-8256 OR
EMAIL codesAaueensburv.net
VISIT OUR WEBSITE FOR MORE
Person in Charge or Manager: il Q I\)Q,� INFORMATION
www.aueensburv.net
Business Phone Number: )ragiB
Type of Business: JetkOY)
Owner of Property: QJ' vim() Phone Number(s): 63
Home Cell
Owners TV ,q�/ �
Address: U ktuj I l,K `Y�O t I� 1 ►Y� (l i 4 N19 1i
Pleaserovide an accurate layout yout of your store showing all walls, exits, stockrooms, rest rooms,
counters and fixture layout on a separate sheet of paper.
0 NIA) & 1 »
Signature: 9(1 Date: rl
Of pers• thing this form
Notes/ Comments:
o
M_ND \e,q 'v
*Note: This application is for occupancy only, with no work requiring a building permit. No fee required for this permit
,..naafi
SPAM 3)—IV
EMERGENCY CONTACT UPDATE
TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 743-2502
PLEASE PRINT 710
DATE: I/O
BUSINESS NAME: ) QO(s b.4 Am)
BUSINESS ADDRESS: ; ..tom �Q, • Ai 1 '
KA
BUSINESS PHONE: 1.93L 32-V
HOME CONTACT 1: I�IQfhW'I O' PHONE D` -3a5
ADDRESS: r 10.41 O1 �' O t 1..8c)1
CONTACT 2: MO,Yy fity) c_trykb PHONE 101 _
Lvt 1 - a.05r,
ADDRESS: ei IIT om/ I It I y �� t�� k
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
firemarslud@queensbury.net • www.queensbury.net
Inspection for Permit to Occupy
Fire Marshal's Office Request Rec'd Permit No.( 2/V 7"•••;9/0
Town of Queensbury ,,/✓
742 Bay Road �7 7i-/U �� cf`�S
Queensbury,NY 12804 Scheduled Inspection Date: /� Time:
•
Phone: (518) 761-8206 Business Name: 4;6 hy 2,e ey
Fax: (518) 745-4437 Location: 3f3 L7 /71,
Type of Inspection N/A Yes No
EXITS:
Exit Access
Exit Enclosure 4.// COMMENTS
Exit Discharge 6,//
AISLES:
Main Aisle Width ✓
Secondary Aisle Width 6,
EXIT SIGNAGE /
Sign-normal f/
Sign-battery 6.�
EVAC signs in rooms
TRUSS ID SIGNAGE //
EMERGENCY LIGHTING
FIRE EXTINGUISHER:
Hung //
Inspection of extinguisher �f�
FIRE ALARM SYSTEM y
Fan Shutdown il
Fire Sprinkler System (FDC)
Fire Suppression-kitchen 1/,
Fire Suppression-Gas Islan i
Generator /%
Hood Installation f
Elevator
Interior Finishes Vi
Storage '/
Compressed Gas t./Clearance to Sprinklers
Clearance to Electrical /
Electric Wiring Enclosed/Labeled
Combustible Waste v
Vehicle Impact Protection
Knox Boxl F.D.Signage-Utility Rooms
No Smoking Signs
Maximum Occupancy Sign
Emergency Evacuation Plan
Approved (If no other approvals apply,the B&C Office will issue the Certificate of Occupancy)
❑ Denied / call for Recheck ,,//
Inspecte' By: AiI
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