2010-170 gait TOWN OFQ UEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20100170 Date Issued: Friday, May 21, 2010
This is to certify that work requested to be done as shown by Permit Number P20100170
has been completed.
Location: 1019 STATE ROUTE 149
Tax Map Number: 523400-266-003-0001-081-000-0000
Owner. KEVIN QUINN
Applicant: BLUE ROOF CAFE & BISTRO
This structure may be occupied as a:
Certificate of Occupancy(COM) By Omer 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 :
Dire r of Building& G� . :` ement
Planning Board or Zoning Board of Appeals.
" TOWN OF QUEENSBURY
cw 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20100170 Application Number. A20100170
Tax Map No: 523400-266-003-0001-081-000-0000
Permission is hereby granted to: BLUE ROOF CAFE & BISTRO
For property located at: 1019 STATE ROUTE 149
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: KEVIN QUINN
NAOMI POLITO Certificate of Occupancy(COM)
PO BOX 4133 Total Value
QUEENSBURY,NY 12804-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans &Specifications
2010-170
BLUE ROOF CAFE &BISTRO - C/O ONLY
$0.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Saturday,April 30, 2011
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the own of ee u71
/rr. . pril 30, 2010
All -1
SIGNED BY \ for the Town of Queensbury.
Director of Building&Code Enforcement
u- , b
f
Community Development Office ; r
tl Town of Queensbury • 742 Bay Road- Queensbury, NewYork •12804 APR , `
•David Hatin,Director of Building&Codes ; ;;
Craig Brown,Zoning Administrator•Michael J. Palmer, Fire Marshal :.
ESTABLISHMENT OF A NEW BUSINESS
CERTIFICATE OF OCCUPANCY PERMIT APPLICATION
TAX MAP# L �— g — / — #g 1 / BLDG. PERMIT FILE# /&170
If
Name of Business: 3-0Li &5 t- o j�1 w.e-t - ° rjn S 12E
Address /14, (.6
C�
of Business: /0/°1 v<E `1'f l, kF",y�i-I�71 ,/ 4/'-'7. 44- QUESTIONS? CALL 761-8256 OR
EMAIL codesc aueensburv.net
‘, ,
!�/ VISIT OUR WEBSITE FOR MORE
Person in Charge or Manager: //- '� Keil T INFORMATION
www.aueensburv.net
Business Phone Number: £e ( / 6- gl6$) --6tc(‘,...e ,C 1-17,�
Type of Business: n e r �
DI /1 1,ts1 S ir -j
0 ('W
)1A-11,-t.,0 cl,),yi,--:1 ') P1A-t, x OAT 1,J-e -' .1V
i i/
Owner of Property: 1. .//AI 0.ia "Id • Phone Number(s): .*a'- 1'/ 3 •:f-'/
Home Cell
Owners
Address: ,Z69-71/6,(' ovs /6S 6 '� 1 p4.eF 9ec,it E r\/`--1 (2.g44f -
Please provide an accurate layout of your store showing all walls, exits, stockrooms, rest rooms,
counters and fixture layout on a separate sheet of paper.
Signature: -i---
- Date: C340-V-20/C
Of person submitting this form
Notes I Comments:
*Note: This application is for occupancy only, with no work requiring a building permit. No fee required for this permit
EMERGENCY CONTACT UPDATE
TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 743-2502
PLEASE PRINT
DATE: 6/f/ice,/2-6)/D
BUSINESS NAME: �JE Li E Ss-izo
BUSINESS ADDRESS: /0/91 Le- 449 C 4•5a/t y/,A(y 72gOc
BUSINESS PHONE: eel( X3/6-616 Y/6 52iiW ee_ � ,)
CONTACT 1: HOME
`/�i�,L.�� PHONE . /8- /WD` �9�l
ADDRESS: 960�Qi.(oc� , �.�63✓•%7 (/ V /2.gD -.
`/e/f -/e // HOME
/
CONTACT 2: / ' ��-� PHONE -5/8--4`80 6 of
ADDRESS: ,72-9 /1,2„,q, ((y))6-6".d,,5✓,-7 . Y (7 O(
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
firentarshal@queensbury.net • www.queensbury.net
/id
inspection for Permit to Occupy
Fire Marshal's Office Request Rec'd_ Permit No. 60(6//7
Town of Queensbury
742 Bay Road I
Queensbury,NY 12804 Scheduled Inspection Date: - %% Time: i 7
Phone: (518)761-8206 "
Business Name: or
Fax: (518)745-4437 Locafion:___SDI'lam 'S� ,cam �'
Type of Inspection N/A Yes No
EXITS:
Exit Access
Exit Enclosure COMMENTS
Exit Discharge
AISLES:
Main Aisle Width
Secondary Aisle Width
EXIT SIGNAGE
Sign-normal
Sign-battery CIL
EVAC signs in rooms
TRUSS ID SIGNAGE
1CiFIEMERGENCY LIGHTING 01C--
FIRE
RE EXTINGUISHER:
Hung
Inspection of extinguisher
FIRE ALARM SYSTEM
Fan Shutdown
Free Sprinkler System (FDC)
Fire Suppression-kitchen
Fire Suppression-Gas Islan
Generator
Hood Installation
Elevator
Interior Finishes
Storage
Compressed Gas
Clearance to Sprinklers
c(--/ 6C3
Clearance to Electrical
Electric Wiring Enclosed/Labeled
Combustible Waste
Vehicle Impact Protection
Knox Box
F.D.Signage-Willy Rooms
No Smoking Signs
Maximum Occupancy Sign f
Emerge . Evacuation Plan
■ Approved (If no other approvals apply,the B&C Office will issue the Certificate of Occupancy)
u Denied / call for Recheck
Ins• = ed By:,
L:\FireMarshd\FM Forms Masters\permitto occupyform.da:
Inspection for Permit to Occupy_
Fire Marshal's Office Request Recd_ Permit No. i t
Town of Queensbury
742 Bay Road C LI li U
Queensbury,NY 12804 Scheduled Inspection Dote: `� Time:
Phone: (518)761-8206 Business Name: q-' ivy 20A-)+' Ccc 1
Fax: (518)745-4437 Location: I v i c1 at It-I I
Noe of Inspection N/A Yes No
EXITS:
Exit Access
Exit Enclosure , COMMENTS
Exit Discharge
AISLES:
Main Aisle Width
Secondary Aisle Width ek
EXIT SIGNAGE
Sign-normal OC-
Sign-battery PC)
EVAC signs in rooms
TRUSS ID SIGNAGE (/
EMERGENCY LIGHTING -
FIRE EXTINGUISHER:
Hung
Inspection of extinguisher eik.s____
FIRE ALARM SYSTEM
Fan Shutdown 1/'
Free Sprinkler System (fDC) t/'
Fire Suppression-kitchen
Fire Suppression-Gas Nan I/
Generator 1/
Hood Installation Ot-
Elevator
Interior Finishes dr"
Storage Qom.
Compressed Gas GPX-
Clearance to Sprinklers 1.7
Clearance to Electrical g
Electric Wiring Enclosed/Labeled
Combustible Waste
Vehicle Impact Protection 1/1_,,, liC-
Knox Box li
F.D.Signage-Utility Rooms —00✓
No Smoking Signs __L-
Maximum Occupancy Sion OL
Emergency Evacuation Plan AV
❑ proved (If no other approvals apply,the B&C Office MI issue the Certificate of Occupancy)
enied /call for Recheck
Inspec .-,. By: /, 9iIA
_,,„,„,....„-/
L:\FireMarshal\FM Forms Masters\permitto occupyfonme.
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