CO-0370-2023 E C E 0 V E
JUN 2 7 2023
mc ONLY
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UIL ING & CODES Pernt2-
APPL A
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742 Say Road,Queensbury,Ny 12804 Involct,
P,518-761-97OG or 538-761-8205
"This application is for occupancy only,with no work requiring building permit"
BUSINESS INFORMATION:
Name of business: Kelley's Custom Carts
Business Address(including suite,space,etc.): 1019 State Route 149 Queensbury, NY
Detailed explanation of business(attach a separate piece of paper, if necessary):
Sales, Service and Rentals of golf cars
***Please provide an accurate layout of your space showing
all walls,, exits, stockrooms, rest rooms, counters and fixtures
on a separate sheet of paper***
IMPORANT: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: Chris Kelley
Applicant signature: Date:
Property Owner name: Kevin Quinn
Property Owner signature,
Certificate of Occupancy Only Revised September 2022
741 NNY Road,Queenshury,NY a 2W4
P:536 7G1 E2QGafi53.9-761-2205 ww_1v,ger nn5i,,j y.Liq
EMERGENCY CONTACT INFORMATION
**THIS FORM IS USED TO ASSIST EMERGENCY SERVICE PERSONNEL WHO MAYBE 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:
Business Name: Kelley's Custom Carts LLC
Business Location(including suite,space,etc.): 1019 State Route 149 Queensbury, NY 12804
Business Phone#: 802-779-4669
1. Business contact name: Chris Kelley
Main Phone:_( Z 1 ;Secondary Phone:_( a Z 1 2-S6)-3 11
Contact is coming from what town/village? Belmont, VT
2. Business contact name:
Main Phone:_f 5I1 ) qC1 ` 1051 :Secondary Phone:_( )
Contact is coming from what town/village? QU eCi)SbLt� Aivi
TOWN OF QUEENSBURY FIRE MARSHAL'S OFFICE
P: 51&761.8206 F:516-745-4437
FIREMARSHAL@QUEENSBURY.NET
FIRE MARSHAL MIKE PALMER DEPUTY FIRE MARSHAL TYSON CONVERSE
Certirtute of Occupancy Only Revised September 2022
Air
742 Bay Road,Queensbury,NY 12804
P:518-761-8206 or 518.761-8205 www`quennsbu_ry.net
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
e Applicant:
Name(s): Chris Kelley
Mailing Address,C/S/Z: 1019 State Route 149 Fort Ann NY 12827
Cell Phone:_L...J1802-779-4669 Land Line: ( Qn2- 3II2 �AOWM—C�
Emaii:chris@Kelleyscustomcarts.com
Business Owner(s):
Contact Name(s): Chris Kelley
Mailing Address,C/S/Z:
Cell Phone:_( ) Land Line: _(_�
Email:
® Manager:
Contact Name(s): Lisa Kelley
Mailing Address,C/S/Z: PO Box 188
Cell Phone:_( )8023456581 Land Line: _( )
Email:lisa.kelleyvt@gmail.com
• Property Owner(s):
Business Name: Kevin Quinn
Contact Name(s):
Mailing Address,C/S/Z: 10 Brookfield Run Queensbury,NY 12804
Cell Phone:_(_)518-791-4048 Land Line: _( )
Email:
Contact Person for Compliance in regards to this project: Chris Kelley
Cell Phone:(18027794669 Land Line: �)
Email: chri`se(eyscus omca s.c
eeafflwe of Occupancy Only Revlsed September 2012
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FIRE MARSHAL'S OFFICE
Town of Queensbunj
742 Bay Road, Queensbury, NY 12804
"Honte of Natural Beauty ... A Good Place to Live "
PLAN REVIEW
Kelley's Custom Carts
1019 State Route 149
CO-0370-2023
6/27//2023
The following comments are based on a review of submittals:
• Verify fire extinguisher location and inspection
• Verify paths of egress
• CO detection is required
• Function test all Exit and Emergency lighting fixtures
• Verify locks and latches for compliance
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
-flreniarshal@queensburil.net - zMMqueensbut-tt.net