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1986-627 CERTIFICATE IFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date January 29 . 19 87 gt1)\ iY This is to certifythat work requested to be done as shown by Permit No. 86-627 a has been completed.' This structure may be occupied as a One Family Modular Dwelling 63 Zenas Drive Location Owner. Rick Rothstein ,j. By Order Town Board TOWN OF QUEENSBURY. . Building & ZZoning Inspector BUILDING PERMIT TOWN OF QUEENSBURY No. 86-627 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Rick Rothstein OWNER of property located at 63 Zenas Drive Street, Road or Ave. in the Town of Queensbury,To Construct or place a One-Family Modular Dwelling at the above location in accordance to application together with plot plans and other information hereto filed and approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. 1. OWNER'S Address is Lot 120 Lamplighter Acres Fort Edward, New York 0 2. CONTRACTOR or BUILDER'S Name Lamplighter Homes 3. CONTRACTOR or BUILDER'S Address RD #2 Fort Edward, New York 4. ARCHITECT'S Name w (D En 5. ARCHITECT'S Address t7 rl • CD 6. TYPE of Construction—(Please indicate by X) (x)Wood Frame ( ) Masonry ( I Steel ( 1 7. PLANS and Specifications No. 52'x24' per plot plan, specifications and application submitted 0 including sewage system. 1,1 CD 8. Proposed Use THE ATTACHMENT OF THE TWO PARTS OF THIS MODULAR HOME MUST BE APPROVED BY A LICENSED PROFESSIONAL ENGINEER. `e One-Family Modular Dwelling p, $5.00 C/O $ 91.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 1 19 87 (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the town of Queensbury before the expiration date.) F-' Dated at the Town of Queensbury this 24th Day of September 19 86CIQ SIGNED BY ` a L'L< ,o for the Town of Queensbury Building and Zoning Inspectors • TO BE COMPLETED BY BLDG. DEPT. . own ofApplication No. Qnj1ury Permit Issued ly BUILDING and ZONING DEPARTMENT Permit Expires 19 2+ter OF QUE UFi'Y Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation ) ; \ ''iDEOVIE 0 Queensbury, New York 12801 Variance No. Site Plan Review No. 7 �. . . 3rr 1 916 410V ii LPr2� - - J Approv , `� tI APPLICATION FOR tiv A3"---- A•A . NI ' �`�� � ��• 7181911i I Ve asp,112)3)4016 BUILDING AND ZONING PERMIT * * * * * * * * * * * * * * * * * * * * * * -.tt. # .*. .*. * * * * * * * *. * * *:*. . A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. ANSWER ALL OF THE FOLLOWING. The undersigned hereby applies for a Building Permit ,to do the following work which will be •done in accordance with the description, plans and specifications submitted, .and such special conditions as may be indicated on the Permit. The owner of this property is: I . C /C . P.O. •Address L p T � / /2-v 44-7n PA / L/f . g Griry J ' cr. 0 sixtder I Tel. . f P -Or . Property Location: 61 r i p,)A S -p et,d r Tax Map No. / / Street number or building lot number Subdivision name (if applicable) THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK 1\S REGARDS BUILDING CODES IS: 604m Nl, 6 7?,t.- Al,vve I e2.P 4`? :-(4.f �,-.AA.-(1/ N L /•z fr-o ( 7 9_-? — 73 P.O. Address Tel. No. • Name of builder -,., P Address • ,.—_ Name of plumber Tel. �„Address (2 C Name of mason l/,, cy `S�"'`� Tel. S �L• .���; a.LS 7)°alCddress Tel.. NATURE OF PROPOSED WORK: * ZONING INFORMATION: Construction of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED, Addition to a building * drawn reasonably to scale and attached hereto, Alteration to a building * showing clearly and distinctly all buildings, (no change to exterior dimensions) * whether existing or proposed and indicate all Other work (describe) * set-back dimensions from property lines. Give * street and number or lot number and indicate * whether interior or corner lot. Show location FOR DEMOLITION PERMIT, STATE SIZE AND of water supply and location and configuration LOCATION OF STRUCTURES AFFECTED. * of septic disposal area. * • * COMPLETE INFORMATION REQUIRED BELOW. * Size of property 1/ ft X / 7 ,3' ft. Existing building(s) Size ft X ft. PROPOSED BUILDING AND USE: * * Existing building(s) Use Size of new structure 7.4/ ft X=5 eft _ * ' • iafull Foundation-pier/slab/crawl/partl * Proposed building, distance from property line (circle one) * No. of stories (habitable space) / * Front yard 0 ft Rear yard 9 ft Height (grade to ridge) r 3 ft. * Side yards 3 ft and 3 J ft * If on corner, setback from side street ft If residential, no. of families No.,of rooms(excluding baths) * OCCUPANCY INFORMATION No, of bedrooms * No. of bathrooms * PRIN�ARY BUILDING - Primary heating system * ! One family dwelling Type of fuel /e . f n * Two family dwelling . No. of fireplaces to be installed ,✓ ,4 * Multiple dwelling / Number of units Will a wood stove be installed? „� ,q_ * __Pe anent occupancy Central Air •conditioning? —i * Transient occupancy BUILDING STYLE, Industrial STRUCTURE * — Businessr * - rial nc Contemporary Log cabin * Other k- If addition, what will use be? ranch Mansion Duplex Split level Old style Bungalow * _______ jt . U& - 5-5, u or D �• 1'G1t1']ll APPLICATION CONTINUED - • BUILDING SPECIFICATIONS: Type of• construction, wood frame, fire safe,etc. Will any second-hand or ungraded lumber raded be SOUcl ��� � used? If so,• for what? Foundation wall material • ' '��� PrP Thickness • Depth of foundation below grade (to bottom of footing) Will there be a cellar? I ) Heated or •, Will there be a basement? unheated 4LI qt FFloor sq, foota e (If so Will any portion be used as living space? l� y sq ft what portion? sq.ft. - - Type of. use? Type of roof - ope flat/shed/other Size, wood studs Material o£ roof WyA ,L 6 ,‘� Joists(floor beams ��X� spacing /6 "o.c. lengtha-� ft. 1st. floor —Y-- Joists (floor beams) 2nd. floor „X spacing /6 "o.c. span /Z ft. Overlays(ceiling beams) X X spacing "o.c. span ft. Roof rafters ea - -- spacings y "0.c, span/ 2 ft. Roof trusses _ spacing Ly o.c. span i ,5rft. (pre-engineered) spacing "o.c. s an Exterior wall finish > pft. � ! G Of what material? r1'� ( Interior wall finish If a garage is to be attached, describe materials to be used for FIRE SEPARATION: Is there to be an opening between garage and dwelling? If so will a Fire-rated door, enclosure, and self-closing device be provided? Will a flue-lined chimney be installed? Depth of chimney foundation below rade Height above roof ft. Depth of fireplace hearth ft. g ft. 11. Water supply i PP y - Municipal or private well �I n C , j'r4 / SEPTIC SYSTEM Distance from ANY private well(including adjoining properties ,.✓/4 ft. (A separate application is necessary for any repair or new installation of septic system) Town of Queensbury County of Warren AFFIDAVIT STATE OF NEW YORK I swear that to the best of my knowledge and belief the statements contained in this application, together with the plans and specifications submitted, are a true and complete statement--of all proposed work to be done on the described premises and that all provisions of the BUILDING CODE, THE ZONING ORDINANCE, and all other laws pertaining to the proposed work shall be complied with, whether specified or got, and that such work is authorized by the owner. . SWORN TO BEFORE ME THIS Signature_ _. L 41;f2 /� --• --� er., owne.a 's agent,a cnit / S day of Notary Public, Warren County, N.Y. * * * * *' * * * * * * * * * * * * * * * * * * * * * * . * * * * * * * * * * * * * * * * * * * SPECIAL CONDITIONS -OF THE PERMIT: f4cenibury '' BUILDING and ZONING DEPARTMENT 9 i1 PI P L E • . Bay and Haviland Road, R.D. 1 Box 98 Oueensbury, New York 12801 • SEPTIC DISPOSAL PERMIT APPLICATION • •Owner.'s Name -A,. c, /4-- 12. tMsrei.,_) Tel. 2 j(P- ® / z�' Address ' � 3 Z 9,33 pa. J. Person/Eirm installincg. system /.44 121 ig-. / P • ' .Number of bedrooms (residential only) 3 Total daily flow: (compute @ 150 aal.per bedroom per day) s:J Topography: rolling - steep - (circle one) Degree of slope % • Nature of soils: san loam-clay- other- Depth ft. Ground water-- at what depth? _y_//, f ft. Bedrock or impervious material--at what depth? /Li/ ft. • .Percolation Test - Not reguiredj Required -Rate A d, min/inch. / Domestic Water Supply - Municipal -, Well - Other IMPORTANT! • On a separate piece of paper , submit a diagram of the proposed septic system with all dimensions; including distance from any structure, distance from property lines and distances from any domestic water supply or shore-line of . lake , stream, pondor. wetlands. Include all dimensions of the system itself. Description of proposed system: Septic tank size_/ av gal . , Tile field.Length of each trench S`� ft. Total field 2-6-0 ft. Size of stone # `3. - . Seepage Pit (s) Number • / Size ftX ft. Size of stone* Any contractor, corporation , individual , Etc. , engaged in the construction of a Sanitary Sewage Disposal System,_ who covers the same before inspection, does not have 'an approved Permit, or varies, from the approved application , will be subject to a Penalty of $250 as provided .for in Section -6. 010 of the Town of Queensbury Sanitary Sewage Ordinance. . .- - ....7.--Z.- ..... - .e... ,4421..."----a=. -ature of Appl ' cant is/ �� . Date 01/86 and/vl BUILDING DEPT.COPY OF APPLICATION FORM 46-EL,NEW YORK BOARD OF FIRE UNDERWRITERS. FILE THIS COPY WITH BUILDING DEPT.WHEN REQUIRED. • ' (TEMP.It IDATE 1 iJ t� / CITY OR l VILLAGE TOWNSHIP t',:t.l G; - \ I. t''7 COUNTY /,, ;(y,4 f/f,;)(.- , • STREET AND NO.OR f -/; _� ROAD AND POLE NO. f," •z)/( • .; C ) POLE NO. BETWEEN WHAT TWO CROSS STREETS IS - - PREMISES LOCATED? SECTION BLOCK LOT / ' -- OCCUPANT'S--• ---i `, BUILDING , NAME /f' c r- l ,- / 1 ' /t-r - OCCUPANCY i / /..: OWNER'S NAME " -• - _ - AND ADDRESS -r: . 6 I..... I_ -1- L, c, +.- . ., _. i' ) , .(, :i r //,_ TEL.# 7 , - L, / / CURRENT i` , '-- " ' SUPPLIED i 'C._ , - BY /'-' ) i I,/•./! ;'( <` FROM THEIR T. , 1 OFFICE BIS NEW WNEW L� OLD CI IS NEW In ADDITIONAL❑ REMOVED DEFECTS ❑ LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED No.oFixtures& BRANCH NUMBER OF OUTLETS Lampf fReceptacles MOTORS HEATERS CIRCUITS OFFICE USE Loca- ONLY • tion Side Attach't H.P. Watts A.W.G. Ceiling Wall Recep'Is Switch Pendant Bracket No. Type Each No. Each No. Gauge INSPECTION Out- side - Sub- base Base- . ment 1st Fl. , 2nd Fl...., 3rd Fl. • REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: DO NOT USE THIS SPACE. This application is intended to cover the above-listed equipment to be inspected but if at time of inspection there is found additional equipment not above listed, you are authorized to make the inspection and adjust the fee to cover the additional equipment,as provided by the applicant. SIZE OF • ELECTRIC SIGN r TOTAL MAINS C .) FEEDERS LAMPS t WATTS CHARACTER i EXPOSED GAS TUBE SIGN OF WORK ,,-,' if, ((\ f-; ( U C '''''' CONCEALED TRANSFORMERS OF VA WORK TO BE (NUMBER) (CAPACITY) . STARTED T,;- % )l ` COMPLETED SIZE OF SIGN SERVICE OVERHEAD UNDERGROUND MAKER ENTERS BUILDING ./ OF SIGN • INSPECTION REQUESTED 'ON n PO OSI LEAS NEAR AS ' --- b NEW OLD I I POSSIBLE -�" i , - > 7 AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES DATE OF MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. APPLICATION PRINT NAME AND ADDRESS - / i NAME OF ,��, I -,�, " /- ';' -TL,(_ SIGNATURE ./ ./ / L':�. %,. 7. r APPLICANT f ! f�/. � f,'s` ',�L; +�(',%"` OF APPLICANT � ' , ( / STREET ADDRESS �" ^' 1 yy1- i --`-1;�, it c( TELEPHONE# 'l - - - CITY OR IZIP ,_LICENSE NO. /" POST OFFICE -' . I CODE• ' -/ ' c ` WHEN APPLICABLE 46 EL (REV. 1/86) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING . . . .. . ,. GA,GEORGE KUROSAKA JR.,P.E. BUILDING SYSTEMS CONSULTANT POST OFFICE BOX NO.660 GLENS FALLS.NEW YORK 12801 (518)792-1522 13 ARBUTUS DRIVE QUEENSBURY. N.Y. 12801 . PHONE SIB 792-1522 BUILDING INSPECTOR Town of Queensbury re: Factory Manufactured Home Town Hall Installation Certification. Queensbury, New York 12801 I/i��� Attention: Mack Dean - ' "" • 'l 41fe ' Dear sir, This is to certify that• I have observed and inspected the installation of a. "Factory Manufactured Home"; as defined by the New York State Uniform Fire Prevention and Building.Code, Chapter D - MANUFACTURED HOUSING, Article 2 - FACTORY MANUFACTURED HOMES, as applicable to your local building regulations; there appeared to be norapparent structural damage to the units, due to or • attributable to the transportation or loading/unloading of the units, herein- 'after described as follows: . ,a1 • Date of Installation: /J/2.0, . 4, ' Site Location: s /� . • - Community: Town of Queensbury County: Warren Manufacturer/Supplier: RITZ-CRAFT CORP OF PA INC. Address: P. 0. BOX 70 MIFFLINBURG, PA 175J11 Insignia Serial No. Z 36 • • Plan Approval No. Lf !p/e z- • Manuf acturer's Model/Component No.: Z 9-.452..— Ci Z//t7.. 4?74 Date of Manufacture: 1146-� Installer/Supplier: LAMPLIGHTER HOMES I have" also examined the approved Plans & Specifications for the above.•nentioned "Factory Manufactured Home", and to the best of my knowledge and belief, this "Home"' has been installed in accordance with these approved Plans & Specifications, and all other applicable laws codes, ordinances,standards &/or. regulations. O F NFL•; . . • . Gt.KuRoe O O ? ?.. " •V ; Re s tfull s mit ed; i- (ILA c � 41• l/• - cr. A„:-...,---...:,! •, • - GEORGE KUROSAKA A., P.E. s • NYS PE Lic. No. 35869 cc: ..so ti ��� = ,p O•J5860 �,, A s4 . /6 gown of Queen iury A--1" BUILDING and ZONING DEPARTMENT , 4 , Bay and Haviland Road, R.D. 1 Box 98 JJ Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME g --7.-5T I LOCATION Z)VNis 1)J- I VI; //L / L Permit. No. e - (p I/ �,* * * * * * * * * * * * * * * * * * * * * * 3D ✓ = APPROVED - YES / NO Fodting/Pier Forms Foundation Waterproofing Backfill Framing 'roofing • a K l2ding no K Masonry Veneer Rough Plumbing lelief Valves } ,Y Ext. Porches aK. tr�inished Floors 'LK• °' nterior Trim \/\:;/////7 0 t- fairs & Railings ojK\ Cellar Drain Tile Concrete Floors kPlbg. Fixtures tIar. Fireproofing A©j� tj eor Closers N it —moke Detectors �� r 1.0Nimney NIX INSULATION*: foundation De k.` Lproo r s Walls Ceiling I:L140 FINAL ELECTRICAL INSPECTION � DRIVEWAY APPROVAL )(Final Building Survey Next scheduled inspection (call when ready) Remarks- P[uGu I° .i'',v 6 rit)N&) 1--G 1-T6iz ry►z-TilIS y- k,Lv,vrr v 6 r o,J. , 1,,,),,,, v,„4- -4,- ,,,,,_ 4 .., r • . 6,16 Building Inspector 6/86 and-vl awn of Quecnur1 BUILDING and ZONING DEPARTMENT ay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 ( BUILDING INSPECTOR ' S REPORT NAME O VS i ' LOCATION � Mc 1 2p OK (D - Prpoc% Date 11 if 4 / Permit No. -6a. )-OPcti * * * * * * * * * * * * * * * * * * * * * * * Or = APPROVED - YES / NO Footing/Pier Forms Foundation Waterproofing Backfill &Flaming C ✓2 acLit, eeca..9 ff..9-"e4 , .jt'irl Roofing Cyr," /i Siding Masonry Veneer Rough Plumbing Relief Valves Ext. Porches Finished Floors Interior Trim Stairs & Railings ‘.;;;X/::\ss Cellar Drain Tile Concrete Floors Plbg. Fixtures Gar. Fireproofing Door Closers Smoke Detectors Chimney INSULATION: Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL I Final Building Survey Next scheduled inspection (call when ready) Remarks- VOID L._. 4_ P 6-c_fz , /--e wiz, r-ct 1/046 . Building Inspector 6/86 and-vl ' Jown oI Queenabur y • BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 • SEPTIC DISPOSAL SYSTEM INSPECTION NAME fZd rc-i s rr(AI LOCATION ( J 2 dL,(//(-s D}Z DATE [ 4/( _ PERMIT NO. '(a (., J SOIL TYPE - Sand - Loam - Clay - . Percolation Test Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM: .Absorption field, total length Length of each trench (25 Depth of trenches J fe' Size of gravel SEEPAGE PITS{Number off ' Size- ft. X ft. • Gravel size • PIPING: Size Type Bldg. to tank ''' r N 4_P Tank to dist. box /f Jf --P 7 4A 4 Dist. box to field/pit 40 , ir • Openings sealed? YES ;' NO Partial / LOCATION/SEPARATIONS: / ' Foundation to tank / /6 ft. Foundation to absorption P^v; !ft. Absorption to lot liO ",,,:. ft. Separation of pits ft. LOCATIONNS.YSTEM ON PROPERTY(circle one) Front - earN)- Left side - Right side - COMMENTS:r- V • SYSTEM USE APPROVED ,YEAS NO ---• • . Lt-i.r. 4'..:- ----4,-_,--, 1)n ) • Building Inspectof 01/86 and vl Jouin of Queenibur j BUILDING and ZONING DEPARTMENT ' Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME (75)71(01teti,a-bV p61/4J- 1 h LOCATION -7 I, J./I-L - Date 1O)/( / Cap Permit No. Q� - +° ! * * * * * * * * * * * * * * * * * * * * * * * ✓ = APPROVED - YES / NO Footing/Pier Forms Foundation 1''W terproofing V8ackfill r\ Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext. Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg. Fixtures Gar. Fireproofing Door Closers Smoke Detectors Chimney INSULATION: Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection (call when ready) Remarks- vi6 Building Inspector 6/86 and-vl _locun of Queenitury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 ` =i BUILDING INSPECTOR ' S REPORT NAME --�. LOCATION Ze � �O_ ( o7 Dater /e64 Permit No. !i�, * * * * *. * * * * * * * * * * * * * * 1 * ✓ = APPROVED $ / NO noting/Pier Forms . Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer , Rough Plumbing Relief Valves ' Ext. Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg. Fixtures Gar. Fireproofing Door Closers Smoke Detectors Chimney :///\ \/\ \11 . INSULATION: Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION Final Building Survey Next scheduled Inspection(call when ready) Remarks- - tai , r)_/V6-- Buildi y Inspector 6/86 and-vl .. 77---- . ,1_______ i i / / - . / . 0/ cx -t; a,,7/ i ,�'J t.e P �.K F, I d ;b ' — r3 4 \ 0 9,,Y. by. 3. C D.-0z , 1 J 02 r •� ,r r'c . n . ...- j Z ,q �.7U4 / S, e n a �- J,,,,Al e rb„ 7 /6 /- e 7,6 # O sO i -C