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86-598 CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date Oct, 7 19 87 This is to certify that work requested to be done as shown by Permit No. 8o 598 has been completed. This structure may be occupied as a Mobile Home Dwelling Moon Hill Road Location Owner Howard Emmet t By Order Town Board TOWN OF QUEENSBURY Building & Zoning Inspector BUILDING PERMIT TOWN OF QUEENSBURY No. 86-598 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Howard Emmett lessee of property located at Moon Hill Road Street,Road or Ave. in the Town of Queensbury,To Construct or place a Mobile Home x at the above location in accordance to application together with plot plans and other information hereto filed and113 °g approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. 1. OWNER'S Address is RD #1 Lake George, New York 12845 rt 2. CONTRACTOR or BUI LDER'S Name Todays Modern 3. CONTRACTOR or BUILDER'S Address Gansevoort, New York 0 4. ARCHITECT'S Name 0 0 x r• 5. ARCHITECT'S Address p a 6. TYPE of Construction—(Please indicate by X) ( 1 Wood Frame ( ) Masonry ( )Steel ( 1 7. PLANS and Specifications No. 14'x66' per plot plan, application submitted including 0 sewage system and Per Variance 1112 granted 8-20-86 8. Proposed Use 1986 Skyline of Vermont Model 5195 Mobile Home Dwelling $5.00 C/0 $ 25.00 PERMIT FEE PAID—THIS PERMIT EXPIRES April 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.) Dated at the Town of Queensbury this 18th Day of September 19 86 SIGNED BY E �• , —' for the Town of Queensbury Building and Zoning Inspector • - I TO BE COMPLETED BY BLDG. DEPT. ac� I wn r. Queoni‘ury AppiicaLioa No. . Permit Issued 19 TOWN OF QUEEMBURY BUILDING and ZONING DEPARTMENT Permit Expires 19 r Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation ECEIVE B Queensbu , New York -12801 Variance No. / / /-Z. 9,...:3 .. 12 Site Plan Review No. SEP 2 2 ,1986 APPL I CAT i ON FOR Approved by: . M. - d ¢`� P.M. IIOB I LE HOME _. � . !�lgl1° 112131415160 PU I L.D I No AND ZONING PERM I T .. _ dJ / 4.Q. e * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *:;* 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 indic:„ted on the Permit. ii / TTOGUG,r-L , /LI oy e- The owner of this property is: /,,/,:--1 tAitJe AC-S e--.. p.O. Address ,Q.#/ ecjr /6/5 Z1� // e- /4�Er� � 1• 79 Y37 iroperty Location: and w, M ill RC er,,, Tax Map No. / / Street number :r building :..t number Subdivision name (if applicable) THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS: Name P.O. Address Tel. No. Name of Installer loo",ri fle�Aert,-,/ Address_al Veia.56/ 'vO7 /1H- Tel. 799-fO3. rot "2 Name of plumber Address Tel. Name of mason Address Tel. MOBILE HOME INFORMATION: * ZONING INFORMATION: New Home Placement _ . * A P'L•jf PLAN MUST BE PREPARED AND SUBMITTED, --a* draw : reasonably to scale and attached hereto, Replacing existing Home 011110 .. * showing clearly and distinctly all buildings, Size of new Hc:r.A 4C ftX pi ft , * whether existing or proposed and indicate all * set-oack dimensions from property lines. Give Single wide yiS Double wide7-4- _ * street and number or lot number and indicate No. of rooms (exclude ng } tns) L� _^ * whether interior or corner lot. Show location 11 r' o.:. water supply and location and configuration No. of bedrooms * of septic disposal area. r,• No. of bathrooms _ * COMPLETE INFORMATION REQUIRED BELOW. Fireplace?//p Wood stove? /I Q ^, * Size of property ft X ft. Foundation style and ire: * Existing building(s) Size ft X ft. /nOni0 Li Tit j`ALAS#r�� r Piers- No.of_ Size- trt x 4 ft. * Existing building(s) Use * Deng helow grade ft. • Proposed bui::.ding, distance from property line FOUNDATION - Footing size " X If * - , Front yard ft Rear yard ft Wall material _ * Side yards ft and ft Wall thickness " Height ft. * If on corner, setback from side street ft * OCCUPANCY INFORMATION Total depth below grade ft. * Grade to Home floor level ft. * PRIMARY BUILDING - * * * * * * * * * * * * ** * * * * * * * r. ' One family dwelling * , Two family dwelling Proposed date of placement / / * -_Multiple dwelling / Number of units e` Aprox. Value o home Y _ * Pc::?':��''Teent occupancy * Transient occupancy Water supply - Well X Municipal * Business _:rni estrial Septic' Permit required? * O h r * If addition, what will use be? FURTHER INFORMATION REQUESTED * ACCESE,C,RY BL'ILDING- ON THE REVERSE SIDE OF THIS SHEET .* Det;:ched garage/one car/ two car/ • car * Attached garage/one car/ two car/ car * Private storage building * -'Other * --- Form MHP 5/86 and-vl APPLICATION FOR MOBILE HOME PERMIT, (CONTINUED) State of New York Division of Housing and Community Renewal INSIGNIA OF APPROVAL OF THE STATE BUILDING CODE . INSIGNIA SERIAL_ NUMBER L . NAME OF MANUFACTURER S y/`/f P. ,mo77) . PLAN APPROVAL NUMBER . MODEL OR COMPONENT DESIGNATION /96--- 11AAlP574Ir _ MANUFACTURER ' S SERIAL NUMBER DATE OF MANUFACTURE / 9 a f e €QX 04 ec7v ///. All the above information is to be found on a plate or sticker which Tould be affixed to the Mobile Home. Complete above with that information. * * * * * * * * * * * * * * * * * * * * * * . * * * * * * * * * * ** * * * Town of Queensbury AFFIDAVIT STATE OF NEW YORK County of Warren 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 :omplete 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 not, and that such work is authorized by the owner. Signature .&42:(1474-6" Own r, owner's gent,arcnitect,contractor * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * SPECIAL CONDITIONS OF THE PERMIT: By awn of Quenitury APPLICATION FOR SEPTIC DISPOSAL PERMIT BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 DATE / S-----/Z LOCATION OF PROPERTY FOR INSTALLATION 7E/ OWNER'S NAME • ADDRESS freni 711, (7 fr67 64✓ 444E- TEL 7f-3— /2 2 INSTALLER' S NAME C// v Number of bedrooms (residential only) _ 7 / ) Total daily flow(compute @ 150 gal per bedroom) U Topography: Flat Rolling - Steep slope - (circle one) % of slope Soil nature: Sand - Loam Clay - Other Depth ft. Ground water -At what depth? e) ft. Bed-rock or impervious material - At what depth? U/ ft.. Percolation test - Not required - Required - -Rate min-inch. Domestic water supply - Municipal .- Well - Other_, Separation - Watersupply(if well) from Septic absorption / _ ft. Proposed System: Septic tank /%9 gal. ( Minimun size, 1000 gal. ) Tile Field - Each trench 5 C) ft. Total system legnth , ? C� ft. Seepage pit(s) Number of . Size each ft X ft r Size of stone to be used # / ,2 Depth or thickness ft. IMPORTANT! ! On a separate piece of paper, submit a diagram of the proposed system with all dimensions shown; including distance from any structure , distance from property lines and from ANX DOMESTIC WATER SUPPLY or shore-line of lake, stream,pond or wet-lands. Include all dimensions of the system, itself. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * I .have read the regulations on the reverse side of this sheet and agree to abide by these and all requirements of The Town of Queensbury Sanitary Sewage Disposal Ordinance. (.--,,\ _,;-- ;///r Signature of r sponsible person • - __‘7 `'� Date 05/86 and/vl sAVaLeli 1111 ,)15 ' • - _Down o/ Queenitur, BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME io w ew i hi m e7T LOCATION n1 doh /9/1 1/ / ►a°{/ Fri J.) DATE /l // '/3(• PERMIT NO. '(o-ts73 SOIL TYPE - Sand - Loam - Clay - Percolation Test Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM: 1 Absorption field, total length Length of each trench a r> (,D co Depth of trenches Size of gravel _ SEEPAGE PITS{Number of) Size- ft. X ft. Gravel size - PIPING: Size Type Bldg. to tank (f-/f t/D Tank to dist. box Dist. box to field/v. Openings sealed? NO Partial LOCATION/SEPARATIONS: Foundation to tank ( 12 ft. Foundation to absorption if ft. eqt.</ Absorption to lot line 3 c ft4- Separation of pits ft. .s- ON OF SYSTEM ON PROPERTY(cir le one) Fron - Rear - Left side - t side ENTS: y2 .F" SYSTEM USE APPROVED YES NO t0143 Building Inspector 01/86 and vl TOWN OF QUEENSBURY Building Department Inspectors Report Date /O 7 /4 Name F him Location MOdt) +i_trL. (Z.ol Permit No. 86-5 y 8 Weather Remarks Excavation )( Footing Forms Footing & Piers V Foundation (!))1(—I Cement Coat Waterproofing Backfill Final Survey Framing Sheathing Roof Felt Roofing Siding Masonry Veneer Rough Plbg. Relief Valves Wall Board \\Nx/c Ext. Porches Finished Floor Interior Trim Stairs & Railings Cellar Dr. Tile . Concrete Floors ( Plbg. Fixtures Gar. Fireproofing Door Closers Chimney Water Meter Inst. Septic Approval Floors Insulation Foundation Walls Ceiling Buildin Inspector cr REMARKS .M0OLLp4(c s f r G(I 12/ -)21'l Y0 - AtZ-51 i -`-V A-Poe y dibz. , 4.-•....).., e A . _ , e \ k.1) 7 C) 1 'Cs,4 \ tz, .., , \ .......L. ,,.,.: . •••,,,, • -\7--.-. . ... :..).) - i 0 , 1 ,_s.... .4‘ •-4,— - ,„, ..., , 4:3 . C-.) ,c--.•„ ,'1%\\\• loot ''.) A/ ` 4. 0J ------ ....› -,-.... . 14.. N ' ---- -•";.<-- — ..) .. *41 ...k , t ----- - i k. Lt, tl \ ! ci5 ' e * , o a k a 1 k 1 .. . 1 ; 1 . i . , I , 11 . . N. -- 1 . . 0 ! c:_3( '•:• Qt. I . , \I kl 1 0 s) Ns te) , N 1 tO . `T 1 • N ./) I , 1 1 Iv N ••*1.. I 1 . to ,•-•. -vt• ---.1` - -Nc 1• • I 1 . 1 , 1 I 1 . I I 1 .•,-- T 1 . ' ' 1 I I . I . e I I— — / I 1 . to r- I -k--- . 70 /Io/njo jr-e Yid/ pies DVF2/�G� CG L E4)67fi j014)E(z. S421,0-e,1 im2. Ou"/ ocP pool)cl v�sio% e, boxes i poss/6le . .Zz' nv/ g-e-f y as c,Ios(2, as cools /b/e p20 JT (ZEA2 SEwE 2 SE Mc2 O 561 ] 60'---1 gig e f t R 1\ 0) � s )ti li it4 Pole L • 02 cc h basin i n Lo Nctrol d A. Rc 1 h bun, 5r. anO 5cafr(cTc, n. Forafhbon (423/434) 4 le \ r0 _l Oe tp� - a 44/ d0p op V') Anna = O 4 t rem s#Z ... (Leor�ord CUMOUI In 505497) r garden �\ I 6 '� Lo f A. _Iro_n, P-� a `ix)r- �--- \ We ll - � -' � axe conKr L:of A I.5 ± acre s I � acre 0 /,. Lands now or formerlq of Mi I lard F Lille Coons, Kcnneth Coons �_� --, Tax Map Refcrcrnc 000 Zp Londe now or �rrr,cr of Rt�gmald A Town of Queensburl �9. /�� Nlar Qr� T• 1( Section 48 ;n deed BI Oct�i 3 r p �� 8 o a c�X>I"�/�arcels t I and t2 i 4 P * Lnl Deed lf:;�cfcrer)ces 7� I !� \ r•Or1 Qff `l / f �Ortio Cwinup ��d �gean sburq �- Cocxn ilof WorrenF-xeccfor of Carncr Cwinup 5�o tc o� to Lands now or �ormeriy of� njewcc� iCcx�sfrucf ion Corp. �� �, new�orKi C 204) �O feet ate: 2 J� �1 ��5 L.conord C�urnoulin ccr-�d Lena Qurnoulin �j©te. 3 I�ev�se 5 Home lo s cafic�n - ubd( _vistican lme as �er- = t• rgmbq Cert Gci t e . W A- c3u�t I -OD 71 .Cmrnc.t. Andrew Ei Ieen Aarlswl < F�cac rnc�nd d- Corol Stevenson A nericariTile Irmirci CompCtrq Survmj(c Map to that this ptart was ef)areri fram ■ an actual on the Q �a� Orlart� L�rr1oC.�l!f'1 SUrV 7� �S Al A ctccordinq io recor-d ascriptions ��ssocc,aTES = o Tit te; ( M cl rch ► �J 7G •r>t�ers Z o 12 SEP 1986 L.A.K�. � �. 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