91-738 _ra'.. - �� - -,., -.- ,i:�- •-- - -. .. - - . - � . - fie(
CERTIFICATE OF ' OCCUPANCY
TOWN OF QUEENSBURY
r
WARREN COUNTY, NEW YORK
Date Octobers 24, 19 91
This is to certify that work requested to be done as shown by Permit No. 91-738
has been completed.
This structure may be occupied as a Umbi l e D
Location Lot 24 Mn Uieu Park
Owner Deboy°ah Goo Man
By Order Town Board
TOWN OF QUEENSBURY
'v
Director of Bldg. do Code Enforcement
{ "6
BUILDING PERMIT
TOWN OF QUEENSBURY No. 91-738
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Deborah M. Nolan
OWNER of property located at Lot 24 Aviation Rd Mountain View Park Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Mobile Home
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
RR2 Box 79
2. CONTRACTOR or BUI LDER'S Name
Paradise Mobile HOmes Inc
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
NoW x 70' Mobile Home as per plot plan specifications and
application
8. Proposed Use
Mobile Home
$ 35.00 PERMIT FEE PAID —THIS PERMIT EXPIRES October 21, 19 9
(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 21 st Day of October 19 91
SIGNED BY ;„� for the Town of Queensbury
Building and ZoningInspector
TO DE COMPLETED BY f3LUG. DEFT. �
_JuPen,bWry Application No. %OPIAIN OF QUEENSE(�H
uevn o/ Q
Permit Issued 19
BUILDING and ZONING DEPARTMENT -Permit Expires 19 RECEIVED
Bay and Haviland Road, R.D. 1 Box 88 Zoning Designation
Oueensbury, New York 12801 Variance No.. -OCT 15 1991
Site Plan Review No..
APPLICATION FOR Approved .by E!_DG. CODE DEPT.
MOBILE HOME
PUILDINO AND ZONING PERMIT LJ
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.
------------------------------------------------- ---- r-���---2/f�'�)
The owner of this property is: �y_-,n 1TA_ V-\ VY1,'1go
---------
P.O. Address ��
Property Location: i� Tax M p No. /
Street :umber or building lot number V
Subdivision name (if applicable)
THE PERSON RESPONSIBLE F R SUPERVISION OF WORK AS REGARDS BUILDING CODES IS.
r RBI S& i��l v�I 1. 44)7vifs
Name n R.0. Address Tel. No.
�
Name of Installer q�U(6 Ati�- YYI� Address ��� rf,(fTel. 93- 91n 39
Namc of plumber Address ~--Tel.
Nauw of mason Address Tel.
MOBILE HOME INFORMATION: * ZONING INFORMATION:
New -home Placement �- + A PLOT PLAN MUST BE.PREPARED AND SUBMITTED,
drawn reasonably to scale and attached hereto,
Replacing existing Home S • showing clearly and distinctly all buildings,
Size of new Home 14 ft Xft + whether existing or proposed and indicate all -
* set-back dimensions from property lines. Give
Single w "le •"5L Double wide • street and numbe:r .or lot number and indicate
No. of rooms (excluding baths) * whether interior or corner lot. Show location
• of water supply and location and configuration
No. of bedrooms of septic disposal area.
No. of bathrooms * COMPLETE INFORMATION REQUIRED BELOW. --�----
Fireplace? 1r -Wood stove? • Size of property ft X ft.
Foundation style and size: ' Existing building(s) Size ft X ft.
4 ,
Piers- No.of Size- ft x ft. * Existing building (s) Use
*
Depth below grade ft.
' Proposed building, distance from property line:
FOUNDATION - Footing size " X of +
+ 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
•Total depth below grade ft. OCCUPANCY INFORMATION•
Grade to Home floor level ft. + PRIMARY BUILDING -
# * * * t * * w * * * * * * * * * # * + e family dwelling
* Two family dwelling
Proposed date of placement /0/r / * Multiple dwelling / Number of units
• Permanent occupancy
Aprox. Value. of Home $ Hai _ * Transient occupancy
Water supply - Well unicipal * Business
Industrial
Septic Permit required? V (i + Other
+ If addition, what will use be:?
*
FURTHER INFORMATION REQUESTED
ACCESSORY BUILDING
ON THE REVERSE SIDE OF THIS SHEET.* Detached garage/one car/ two car/ car
• Attached garage/one car/ two car/ _car
• Private storage building
• Other
*
Form MIIP 5/86 and-vl
APPLICATION FOR MOBILE HOME .PERMIT, (CONTINUED)
State of New York Division •of Housing and Community Renewal
INSLGNIA. :OF APPROVAL OF THE STATE BUILDING CODE .
- 1 . INSIGNIA SERIAL- NUMBER
2 . NAME OF MANUFACTURER l_ PLAN
3. PLAN APPROVAL NUMBER
4 . MODEL OR .COMPONENT DESIGNATION
5 . .MANUFACTURER'S SERIAL NUMBER
6. DATE OF MANUFACTURE
All the above information is to be found on a pZate or sticker which `
should be affixed to the MobiZe Home. Complete•.above with that. information.
A * +t # A A k f.
Town of Queensbury A F F I D. A V • I T 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
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 not, and that such work is
authorized by the-owner.
Signature ---- - --- -�=-1 ---- -------
Owner, -owner's agent,arenitect,contractor
r r r r * r • ► # • # # # r # • -# # # # ,# # r # # # # w # r # • • r • w # r # +r r + r • r •
SPECIAL CONDITIONS OF THE PERMIT:
• • . BY--------------------------------------- ..
OCT T 99
13UILDING & CODE DEPT.
r
F
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Y)e,Awc, dUa�
TOWN OF QUEENSBURY
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
�-_EJLA
' NG-IFSPE C�ARSS REPORT
PECTION
REQUEST -RECEI D 1 C5
MANE 1 `
LOCATIO OfA)
DATE PERNITF — 1 2
4
T STRUCTURE
RECHE
_FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
_FOOTING FOUNDATION BACKFILL _FRAMING
_ROUGH PLUMBINGAL ELECTRICAL _SEPTIC
INSULATION WOUDSTOVE/FIREPLACE
R RKS
1C� uio c-/o ar cxzz ox�c4_
APPROVAL
N/Al YES NO
CHIMNEY HEIGHT/LOCATION
B VENT/LOCATION
PLUMBING VENT
ROOFING
SIDING --- -- - ___
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES i
FURNACE/HOT WATER OPERATING
BASEMENT INSULATION/DUOTWORK J.'
INTERIOR TRIM/PRIVACY DOORS '
FINISH FLOORS: '1 l
BATH/KITCHEN WATERTIGHT\
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
HANDICAPPED ACCESS
SMOKE DETECTORS \
BATHROOM FANS/WHOLEHOUSE FAN
ALL PLUMBING FIXTURES OPERATjNG
GARAGE FIRE PROOFING_
DOOR CLOSERS_
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS
DUMPSTER
SITE PLAN/VARIANCE REQUIRE ENTS _
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C
COMMENTS:i„
I C-AlPo2/W/S i_p5 J RZvxj 8or*
Si�t rc-frl AJt T-o f3& i 1v PLNC-&
ARRIVE
DEPART " rlk�l
INSP f
6 , J+jn+/o,'Z
TOWN OF QUEENSBURY
531 BAY ROAD IM,
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
B _ �C,—it�PECTOR'S REPORT
INSPECTION
REQUEST FOR INSPECTION REC 3 ��
WME
LOCATIO
DATE 0 PERMITF
TYPE OF STRUCTURE
RECHECK
_FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
_FOOTING FOUNDATION BACKFILL _FRAMING
_ROUGH PLUMBING FINAL ELECTRICAL SEPTIC
INSULATION _WOODSTOVE/FIREPLACE
II�
REMARKS (��31L�` � i-1lt0/{ L
APPROVAL
CHIMNEY HEIGHT/LO fATION N/Al YES NO
B VENT/LOCATION
PLUMBING VE14T
ROOFING a
SIDING v'
DECK/PORCH/STEPS/RAILINGS-
RELIEF VALVES
FURNACE/HOT WATER 0 ERAJTING_
BASEMENT INSULATION/+U&WORK
INTERIOR TRIM/PRIVAC BOORS
FINISH FLOORS:
BATH/KITCHEN WATERTLGHT
OTHER FLOORS SWEEP, AE _
OTHER FLOORS CARPE'TEk,
STAIR CLEARANCE/RALLING!
HANDICAPPED ACCESS/ V
SMOKE DETECTORS �\
BATHROOM FANS/WHOfEHOUSE NS
ALL PLUMBING FIX RES OPERATING
GARAGE FIRE PROOFING_
DOOR CLOSERS I
OTHER FIRE SEP RATION
FIRE/DEMISE WAKLS
DUMPSTER
SITE PLAN/VAR ANCE REQUIREMENTS ',
FINAL ELECTR CAL
OK TO ISSUE /O OR C/C
COMMENTS: t
QGI w6,-L GUc t—L r—A i Af 5!CPS
r1101A f 20.V774 IZPhZ- 000tiS �I*OJ�-
ffAA1,,0 A Lr -(-a fiWj0&n S-lDC
ARRIVE__
DEPART��
IISPV-ruR
THE NEW YORK BOARD. OF FIRE UNDERWRITERS PAGE 1
SO�l�i20 BUREAU OF ELECTRICITY
F 41 STATE STREET,ALBANY.NEW YORK 12207
Date 1VOVE?HBER 12 Y,1991 Application, .on L `),81�84091/91 H 414315
THIS CERTIFIES THAT PERK NC ' 91-7 iS
only the electrical equipment as described below and introduced b he opplica4undined on the above application number in the premises of
DEBORAH NOLAN, AVIATION RD. RR2 BOX 79, QUEENSBURY, N,.Y,-
in the following location; ' ❑ Basement OUT❑ 1st Ft. ❑ 2nd Fl. Section Block Lot
was examined on NOS°EAIBER 06;1991. and found to be in compliance with the requirements of this Board.
FIXTURE KEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT.- I K.W. AMT. K.W. AMT. K.W. AMT. H.P.
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RK'PT TIME CLOCKS SELL UNIT HEATERS MULTI-OUTLET DIMMERS
AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT, AMPS. TRANS. AMT. H P SYSTEMS AMT. WATTS
SYSTEMS. NO. FEET
'1 50
SERVICE DISCONNECT NO.OF S E R V 1 C E
AMT. AMP. TYPE METER 1 0 2W 1 0 3W 3 0 3W 3 X 4W NO.OF CC COND. A.W.G. NO.OF HI-LEG A.W G. NO.OF NEUTRALS A.W.G.
EQUIP.
PER Ar OF CC.COND., OF HI-LEG OF NEUTRAL
OTHER APPARATUS-
I
I
I
DEBORAH NOLAN
RR2 BOX 79
AVIATION RD. BRANCH MANAGER
QUEENSBURYr NY, 12804 � 39
Per
This certificate must not be altered in any manner;return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
0
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE A411ST NOT BE ALTERED IN ANY MANNER.