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98-223 r CERTIFICATE OF kd`.. ....CUPA.N+CY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK r� Date June 8 =� 98 es is to certify that work requested to be done as shown by Permit No. 98223 has been completed. MOBILE HOME This structure may be occupied as a LOT 56 HOMESTEAD VILLAGE Location '�-.�✓ Gam-- f Owner BERG , WILLIAM TAX MAP NO . 9 3 . - 2 - 1 1 . 1 By Carder Town Board X�OWN OF QUEENSBURY Director of Bldg. do Cade Enforcement BUILDING PERMIT VALUE $ 25900 TOWN OF {QUEENSBURY No. 98223 TAX MAP NO . 93 . — 2 - 11 . 1 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to BERG r WILLIAM OWNER of property located st LOT 56 HOMESTEAD VILLAGE Street, Road or Ave. in the Town of Queensbury, To Construct or place a MOBILE HONE 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_ t. OWNER'S Address is LOT 56 HOMESTEAD VILLAGE QUEENSBURYr MY 12804 2. CONTRACTOR or GUI LDERIS Name GLENS FALLS MOBILE HOME INC . 3 C399T$RO T or OGAL RDRS /0.ddrrss GANSEVOORTe NY 4. ARCHITECT'S Narne NEW YORK BOARD 6' A1QE*T%61*dVBARD OF FIRE UNDERWRITERS 6. TYPE of Construction — (Please indicate by ? ) MOBILE HOME I } Wood iFrame I I Masonry 1 1 Steel I I 7. PLANS and gpeaificstiOns 112%0.SQ FT MOBILE HOME AS PER PLOT PLAN SPECIFICATIONS G. Proposed Use MOBILE HOME 41 May 7 2000 S PERMIT FEE PAID — THIS PERMIT EXPIRES , 1$ SIf a longer period is re4wwed on application for en extension must be meda to the BuildI g and Zoning inspector of the town of Oueenslwry before the expiration date.} 1 7 MaY Crated at the Town of Queensbury this k Day of t9 SIGNED BY for the Town of Ouoensbury Building end Zoning lm%WCtor L L 1A r • ..' • 9 MAY () 5 1998 `Z A TO lu ^7fr i REVIEWED BY : r FEE PAID : $ ` PERMIT NO , APPLICATION FOR PERMIT MOBILE HOME Olt MODULAR A BUILDING PERMIT MUST BE OBTAINED BEFORE PLACEMENT OF MOIIILE HOME . NO INSPECTIONS WILL BE MADE UNTIL A VALID BUILDING PERMIT IIAS BEEN ISSUED . . . , . . . . The owner of this property is : P . O . Address : Phone Number Property Location L4 jr' S� k:::� Tax Maly No . / / NAME OF APPLICANT : ~� Address of Applicant : d [,( /i- Ail applicants spaces on this application MUST be completed and the signature of the applicant MUST appear on the reverse side of this application . PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES : MOBILE. 11014E IHFQBMATION APPROXIMATE VALUE OF HOME : $ S `� New Home No ZONING INFORMATION : Rep acement Fea No Size of Property : ft x ft Size of mobile home GS ftxQPt Existing Buildings • Singlewide Doublewide Proposed building-distance from property line : No . of rooms ( exclude baths ) Front Yard ft Rear Yard ft . No . bedrooms 2 Side Yards ft and ft . No , of bathrooms Occupancy Informat �' Primary dwelling : Yes No FirepIace�_Woodstove Accessory Building ( s ) : Detaclied garage one car / two car car Foundation style and size : Attached garage one car / two car car ) ' Storage building Piers- No . of Size ft x ft Other Depth below grads_.._ f t * * Ar * w Foundation -Footing size x Proposed date of placement : Wall material Wall thickness." height " Water Supply : Well Municipal Total depth below grade ft . Septic permit required ? Grade to home floor- level ft . FURTIiER INFORMATION REQUESTED ON THE REVERSE. SIDE OF T11IS SHEET NAME OF INSTALLER/MOBILE IIOME DEALER : ADDRESS/PlIONE NUMBER ro STATE OF NEW YORK DIVISION OF HOUSING AND COMMUNI `# Y RENEWAL INSIGNIA OF APPROVAL OF TIIE STATE BUILDING CODE 1 . Insignia serial miniber _&46 Q`7 :2-• ( k (lZ r f 2 . Nawe of Manufacturer 3 . Flan Approval Nunlber ,�r }� y � } 4 , Model or Component DeslgnaLion f� �? (45170 13 q;zf-- 5 . Date of Manufactured All the above inforltlatlon is to he found on a plate or sticker which should he affixed to rile Mobile Ilame , Complete above wi I. ii that inforinaLlon , Town of Queetlsbury State of New York County of Warren AFFIDAVIT I swear that to the hest of my knowl edue anti belief the S td telilents contained in this application , together with the plans anti specifications submitted , are a true and coinplete statement of all proposed work to J)q. 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 own r. Signature C k P4 Owrl Jeri s agent , architect . . co ttractor '� SPECIAL CONDITIONS OF PERMIT : By Cade Enforcenient Orficer DECL. RA770N.4 Please sign below gj?er you J)ave carefully mead the statentexat. ' Co the best of my knowledge the slateuICIUS C011(aillCd in this application, together with the plans and specifications submitted, are a Irue and complete statement of all proposed work to be clone 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 noted, and that such work is authorized by the owner. I urther, it is understood that I/we shall submit prior to a Certificate Of Occupancy or Certificate of Compliance being, issued , an AS BUILT PLAT PLAN by a licensed surveyor; drawn to scale, showing actual location of project on premises. Signature; (owner, owner's agent, architect, contractor) ,- 1 IF r TOWN OF Q UEEI • SB URY A 742 Bay Rd. , Queensbury , NY 12804 ; AP LICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS Date # , 19 1 r Permit No . ` G"+=22 APPLICATION IS HEREBY MADE to the Building Dept. for the issuance o€ a Building and Use Permit pursuant to the New York State Fire Prevention and Building Code. The applicant or owner agrees to comply with all applicable laws, ordinances, regulations, and all conditions that are part of these requirements and also will allow all inspectors to enter premises to perform required inspections. Please fill out additional form if more than one appliance andlor chimney. Applicant APPLIANCE {check appropriate boxes} Address ❑ STOVE : ❑ Wood ❑ Coal ❑ Pellet ❑ Gas p ,,FI REPLACE INSERT pf Zip Fl REPLACE, F60TORY-BUILT: ood cl Gas Phone '' 0 FIREPLACE, MASONRY: ❑ Wood ❑ Gas Owner ti, tyl�3#,r W-�o © FURNACE: D Wood ❑ Gas o Oil 1 Address }„ c CJ w S "C�+e�D 11 +�-+��.- IF NON-MASONRY APPLIANCE: Manufacturer: �r r � ZI10 lk �� Model : Phone ' ` y''" CHIMNEY (check appropriate boxes) * EXACT ADDRESS of proposed construction ❑ MASONRY : ❑ Block ❑ Brick ❑ Stone FLUE: o Tile ra Steal ,/ Size: inches CONSTRUCTION 1 INSTALLATION MUST LYFACTQRY-BUILT: Model : CONFORM TO NYS FIRE PREVENTION & Manufacturer: Number. BUILDING CODE, CONSULT AVAILABLE Listed By : TOWN OF QUEENSBURY HANDOUTS ❑ Double Wall © Triple Wall REGARDING REQUIRED INSPECTIONS. 13 Insulated Chimney Liner❑ Direct Venting Cashier' s Department Town of Queensbury, New York Dept: Fire Marshal Amount Collected Amount Refunded Code Number Title ^ �- A 173 3189 ( 190) Public Safety — A 233 2655 (230) Minor Sales Fee Collected From or Refunded to: Address: Dated : Town Clerk or Deputy: r� White: Applicant Green: Fire Marshal Yellow: Bldg. Dept. Pink & Goldenrod: Cashier's Dept. TOWN OF QUEENSBURY FIRE MARSHAL QUEENSBURY, NY 12804 (5 l 8) 7 b 1 -82C15 FIRE MARSHAL INSPECTION REP ART REQUEST FOR INSPECTION RIV C7 NAME LOCATION DATE PERMIT # APPROVED NIA YES NO EXITS AISLE WIDTHS EXIT SIGNS EMERGENCY LIGHTING �-- FIRE EXTINGUISHERS AUTO- EXTINGUISHING SYSTEM HOOD INSTALLATION AUTO. SPRINKLER SYSTEM ALARM SYSTEM INTERIOR FINISHES STORAGE: CLEARANCE TO SPRINKLERS CLEARANCE TO HEATING UNITS REQUIRED SIGNAGE CHIMNEY WOODSTOVE FIREPLACE - MASONRY FIREPLACE - FACTORY BUILT OK TQ THIS DATE REMARKS: d Ida,, INSPECTOR lt1SPSLIP.PUB �rnr.s►L rnrslca�c�-rrsnii +�e+�r�vs.�-r ,� '�-p , MO011LE / MC313UL ALR Town of Queensbury Building $ Code Enforcement 742 Bay Road CKmensbury, NY 12804 (518) 7614Mw ARRIVE: DEPART: L • "_ INSP: �' DATE INSPECTION REQUEST RECEIVED: I NAME: ; LOCATION: --t�7Co DATE: PERMIT # 1 ORTLE HOME IbfaMR71L ►Irt MOMS FOOTINGS FOUNDATION , RACICFR.L FRAWNG I N/A YES No F dation support, pier spacing per manuf. oring per rnanuf. er line shut off .. .. .. . . . .. .. .* " *A er line support 4 feet ing crosfins ewide) off p�rd. — r vente ing ve water rpip outside — { , porchailing . .. .. .. .10. furnacelhotatingI I . garage fire .. . . .. . .. .... . . . . . .. .. 12. door closers 13. plumbing fixture . .. .. .. .. . . . . . .. .. .. .. 14, foundation insulation (if appI.). . .. .. 15, smoke detectors .. ......, 16. final electrical . ..... . . .. i 17. variance required .. .. ..... . . .. . . .. . .. 16 data plate okay = I9, mobile HUD seal okay . .. .. . .. .. .. .. Model # Serial # Manufacturer C-�- l ► gg wuj w S < c — Date of Manufacturer EQ ISSUE CIO YES NO �! TOWN OF QUEENSSURY FIRE MARSHAL QUEENSBURY, NY 12804 (518) 76 1 -8205 FIRE MARSHAL. INSPECTION REPORT REQUEST FOR INSPECTION RECEIVED NAME /ff LOCATION "' DATE PERMIT # APPROVED NIA YES NO EXITS AISLE 'WIDTHS EXIT SIGNS EMERGENCY LIGHTIN FIRE EXTING I IRS AUTO. EXTINGUISHIN YSTEM HOOD INSTALLATIO AUTO, SPRINKLER SY TEM ALARM SYSTEM INTERIOR FINISHES STORAGE: CLEARANCE TO SPRINKLERS CLEARANCE TO HEATING UNITS REQUIRED SIGNAGE CHIMNEY W OODSTOV E F,4REPLACE - MASONRY IREPLACE - F TORY BUILT REMARKS: ❑ OK TO THIS MATE iNSf SLiP.PU6 IN. PECTO F1NA.1. INl3P�CTlCiN �1�1�*aalFrr MC/Wli..>E 1 MC3'1a1.11WAF1 Town of Clueensbury Building & CGde Enforcement Aly) 742 Bay Road Oueerlsbury. NY '12$04 (518) 761-8256 ARRIVE, Fn� DEPART: / 60; 1 SP: DATE INSPECTION REQUEST RECEIVED: NAME: Y ' LOCATION: DATE: ! — PERMIT # M001LK 190 MD ]t; ILil11[>G FOOTINGS � FOUNDATION � $ACKFlLL FRAMING NI YIES NO Y. foundati support, Ater spacing per uf. 2. anchoring manuf. 3, water line ut, off . .. .. .. . . . .. .. .. . .. . 4. sewer line 0 4 feet 5* heating c ver (dblewide) off grd. 6. dryer vented ide . ... .. .. .. ..... .. .. . 7, . skirting — / 8* hot water relief alve Piping outs _ -- 9. deck, porches, s railing . .. . 10. furnace/hot water ling 11. garage fire proo I .. .. .. .. .. . . . / 12, door closers . .. ..... .. . .. . . . .. .. .. . .. ✓V �_/ 13, plumbing feature . .. .. .. 14, foundation insulation (i ). .. ... ��/ 15. snWke detectors 16. final electricals �`Jt7.. lA4Gk - _ 17. variance required . .. .. �/ — 18. data plate okay �C 19. mobile HUD seal y . . . ... .. .. . .. Model #'LWE) 0-7.- 1 0 Se # ' Manufacturer Date of Manufa OKAY d ISSUE C/O YES C , t��I \ FN�� Il�ev lY l OA_o.J 6 q FINAiL lIV'BPIIECTlO1V q�p��e71C' r MC7BILE / MC30U1 iR1 Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 7+61-8256 ARRIVE: aqtppPAItT: IN DATE iNSPEC"f'iC)N REQUEST RECHI � 7 NAME: LOCATION: DATE: PERMIT # C) MOBILE NO MOMKTLAR. Hems FOOTU40S POUNAATION � BACKFILL FftWING NIA YES NO 1. f6und ti�u support pier spacing / per 2. anchoring Per manuf. ,��•�tt .•' 3t water line shut. off . . . 4. sewer line suppdrct 4 feet — — 5. )Yeating crossover (db de) off grd. 6. dryer vented outside 7. 1 skirting ventilated .. + xla' ...� 8* hot water relief valve piping outsi ✓ 9. deck, patches, steps, sailing . .. ., .» . 10, finuace/'hot water operating 11. garage fire proofing . .. ..... .. .. .. .. . 12. door closers . .. .. I. . .. .. .. . . . .. .. .. .. 13, plumbing fixture .. .. .. .. ... . -- 14, foundation insulation 15. smoke detectors A" .. ..# 16. final electrical .. ... .. .. ... .. .. .. .. . . . . 17, variance regtdred .. .... ... .. .. . . .. . .. . 18, slats plate okay . ... .. ....... .. .. ... .. . 19, mobile HUD seal okay . . . .. .. .. . . ... Model # Serial # - j ManuWturer Date of Manufaoturssr _ (n� �- '—�i 011 OKAY TO ISSiM CIO Yi~S NO Comments: ALLIED ELECTRICAL INSPECTION AGENCY ELECIMCOAL IMowmcTIOMi DWPLICATs NU@d@CIPAL IIECOIlo 2 Qbcuiow+K D Lwcliw► U�wfs"tion"*emizwdonoewwM side hasElrwnwkKwlyimpvctedPwrwm l o AOVON wtRIME OUTLETU M.P. AIR CONQIT{ONER OUTLETS w{RIN6 # CONTROL FOR ■uRNE RECEPTACLEi n.►. PVMr f1%TVREs K.W. OVEN AMP. SCRV{CC EQUIPMENT P. +GAR#AGE O{SrOihL UN AMP. SERVICE CQNOVCTO!!i K. O{EMwAENER K W. SURFACE UNIT R_ OR VCR K,W. RhNOE AMr. RECEPTACLE K.W. WATER NEATER PRAC. itP. VENT PANT Ir{orrowa I+.■. trtt VH 14 % X 7}f ]0 1S tVl 2S 7[[ i0 SG 75 MARS{ NUM#E PF E+{CR y{iE APPARATUS FINA1� 1N'SREC7"ION rMerPC�wt'!I' IVICiBMM ./ AAC E3ULWAR Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12844 (518) 761 -8256 ARRIVEA f "DEPART: /0, INSP:N DATE INSPECTION REQUEST RECEIVED: NAME: LOCATION: ..� +/'�' ei V C DATE: I~"' PERMIT # MOBILE HOME MOIWLAK HOME IZO(YI7NGS ! F[ W4DATION RACKFII L FRAMING - NIA YES NO 1, fourkdation support, pier spacing per tnuanuf. 2. anchoring per rnanuf. . . . . .. .. . . .. . .. — 3. water l' jo . . — — — 4. server line s4 . .. .. .. _ S. treating crosdb wide off grd, — 6. dryer ventee 7. skirting ven .. .. .. . ..$. hat water relve aping outside9. deck, pouchs, .. .. ..10. futnacelhot pera ... .. .. .11. ,garage fire g . . .. .. . .. .. . .. .. .12. door closers . .. .. .. . .. `. .. . . . . . . — 13. plumbing fixture .. .. .. .. .. ... .. .. ..... - 14. foundation insulation (if appl.). .. .I. — 15. stroke detectors .. .. ..... .. .... . . . .. .. . — 16. final electrical . ... .. ...... . .. .6 . . . . . .. 17. variance required ... .. . . .. .. . .. .. .. .. . — L data plate okay .. .. .. ... .. .. .. ... .. .. . � — 9. a HUD seal okay ... .. ..... .. .. — — Model # Serial # Manufacturer Data of Manufacturer OKAY TO I5SOE^ C/O YES ,NO Comments: //L / -f:;;;k 'FIIVIo1,L. 1NfS CTICitiV �EPt�r-�c's' MC3=111 115 / M001JIWAR Town of Queensbury Building Code Enforcement 742 Bay Road Queensbury, NY 12804 ARRIVE Lfl DEPART: "INSP: DATE INSPECTION REQUEST RECEIVED: NAME: LOCATION^ : ��� o DATE: J �j PERMIT # MOISILE HOME IMt0EKn6AA HOME F K)o7 NGS FOUNDATION RACKFULL FRAMING NIA YES NO 1 . foundation support, pier spacing per manuf. _ 2, awhoring per manuf. . . . . .. _. ... 3, water line shut. off . .. .. .. . ..'li `. 4. sewer fine support 0 4 feet , . y — — 5. .heating crossover (dblewide) o — 4. dryer vented. outside .... .. ....... . . . .. . _ _ 7. skirting ventilated .. ..... .. .. .. .... - 8. hot water relief valve piping outs — — 91 deckt pouches, steps, railing ...... . — 18& furnace/hot water operating . .. ... . — 11. garage fire proofing .. .. ... .. .. .. ..... _ 12. boor closers .. .. .. ... .. .. .. .. . .. .. .. .. . 13, plumbing fixture .. ... .... .. .. ... .. .. .. — 14. foundation insulation (i£ appl.).. .. ., - 15. smoke detectors ... I.. . . . . ., .. " , ...... — 16. final electrical ..... .. .. ... .. .. .. .. .. . . 17. variance required .. .. ...... . I. .. .. .. .. — —_ 18. data plate. okay . .. .. ... .. .. ..... .. .. .. — — 19. mobile Hi TD seal okay .. .. ..... .. .. . Model # Serial # Manufacturer Date Date of Manufacturer to — Jc~ c7� 7 OKAY TO ISSUE CIO YES VNO Comments: 1 ck\ Nr �' TOWN OF QUEENSB U RY (:4w 742 Bay Road, Queensbury, NY 12804-5902 518- 7 F 1 -8201 June 8, 1998 Mr. William Berg 56 Homestead 'Village Queensbury, NY 12804 Re: Building Permit 98-223 Dear Mr. Berg: In order for you to occupy your residence without required fireplace repairs being completed, please sign, the statement below. I agree that the fireplace at the above property will not be used until the broken rear firebrick panel is replaced and the emit is inspected by the Fire Marshal. zl�JA� Mr. William Berg I an hoping to hear from you within the next few months. Please call me at 761-8205 if I can be of further assistance. C. A. Grant Fire Marshal cc: File-98-223 DONT GIVE FIRE A PLACE TO START PRACTICE FIRE PREVENTION YEAR WOUNC7 "HOME OF NATURAL BEAUTY . . . A GOOD PLACE TO LIVE" SETTLED 1763 f ���•+M' ... 'may n.. .. .��w_ . . .. .. ___ ' `w! ,(� PTV•'�?`! _' '___� �_✓`—'� Y `.� "'�+�— � 1 Y. !I /� w 61 L_ LL_ L LLL L_ L DMVIM�NL". L_ t _ L ft"r " aw Imw ONVAN&MI L. L_ L SECQND oil 1 aft ow I� rM 1IM1 BEDROOM a� tt10 MPISTER L L L L_ L wm aid �MM tun +k BEDROOM . - OOwI � o � raw I I i i CATNfORAL cell.le+u STANQMRp iE *NROuGMOui THIRD BEDROOM ! 3 ROOM (OPT DEN) �l E cad\ Ar- 2BA, CORNER OVAL TUB MS28442-AAV �y �y4 pp it i ��xl i' ;s ,-• µ 'I —o r, - � . FIL E COPY S ATE ,� j' ddd _ E... .. E i L . i ! . L_. L- l KITCHEN I. L_ L . SECONDBED XIM l DINING ! _ L_ ;. l W-a` . Wa- I 1 . . ,o•-� . a'-Y l t : . 1. . GK.+NEDRAL CEILING aR STANDAAp SNROuGNOVT�� u�new MASTER LMNG BEDROOM ROOM TFNRD 1.] -3' . +2'-,a• +a•-r . ,2 -+a' BEDROOM 1156 5Q. FT, 3BR, 26A• 2 FRONT BEDROOMS MS284820 1E Ik p I I i �� k _ j f u a I AWV THIRD ROOM BEDROOM � r . I loom OPTIONALOR MS2E482ONTR,f OPTIONAL FOR�M52E4B20EMENT E hR'RY i I �tl eN i f: 3 f,. Ki fi