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1987-482 +CERTIFICA 'Tr, OF OCCUPANCY TOWN OF QUEEN58URY WARREN COUNTY. NEW YORK 21794 ( 5 � 1 w !Z Date 19 Tlxia is CO certify thac work requested to be done as shown by P'erinit No. 87-482 has been completed. This structure may be occupied as a Modular Home ration far . Mud Pond Rd . & Asure �k-� }. Owner Edxwil Roberts By Order Town Board 74'OW" 'I OF QUEENSBURY Building & Zoning Inspector BUILDING PERMIT TOWN OF QUEENSBURY � Na. 87-4$2 � WARREN COUNTY, NEW YORK 0 PERMISSION is hereby granted to Edwill Roberts vi t n N N OWNER of property located at Corner Mud Rd . & Asure (Lot 2 & 3) Street, Road or Ave. i w nr in the Town of Queensbury. To Construct or place a Modular 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 # 1 Buckley Ave . Granville , N . Y . 12832 x 2. CONTRACTOR or BUI LDER'S Name o G Simplex Industries m rt rt w 3. CONTRACTOR or BUILDER 'S Address Scranton , Pa . 4. ARCHITECT'S Name C43 0 'i ro m 5. ARCHITECT'S Address CL *rJ 0 6. TYPE of Construction — (Please indicate by XI { 1 Wood Frame { ) Masonry { T Steer f Y w un C 7. PLANS and Specifications tv No. 24 ' x 40 ' Modular home , per plot plan , specifications and application Including * septic system and drive way permit . 8_ Proposed Use One--Family Modular Home ra I $5 . 00 C/O 19 $ 8H. February 8 70 . 00 Febru 1 , 19 ' ` PERMIT FEE PAID — THIS PERMIT EXPIRES {If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the CT town cf Oueenslwry before the expiration dare.} E ra I� Dated at the Town of Queensbury this 24th Day of July* 79 87 oc SIGNED BY ���+'� � � �9't,.� �-ar^ for the Town of Queensbury 8 Building and Zoning Inspector C I� w ----------------- / TO BE COMPLETED BY BLDG � DE T . Application No . TOWN ;}F `NCue rtdhLire� .Permit Issued 19 ; w .Ec+kSv ._BUILDING and ZONING DEPARTMENT Permit Expires 19Lo ' t! Bay and i-laviland Road, R. D. I Box 98 Zoning Designation �r (]ueensbury, New York 12801 variance No . JUL 2 QI ' - Site Plan Review No . ' 1 Approue by +EUILDING a C:C)DE D$ GV APPLICATION FOR i e" C> / PLUILDINC AND ZONING PERMIT 1, 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 : ( --- P . O. Address f �' ] . 4 r ry Tel . Cw� LS Property Location : + C5c 77z.� W�- 4 -1- c,Q , y,, J. Tax Map No . Street number or building lot 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 builder -R � �! ' 1GdAddress l.�rP + 1 ` 7`?�f - Te . � Name of plumber a _ T• Tel .—_._. 5� Address � Name of mason ��,y,,. "-" Address fir. 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 , , ,(ago 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 FOR DEMOLITION PERMIT , STATE SIZE AND whether interior or corner lot . Show location LOCATION OF STRUCTURES AFFECTEDa of water supply and location and configuration * of septic disposal area , ,f COMPLETE INFORMATION REQUIRED BELOW , - - - - * Size of property , 4� 5 ft X .iC•`i_�_ft _ Existing building ( s ) Size�ft x PROPOSED BUILDING AND USE : * Existing building ( s ) Use Size of new structure =ft x L'} ft Foundation-pier/slab/crawl/partia fu Proposed building, distance from property line ( circle one ) * Front yard (;3 C-) ft Rear yard_ -7( r ft No , of stories (habitable space ) � Side ands Height ( grade to ridge ) _ // ft . * 1' a d rt and £t If residential , no . of families * If on corner , setback from side streetr 7 ft No . of rooms ( excluding baths ) '+ OCCUPANCY INFORMATION No , of bedrooms Noe of bathrooms * PRIMARY BUILDING - '� * 7 Primary heating system One family dwelling * 1^ryo family dwelling _ Type of el No . of fireplaces to be instal ed � Multiple dwelling / Number of units ' permanent occupancy � /� * Will a wood stove be installed? C' `} * Transient occupancy Central Air conditioning . [� Business BUILDING STYLE, PRIMARY STRUCTURE Industrial Other 9Ra m ised ranch Mansionsion Duplex Ranch Contemporary Log cabin * If addition , what will use be? Split level Old style Bungalow Cape Cod Cottage Other * ACCESSORY BUILDING- Colonial Row Town House Detached garage/one car/ two car/ car ( CIRCLE ONE PLEASE } * Attached garage/one car/ two car/ car Private storage building ESTIMATED MARKET VALUE OF * Other CONSTRUCTION INFORMATION ON BUILDING, SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET , TO BE COMPLETED ! Form BPA 4/86 and-vl i TOWN OF QUEENSBURY WARREN COUNTY , NEW YORK Application for : BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK STATE ENERGY +CONSERVATION CODE A permit must be obtained before beginning work , ANSWER ALL of the following : 1 , Gross floor area 2 , Type of heat E. 3 , Is the building mechanically cooled ? 4 . Percentage of area of windows and doors �Zje A . Over 16 % Only 1 . Uo value of gross area of walls , roof / ceiling and floors exposed to ambient conditions_2 . Floor over heated spaces YES NO a . Are foundation walls insulated YES NO 1 . If YES , what is the R value ? 3 . Slab on grade YES NO a , If YES , what is the value of insulation around perimeter of floor ? ri . Is basement heated ? YES NO a . R value of insulation 5 , 'Type of insulation ✓V � - B . Under 16 % Only 1 . R value of roof and floors exposed to ambient conditions_ 2 , R value of exterior walls - �� � �tc C -y• r> n, ,�.�<,,_ .e....t-� , r 3 , R value of glazed area G-✓Cx, 4 , R value of doors — 5 . R value of floors over unheated spacesjoi 6 . R value of slab edge insulation - unheated slab 7 , R value of slab insulation - heated slab 8 , R value of heated basement cellar walls g -- / ( above grade ) � y� S 9 . R value of heated basement /cellar walls ( below grade ) Q - 10 . Type of insulation C . Controls a 1 , Thermostat maximum heat setting [� D , Duct Systems 1 , Is duct system installed in unheated spaces ? YES a . If YES , R value of duct installation b . R value of duct in other areas E , Piping Insulation 1 , Size of hot water or cooling carrying agent pipe 3 9r 2 . R value of pipe insulation F , Service Water Heating 1 . Performance efficiency_- - 14 ZO 2 , Temperature control setting maximum C7 ° G , For Swimming Pool Only 1 , Maximum heating J - Telephone Now 1 - rY k o61&-� ( applican ' s signature ) APPLICATION FOR SEPTIC DISPOSAL PERMIT DATEi i f / LOCATION OF PROPERTY FOR INSTALLATION � ,� �a� 0 -1 QC-t2-•c.s--a..2. Owner's Name: 3G tom_,-cQ k a Telephone: Address: Installer's Name: Telephone: Number of bedrooms (residential only) _._ _ Total daily flow (compute @ 150 gal per bedroom) i Topography: circle one: Flat Rollm Steep Slope % of slope _ } Soil Nature: circle one San Loam Clay Other { Depth: feet Ground Water: At what depth? Z ,;2-- feet Redvo�ck or Impervious Material: At what depth? i 43 C-> feet Percolation test: circle one: MIA7 require required / rate in in. inch. Domestic water supply: circle one: Municipal W ell ther IF domestic water supply is a Well: Separation: Watersupply from Septic absorption � Z ,22 to feet PROPOSED SYSTEM: Septic Tank D gal. (minimum size: 1 ,000 gal.) TILE FIELD: Each Trench j-'D feet / Total system length _ � 3 G feet SEEPAGE PIT(S) : Number of A264j6 / Size each feet by feet Size of stone to be used # "'� 2- / Depth or Thickness /� feet IMPORTANT ...P'lease...LIST NEW EQUIPMENT TO BE INSTALLED (over) PAA BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME 1 C� —e 1 LOCATION toln ja - �y ,I DATE CW?J/—=� PERMIT NO. SCIL TYPE - and Cda )- Clay - Percolation Test Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM: Absorption field , total lel "' Length of ea h txenc Depth of tire ch Size of grav _ �^ SEEPAGE PITS4 umber of SIZe- ft. -ft Gravel size PIPING : Size Type Bldg . to tank & f A J ` Tank to dirt_ box Dist . box to field Openings sealed? S NO Partial LOCATION/SEPARATI S : Foundation to tan ft. Foundation to abs rption Absorption to to line f (�* Separation of p ' s LOCATION OE.. SYS ON PROPER circle one ) Front - ear - Left side - Ri t side -- CCIKMENTS : SYSTEM USE APPROVED YES NO Sui ding In_ ec }r 01/86 and vl + _JOurn 01 Q" een3 ury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R, D, 1 Box 98 qj Queensbury; New York 12801 SEPTIC O i S SAL- T_EM�AINSPECTION LOCATION 2 . '- ��1 �� r DATE / PERMIT NO . SOIL TYPE - Sand - Loam - Clay Percolation Test Required? Y S = NO Percolation rate - Min/Inch TYPE of SYS Absorption eld , Iota length Length of ea trench Depth of tren es Size of gravel SEEPAGE PITS{N of ) size- ft. X ft_ Graved Size Y PIPING : Size Type Bldg . to tan]c Tank to list_ x Dist . box to ield/pi Openings se ed? YES NO Partial LOCATION/S ARATU)NS : Foundation to tank ft_ Foundatio to absorption ft. Absorptio to lot line ft . Separati of pits ft. LOCATION SYSTEM ON PROPERTY (circle one) Front - Rear - Left side - Right side - COMMENTS : SYSTEM USE APPROVED YES NO Building Inspector 01/86 and vl (/ I / BUILDING and ZONING DEPARTMENT Oil � ,rBay and Haviland Load, R.D. 1 Box 98 l Iv Clueensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME C. & r LOCAT I ONeggA % State J '// /� Permit NO . APPROVED - YES NO Footing/Pier Forms Foundation Waterproofing 4�f 'ackfill Framing lie 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 ELECOIRICAL INSPECTION DRIVEWAY APPROVAL,,_ Final Building Survey Next scheduled Inspection (call when ready ) Remarks- � Z� Building Inspector 6/86 and-vl fcca�rr II own 01 Queenjhury BUILDING and ZONING DEPARTMENT Say and Haviland Road, R.0 1 Box 98 oueensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME LOCATION aaz Date f � Permit No . �' ..- ✓ = R D . - NO v'Footing/Pier Forms �. Foundation Waterproofing Backfill Framing Roofing Siding Masonry Ven r Rough Plumbin Relief valves Ext . Parches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg . Fixtures Gar . Fireproofi Door Closers Smoke Detect s Chimney INSULATIONif Foundatio Floors Walls Ceiling FINAL EL TRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection ( call when ready Remarks- 20 ` Building Inspector 6/86 and-vl BUILDING DEPT. COPY OF APPLICATION FORM 46-ELr NEW YORK BOARD OF FIRE UNDERWRITERS. FILE THIS COPY WITH BUILDING DEPT. WHEN REQUIRED. TEMIP. s DATE ,/ . f CITY OR VILLAGE TCriVNSHIP COUNTY STREET AND NO. OR ROAD AND POLE NO. 0 POLE " .. BETVMEM WHAT TWO PREMISES S REETS IS LOCATED? --}*� �- � �.. / / " ." "�'4+� • SECTION ._1' -``i BLOCK '` ' LOT '•''� ��+' OCCLOPAIIOT'S ,- "� "' BUILDING NAME OCCUP/1NCY OWMEWS AHD ADDRESSE -• ft TEL. -CUTEff CRT- ByyPPLifD Ali/ o FROM THEIR ti+?' e^' OFFICE IBLOIL£N PIG WOECTS NEW OLD ❑ IRK NEW ADDITIONAL ❑ REFMOVED ❑ LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED Flamm" a NUMBER OF OUTLETS L�wp R itwhm MOTORS HEATERS BRANCH OFFICE USE Loea- ONLY tron '$xide AtencWt H.P. !Mats A1M.G. CeBl..S WaB Reoip9a Switch Platdewt llraipkrx Nee Type Eeelt Ns Estdr Nee Glow INSPECTION Out- siW Bus bear Bheer attpn min FL 2nd FI. &d Fl. REMARKS; LIST OTHER ELECTRICAL DEVICES POW SET FORTH ABOVE: 00 NOT LOSE THIS SPACE. This application is inwo"d to carer the abore•lisled eyuiprnant to be Wippected but it at rime of inspection there is taurM 'dditiwd oguiwnnaot root ebose listed, you pre outlhpsued to make the inspection and a lipsul the fee to eoesr the additional equipanant, as Provided by liar applicant. SIZE OF ELECTR IC 'SIGN TOTAL MAINS FEEDERS LAMPS WATTS CHARACTER EXPOSED GAS TIME SIGN OF WORK CONCEALED TRANSFORMERS OF VA WORK TO SE INUInIBERI SCAYACITYI STARTED COMPLETED SIZE OF SIGN SERVICE OVERHEAD UNDERGROUND MAKER ENTERS OF SIGN BUILDING INSPECTION REQUESTED BIBLE NEAR AS NEW OLD i l AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES DATE OF MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. APPLICATION NAME AA PRINT OF AND ADORES - Y [ �.�,,� y SIGNATURE -:57. ,— APPLICANT APPt WANT eZ. L _ ]G..:_ �'��� .iti lir'_1 /S. OF APPLICANT "�- STREET ADDRESS ` L- � 5 -3`''L '�J^-" " . TELEPHONE # CITY OR ZIP LICENSE NO. POST OFFICE CODE WHEN APPLICABLE as EL (R"y 1/86) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING k (law TOWN OF QUEENSB URY Bay at Haviland Road, Queensbury, NY 12804-9725 (518) 792-5832 December 4 , 1991 Mr . Edwil Roberts 2 Asure Drive Queensbury , New York 12804 RE : Building Permit 87 - 482 Modular Home Dear Mr . Roberts : Through an oversight by this Department , the final electrical inspection on your modular home as well as the final inspection by this Department were not completed . Would you please call us as soon as passible so we may schedule a final inspection of your residence . The electrical inspection should have been done by New York Board of Fire Underwriters . The local inspector ' s name is John Heaudette and his phone number is 793 - 2851 . Thank you for your anticipated cooperation in this matter . Very truly yours , DAVID HATIN , DIRECTOR BUILDING & CODE ENFORCEMENT DR : lm "HOME- OF NATURAL BEACITY . 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