1988-683 CERTIFICATE OF OCCUPANCY -
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date November 15 19 88
This is to certifythat vbork rre ukated to be done as shown byPermit No. 88-683
Q
has been completed.
This structure may be occupied as a Dnv cmi1Y D.lodular TT„mc
location 1 Zenas Drive
Owner Thomas Derecko
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoning Inspector
BUILDING PERMIT
TOWN OF QUEENSBURY No 88_683
WARREN COUNTY, NEW YORK 0
PERMISSION is hereby granted to Thomas nerecko
IND
OWNER of property located at 1 ZPrias Drive Street, Road or Ave.
in the Town of Queensbury,To Construct or place a One Family Dwelling (Modular)
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
Thomas Derecko
3 Zenas Drive
Glens Falls, N_Y_ 1 2R1)1
2. CONTRACTOR or BUILDER'S Name CD
CD
A.S.C. Development Corp
3. CONTRACTOR or BUILDER'S Address
P.O. Box 3
Lake George, N.Y. 12845
•
4. ARCHITECT'S Name N
pD
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( Wood Frame. ( I.Masonry ( )Steel ( )
7. PLANS and Specifications c '
tb
No. •
24' x 38' as per plot plan, specifications and application including
septic system.
8. Proposed Use
THE ATTACHMENT OF THE TWO PARTS MUST BE APPROVEDCrq
One Family Modular Home BY A LICENSED PROFESSIONAL ENGINEER.
$5.00 C/O
$ 63.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 1 19 89
(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 20th Day.of September 19 88
SIGNED BY for the Town of Queensbury
Building and Zoning Inspector
•
/uwii u/ Q .3I ur y I .__
BUILDING and ZONING DEPARTMENT LIJ
Bay and Haviland Road, R.Q. 1 Box 98
SEP 9 1988
Queensbury, New York 12801 BUILDING & CODE DEPT.
0- eis-
4a�� Approved b /4(/' 4 j�
LIGATION FOR#6') '
/�/ Cd J }
a)
BUILDING AND ZONING PERMIT•
/,, •
it it * it it it it .* * * * it * *. *. * it .* * it * it it * it * * * it * * * * * * it ::*
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; 1 /oMfi-S T. DERECKo
P.O. Address 3 Z-r Ewi45 :1)010 E• Tel. •?9ff- 5/.SS/
Property Location: / terms -D2tvE Tax Map No. 9Z / Z / V-
•
•Street number or building- lot -number
Subdivision name (if applicable) ff&Wi tT DELELoPn4 6n,T •
T.Ini.. PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES 'IS:
A•3•e. 1D€v6LO13n4ENT o#p 9 D•. gax 3 LAX CEPZ6er f J 9 /iv/S- 6 23-3/32
Name P.u. Address .t Tel. No. -
Name of builder Address Tel. -
Name of plumber 4 e Address Tel.
Name of mason A S L Address ' . . — Tel.Tel.
NATURE OF PROPOSED WORK: * ZONING INFORMATION:
Construction of a new building * TWO PLOT PLANS 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
FOR DEMOLITION PERMIT, S'1'AtPI; SIZE AND * whether interior or corner lot. Show location
LOCATION OF STRUCTURES AFFECTED. /✓/�q of water supply and location and configuration
* of septic disposal area. ��; 30 '
* COMPLETE INFORMATION REQUIRED BELOW. /0 S/, Apo '
* Size of property ' ft X ft.
* Existing building(s) Size ft X ft. -
PROPOSED BUILDING AND USE: ND,vE
* Exist.ing building (s) Use h1A9 •
Size of new structure 24 ft X 3$ ft *
Fo ndation-pier/slab/crawl/partial ul * Proposed building, distance from property, line
(circle one)
•No, of stories (habitable space) / *• Front' yard Ter p/or ft Rear yard ft
Height (grade to ridge) / ft. * Side yards '�Lf}06/ , ft and ft
If residential, no., bf families / * If on corner, setback from side street ft
- No. of=-rooms-texcluding baths) 3- - '' - - --OCCUPANCY INFORMATION
No. of bedrooms 7- *
No, of bathrooms / * PRIMARY BUILDING - • ,
*' ✓One family dwelling
Primary heating system Et�e.TQiC. * Two family dwelling
Type of fuel ASE3oR219
No. of fireplaces to be installed p * • Multiple dwelling ./ Number of units
* V/ Permanent occupancy
Will a wood stove'be installed,,. /�!
* __Transient occupancy
Central Air conditioning) NO ' Business
. *
BUILDING STYLE, PRIMARY STRUCTURE *' Industrial
*• ' Other '
11/ Contemporary Log cabin If addition, ,.what will use be? I41/09
Raised ranch Mansion Duplex *
Split level Old style Bungalow *
•
Cape Cod ' Cottage Other * ACCESSORY BUILDING-
Colonial 'Row''' Town House *•flo Detached garage/one car/ two car/ car..
( CIRCLE 'ONE PLEASE ) , '* Oo Attached garage/one car/ two car/ car
* * * * A * * ` * * * * * . * * * * * el Private storage building
ESTIMATED MARKET VALUE OF . * It—DOther
CONSTRUCTION $ �00 ® *
60
INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
Form BPA 4/86 and-vl .
BUILDING 1 PERMIT; APPLICATION CONTII'JUED - • •
BUILDING SPECIFICATION: .
_Type of construction, wood frame, fire safe,ete. &SOD .rRAfE- AZOM.4.-uAR .
Will any second-hand or ungraded lumber be•used? If so; for what? MOW Aht, .
Foundation wall material (oNCiter6 'Thickness 8 �I
Depth of foundation below grade (to bottom of footing) II- '
Will there be a cellar? )/e! Heated or(il heated) Floor sq. footage 9'/7-- sq ft .
Will there be abasement?./Vo Will any portion be used as, living space? No
(If so, what portion? 1 /i4- sq.ft. - - Type of use? Al/A '
Type of roof -rt one flat/shed/other Material•'of roof Z3s40- ,P' a GGA$S
Size, wood studs •y ','X q " spacing / . "o.c—length 5 ft.
Joists(floor beams)-.,1st. floor a- "X a " spacing /6 "o.c. span P'a- ft.
Joists (floor beams),;•..2nd.- floor.N14 "X " spacing "o.c. span ft.
Overlays(ceiling beams) . "X G " spacing Jib "o.c. span J2 ft. .
hoof rafters _ _ -"1 t, " spacing / . .o.c. span.•/' ft. -
Roof trusses(pre-engineered) spacingA/4 "o.c. span ' ft.
Exterior wall finish WDor, (o',Qq.w1 • Of what material? Vi 1 y / ' . .
Interior wall finish (gyp54,..+� y�" • • .
If a garage is'-to be attiched, describe materials to be used for FIRE SEPARATION: A)M
Is there to bean opening between garage and dwelling? Al/A If so will a,Fire-rated
door, enclosure, and self-closing device 'be provided? ' _N/A
Will a flue-lined chimney be installed? Height above roof /)/A ft.
•
Depth of chimney foundation' below grade N/A ft. . -
Depth of fireplace hearth N/A ft. in. . •
Water supply - icipal)or private well* • .. ' • .
•
SEPTIC SYSTEM Distance from ANY private well(including 'adjoining properties .N/1 ft.
(A separate application is necessary.for any repair or hew installation of septic system)
•
Town of Queensbury A F F .1 -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.tne 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 o no and that. such work-is
authorized by the owner. * •
l
SWORN TO BEFORE ME THIS • Signature__ __ � .
, ' cnrtact,contract-cr .
day o �. F 1 S Owner, ���c��fo sic"�-� no <Co,J7-ten J.
- . / S
N ar ublic tr rren County, N.Y. � ?'
* * * * * * * * '* * *- * * *' * * * * * * * * * * * * i * * *-
SPECIAL CONDITIONS"OF TilE PERMIT: , .
I3y: •
TOWN OF QUEENSBURY
WARREN COUNTY , NEW YORK
Application for: BUILDING PERMIT IN COMPLIANC WITH THE NEW YORK
STATE ENERGY CONSERVATION CODE
A. permit must be obtained before beginning work.
ANSWER ALL of the following
/C)" 55. .1f ( 1I X3
1 . Gross floor area
2 . Type of heat
3 . Is the ' building mechanically cooled? /L/Z)
4 . Percentage of area of windows and doors 14.6•4e4c. 1(v 7o
A. Over 16% Only
1.' U 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 R. value of insulation around
perimeter of floor,?
4 . Is basement heated? , YES NO
a. R value of insulation
5. - Type of insulation
B. Under 16% Only
1. R va ue f. roof and floors exposed_ to ambient conditions
2 R value of exterior walls iftlinik , °S
> R value of glazed area C7,39
4. R value of doors 0 / Y •
5.; R value of floors .over unheated spaces
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 (above grade)
9 R value of heated basement/cellar walls (below grade)4^/C
10 Type of insulation /"i/eL /4 C> tl- .-C7744.14';•+
C.f Co'ntrols SQ
1. Thermostat maximum heat setting 7
D'. Duct Systems
l-.;,; Is duct system installed in unheated spaces? YES NO
• 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
2,•.. R value of pipe insulation
F.' Service Water Heating
1'.': Performance efficiency
2' ` ` Temperature control setting maximum
G. ., For Swimming Pool Only •
1;.:: . "Maximum heating
Telephone No. (OZ/S_ 1/3e
(ap plicant ' s sign ure)
o Ottandrietr
nATRn
APPLICATION FOR SEPTIC DISPOSAL PERMIT
2U►iII;G 1:D1.D0 CODES OU r.
:. 10'01OfOUCU OILY
•
DA'1'L', �..
LOCATION 0F PROPERTY FOR INSTALLATION �FJj. v
Owner's Name:-Itc rF Telephone: _`i 97 95f."?
Address: _ ''i ! . 2c: /A 5 10'
Installer's Name: ' > S 41,/A Telephone: J'J3 ,j/3c
•
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom) 300
Topography: circle one:40 Rolling Steep Slope % of slope -14 t
Soil Nature: circle one- Sand oam Clay, :Other / Depth: feet
Ground Water: At what depth? �� feet
Bedrock or Impervious Material At what depth? feet
PercoLition test: circle one: not required required / rate O-S min.. inch.
Domestic water supply: circle one: (unicipaTWell. Other.
IF domestic water supply is a .Well:
Separation: Watersupply from Septic absorption NIA feet
PROPOSED SYSTEM:. Septic Tank%Gtjl/ gal. (minimum size: 1,000 gal.)
:ac - - -
SEEPAGE P1T(S) Number of a A / Size each y
feet li' feet
Size of stone to be used II / Depth or Thickness feet
* *. *. i * 4 s 4 * * * * 4 * * * 4 4 * * * * * * * * * * 4 * s ? * * * *
IMPORTANT
...Plea e...LIST NEW EQUIPMENT TO BE INSTALLED
4 * *:* * 4 4 4 4 4 4 4 4 4 4 4 * * 4 * * 4 * 44 4 4 4 4 4 44 4 4 4 4 4 4 * * *
(over).
•
•
Section II . Septic System Inspections: '
A. ! All applications for septic system installation, alteration or repair, as
;, required by the Town of Queensbury Sanitary Sewage Ordinance, shall
be submitted to the Building Department at least 2.1 hours before start
. of construction and shall include a plot plan showing: •
1.) the proposed location of the system '
2.) `location and distance to lot lines
•3.) location and distance to structures
4.) 'location and distance to any water supply
.• 5.) .size and dimensions of all tanks, distribution
boxes, tile fields and/or drywells . ,
B. No system shall be covered before inspection and approval by the building '
Inspector. Failure to comply with this requirement may result in the
. uncovering of the system by the installer and a fine of up to $250.00.
C. An approved copy of the plot plan shall be available on the construction
site. Failure to produce said plot plan at time of inspection may result
in an immediate work stoppage.
D. Should unforeseen problems during construction prevent proper installation. •
alteration or repair of an approved system, a new proposal must be submitted
to the Queensbury Building Department before further construction.
I have read the regulations above and agree to abide by these'and all requirements •
of the Town of Queensbury Sanitary Sewage Disposal Ordivanc . '
Signature of,responsible person: �57-s-1-1.- e S-- 7
Date: 8 Z-?/FS/ . roc,- J O_S- / j ci
Town of Queensbury .
Building and Code.Department
' tray at Haviland Road
Queensbury, New York 12801
•
(518) 792-5832 •••
. I r r, I
INTERIM BUILDING PERMIT
PERMIT APPLICANT
CONSTRUCTION LOCATION /
EFFECTIVE DATE
APPROVED BY
/1
SPECIAL CONDITIONS :
This will certify that all submittals for a Building
Permit have been received and fee has been paid .
During the processing of the Permit , the above named
may begin construction per plans submitted . It is the
responsibility of the applicant to obtain the Permit
from the Building Department, following proce9„sing .
/9/ /
7..7)
POST THIS INTERIM PERMIT IN A CO SPI/96,118/5WCA,TT,ON ! !
W 5
Building & Codes Department
TOWN OF QUEENSBURY
FILE COPY
• YOU ARE HEREBY REQUESTED TO
- INSPECT AND ISSUE CERTIFICATES
FOR THE FOLLOWING ELECTRICAL
EQUIPMENT TO BE INSTALLED BY
•
THE UNDERSIGNED
• TEMP# DATE.
CITY OR VILLAGE _jj .• TOWNSHIP COUNTY
STREET AND NO.OR ROAD' ':({. !l� rryt POLE NUMBER
f,._ ,}G'f 3 7/`r ! (., - . .
BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? SECTION -- BLOCK - LOT
OCCUPANTS NAME _� - BUILDING OCCUPANCY
I 2( / •
OWNER'S NAME AND ADDRESS; _ HOME TELEPHONE NUMBER
y.
CURRENT SUPPLIED BY,, s FROM THEIR OFFICE i' , WORK TELEPHONE NUMBER
BUILDING IS -
• NEW 0 OLD❑ • WORK IS NEW CE ADDITIONAL❑ DEFECTS REMOVED❑ •
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETS No.of Fixtures& MOTORS HEATERS BRANCH OFFICE USE
Loca- Lamp Receptacles CIRCUITS 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:
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 MAINS - ' . . FEEDERS ELECTRIC SIGNS/LAMPS • TOTAL WATTS
CHARACTER OF WORK - ❑ EXPOSED GAS TUBE-SIGN(TRANSFORMERS OF VA
- ' • ❑ CONCEALED .
DATE WORK TO BE STARTED DATE COMPLETED SIZE OF SIGN(NUMBER) "CAPACITY
•
SERVICE ENTERS BUILDING MANUFACTURER OF SIGN
❑ OVERHEAD ❑ UNDERGROUND
DATE INSPECTION REQUESTED ON(OR AS NEAR AS POSSIBLE) MUST ENTER APPLICANTS ►
IDENTIFICATION NUMBER
AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
PRINT NAME AND ADDRESS ; ' ;I i
NAME OFAPPLICANT - 7 �/
DATE APPLICATION SIGNATNRE:OF APPLICANT f -
STREET ADDRESS_ _ •-1 TELEPHON'O -
-2. .; _ - _
? C/ l✓�-, ZIP CODE LICENSE NO.WHEN APPLICABLE
C{TYOgPOSTOFFICE ^h /f t/ . - -
6 Y , - j /7.;. - /I,/ s i. - i 6 /
❑ 85 John Street - ❑ 41 State Street. ❑ 584 Delaware Avenue ❑ 217 Lake Avenue ❑ 202 Arterial Road
NEW YORK,NY 10038 ALBANY,NY 12207 BUFFALO,NY 14202 ROCHESTER,NY 14608. SYRACUSE,NY 13206
TI NI IA/ yr nv u P( ARn nF FIRF UNDERWRITERS
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12801
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED ;/�/v
NAME -----.- 'fO777G.2 /-62•Q�I 1-'61(i9
LOCATION / ��u� -'?
DATE /7-/C" PERMIT # fjy- �, 3
QAPPROVED
— GL/'(,4 /C IJL.�- YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING '
ELECTRICAT ROUGH-IN
INSULATION:``•.
FOUNDATION
FLOORS f`
ALLS
EILING
✓✓FINA L INSPECTION: \
CHIMNEY HEIGHT ;`•
ROOFING /j
SIDING
i
EXTERNAL PORCHES/STEPS•:,
STAIRS-CLEARANCE & RAILS
PLUMBING FIXTRES/RELIEF 'VALVE
INTERIOR TRId/PRIVACY DOORS
FINISHED FLOORS
GARAGE FIR 'PROOFING
DOOR CLOSE (S)
SMOKE DET CTORS
FINAL ELEC RICAL INSPECTION \
FINAL APT OVAL OF CONSTRUCTION • '
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMAR
(VC--
/ A: 4, 1
(/A
\ C''V/7 /1 70 6:-(. t<:e/ill'i
,,,,-, /
INSPFtcTOR
_/own of Queenitur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION y'
NAME � S f�CJ�C � ) /�O' `,-Ls
LOCATIO 7�'11/(VS (rn,e
DATE 1 q/ PERMIT NO. c(�`6 ?-/
SOIL TYPE - Sand - Loam - Clay -
Percolati n Test Required? YES - NO
Percolatio rate - Min/Inch
TYPE of SYS EM:
Absorption f eld, total leng h
Length of eac trench
Depth of trenc s
Size of gravel_, /
SEEPAGE PITS{Numbr of) / 1
Size- cr ft. X '\ ft. f
Gravel size
PIPING: gize Type
Bldg. to tank %A'C
Tank to dist. box /' 7/0'L
Dist. box to field/p t /GIB.,
Openings sealed? -ES 0 Partial
LOCATION/SEPARATIO S:
Foundation to tan ft.
Foundation to absorption �' t.
Absorption to lol line -h ft.
Separation of p31ts - 'ft.
LOCATION ' SYSTEM-0 ROPERTY(ci &cle one)
Front - ear - eft side Right s e -
, COMMENT
\
SYSTEM USE APPROVED ES NO
. •
. ___
Bui ingylnspector
01/86 and vl
awn o/ Queenilury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION
Date C.
.;215/ c' Permit No. Sc'--,6'g,
* * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES / NO
Footing/Pier Forms
)(Foundation /,
kWaterproofing 1
)ackfill 1 f
Framing '
Roofing `t '
Siding t °
Masonry Veneer /
Rough Plumbing
Relief Valves r
Ext. Porches /
Finished Floors
Interior Trim
Stairs & Railings ,;'
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures is
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- /?
--), .//
I)/
/(./p „/l /
'-------'----------"----T-/ /
Building Inspector
6/86 and-vl '
Jown of Queeniur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME c_1/€Qe c`cc
LOCATION / .2e<4as � •
Date y
g / ow- Permit No. / " 6i
* * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES / NO
,cFooting/Pier Forms L-----
Foundation
Waterproofing
Backfill • `
Framing •
Roofing
Siding
•
Masonry Veneer
Rough Plumbing
Relief Valves 3•'
Ext. Porches .
Finished Floors
Interior Trim
Stairs & Railings il
Cellar Drain Tile •7
Concrete Floors /
Plbg. Fixtures / •
Gar. Fireproofing
Door Closers rI •
Smoke Detectors
Chimney ,f
INSULATION:
Foundation/ .
•
Floors
Walls
Ceiling' I
FINAL ELECTRICAL INSPECTION •
DRIVEWAY APPROVAL
Final Building Survey •
Next scheduled inspection (call when ready)
Remarks-
\, g Inspe or
S/86 and-v
5_„:„ 6,?0,
October 31, 1988
Raymond Buckley, P.E.
Box 7 Star Route
Glens Falls, New York 12801
Tom Derecko
2 Zenas Drive
Glens Falls, New York 12801
Re: Modular Home Inspection - #1 Zenas Drive
Dear Tom;
I have inspected the recently installed modular home at #1
Zenas Drive. The modules have been properly assembled and
secured to each other and to the building foundation as required
by the plans I had previously certified and by the New York State
Building Code.
Respectfully submitted,
"gam--�- -v
Raymond Buckley, P.E.
Mary.
.. .. i,•y .h{ �� : lee ;+
•
} .
----t. DEVELOPMENT CORP.
P.O.Box 3•Lake George,N.Y. 12845•(518)623-3138 ,
PLOT PLAN
( J• FOR LOCATION OF STRUCTURE ON.SITE
.
Customer i/"°K-1s - )�,'L-c/_� - Tel # 7 9 — yS51
Job Site Address or.Legal Description / 2 c../4 s D.e,uc a-,e&N`e(i.- 1J. c_f i 2 /
1-1--c L.J i 1 c:Ur"10,/-f r b-T
Model S Tv Le-c ,rT C- 1 ( -,- L/ x 3 i ) .- Foundation Style Pc---`: - ''
DRAW IN JOB SITE LOT BELOW WITH DIMENSIONS IN FEET, LOCATE HOUSE PLACEMENT,
STREET NAMES, SET BACKS, PLEASE BE ACCURATE WITH DIMENSIONS
1
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