1990-774 .::.CERTI CATS OF OC U AN Y
TOWN OF QUEENSBURY
WARREN COUNTY, NEW :YORK
Date November 26 19 IQ
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This is to certify that work- requested to be donee=-as shown by. Permit No. 90�574 ,
, has been completed.
' This structure may be occupied as a single family inhi 1 P homy
' p Lot 51 Northwi nds.
Location
LAMPLIGHTER. HOMES
Owner
r By Order Town ,Board
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/. TOWN'OF QUEENSBURY
i
• Bldg. &
Director of Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY No 90-774
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to LAMPLIGHTER HOMES w
Lot 51 Northwinds
OWNER of property located at Street, Road or Ave. ifl
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
Northwinds
Luzerne Rd
Queensbury NY 12804
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2. CONTRACTOR or BUILDER'S Name
1-1
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Lmaplighter Homes
3. CONTRACTOR or BUILDER'S Address
RD#2
Fort Edward NY 12828
4. ARCHITECT'S Name
5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
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( )Wood Frame ( ) Masonry ( ) Steel ( ) -S
cr
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7. PLANS and Specifications
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No. 14'x70' Mobile Home as per plot plan, specifications and application.
8. Proposed Use
Single family mobile home
$ 35.00 PERMIT.FEE PAID —THIS PERMIT EXPIRES November 9 19 91 0
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the JI
town of Queensbury before the expiration date.) �p
9th November 90
Dated at the Town of Queensbury t Day of : 19
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SIGNED BY \ %2Z for the Town of Queensbury
Building and Zo idg Inspector
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c-� TO BE COMPLETED BY 11LDG. DEPT.
_2 w11 o/ Qu ,eiuiLu,.,, Application No.
UILDIG and ZONING DEPARTMNT Permit Issued ]9B1® OF Dl.1F�.'' (IRY
Day onq Havil�nd Road, R.D. 1 Box fl8 Permit •Expireelg� r,I. _k-
OudensDury, New York 12801 Zoning Designation
Variance No..
Site Plan Review No. NOV:. 1990
APPLICATION FOR Approved by:
MOBILE HOME BLDG. & CODE DEPT.
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PU I LD I N G AND ZONING PERMIT • 2 D —lief
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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 au may be indicated on the Permit.
1'hu owner of this property is:
P.U. Address /4 ' +,A / jr ./'' ' Tel. 3—�.3 y
Property Location:
��......:!r�i Tax Map No.
Street• I:umbcr or building lot number '
luLdivision name (if applicable) .
. XrHE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
/47-f-7-gleLJ
1,101
Y.O. Address/Al* (�/i L 7 2
/ !� 71 -73 f
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Tel. No.
tune of Installer Address 'i '
+emu ul' plumber • •Diu.[- , L. Tel. ?�J? --7, ai
Adc]ress %':' �Z C co�,w -0L Tel. J1 7,3L
Address JOA t' , c../ • Tel. 7 9./ - 73 1',;(
!OBILE HOME INFORMATION: + . ZONING 1NFORMATICr1:
low home Placement )‹. . + A PLOT PLAN MUST BE PREPARED AND SUBMITTED, .
ceplacing existing Home ' drawn reasonably to scale and attached hereto,_
r�// showing clearly and distinctly all buildings,
:ize of new Home `f ft X /y ft • . * whether existing or proposed and indicate all
:inglc v./ le -/- Double wide +.set-back dimensions from property lines. Give _
street .and number or lot number and indicate
to, of rooms (excluding baths) + whether interior or corner lot. Show location
to. of bedrooms .� • of water supply and location and configuration
nn + of.,septic disposal area.
to. of bathrooms d + •
7� _ + COMPLETE INFORMATION REQUIRED BELOW.
'fireplace? f� Wood stove? • Size of property 53 ft--.X /l0 ft.
oundation style and size: , ! * Existing building(s) Size ft X ft.
i
.iors- No.of Size- t xafr g. •.
Existing buildiny(s) Use
Depth below grade r( Eg, •+
OUNDATION _ Footing size �� X •„ I'ropobed buildiny,, distance from property line
+ Front yard ccf- ft Rear yard / ft
tall material PM + Side .yards /0 ft and 7 ft
all thickness " Height ✓ ft. . If on corner, setback from aide street ft
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otal depth below grade ft. + OCCUPANCY INFORMATICdV
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rade to Home floor level gig . PRIMARY BUILDING -
i * + One family dwelling
+ •Two family dwelling •
roposed date of placement // / �', /7O + Multiple dwelling /. Number of units .
prox. Value. of Home $ /5-d '6U * Pernwnent occupancy
+ 'transient occupancy
ater supply - Well Municipal X Business
* Industrial
optic Permit required? /9 • Other
,?1,4-41--r441)4,11slerli , If addition, what will use be?
JRTHER INFORMATION REQUESTED +
+ ACCESSORY BUILD.ING-
N THE REVERSE SIDE OF THIS SHEET.* Detached garage/one car/ two car/ car
* Attached garage/one car/ two car/ car
• Private storage building
* Other
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Form MIIP 5/86 and-vl
APPLICATION FOR MOBILE HOME PERMIT, (CONTINUED)
State of New York Division of Housing and Community Renewal
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INSIGNIA OF APPKOVAL OF THE STATE BUILDING CODE
. INSIGNIA SERIAL NUMBER
• NAME OF MANUFACTURER •
PLAN APPROVAL NUMBER PA)
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. MODEL OR COMPONENT DESIGNATION fe) 2- 6 /‘/X`26'
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MANUFACTURER 'S, SERIAL NUMBER
DATE OF OF MANUFACTURE ///,7O
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All the above information is to be found on a plate or sticker which
•ould be affixed to the Mobile Home. Complete .above with that information.
A A 4 4 4 4 4 4 4 4 4 44 4 4 4 4 4 44 ' 4 4 4 4 4 44 4 4 4 444 4
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'own of Queensbury
AFFIDAVI T STATE OF NEW YORK
:ounty of Warren
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I swear that to the best of my knowledge and belief the statements contained
•n 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
xovisLons of the BUILDING CODE, THE ZONING ORDINANCE, and all other laws pertaining to
he proposed work shall be complied with, whether specified or not, and that such work is
•uthorized by the owner. • • • • • • •
SigiiatureiLl„A47Cie _
Owner, •other s age t,arcniteci,c traci—r
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* * * * * * * * * * * * * * * * * * * * * * * * • * * * * * * * * * '* * * * * * * * * . •
aJECIAL CONDITIONS OF THE PERMIT:
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il�,,."... MIDDLE DEPARTMENT INSPECTION AGENCY;INC. -
' National Headquarters
�•-•// • 1337 West Chester Pike,West Chester, PA 19380
APPLICANT COMPLETES THIS SECTION Date: /y. C/ ..`
City, Town or Township 0, •< •< J L� , ,/ County •j�..lq ;- ;,,„ State A( �/�
Location/Address / I ;/1 A! C k i 1-, ;/ ;. l c 1 r l :' _',--�, f`-J,
`-(If Located in Rural Area-Please Attach Directions) Pole #
r
Owner j L v r, ,,,,1 '') I ' I- 1" -E" '' A 0 v.z„ /,,. "Permit # 90 /
Occupied As Building:' New❑ - Old❑
Occupant
Work Area in Building (Floor #,etc.): _ -
App. for: Wiring❑ Servicecr: Ready for Inspection:
Fee Remitted-$ Cash n Check❑ M.O. 7- • Make Payable To: M.D.I.A.
• 500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000 -
Number of Rough Wiring Outlets Elect. Heat
Switches -
Lighting Amp. Service Surface Unit Dishwasher Range
Receptacles Water Heater Air Conditioner Dryer ' Pump
Number of Fixtures Oven - Garbage Disposal Wiring and Controls for Burner
Amp. Receptacles Fractional H.P. Vent Fans
• Other Equipment:
MOTORS H.P. 1/201/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 1,/2 2 3 5 7,/2 10 15 20 25 30 40 50 75 100
Mark Number
of Each Size - •
Applicant's
Signature License # " Permit #
T/A /" n — ) r / r Utility:
L VI `' , �, i / `' ' (NAME) (OFFICE LOCATION)
Applicant's Address: � `}
(City) , I--,`�4 ; 0 r-/' (State) / (Zip) �`� Service Request #
Phone # - Electrician:
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MDIA USE ONLY 'DATE RECEIVED: "' / // ( C v DATE INSPECTED: ///
Correct Location: Same as Above n or:
- Red Notice Label n •
Rough Wiring Outlets Surface Unit Oven
Switches Range Garbage Disposal
Receptacles Water Heater Dishwasher
Fixtures Air Conditioner Dryer
) -_ Amp. Service Equipment Burner,Wiring &Controls for Amp. Receptacle
Amp. Service Conductors Pump Vent Fans
MOTORS H.P. 1/20 1/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1- 1'/2 2 3 5 7,/2 10 15 20 25 30 40 50' 75 100 '
Mark Number '
of Each Size -
500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000
Elect. Heat
CERTIFICATIONS USE FOR INITIAL VISIT ONLY NOTIFIED DATE CORRECTFEE FEE PAID
❑ Progress: Inc.❑ LKD I I Contractor
1Comp.❑ Inc. ❑L1 CFT Violation: Work L/( L/A Owner CASH ❑
Fee _ CH K #
L/A Due
n IPA Municipal MO #
' - INV #
Date: ?� - - Other Side El '`
Utility Applicant . ❑Owner
Cut in Card 'n Temp # • - Date ii-
/ ' --,......---01..44_,/ -
1 / INSPECTORS SIGNATURE
n Final # Date d
APPLICATION FORM NO.250'EL 11/89 •
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT 1,3/,( 2
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12801- •
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED )/h /`(J
NAME 417://-11).2h&-1. �,,-/
LOCATION , 7 frt 1(///-77/�„
DATE ///V9Z) PERMIT # �U-7/X
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL .
ROUGH PLUMBING
FRAMING .
ELECTRICAL ROUGH-IN '
INSULATION:
FOUNDATION If
FLOORS. . . .
WALLS •
4 /
CEILING P
XFINAL INSPECTION: �CHIMNEY HEIGHT / q
ROOFING /
SIDING f /
EXTERNAL PORCHES/STEPS /
STAIRS-CLEARANCE & RILSf
PLUMBING FIXTURES/RE IEF VALVE
INTERIOR TRIM/PRIVACY/DOORS
FINISHED FLOORS
GARAGE FIREPROOFING 1
DOOR CLOSER(S) 1
SMOKE DETECTORS
FINAL ELECTRICAL SPEpTION
.FINAL APPROVAL OF CONS RUCTION
OK TO ISSUE C/O OR C/
A SIGNED CERTI ICATE O• OCCUPANCY MUST BE
OBTAINED FROM THE BUIL ING DEPARTMENT BEFORE
THESE PREMIS:S ARE OCCUPIED!
/ 1
,�REMARKS: , ,25X.TC2 /fD/ 07,ei. 2
��5 nu/ei-' nv t =
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/G a Wa/e /ii- home_-,---C3o
49r. fr // ki/2 y wrlde-4�
0 Lo crc plc 1- R-L
ARRIVE `. 3 J
DEPART I �� /tc_.)
INSPECT R
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 1280k
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR NSPECTION RECEIVED /%%:,2
NAME ��')��� �lJA,/ lf �
LOCATION /�� /7(}). , 0 �
DATE //// / ed PERMIT # -77y`
APPROVED
YES NO '
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING •
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN ' ;1
INSULATION: 1
FOUNDATION
FLOORS.
WALLS
CEILING •
*FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/STEPS «,
STAIRS-CLEARANCE & RAILS j
PLUMBING FIXTURES/RELIEF VALVE
INTERIOR TRIM/PRIVACY DOORS /
FINISHED FLOORS ./
GARAGE FIREPROOFING ;/ Ai/I-
DOOR CLOSER(S) 444-
SMOKE DETECTORS
FINAL ELECTRICAL INSPECTIO/,N
-FINAL APPROVAL OF CONSTRUCTION J\
. OK TO ISSUE C/O OR C/C /
/
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS: ,6f} l f1 5.1s 4;0 i C'`J L t.4r`ivL
CA-53 11,16.---TC-K-A-17-541-- W ATe'ria. INT & -
• Cam.o ,)) t�
ARRIVE 2 /L r
DEPART - 0 /•
y /
INSPECTOR
MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
Electrical-Building-Plumbing-Fire Inspections
. ,
Date It. 411'
climitt410110—_
1„..cto
T' - constitutes certification that the
above installation;S but not the equip-
• ment itself,has been visually inspected
as of this date pursuant to the applic
able codes. If additional equipment
•'should be introduced •or alterations
• made to the existing system or struc-
• ture, application for inspection should
be submitted promptly to this Agency.
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i'OWN OF QUEENSBURY
RECEivFn
NOV 7 1990.
SS • B . & CODE DEPT.
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3I �•� •/ y � :< /o - >
TORN OF CIL,FENSBURY
Zoning Administrator
Jstrator