1990-508 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
August 23 19 Date
90
DI
This is to certify that work requested to be done as shown by Permit No. 90-508
has been completed.
This structure may be occupied as a sins)e fRmily mobile home
Location
Li�2��f� V�-- 1 of 12 NORTHWINDS
_.,
NORTHWINDS INC.
Owner
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY No. 90-508
WARREN COUNTY, NEW YORK b
z
0
PERMISSION is hereby granted to NORTHWINDS INC. w
OWNER of property located at Lot 13 Northwinds Street, Road or Ave. co
in the Town of Queensbury,To Construct or place a Single family 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
Luzerne Rd z
PO Box 224 O
Glens Falls NY 12801
y
2. CONTRACTOR or BUILDER'S Name
Adirondack Housing
3. CONTRACTOR or BUILDER'S Address
114 Saratoga Av 0
S Glens Falls NY 12803
4. ARCHITECT'S Name
5. ARCHITECT'S Address 0¢¢
f!a
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( ) Steel ( )
7. PLANS and Specifications
No. 28'x66' Single family mobile home as per plot plan, specifications and
application. aq,
m
8. Proposed Use
Single family mobile home .
83.00 February 9 91
$ PERMIT FEE PAID —THIS PERMIT EXPIRES 19
(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.) 0 O
9th August 90 CD
Dated at the Town of Queensbury this Day of 19
`
SIGNED BY \•/ wn ice/ for the Town of Queensbury
Building and Zoning Inspector
•
TO BE COMPLETED BY BLDG._ DE1 r.
/ Application No. ?'--S�awn 019 QueeniburBUILDING andZONING DEP Permit Issued � 19 y'D •
DEPARTMENT Permit -Expires 19 •
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation °C3iPJN OF VENS URY o OF
Oueensbury, New York 12801 Variance No.: RECEIEI VE i
Site Plan Review No.
APPL 1 CATION FOR Approved by / _ •
AUG 0 3 1990
MOBILE HOME
iI
t LDG. &.CODE DEPT.
• PUILDING AND ZONING . PERMIT ' ` • a, • h
* * * * * * * * * * * * * * *• * * * * . * * .. . *• * * * * * * * * * * * * *::*
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. /J
/el
• The owner of this pro erty is: -• 1tki--71/�r�) i rl aS.,
•
P.U. Address n BoX �.-3-`{ G t`C'kc ` CL/t S Tel. e7g2-`7ZS_/--7
Property Location: Les( (: Yl..,.)0y-` 4.) i A �, Tax Map No. 9fl A/ 47
Street Number or building lot number
Subdivision name (if applicable)
TILE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
AD 1►26rL ti4c k ' 1-1sust A Sort_ ,,e. sow G As 77 co
Name P.O. AddrT HA
Tel. No.
Name of Installer Address Tel.
Name of plumber Address Tel.
Name 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 * showing clearly and distinctly all buildings,
Size of new Home ZS-ft X 4 (a ft . * whether existing or proposed and indicate all
• * set-back dimensions from property lines. Give
Single wile • Double wide *. street and number 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? ), Wood stove? * Size of property ft X ft.
Foundation style and• size: » Existing building(s) Size ft X ft.
Piers- No.of Size- ft x ft. * Existing building(s) Use
*
Depth below grade • ft.
FOUNDATION - Footing size g " * Proposed building, distance from property line
* 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 •
* OCCUPANCY INFORMATICN
Total depth below grade ft. *
Grade to Home floor level ft. * PRIMARY BUILDING -
* * * * * * * * * * * * * * * * * y t * * One family dwelling •.
* Two family dwelling
Proposed date of placement _ / c 1 7 d: Multiple dwelling / Number of units
Aprox. Value, of Home $ :�� e)o-7" * Permanent occupancy
' * Transient occupancy
Water supply - Well Municipal > r Business
Septic Permit required? e C � * InduOthestrial
* r
* 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
. TOWN * Attached garage/one car/ two car/ car
A` '� J " Private storage building.
4 Other •
8uTLD; NG IA 1 .011 DE PT.
rREVIEwED BY •
Form"I�1T
eTE -rc --
APPLICATION FOR MOBILE HOME PERMIT, (CONTINUED)
State of New York Division of Housing and Community Renewal
INSIGNIA OF APNnOVAL OF THE STATE BUILDING CODE
1 . INSIGNIA SERIAL NUMBER /C 11-0 s S Li fj � 1 -
2 . NAME OF MANUFACTURER p bvk: dt• y?
3 . PLAN APPROVAL NUMBER (j Li 6 C7 -
•
4 . MODEL OR COMPONENT DESIGNATION c-Pr G. v A•c.A.5 p D .
•
5 . MANUFACTURER 'S SERIAL NUMBER r I 6c) -B
6 . DATE OF MANUFACTURE • -- ` 9 o
•
•
•
•
All the above information is to be found on 'a plate or sticker which
should be affixed to the Mobile Home. Complete .above with that information.
* * * * * * 4 * * * * * * * * * * * * if •* * * * * * * * * * * * ** * * *
Town of Queensbury
County. of Warren A F F I D A V . I T STATE OF NEW YORK
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
Owner, owner's agent,arcnitect,contractor
•
•
* * * * * * * * * * * * * * * * * * * • ,* * * * * * * * * * * * * * * •* * * * * * * * * * •*
SPECIAL CONDITIONS OF THE PERMIT: /
,K1•
`A c/f .
7/(1°
•
By•
_f
,
YOU ARE HEREBY REQUESTED TO
INSPECT AND ISSUE CERTIFICATES
FOR THE FOLLOWING ELECTRICAL
EQUIPMENT TO BE INSTALLED BY
THE UNDERSIGNED �--. _
TEMP.# DATE .-.--;GI_ /--; ,� /
CITY OR VILLAGE TOWNSHIP COUNTY
' 1 - i _!` i
-
STREET AND NO.OR ROAD I POLE NUMBER
BETWEEN WHAT TWO CROSS STREETS Id PREMISES LOCATED? SECTION BLOCK LOT
OCCUPANTS NAME BUILDING OCCUPANCY
OWNER'S NAME AND ADDRESS I HOME TELEPHONE NUMBER
CURRENT SUPPLIED BY FROM THEIR - _ ] OFFICE WORK TELEPHONE NUMBER
BUILDING IS J
NEW❑ OLD❑ WORK IS NEW❑ 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
DIVE 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 /2
NAME\OF APPLICANT DATE OF APPLICATION
f _SI F APPLICANTT.(1\ i fi.i, I 'v/ . :i I F-- ` �(( )::"i1 E `I; ) 11 C ; X �p^-&-,0 '-1 (,(e, t
STREET ADDRESS )
i TELEPHONE NO.
CITY OR POST OFFICE' f' ! % ZIP CODE Ir11C@�1tNOrWEN'AyPILfCABL
•
{ // r
85 John Street J 41 State Street Cl CI DelaWare Avenue CI217 fake AVena 202 Arterial Road
NEW YORK,NY 10038 ALBANY,NY 12207 BUFFALO,NY 14202 ROCHESTER,NY 14608 SYRACUSE,-NY 13206
(212)227-3700 (518)463-2122 (716)884-1155 (716)254-0141 - (315)463-8552
TI-IP NFW YnRK RCARf OF FIRE 11N1)ERWRITERS
ELECTRICAL INSPECTIONS •
. DUPLICATE MUNICIPAL RECORD
ii,
Permit No. 5v,o
Owner P ✓71/111_ --
Occupant ) , r
Location ----_- - � �l..ft--Y' -L�l-x V��C�
No. L
u '/Street
u-e_�n-s u -0u
--i~y /I6
Town or City State ,
Installation as itemized on reverse side has been visually inspected pursuant to applicable
codes.
Installed by if:7,-Tt (11 Z i eG:747:=-r_C-.
No.
r - Date,--_-Cl - a 3 -� - --- Inspector
MIDDLE DEPARTMENT INSPECTION AGENCY INC.
FORM NO.18 EL. 900 Haddon Ave.,Collingswood,NJ 08108
ROUGH WIRING OUTLETS H.P.AIR CONDITIONER
OUTLETS WIRING &CONTROLS FOR BURNER
RECEPTACLES H.P.PUMP
FIXTURES K.W.OVEN
AMP.SERVICE EQUIPMENT H.P.GARBAGE DISPOSAL UNIT
AMP.SERVICE CONDUCTORS - K.W. DISHWASHER
K.W.SURFACE UNIT K.W. DRYER
K.W.RANGE AMP. RECEPTACLE
K.W.WATER HEATER FRAC. H.P.VENT FANS
MOTORS H.P. I/20 1/12 I/I0 % % '/ 3/3 '/2 3% 1 11/2 2 3 5 71/2 10 15 20 25 30 40 50 75 100
MARK NUMBER
OF EACH SIZE
APPARATUS
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT n
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 1280$
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT�i
REQUEST FOR INSPECTION RECEIVED O Q
NAME gjp-1�/UJI/y,d 4
LOCATION h.� M /p�
DATE 11/20.[ 9\\ PERMIT # 9d;_-o f
/ APPROVED
YES NO
FOOTING/PIERS \ /
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL \
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN\
INSULATION:
FOUNDATION
FLOORS . . . .\ .
WALLS
CEILING
1( FINAL INSPECTION:
/ ' CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/ST S
STAIRS-CLEARANCE & IL
PLUMBING FIXTURES/ ELIE VALVE
INTERIOR TRIM/PRIV CY DO S
FINISHED FLOORS I
GARAGE FIREPROOFING
DOOR CLOSER(S)
SMOKE DETECTORS I
FINAL ELECTRICAL INSPECTION
_FINAL APPROVAL OF!CONSTRUCTION \O I L f'-51)
OK TO ISSUE C/O OR C/C OcKL,
A SIGNED CERTIFICATE OF OCCUPANCY`MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS: V 1.670DP/41 ®VA
ir, pg.. 5-3-0 r — D) 1.7---- 1-4
rAIr-L £L, e, (lll Pillii
ARRIVE
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DEPART '
INSP CTOR
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