1990-444 • ".._
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CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date A i,sri isr 19 .i1
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90-444
This is to certify that work requested to be done as shown by Permit No.
has been completed.
This structure may be occupied as a
mobile home
\ ,7 1L76 Northwinds
Locarion 6 L( 4 7ty/1 �� �-C
Owner VALERIE LE ROUX
By Order Town Board
TOWN OF QUEENSBURY
y
Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 90-444
WARREN COUNTY, NEW YORK •
PERMISSION is hereby granted to VALERIE LeROUX
OWNER of property located at Mobile Home Street, Road or Ave.
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.
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1. OWNER'S Address is
0
2. CONTRACTOR or BUILDER'S Name
O
Lamplighter Homes 18'
3. CONTRACTOR or BUILDER'S Address
RD#2
Fort Edward NY 12828
4. ARCHITECT'S Name
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5. ARCHITECT'S Address
6. TYPE of Construction— (Please indicate by X)
( 1 Wood Frame ( 1 Masonry ( ) Steel ( )
7. PLANS and Specifications
No. 14'x70' Mobile home as per plot plan, specifications and application.
8. Proposed Use
O
Single family mobile home.
$ 35 00 PERMIT FEE PAID —THIS PERMIT EXPIRES 19
January 9 91
(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 thi th Day,o 19 90
SIGNED BY for the Town of Queensbury
Building and Zorfi Inspector
,..•
TO DE COMPLETED BY BLOC. DEPT. el
/...1
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-juivil 41 61"fen41_44._rti . Perstit Isaued Application No. 19 '
lOWN OF QUEENSBURY
BUILDING gnu ZONING DEPARTMENT ' Permit ..Expirea - . 19 ,':
REOFIVFO
Day ana Havaand Road. Rill 1.Box 08 Zoning Deaignation • .
Quuensbury. NO*;VOrk-120017 -. ' Variance No. . .
,::: ':-:-:',7',--•-_- ' = Site Plan Review No. J
• UL" 0 -5 1990
APPLICATION FOR- ' • .' APProvii4.4Y8 - • - - •
MOB!LE HOME
BLDG. & CODE DEPT.
.
. : 0 ._;IT I LD I NG AND ZONING PERMIT ' - - '. . I 14 At ,
* . * • • • • * • • • • * • • • • • *, Ai, ii. • • •• * * *I.* • • • • * * * * • •::*
A PERMIT MUST BE OBTAINED BEFORE BEGIMING-.CCNSTRUCTION. ANSWER ALL OF THE FOLLOWING.
The undersigned,hereby applies for a Duilding' 13ermit to do the following work which will
Lc done in accordance with the description.. plans and, specifications submitted, and such
special. conditions. as may be indicated on the'PerMit.
....... .02.12
The owner of this ,property is i p/;14,VIA-Li' (4e/4Zti6.
P.O. Mare:4a --
•Tel. ec2f-99(-3/op
..- Annomimaaminrommilemarst
Property Location: 7i., "1.8•Are..44,t-444-44., ' ' )111,7 Tax Map No.____
Street liumber or Luililing: lot n --- - - - Tax
Subdivision name, (if 'applicable)
TILE PERSON RESPONSIBLE FOR SUPER_V;sica OF WORK AS REGARDS BUILDING CODES IS;
ag,1473,/, fdicti M Foe -2,re.eeeia4,44_,4 - trie- 5:3 -
II •me : :-: 4 -. ... • KO.'. AfddreSLI : : ' -./ . Tel' Na• ' ' '
lll
ame of Instaer i0 Add--:s eau ieLf.9 411;1 3ted.r.4.41f41 )1- Tel: •Cle-7 " f,31-73 ';•:.< ,
,. kc./.. .. .
lume uf Plumber : - - ' Addreaa -:------' . • Tel. --7-- ' • . '
Aalw of mason '-------- . Address ' -----7 . , . -- - - Tel. ----7 ' . ,... . .. ., . ..
10BILE HOME INFORMATION: • ZONING.' INFORHATION:
Yew Home Placement 6/41,1 - .. It A PLOT:PLAN riUST'BE -,PREPARED-AMD SUBMITTED,
i • drawn reasonably to scale and attached hereto,
Replacing existing Home -- * Showing clearly and distinctly all, buildings,
Size of new Home / 1. ft X '7,0 ft . *• whether existing or proposed and indicate all
•
set-back dimenSions-frola propertY:linea. Give; ;: •single w'• te •-6,' Double Wide ,..• 1.• street. and::nUillbur,„.or41.40t-64thor ioid:indid.Atfl...
No. of
N roOms (e X' ei,••i aing ;41/4'i s).::47.- 4 *h4 *40044rf5ilOr' lo't Showlocation
,' = ct:water-SuPP1V:and: Iocation and configurationo. of bedroonis . • . - - ' !. -
* Cif septic disposal area.
No. of bathrooms .- I
'• • COMPLETE INFORMATION REQUIRED BELOW
Fireplace? NO Wood stove?' • -
• bize.'Of property Jo-?) ' ft X -5-. ft.
'
Foundation style and size Existing building(s)- Size . ft X ft.
:
• • ,
._ _
Piers- No.of 'Sire- -- ft x ft. " ExisLing building( )- Use
Depth below grade ft.
• Proposed building, distance tram property lino .
FOUNDATION - Footing size " X " .. •
-
-- • Front yard 5- - ft- Rear yard 45-.. ft
dell material • Side ,yards - ft and —72777—ft
Ball thickness .TM Height _
. If on corner, setback from side street ft • .
ft.
* , OCCUPANCY 1NFORMATICN .
total depth below ,grade _ ft. ,
..PRIMARY BUILDING -3rade to Home floor level ' ft:
* . ..../brte family,dwelling
. • * * * * * * * * • .. * .. * * * * *
• a • _Two family dwelling.;?
reposed date of placement /50 / 14 , : . MUltiple dwelling / Number of units
ntoccupancy.
Iprox. Value. of Home .$ ,,,2 r, 4/ ...:_,Peirmane 2/4 ft- • ;. .
, ,..--- • fransient occupan‘y .
dater supply - Well Municipal . s-- ,,, Business .
.' Industrial
Septic Permit required? -)i./6 is. .. .76i htt ir
• If addition, what will use be?
•
'URTHER INFORMATION 'REQUESTED: .. -. •,, , • • . .- -
ACCE.SSORY app.DTNG- . .
)N THE REVERSE SIDE OF THIS SHEET.* = - Detached garage/one car/ two car/ car i
' -Attached garage/one car/ two car/ car
' —
• PrivatePrivatete storage building Other : -
, • -••• ••
. . .... ..
• _ . . .
Form MI1P -5/86 md-v). : ,
,
,
• 'I
APPLICATION FOR MOBILE HOME PERMIT, (CONTINUED)
State of New York Division of Housing, and Community Renewal
INSIGNIA OF APPKOVAL OF THE STATE BUILDING CODE •
. INSIGNIA SERIAL NUMBER
sfrnt.eAf
. NAME OF MANUFACTURER eeptoi, it
. PLAN APPROVAL NUMBER 4.)//71
•
. MODEL OR COMPONENT DESIGNATION 21_,.4...4-:7C.71— LA).
. MANUFACTURER' S, SERIAL NUMBER twV0
,
• DATE OF MANUFACTURE • /01--7/70 •
•
All the above information is to be found on a plate or sticker which
hou id be affixed to the Mobile Home. Complete .above With that information.
4 A 4 4 * '4 • * * * * ** *
Town of Queenabury
AFFIDAVIT 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 the described premises and that all
provisions of the BUILDING CODE, intE ZONING ORDxNAticg, and all other laws pertaining to
Lhe proposed work shall be complied with,. whether specified or not, and that such work is
authorized by the owner.
Signature
C4/4441-e'k.L.2t('<4-iP-"I
ert o r a gent rchltect,cont actor
• •
•
• • •
. * * * * * * * * * * * * • • * * * • * .• • • * • • • • • • * * * • • '• * • • • * • * • • •
SPECIAL CONDITIONS OF THE PERMIT:
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gint/6 .n/10/41;4d ' 1 -y r
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16‘°
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MIDDLE DEPARTMENT INSPECTION AGENCY, INC. ��` C
p 900 do uen Aven C ollingawood NJ 08108
P S;.� ''J •--- _ 9 ; • Date August 2, 1990
Q1!� ° .lv , C
ertif leg that they electrical equipment listed has been examined and:is approved as being in accord e
with the National Electrical ,Code,.applicable governmental, utility.and•Agency rules. C
Owner: Valerie LeRoux,j 7 , r4, ,. occupancy Dwelling
st Occupant: Same
C
P Location: Lot 76 Northwinds, 4Queensbury-- '(Wa-rren TIIiGQeJ4fic5le+covers the electrical equipment and installation inspected this 6
date. If additional equipment should be introduced or alterations made to ,_,
existing system this certificate shall be null and void, and application for C
Service
inspection should be submitted promptly to this Agency.
Equipment: 100 Am
p`-`-,. i . ,� _, , ,,,, ,; __ ,.Holder of this certificate should present same to his property insurance carrier
' r� `., (agent or company)asevidenceof certification of electrical equipment approved
' as specified.,
P 1Lamplighter`Homes. - , ' c
Applicant: Sarato a Rd
i
g ,, .., No. 16-000107/031
[...fort Edward, NY 12828 :_,...2_,,.-z. C)
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Form No.703 EL 1-E3
)WN OF QUE SBURY iffiz-!/-7'
BUILDING AND C►'►ES DEPARTMENT fj
BAY & HAVILAND 'GADS �,�
ill '
QUEENSBURY, NE YORK 1280k - -
TELEPHONE (518., 792-5832
BUILDING INSPECTOR'S _ PORT
REQUEST FOR INSP CTION ECEIV D
NAME G�a'At 1/ 16` I /7 6'✓.%9f'l / /1
LOCATION ' , / /11/ 1(il / /'//1 /4 ,
DATE j G1 , PERMI # C7 _4/t L1---
v /
APPROVED
, YES NO
FOOTING/PIERS
1 MONOLITHIC POUR F RMS
FOUNDATION/DAMP-P OOFING/`
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-I
INSULATION: i
FOUNDATION
FLOORS
WALLS k I
CEILING
k
NI_INAL INSPECTION:
]CHIMNEY HEIGHT
ROOFING
SIDING B l'
EXTERNAL PORCHES/ EPS I. -
STAIRS-CLEARANCE & ILS /&r/-Z
PLUMBING FIXTURE ;/ LIEF VALVE L.!
INTERIOR TRIM/PRfV.&Y DOORS %-'
FINISHED FLOORS ' L
GARAGE FIREPROO N
DOOR CLOSER(S) t /j I%
SMOKE DETECTORS . ‘ !/-
FINAL ELECTRICAL NSPE TION Vl
FINAL APPROVAL OF CONS UCTION
- OK TO ISSUE C/O c C/C
A SIGNED CERTIFI ATE O SCCUPANCY MUST BE
OBTAINED FROM T BUIL G DEPARTMENT BEFORE
THESE PREMISES RE OCCUr D!
REMARKS: ! t ;-6- °
44/ 4 AW'42 '''
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a)4,07 / ,ir
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. ARRIVE / (4"X. 77'
fr ,
DEPART J / /
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INSPECTOR
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- - - - •-
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MIDIDLE DEPARTMENT INSPECTION AGENCY, INC.
Electrical-Building-Plumbing-Fire Inspections
7C /tAl
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Date _ ••• -Au
1 , -
nVit;
I •-ct T' - constitutes certification that' the.
- • above installation, 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.
0.= st ,. 76-
(1) o ,2_TtiLA) , ,. cis
TOWN OF 3 /J RI(
CEIVFD
- -- l 0 5 1990
- - CODE DEPT.
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