1989-581 WWI
CERTIFICATE CIFCCLTPI`�TCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date Sgptember 6 14 !L j
_ lI _ ) f
l Thi o ~certify that work requested to be done as shown by Permit No,. P'�` �$ I �
has been compleud.
Tl.is structure may be occupied as a Mobile Home
LUL2er�c�
Location J o IQ Luzerne road Northwi nds Park
I
r North*inds , Inca
owne
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. do Code Enforcement
{
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�'-- BUILDING PERMIT ru
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TOWN OF QUEENSBURY
No. $9- 5$ 1 '
WARREN COUNTY, NEW YORK w
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PERMISSION is hereby granted to
OWNER of property located at i-ot .#I1 ft 1 ulper a Road Street, Road or Ave_
in the Town of Queensbury, To Construct or place a Mohr_„ 141 __4iomp
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.
0
1 . OWNER'S Address is :C+
P . O . Box 224 z
Glens Falls . N Y -
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2_ CONTRACTOR or BUI LDER'S Name
Today ' s Modern
3. CONTRACTOR or BUILDER'S Address
54 Rte . 9
Gansevoort , N . Y . 12831
4. ARCHITECT'S Name
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S. ARCHITECT'S Address
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6. TYPE of Construction — (Please indicate by XI
Q
to
l ) Wood Frame i ) Masonry ( } Steel l 1 0
ao
7C
7. PLANS and Specifications t
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No. 60 ' x 26 ' Mobile Nome as per plot plan , specifications , and applicati na
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Existing Septic
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rn
8. Proposed Use
Mobile Home �
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$ 71 . 00 PERMIT FEE PAILS — THIS PERMIT EXPIRES February 1 ig 90
lit 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.!
C
to
Dated at the Town of Queensbury t �. Day f illily 1989 n
SIGNED BY -�• "�"r for the Town of Queensbury c
Building and Zo irg Inspector n
�j // 'In3 BE COMPLL'TzD ICY nuic. DEPT.
�lUWII 01 Quie didGurr Application No.
SUILDju+G Unu .ZOI41tVG OCPAnTPALZ IT lPw:rmit Isr3us3d ] 9 TOWN OF QUEENSBURY
Bay Una F1sviland Road, R.D. I Box OB ]Parmit F.Upiresa 1U RECEIVED
QuuonsUury, Now York 12801 Zoning Designation
vare plan
Na..
Site
JUL 2,4 1989
S3. a Dian Faa+,ric N
APPLICATION FOR Approved BLDG. & CODE DEPT.
MOBILE HOME
FU I LD I N i AND ZONING PERMIT
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
t.+s done i�c accardancu with the dssscription , Plans and srx.:cifications7 uul"Uittud , and such
Ys)eci: l con""OnU as: uway be indicated an the Permit .
•.'���..f�1��fiiVY��F w..wlr�..i_....���.iYiiii��,�Y�..i1.y��.I�sM��A,��� .Yw����iT.liY.Y�.��Y i,.l+l l,Y,r_iTY��T.ri
The owner of this property is : X199/�'G /�i'/f�GG�'/''412ti'..S 4/G
P . a. Adilres$ J * 10. Q d acgnsavA ZdS CL_3",
Property Looationc G !-+`�rJ2rti►EDRG� _ /[ 'fax .Mar+ No . �/ +
Straut 1twid3ur or building lot nuu�bCr
+uLdivisiart name ( if applicable) lU0 /Z Z:ZIAJI 1 6;>
1'ilE I'r=s7soN IRESPaNSIBLC F`al� sv3'EftwlsIar Pa WORK AS "EGG;.DS UUXLDrNNC1�+C�o_D£s IS s•000e� vet
t�.4 y's MD [_�, 2 Au ( 7ca ti+ �, -yr � r �9 �u s e� urn r�7� A) Y t ZA931 �9S 4nJ ?.t t n iqe ..._�
N. O. Addrres u r. , - .--
NamO of Installer Tole
No .
N.auat OfS +��`" '� Address ,rel .
F.lunLliur wgr.,•y Ad[3ras,s
Narax: of S16aUon Tat .- 17 i Addrs:sAu
Tole
MOD ILE HOME INFORMATION ** + ZONING INFORMATION :
New 11 one Placement _ i,,t�s ; A BLOT PLAN MUST BE PR£PARsED AND SUBMItL"T£D,-
drawn raasonabiy to scacl4a and attach ed hereto,
Replacing existing Flc,rn /��0 uhowinq clearly and djutInctly :all b"Ildings ,
size of new Home IF7Q ft x ft . whether existing or proposed and indicates all
Single w '• -to Double wide + sat-back dimonsionst from property lines .. Give
street and numb4ar Or lot nuuwuer and .indieato
Now of rooms (excluding baths) j "' whathor interior or corner loc . Show laeaclon
Noe of bedrooms ,,�`� + of water supply and location and configuration
Of noPtic disposal area ,
Noe of by tks reams •
'f + COKPLETE INFORMATION REQUIRVD BELOW O
Fireplace? 7 .Swood stove?Madame/L1 + size of property / o-D ft Xenon, ft .
Foundation st le and size • ' UXLUti11q buiidinglsf SiZU ft x ft .
KIZ
Pier. s- o . o Size- vlvt x ft. + "isting building ( " ) Uua
Depth below grade ft. ~
lropeas:ud buildings , diriL.snt:u .trove property line
FOUNDATION E Pooting size " x No +
Wall material ear Y
+ Front yard ft R and ft
„ Sido yards tc and ft
Wall thickness Height ft„ . rf on corner , uarb"Azk from silo acruat tt
Total depth below grade ft . + OCCUPANCY INFORMATION
'grade to Home floor level ft. + PRIMARY BUILDING em
• w * * r r w : w r s . s w r • w • * r $g:K.Ona f"m1ly dwuliing
+ Two f"Mily dwullinu
Proposed date of placennent / .�"'' ,/ + Multiplu dw0111ng / Number of units
Aprox . valu +r, of Home 5 a pQGa + Pexvuwnunt occupancy
water supply .. wellMunici,pal� + `uusinee�st occupancy
Industriai
Septic Permit required? � �? + Othur
Arraa4y eh o+ &A S pa t 4A2-dw ; if additiosc , wh" t will use bu7
FURTHER INFORMATION REQUESTED +
+ Accrssony BUILDING-
ON TH15 REVERSE SIDE OF THIS SHEET . + s]etached garage/one car/ two car/ car
n ! Attached garage/one car/ two car,/ ar
-k 1L7D(`r ow, + Private storage building
ewowwooOther
Form MnP 5 / 06 mc] - vl
APPLICATION FOR MOBILE !-TOME PERMIT, ( CONTINUED)
State of New York Division of Housing and Community Renewal
INSIGNIA OF APPIMAL OF THE STATE BUILDING CODE
14 INSIGNIA SERIAL NUMBER
2 . NAME OF MANUFACTURER �S 7, qC I AJ45
3 . PLAN APPROVAL NUMBER
4 . MODEL OR COMPONENT DESIGNATION
5 , MANUFACTURER ' S • SERIAL NUMBER
G . DATE OF MANUFACTURE
A ZZ the - above i. nf6rmation is to be found on a pZate or sticker which
ahau Zd be affixed to the Mobi Ze Ilorae . Complate .above wtith that infararncxtion,
r w A w w t { w A w r +! w k +f # R rt * # 4 +1 .► a w # +F s +w k +F rt r at +► �!
Town Of Qucensbury .
County of warren A F F I D A V . I T STATE OP NEW YORX
I swear that to the bast of my knowledge and belief the statements contained
In this applies tlen, together with the plans Ana specifications aub"tted are a true and
C[SmjJ'i L•Ce $Cateuien,i� fSE' d]. ]. • _
provision,. of the Buzzalwa C00e, THE ZONINGbORDINANCZ, and done On the daallrother ibed plaws s,per ainingttoall
Lhe proposed work shall be complied with, whejr
r apaeLEicad or not, and that such work is
authorIzed by the owner.
Signature _
own I
ran agent . ar nicect . contractor
* w r r r r w • r r r r w w • r r r * r . s r r r r r r r r r r x r r r r s w r r r * r r r ' w
SPECIAL CONDITIONS OF THE PERMITS
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEEN.SBURY, NEW YORK I280&
TELEPHONE (518) 792-5832
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTION RECEIVED...
NAME
LOCATION "
DATE PERMIT # ` s
APPROVED
YES NO
FOOTING/PI*RS
MONOLITHIC OUR FORMS
FOUNDATION P-PROOFING
BACKFILL APP VAL
ROUGH PLUMB
FRAMING
ELECTRICAL ROUG .IN
INSULATION.
FOUNDATION
FLOORS
WALLS
CEILING
�INAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
4,oeRXTERNAL PORCHES/ TEPS
STAIRS-CLEARANCEI& RAILS
PLUMBING FIX
TUR SIRELIEF LVE
INTERIOR TRIM/ RIVACY DOORS%
FINISHED F7�O0
GARAGE FIREP FIND
DOOR CLOSER ( I
SMOKE DETEC RS
FINAL ELECTRI AL INSPECTION
FINAL APPROV L OF CONSTRUCTION
A SIGNED CE TIFICATE OF OCCUPANCY MUST BE
OBTAINED FTM THE BUILDING DEPARTMENT BEFORE
THESE PREMES ARE OCCUPIED !
REMARKS.
r" I
4 xo�o
INSPECTOR
iiiiijilili'lli 'llilllilljlllll"]M RR
THE NEW YORK BOARD OF FIRE UNDERWRITERS ,,, [,
1i? 1 .1 }j + BUREAU OF ELECTRICITY
F 41 'STATE STREET, ALBANY. NEW YORK 12207
Date ,; i'. f' Tk tlf' i2 1 ^• f ' + 4 �,3 Applicatiore ,Ya. anfiler , P , ; + .
THIS CERTIFIES THAT
only the electrical equipment as described below and introdncad by the appfscant nomad on the above application nw»aber in the premises of
;f : 17t(�T .K f1 .', f}icf 1 .t_f_ ;; . � . >vr s r11 V, Tx.I}; LX. X FfZNT rf: , _ ;� � rr, yr,
in the following location. ❑ Basement ❑ ]at FY. 0 8nd Fl. '. �� T Section Block Lot
1 S:, i T " � f ; : ' d ound to be in compliance with the
toss examined an � - an f b' requirements of this Board.
FIXTURE �TwcLEs SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT FUJORE5C'ENT I 'OTHER AMT, K. W. AMT, K. W. AMT- K.W. MST, K. W. AMT. H. (-
DRYERS FURNACE MOTORS PLITURE APPUANCE PEE I[EIs SPOCIA& MCOPTI TUNE CLOCKS WU UNIT NEMTERs
AMT. K- w. OIL H. P. GAS H. ►- AMT. HIO- A. W. M wMr_ Ah1►. AWL AMM TRANS. AMT. 14, ►. RATE AMT. worts _
NO.ST FEE
MEN DISCONNECT go. or S E R V I C E
AMT- AMP. T'cMF M EQUIP. 1 0 2W 1 AV 3w 3 .0 3W 3 X uW 140.. OF CC. COf1D. OF CC Na. Of "#tiUG. •ww„•L Not, c# NEUTtA45 1 A. W. GI
OTHER APPARATus:
BRANCH MANAGER
Pdr, 1 ' }
This certificate must not be altered in any mannerr return to the office of the Board if incorrect, Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
RY
TOWN OF QD CODES DE
BUILDING AND CODES DEPARTMENT
BAY & HAVIL.AND ROADS
QUEENSBURY, NEW YORK 12804-
TELEPHONE (518) 792--5832
BUILDING INSPECTOR' S REPORT
REQUEST FOR INSPECTION RECEIVES
NAME 'S 17
WCATION
DATE ` t r-,PERMIT #
x
APPROVED
FI YES I NO
FOOTING/PIEPS
MONOLITHIC POUR FORMS
FOUNDATION/D P-PROOFING
BACKFILL APPR�VAL
ROUGH PLUMBINCst
FRAMING
ELECTRICAL ROUG -IN '
INSULATION
FOUNDATION
FLOORS
WALLS
CEILING
Z, FINAL INSPECTION:
CHIMNEY HEIGHT Id
ROOFING x�
SIDING
,EXTERNAL PORCHES/ST
STAIRS-CLEARANCE & RA
PLUMBING FIXTURES REL� VALVE
INTERIOR TRIM/FR ACy LiooRS
FINISHED FLOORS
GARAGE FIREPROO I'NG
DOOR CLOSER (S)
SMOKE DETECTO
FINAL ELECTRICA INSPECTION
FINAL APPROVAL CONSSTRUCTIQN
A
A SIGNED CERTIFICATE OF OCCUPA*CY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIEDP
REMARKS: /'
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
L)UEEN.SBURYII, NEW YORK 128DlE-
7"ELEPHONE ( 518 ) 792-5R32
BUILDING INSPECTOR ' S REPORT
REQUEST FOR
INSPECTION RECEIVED
NAME _ i'!7"l _� •,�'7i" / +�[l�.'LA` r,�'f. "`-�r, 'rrZ�
LOCATION
DATE TAPE T
APPROVED
YES NO
F NG/PIERS
ONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-X � -�-
INSULATION: f
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION :
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHE (STEPS
STAIRS.CLEARAN E & RAILS-
PLUMBING FIXT ES/RELIEF ZVE
INTERIOR TRI /PRIVACY DOORS
FINISHED F RS
GARAGE FIRE ROOFING -
DOOR CLOSE fS) -�
SMOKE DETE TORS
FINAL ELECTR CAL INSPECTION
FINAL APPRO L OF CONSTRUCTION
A ,SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT .BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS :
It
,if—y�J1��tea•--��. / �+" ,./�--'
�� INSPECTOR
YOU ARE I-IEREIEW REQUESTED TO
INSPECT AND ISSUE CERTIFICATES
FOR THE FOLLOWING ELECTRICAL
INSTALLED Y /
EQUIPMENT TO _ !
TH4E UNDERSIGNIED
TEMR 8 O�ILtNT'1
,/� ,/�- �F POLE NUMEE.R
't+ITV OR aL/..�r /V�7 '�I "J`�'] [/ .�/y� !♦ 0 bLOGK LOT
N
STVIEE` ANO C3 '�Rx"CAu+ L ' W +'"+�jr.! `'i �. • ION
�VgFy3 PRrE.M+IS€S 1E09 `y
e€.Sw£FN'WH�TV10 ;AO&'<..� %G"' /✓4 'l / �i'•iI' r / 91J&DING Oc-CUP+^Nl`! Z/ //,,' /// j/ HOME TELEPHONE NlM/BE_A/ V -y.
OCCUFANT's NAME ,,�,//}/ ] /,�(r 4T V'���1 /f,� iI//'•
l ' 0 ice) 7 VJOAK TEI�PFUM9ER
OWNER"S NFMEy'S!'Lt0�.ODI !-f ,�"� OFFICE
ApotTIONAE ❑ - PEF€OTS REMOVED
FROM TKFm
CURREw SUPPLIED 61 /'^j/'J."l
/ V pyORK y3 NEW
OLD ❑ OFFNGE USE
Bl1YLD7NG IS BRANCH ONLY
NEW LIST BEiLOW ALL EQUAPMETST WY-41C1i ` HeATER ALL CIRCUITS
No. o�t 'Fixtures & MOTORS A+rrc. INSpECT1ON
NLSNABER OF OUTLETS temp Recelymcles IT Na F_3V43M No. r_.oa
Loca- Attech't Switch FendaM Bracket No- Type Each
tion Side •Is
Ceiling VVI
OUT
SLOE
Sue-
BASF
BASE-
MENT
1st
FL.
2nd
FL.
FL
REMARKS: LIST OTFI _R ELECTRICAL 4'EV1GE3 µ0T SET FORTH A43Q`4E-
ev nJ �� .yr�7 ..J
PIIII
YOU ARE AUTFAORIZED TO MI°'KE THE INSPECTION AND ADJUST THE FEE TO COVER
IS INTENDED TO GONER E'iu.,Ei�D,E LISTED EOUIPMETST TO BE IhISPECTED, BUT IF Al' TIME 'OF INSPECTA'ON, THERE
THIS APPLICATfON T TSCfT y+"'�i d B I THE APPLICANT"
FOUND ADDATIONAL EQUIPMEN ELEGrR1CJONSILAt'+tPS
THE ADDIT$ONAL EQUIPMENT. AS PRCN FE€DERs
GAfi+Yx1aE SIGNITRANSEORMERS 43F
SIZE OF MAINS I--� yy,PpGtYV
t�y £xPOSED
CONGEALED ,3�E OF SIGN CNUMBER}
CNAFtAEfER OF WOR%
016E GOMPLE I'Efl
MANUFFiCLy.1RFR OP SIGN
DATE 'I t0 8€ STAFSTEa { 11 y
UNDE4t[il'ifRINP �,,��p� 4 1 11
SER ICE ENTER$9UILDRTG � RJ£RNEAD OLOT R
E �-
AS NEAR is t f IfJiw'� _
DIME y1JSP 'Crlf)N C-0IIECiY€.0
i 117E
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PRINT NAME AND ADDRESS _. _. 1 //_�,�,.�
NAME OF I I Le .S
pZp LICENSE NO- yJµEIN Arii'I.iCABLE
STmBvhl A0�ESS, ,,•may _ /� 1. IQ 'J
C1TvO� OF"AAFICE L7L.+�'4 /� -/ - 2o2 P.sterial RoaYdt32os
��� },, S.rR acus�,
gLBANY Street NY t22[77 I 570 rALOP toe Avenue l Cl❑ R Fi S1EF UNY 1Ag08 1 1�
❑ 85 John Street gtyFFALO, NY 142D2 l RITE• S
NEW PORK, NY iOo
T!-1
NEW YORK BOARD OF FIRE U{�UERW
( L-i50 �Q, h i .)
T _ on
SAC"E iw1rE�
BEDROOM
No.3 >
12, G.. Ito UTILITY F. Mnh7ER B ]:
LLLSe06OM
LIVING ROOM No 1
I runts
CA IFI
m urxEuw ax«c umm
. 1 no
7d'• tl"' aTnEaeuams
____--� u,au�rowMcrEm��aau
13
of E DINING r I KITCHENI'
' en-� ; uTREnx au�c 14' 8"
i ROOM P047tE`}
BEDROOM I 12, D„ oaou�l FAMILY ROOM
No. 2 1A,, g,.
14' B"
ik WAS ip� rur er
I mu $*ELVES
7710 * 6428 OPTIONAL SUNROOM
3 BEDROOM • CENTER
KITCHEN *SNACK BAR
FAMILY ROOM • 2
BATHS* GARDEN TUB•
CATHEDRAL CEILING
( 11522 SQ, FT.)
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Luzerne Rd. Phone: O
Queensbury, NY 12801 79M8300
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