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1990-560 CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date August 31 . 19 90 3Q ( 5' 90-560 This. is to certify that work requested- to be done as shown' by Permit No. has been completed. This structure may be occupie a cinjtgl,a family mnhila hnino 3 Yam & UL l3 L.3TC�a.. Location FOREST PARK MOBILE HOME COURT-Land Owner Owner DALAzAR--MuLi1 1.iv,c,C 3 iV1I�t By Order Town Board TOWN OF QUEENSBURY ))4_,1 4-1(l- L&:r �,l Director of Bldg. do Code EnY'orcement BUILDING PERMIT 1-3 TOWN OF QUEENSBURY No. 90-560 WARREN COUNTY, NEW YORK ro PERMISSION is hereby granted to FOREST PARK MOBILE HOME COURT O • OWNER of property located at 91 Briwood Circle Street, Road or Ave. in the Town of Queensbury,To Construct or place a Single family mohiie home at the above location in accordance to application together with plot plans and other information hereto filed and c� approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. 1. OWNER'S Address is 134 Pitcher Rd Queensbury NY 12804 2. CONTRACTOR or BUILDER'S Name �1 0 Today's Moderncn H 3. CONTRACTOR or BUILDER'S Address ro 54 Route 9 Gansevoort NY 12831 4. ARCHITECT'S Name 0 . 5. ARCHITECT'S Address 0 t�7 O 6. TYPE of Construction— (Please indicate by X) H ( ►Wood Frame ( ) Masonry ( )Steel ( ) 0 r+ 7. PLANS and Specifications cfl No. 14'x66' Single family mobile home as per plot plan, specifications and , ro application. 8. Proposed Use Q. Single family mobile home 0 C) 29.00 Augsut 24 91 $ PERMIT FEE PAID —THIS PERMIT EXPIRES 19 6 (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 24th Day of August 19 90 SIGNED BY ` �� for the Town of Queensbury Buil ing and Zoni Inspector c� // `I0. BE COMPLETED BY IILUG. DEPT._lawn of Qaejtur� Application No. BUILDING and ZONING DEPARTMENT Permit Issued 19 Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation 19 - Oueensbury, New York 12801 Variance No., fii N N r - } LtSite Plan ew o, IA u u APPLICATION FOR • Approv d b AUG 23 1990 MOBILE HOME. l BUILpit)DING. r„NG 00 & CODE DES.. LDING. AND ZONING PERMIT / q #i (Pri,v- . � * * .:. 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: PORES T 1?fi k (4CRi c //0 E C.00 7 • P.U. Address /3 y yr©%'TC//6/ /204 iJ `-Tel.s8y-/5/4"/ Property Location: 8(.2 J?c (9®,0 Z071 9/ Tax Map No./, ,)-/ / /c9./.3 Street ;:umber or building lot number� Subdivision name (if applicable) /J,fiEF,S-•/ �I��i7,c- S'elc.,?z n'�` THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS: //D''�E 4"417y1f12 1 • [Jame P.O. Address aide. a/ Tel. No. Name of Installer hp/ii_OfeOC '•�Address 'y �/ err IJ,ScL/OaC7' Tel. 7/U^JW - Name of plumber Address ./t/y /zts/ Tel. Nate of mason Address Tel. MOBILE HOME INFORMATION: * . ZONING INFORMATION: New Home Placement . YES . * A PLOT PLAN MUST BE PREPARED AND SUBMITTED, -* drawn reasonably to scale and attached hereto, Replacing existing Home .4.1.0 * showing clearly and distinctly all buildings, ft * whether existing or proposed and indicate all Size of new Home /� ft XC X * set-back dimensions from property lines. Give wile w ,e �'( Double wide * street and number or lot number and indicate * whether interior or corner lot. Show location No. of rooms (excluding baths) S * of water supply and location and configuration No. of bedrooms 3 * of septic disposal area. No. of bathrooms / • �� * COMPLETE INFORMATION REQUIRED BELOW. Fireplace?4/O Wood stove? /00 * Size of property ft X ft. Foundation style and size: * Existing building(s) Size ft X ft. Piers- No.of / • e- ft x ft. / Existing building(s) Use Depth ow rade ft. *FOUNDATION - Footing size " X .1Proposed building, distance from property line * Front yard ft .Rear yard ft Wall material /2//4 * 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 - * * * * * * * * * * * * * * * * * * * * * _40ne family dwelling � �/ Al . Two family dwelling / 1 Proposed date of placement * Multiple dwelling / Number of units Aprox. Value. of Home $ / O. • Permanent occupancy . / V� * Transient occupancy Water supply - Well Municipal * Business • /v * Industrial Septic Permit required? /1J * Other • 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 * Attached garage/one car/ two car/ car * _Private storage building * Other * • Form MIIP 5/86 and-vl APPLTCATION FOR MOBILE HOME PERMIT, (CONTINU.ED) State of New York Division of Housing, and Community Renewal INSIGNIA OF APPKOVAL OF THE STATE BUILDING CODE 1 . IN:SIGMIA SERIAL NUMBER • •' 2 . NAME OF MANUFACTURER 3 . PLAN APPROVAL 'NUMBER 0 • 4 . MODEL OR COMPONENT DESIGNATION -70X I' V)ST (r, 1 t O3/ • 5 . MANUFACTURER 'S SERIAL: NUMBER J 0(% ! ( 6 . DATE OF MANUFACTURE D' =-, c— c,D • • A Zl 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. A * * 4 4 * #. 4 * . 4 .4 * .4 * 4 # R # k A '4 A * * +4 * A 4 * * * 4 44 4 * Town of Queensbury A F F I .D A V . I T County of Warren 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 `ORDIN CE, and all other laws pertaining to the proposed work shall be complied with, whethe specified or no , a d that such work is authorized by the owner. , . Signature 0-114S__ Own , owner s age t,a c tect,contractor * * * * * * * * * * * * * * * * * * * * •* * * * * * * * * * * * * * * * * * * * * * * * * SPECIAL CONDITIONS OF THE PERMIT: • • • • • • By • • • • YOU ARE HEREBY REQUESTED TO INSPECT AND ISSUE CERTIFICATES - FOR THE FOLLOWING ELECTRICAL EQUIPMENT TO BE INSTALLED BY ." • . THE UNDERSIGNED ?,r `"( 0 TEMP.s DATE CITY OR VILLAGEf �^ c:_c_445 6 ci TOWNSHIP // /� J /� G�COUNTY STREET AND NO.OR ROAD J 1 /v/7' .( . f.. C.� ,6,7/. 4 ,(4)00L.� J / POLE NUMBER BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED'+ SECTION BLOCK f/ LOT LUZG2tic.4"illi 7.C.4{CL OCCUPANTS NAME BUILDING OCCUPANCY OWNER'S' P' C ADDRESS �/3. C v'` /6y , 1/ CA' 4 �7 Lf'.`.+/� /_ HOMETELEPHONE NUMBER f 7" T CURRENT SUPPLIED BY FROM THEIR OFFICE WORK TELEPHONE NUMBER 421 '77U BUILDING IS NEWc OLD❑ WORK IS NEW Cl ADDITIONAL JX- DEFECTS REMOVED El . 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. /1/1C7,3/ /),#"76-- ,��e-,,,J6 . 4, Ccz;' (:).-t./ 6-5v.5 ff-I)6 j' 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� yy U POSED GAS TUBE SIGN/TRANSFORMERS OF VA -(,/� i�,-i U nC761�C eCpNCEALED DATE WORK TO BE STARTED s/z DATE C MPLETED SIZE OF SIGN(NUMBER) CAPACITY_ SERVICE ENTERS BUILDING // ppVV�� MANUFACTURER OF SIGN ❑ OVERHEAD ,.UNDERGROUND �/ / [�DATE INSPECTION REQUESTED ON L(OR AS NEAR AS C.L. NAS POSSIBLE) ex)( V DT F TER APNUMBERS I 7 12101 6 17I J I AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. PRINT NAME AND ADDRESS -. J NAME OF APPLICANT DATE47PPLIC ON SIGN tiE F APP !CANT x STRE PDD ESS `/J�` fE—/ `O NO. trzt, CITY pa POST OFFICE le �/,J /2 5'< / ZIP CO LICENSE NO.WHEN APPLICABLE ❑ 855 John StreetS ❑ 41 State Street `� ❑ 570 Delaawwarre Avenue ❑ 217 Lake Avenue ❑ 202 Arterial Road • NEW YORK,NY 10038 ALBANY,NY 12207 . BUFFALO,NY 14202 ROCHESTER,NY 14608 SYRACUSE,NY 13206 THE NPW YORK ROAR_D lF FIRE UNDERWRITERS TOWN OF QUEENSBURY 67277( BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY NEW YORK 12804, TELEPHONE (518) 792-5832 ILDING INSPECTOR'S REPORT REQUEST FOR NSPECTION f2E EIVEDth`AD 1-11-- NAME - , & � � / / LOCATION I� (,,_,C�.L '���'� C/�L'l . (,C7 /,C r(/DATE �/ U Po' IT # qd -J zo n ' K jC,e c-3J APPYESRONOD FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/LAMP •PROOFI,G BACKFILL APPROV•i ROUGH PLUMBING FRAMING ELECTRICAL ROUGH IN INSULATION: FOUNDATION FLOORS WALLS CEILING /`,(FINAL INSPECTION: V\ CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/ TEPS STAIRS-CLEARANCE . RAILS PLUMBING FIXTURE I•ELIEF VALVE INTERIOR TRIM/PRI !CY DOORS FINISHED FLOORS GARAGE FIREPROOF, Ne DOOR CLOSER(S) SMOKE DETECTORS. FINAL ELECTRICAL NSP:CTION FINAL APPROVAL OF CON +RUCTIO OK TO ISSUE C/O r• C/C Y&S e A SIGNED CERTIFI;ATE 0 OCCUPANCY MUST BE OBTAINED FROM T E BUILD NG DEPARTMENT BEFORE THESE PREMISES :RE OCCU' ED! REMARKS: , 6) (..e 0_,ELC C_CL1 ---/7' 5/ - pm,;c ,2� P2-61153Aii & ARRIVE DEPART /l,-7� INS ECTOR INFORMATION FOR BUILDING DEPARTMENT .-- -- - WE ARE IN THE PROCESS OF ISSUING A CERTIFICATE -- 111 ' OF COMPLIANCE FOR THE ELECTRICAL INSTALLATION AS COVERED IN AN APPLICATION FILED WITH OUR DISTRICT OFFICE. THE NEW YORK BOARD OF FIRE UNDERWRITERS - _. _. __- ., ..., APPLICATION NO. r / -... - _. P LOCyION // 2_ ') DAT INSPECTOR FORM IBD(REV.1/86) . 3 dcz - Cr) ....., � . L.:�J . 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