1990-585 -, , , t.:
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CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date October 25, 19999
This is to certify that work requested to be done as shown by Permit No. go-q*Qc .
has been completed. ,
This structure may be occupied as a e , f‘single f '.1== ==®bile home
ILot 15 Woodland Path
Location
Owner FOREST PARK MOBILE HOME COURT
By Order Town Board
TOWN OF QUEENSBURY
(**- -> A, ti.....,..„---
Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 90-585
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to FOREST PARK MOBIL EHOME COURT
OWNER of property located at Lot 15 Woodland Path Street, Road or Ave.
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
134 Pitcher Road
Queensbury NY 12804
2. CONTRACTOR or BUILDER'S Name
Today's Modern
3. CONTRACTOR or BUILDER'S Address
Rt9 #54
Gahsevoort NY 12831
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
No- 14'x66' Single family mobile home as per plot plan, specifications and application.
8. Proposed Use
Single family mobile home
$ 23.00 PERMIT FEE PAID —THIS PERMIT EXPIRES September 6 19 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.)
6th September 19 90
Dated at the Town of Queensbury this Day of
1
SIGNED BY 7for the Town of Queensbury
Building and Zoni Inspector
67
TO DE COMPLETED BY BLDG. DEPT.
•
-awn o/ Queenjlur Application. No.
BUILDING and ZONING DEPARTMENT Permit. Issued ]9 .
Bay and Haviland Road, R:D. 1 Box 98 Zoning Designation •
19
Queensbury, New York 12801 Variance . 1 •] U
Site P an Rev' w o, I
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APPLICATION FOR
b AUG 3i 1990
MOBILE HOME
—Kir; A. CODE DFr-
FUILDING AND ZONING PERMIT . 1;? , ► l „ oil
* * * * * * * * * * * * * * * * IF . * * * * * * * * '* * *7 * * * • * * * * * *::*
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: FOR EST 14i zk /�_ 5 CL o
7
(l�Il?(�ICE �
P.O. Address /3 y it' / Tc//6f'"M`
,'U4%J Tel /yyy
Property Location: _ C.04-4"1/o 7/ . ' f67.0 Tax Map N ( a, 9/3
Street ,,umber or building lot number ,.7
/vi
Subdivision name (if applicable) F • ".eq � /�/
TILE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS: '11E °' 4167?/)
Name
Ital. P.O. Address Tel. No.
Name of I a-ter/(11��J`�'1,4%dj2C�2/Address 'SY oak 7ei:4.1SC//oae7 Tel.
Name of plumber Address �� 'f
Name of mason y 7 /Zf . Tel.
Address _ Tel.
MOBILE HOME IN:FORMATION: r ZONING INFORMATION: •
New Home Placement . 9"6J . * A PLOT PLAN MUST BE PREPARED AND SUBMITTED,
Replacing existing Home drawn reasonably to scale and attached hereto,
••• • showing clearly and distinctly all buildings, '
Size of new Home lI ft X ft . • * whether existing or proposed and indicate all .
* set=back dimensions from property lines. Give
Single wile • K .Double wide * street. and number or lot number and indicate
No. of rooms (excluding baths) ''' q *. whether interior qr 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?/1J Wood stove? /(J0 * Size of property ft X ft.
Foundation-style-and--size ---- -- - :-Existing building(s) Size` ft X - f t.
Piers- No.of / ' e- ft x - ft. •
Existing building (s) Use
Depth ow Fade ft.
FOUNDATION - Footing size . 1 w Proposed building, distance from property liras
„ / * Front yard ft Rear yard ft
Wall material /// * Side yards ft and
l� ft
Wall thickness " Height ft. r If on corner, setback from side street ft
Total depth below -grade ft. * OCCUPANCY INFORMATICN
r
Grade to• Home floor 'level ft. * PRIMARY. BUILDING -
* * * * * * * * * * *. * * * * * * * * a r , One`family dwelling
/��/ * Two family dwelling
Proposed date of placement * Multiple dwelling / Number of units
Aprox. Value. of Home sa�0�(�0(L. . + Permanent occupancy
* Transient occupancy
Water supply - Well . Municipal, Business
/� * . Industrial
Septic Permit required? AV * Other
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
* Attached garage/one car/ two car/—*- car
* Private storage building
* Other .
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Form MIIP 5/86 and-vl
II I ,
APPLICATION FOR MOBILE HOME PERMIT, (CONTINUED)
State of New York• -Division of Housing and Community Renewal
•
INSIGNIA OF APNHOVAL OF THE STATE BUILDING CODE
1 . INSIGNIA SERIAL NUMBER .. ..:.. ., °L X` s `S 7A
2 . NAME OF MANUFACTURER aCNC
3 . PLAN APPROVAL NUMBER 0/ 3: -
4 . MODEL. OR COMPONENT DESIGNATION . 7//gr/e v�7 g�
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5 . MANUFACTURER 'S SERIAL NUMBER . � - O � �
6 . DATE OF MANUFACTURE /Z/A3-St—
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All the above information is to be found on a 'plate or sticker whih ,
should be. affixed to the Mobile Home. Complete above with that information. '
4 * 4 4 4.•.* .4 * 4 * 4 4 4. 4 4 * 4 4..•* 4' 4 4 4 4 4 * * 4 4 4 * 4 44 4 4 4
Town of Q'ueensbury
County of Warren' A F F I D A V . I T STATE OF. NEW PORK
•
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 ' uch work is
authorized by the owner. •
j
Signature___ 'k�s _
�s agent,a` nitect, ntractor
I
* * * * * * * ,* * * •* * * * '* * '* * * r •* * * * * * * r * * * * * * * •* * * * * * * * * * '*
SPECIAL CONDITIONS OF THE PERMIT: ,
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By
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YOU ARE HEREBY REQUESTED TO
INSPECT AND ISSUE CERTIFICATES
FOR THE FOLLOWING ELECTRICAL
EQUIPMENT TO BE INSTALLED BY
THE UNDERSIGNED /� ,{ _I ^y—
TEMP.# DP, i/ 9V tom(4r. 56�1
CITY OR VILt,Afi) ��f TOWNSHIP �7 COU _ j
STREET ANDDNNFFC 9.5 ROAp., r 7 27f?/1,/ J / '0 A�4 ��4. 17�y7/ POLE NUMBER�BE
BETWEEN WFIgT9/TWO_ C /ST,Z4ETS_IS PREtv]ISES.L�QCA trio`c // 7wION�/� BLOCK / LOT
OCCUPANT'S/NAME rtEf/EL.'I" ,�( r,/ C,J•'-'�'/ BUILDING OCCUPANCY
OWNE�S`1NAME ANO'ypIES g , / O e2 059 � HOME TELEPHONE NUMBER
CURRENT SUPPLIED BY f y, D FROM THEIR`•r' I OFFICE �c WORK TELEPHONE NUMBER
BUILDING IS �a/!! rp,{ +./.
OLD/L]J -WORK IS NEW❑ ADDITIONAL DEFECTS REMOVED ElLIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETS No.of Fixtures& BRANCH OFFICE USE
Loca- Lamp Receptacles MOTORS HEATERS 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.
- a b' & '6 )47e1'I C�=.! & S 7f j/7C
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 p' f �"y",.}�, ,EDERS ELECTRIC SIGNS/LAMPS TOTAL WATTS
Ci..arf�r'�L /i..✓ Fa, ,f C�'iC ❑ CONCEALED EXPOSED GAS TUBE SIGN/TRANSFORMERS OF VA
DATE WORK TO BE.STARTE8/d(/ J/ .O DATE COMPLETED SIZE OF SIGN(NUMBER) CAPACITY
SERVICE ENTERS BUILDING j/ MANUFACTURER OF SIGN
❑ At OVERHEAD UNDERGROUND
DATE INSPECTION REQUESTED ON(OR AS" R AS POSSIBLE) - MUST ENTER APPLICANTS . I I/ I�"1
/ �« �- IDENTIFICATION NUMBER f 6 1
AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
PRINT NAME AND ADDRESS
NAME OF APPLICANT DATE OF APPLICATION vSIGNA R Ff4��'�% rf
STRESS T P O. • 3
700
CITY R POST OFFICE �ry off(� / ZIP CODE LICENSE NO.WHEN APPLICABLE
❑ 85 John Street ❑ 41 State Street ❑ 570 Delaware Avenue ❑ 217 Lake Avenue ❑ 202 Arterial Road
NEW YORK,NY 10038 ALBANY,NY 12207 BUFFALO,NY 14202 ROCHESTER,NY 14608 SYRACUSE,NY 13206
TUC AIc1A/ Vr117)11 Dr1Ar r I mom I IAIP1CLl1A/orrcoo
,\,t..\,.Ca,•L �.C)t�11P,!.a•i_.11,t_iyi,l�e,J.%1ti„1,,,!ve,!, %a..!ayiCJikr_)iit 1.t,a11,),"ye4.?1/4,,,,,,t„Ilti VIV," kV/.", ri,Altt, ,)11,01,�At,,1"/Mi„OP/,"„yr,M i t,1p..,•,..".,ir,,tr:.L Aet,sO_,•1 ,!,}_tn�tr,.e rSt
e
,1 iii(Li
THE NEW YORK BOARD' OF FIRE UNDERWRITERS r
1'106 784 BUREAU OF ELECTRICITY
D' 44
k' 41 STATE STREET,ALBANY,NEW YORK 12207 :
Date OCTOBER 26,1990 Application No.on file 05-.2.790/90 1 041823
THIS CERTIFIES THAT
PERMIT NO. 90-585
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of 14
1 ii
i' FOREST &' '[ 15 �,:I mflt)LA\D P ,T'II. t 1UEE SR1; :N.Y.�� PARK r �-{Si x .�. i .,i
2. in the following location; ❑ Basement ❑ 1st Fl. LJ 2nd Fl. OUT Section Block Lot
was examined on (}CTOBER 2`r,1990 and found to be in compliance with the requirements of this Board. ':
i i
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS ;':
i' OUTLETS SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS SELL UNIT HEATERS MULTI-OUTLET DIMMERS
Z. : AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. MAT. AMPS. TRANS.® H.P. SYFEET AMT. WAITS '`�
III „I
■
SERVICE DISCONNECT NO.OF S E R V I C E '
!: AMP. TYPE EQUIP 1,e'2W 1 3W 3 03W 3,9"IW NO.OF CCCOND. OF CC.COAID. NO.OF HI-LEG . o .HI.LEG NO.OF NEUTRALS OF.W.GRAL
Jil
�°2 -v bU FIT 1 ❑ X ❑❑ 1 4 1 6
i. OTHER APPARATUS:
. -L. i
.t(. s
J.
�' i
i ^
-<
' i _, :is
ji 1
: — \� i
-
iit.
a 3''ODAYS :MODERN HOMES ?
5-I ROUTC 9 .'
t.s` G rtiSEj C}(}I;T, NY. 12831 ,-' BRANCH MANAGER ,:
�, j� 239 1.
:, r... Per ::
iic,: This certificate must not be altered in any manner;return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
iC7r♦Ciii i,iciirieliY'ieY q i.;-i�'i.Y-4i--4(4Yi4Y'4;-.4Y'iii 4—,-.1 4?-4,--(41-4\--ie raii--is--itr ia,-4�-i.eiaf-iei'ie,-uC i.Y.iacieriiv-re-gY,gt..i.C.y6 yi iii.-; e-4-,';46 7if'iik 'i41, 4 .4;.,...).
5 COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. 1
TOWN OF' QUEENSBURY
BUILDING AND CODES DEPARTMENT D
/29
BAY & HAVILAND ROADS ��/
QUEENSBURY, NEW YORK 1280-
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME j01 PtItir�[. YY�D�-�L[,QQ� /_
LOCATION j// /p,� 7q��'-er1,�p�46- /4
DATE /U oQ,3 / ô. PERMIT •# `7 O 5L5
10131tL(. C APPROVED
YES NO
if
FOOTING/PIERS
MONOLITHIC POUR FORMS • I
FOUNDATION/DAMP-PROOFING • • •
BACKFILL APPROVAL'!
ROUGH PLUMBING
FRAMING ; 1
ELECTRICAL ROUGH-IN ' •
INSULATION:
FOUNDATION 6 if
FLOORS
WALLS . •
. .I. .
•
CEILING ' •
)(FINAL INSPECTION: 3
CHIMNEY HEIGHT d
ROOFING /
SIDING • 1 • ' •
EXTERNAL PORCHES%STEPS '• '
STAIRS-CLEARANCE RAIL
PLUMBING FIXTURES%RELIF.(F VALVE
INTERIOR TRIM/PRIVACYOORS
FINISHED FLOORS 1
GARAGE FIREPROOFING, l
DOOR CLOSER(S) V
SMOKE DETECTORS A K
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL OF CdNSTR CTIO ,"�)
�b -
OK TO ISSUE C/O OR/C/C ` - � _ � - ---"A. SIGNED CERTIFI ATE OF OCCUPANCY MUST BE
OBTAINED FROM T E.BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!.
.
•
REMARKS: ^y.�a, .--./ ��,,
U�rLt; 5 (044,1/C-e
ARRIVE laq J /�'�.
DEPART /D-a5 /4i Lis
"NFORMATION FOR BUILDING DEPARTMENT '% . = _
VI A-. . • ..IN THE PROCESS OF ISSUING A CERTIFICATE ;, 4"
,F' COMPLIANCE FOR THE ELECTRICAL INSTALLATION ,"" '
,. -,
A . ;D IN AN APPLICATION FILED WITH OUR
DISTRICT OFFICE. i
�':" THE NEW YORK BOARD OF FIRE UNDERWRITERS fL ., •,.
r9 S ZZ-r_ 7 - .,,
�,
I.'
APPLICATION NO. • ---'
.. j,. . LOCATjb ,.. .
/N /� c , ;
, :., h . o i , DATE INSPECTOR
FORM IDD(REV.I/66)
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;, , ,fi l' ti ;� ;R ,., i, - OPTION FOR CATHEDRAL .CEILING
'' : ,. . . .., - . �_.r ii ti w =' THROUGHOUT AVAILABLE. . '
•
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, .,zi j.Atf.jtjtj) te)j) . . .
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5195 * 7Ox14 6,-\ V•1• _I CIRR . _ I 1 ci
2 BEDROOM •CENTER O ': I I I I I1 II I I i��.� A
ItITCHEN/BAR/ISLAND• g MASTER II C'TYAMl BEDROOM
BEDROOM • —+I " ' _ YAM W I I O
2 BATHS • GARDEN aQ ^ N/ • t — — .No. 2
No. 1 KITCHEN/ LIVING ROOM 10'-0"
TUB . BENCH . / iv- iv' DINING 11 I 1s'-o" 1BAY • CATHEDRAL �,„a, 1 I 1T a' I I 1„ II
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