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1990-848
• r CERTIFICATE OF OCCUPANCY • TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date January 10 1991 This is to certify that work requested to be done as shown by Permit No. 90-848 has been completed. This structure may be occupied as a Mobile Home , Siingl e Fami l,y aOD ^z_ec�l^� S2-0(- Location l Homestead Village Owner Lamplighter Homes By Order Town Board TOWN OF QUEENSBURY Director of Bldg. do Code Enforcement BUILDING PERMIT sv TOWN OF QUEENSBURY No. 90-848 WARREN COUNTY, NEW YORK • w ti PERMISSION is hereby granted toLamplighter Homes 1 OWNER of property located at #109 Homestead Village 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. • r- 1. OWNER'S Address is sv RD#2 Fort Edward, NY J. 2. CONTRACTOR or BUILDER'S Name rD Same 0 a CD 3. CONTRACTOR or BUILDER'S Address 4. ARCHITECT'S Name =tk 5. ARCHITECT'S Address tp 0 a CD U, 6. TYPE of Construction—(Please indicate by X) • >2 ( 1 Wood Frame ( ) Masonry ( )Steel ( 1 J. -1 7. PLANS and Specifications No. 1000 sq ft Mobile Home as per plot plan specifications and co application 8. Proposed Use Mobile Home 0 zT J• $ 35.00 PERMIT FEE PAID —THIS PERMIT EXPIRES December 27 19 91 co (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.) fD Dated at the Town of Queensbury this 27 Day of December 19 9O SIGNED BY for the Town of Queensbury Building and Zoning Inspector • TO BE COMPLETED BY flLDc. DEPT. -.awn ui Q44. pe,rli�urr Application No BUILDING gnu ZONING DEPARTMENT • Permit Issued/di-77 1 tI1 ©ay sna Heviland Road, R.O. 1 Box 08 Zoning • Designation 19 91; Ouuunsbury, New York 12801 . Varianceariag No.. No., . Site Plan Review. No. APPLICATION FOR Approved by: . . 0 Ssr• d MOBILE HOME IVoY • FUILDING AND ZONING PERMIT . s . w t . , a * * * • • * * * • a * • •. • • .a * * * • •° • • * • • • • * * • a 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 bu done in accordance with the description, plans and apecificationu -submitted, and •such :;peci:,l conditions as may be indicated on the Peruiit. ncA! owner of this property is; -ilf-1/1"-f-- ---•" „ P.O. Address aLs#C? el614.717 / Tel. 9.3-.239.2._ Property Location: � �� e! 4E/ x Map No._f_f Street ,;wubcr or building of number .ubdivision name (if applicable) vvU 1'IIE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS ION ��- 1,�, - REGARDS BUILDING CODES IS: u�„► 4-e--• 14e)07,�7�1 //i� , /vf� SW.:7y,3-%3Y, P.O. 'Address 'Teel. No.. - lame of Installer Qiy" ltQiJ Addt'ese�,Cf,(�o7�d C2 ✓� lame of plumbs: Tel. . /9-3 / i:,u.: of mason Addruua ��, � /a/�/// Tel. 3 - 139 Addrerfs Tel. 793'-731, . fOD I LE HOME INFORMATION: • . ZONING INFORMATION: �Cw C�1CkeMSah-, f ow Home Placement . ' A PLOT. PLAN' MUST BE PREPARED. AND SUBMITTED, replacing existing Home drawn reasonably to scale and attached hereto, showing clearly and_ distinctly all buildings, :ize of new Home ft X 21ft ,/p°c5° * S whether existing or +proposed and indicate all single w le Double • g3", - • set-back dimensions from property lines. Give street and number or lot number and indicate to. of rooms (excluding baths) •' whether interior yr corner lot. Show location ' of water supply and location and configuration to. of bedrooms ' of septic disposal area. • b. of bath rooms ' • COMPLETE INFORMATION REQUIRED BELOW. 'fireplace? )us Wood stove? • Size of property ftX /2i ft. oundation style and size: ' Existing buildings) Size ft X ft. • •ior.s- No.of Size- -• ft x ft. Existing building(s) Use Depth below grade ft. •OUNDATION - Footing size// " X DO • Proposed- building, distance from property line: // • Front yard . ft Rear yard ft ;all material r/ • Side yards ft and • ft all thickness " Height ft. • If on corner, setback from side street fc otal depth below grade ft. • OCCUPANCY INFORMATION . 2/ , PRIMARY BUILDING - . rade to Home floor level ft. * . One family dwelling • ' • Two family dwelling ' roposed date of placement /, /2 6 / 7d . _Multiple dwelling / Number of units p r o x. Value. of Home $ iiii 63a S 7 __permanent occupancy Transient occupancy • ater supply - Well Municipal w Business • Industrial cpt.ic Permit required? � tc,..; Other • If addition, what will use be? • JRTHER INFORMATION REQUESTED • ACCESSORY BUILDING- N THE REVERS REVEE SIDE OF THIS SHEET.* I ER S OS � utc� Detached garage/one car/ two car/ car . nn ' Attached garage/one car/ ,two car/ car 71? M 'J i j ` Private storage building 1 II IL q U • Other • DEC VINO`1°Q� _ BUILDING & CODE DEPT. • Form MIIP 5/86 and-vl . • • APPLICATION FOR MOBILE FIOME PERMIT, (CONTINUED) • State of New York Division of Housing and Community Renewal • • INSIGNIA OF APP OVAL OF THE STATE . BUILDING CODE • . INSIGNIA SERIAL NUMBER • . NAME OF MANUFACTURER • PLAN APPROVAL NUMBER / / /4- . MODEL OR COMPONENT DESIGNATION <`(�' V • • • MANUFACTURER 'S, SERIAL NUMBERV ' CI3_ D 4 • DATE OF MANUFACTURE C/d' • • • • • • All ' the above information is to• be found on a plate or sticker which :ou Zd be affixed to the Mobile Home. Complete..above With that information. 4 A 4 4 4 4 4 4 4 .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 ;own of Qucenabury :ounty 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 .n this application, together with the plans and specifications submitted, are a true and :omplece statement of all proposed work. to be done on the described premises and that all _ -'rovisions of--the BUILDING-CODE, -THE ZONING ORDINANCE, and-alI other laws pertaining to .he proposed work shall be complied with, whether specified or not, and that such work is .uthorized by the owner. Signature Owner, •owner's agent,arcnitect,contractor • . • • * • • • * • •* • * • • a * * * • •• * • * a a .• • • • • • • • • .• • • • * * * • • * 'a ;PECIAL CONDITIONS OF THE PERMIT: • • • • • • • • • • • • • • • r , ' 8y__ . In • • • • • • 11 e �(°�."+- I, MIDDLE DEPARTMENT INSPECTION AGENCY, INC. National Headquarters 900 Haddon Ave., Collingswood, N.J. 08108 APPLICANT COMPLETES THIS SECTION • Date/G/ "t" :f/• City, Town or Townshi �'>�e t C-1/-.cl•./61''f:''` :t/k P-4L' 1 At- prY'= County 2 �- State At - State C f, ••r l;? f Location/Address /�J - i,� ta,a. / r'max. -if 6-&- —:i_ 'u,�:.,r y ' , (ILocated in Rural Area - P1 ease Attach'Direction Y Pole # Owner-,J-i ve;.'.�:;%' ref /,ac.t..i a4,- A:1-4 At2e-c, Yt-1 A-- Permit # Occupied As f " rf¢L°� � r f`` a Building: New Old❑ Occupant r .-: 1,.:.. -r ./,_14<'...� ; ."� Zz .-"T7A 'J;1 s- Work Area in Building (Floor #,etc.): App. for: Wiring❑ Service❑ or: Ready for Inspection: Fee Remitted-$ Cash n Check M.O. n Make Payable To: M.D.I.A. 500 750 1000.1250 1500 1750 2000 2250 2500 2750 3000 _ Number of Rough Wiring Outlets Elect. Heat Switches Lighting Amp. Service. Surface Unit Dishwasher Range Receptacles Water Heater Air Conditioner Dryer Pump Number of Fixtures Oven Garbage Disposal Wiring and Controls for Burner Amp. Receptacles Fractional H.P. Vent Fans Other Equipment: MOTORS H.P. 1/201/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 11/2 2 3 5 71/2 10 15 20 25 30 40 50 75 100 Mark Number of Each Size Applicant's r, p�, s ;; Signature k�1 -�.g-{ . L4- .-6 .-�y w..-424"'`21,-,.-4-ti41. -11—it i.. -- License # Permit # T/A /I / / _ Utility: Applicant's A dress: ?•/ 61 d,,r (NAME) (OFFICE LOCATION) (City)V r�c� �j _ �� (State) AA - (Zip) /2- Service Request # Phone # � t' Electrician: MDIA USE ONLY DATE RECEIVED: DATE INSPECTED: Correct Location: Same as Above n or: Red Notice Label n • Rough Wiring Outlets Surface Unit Oven Switches Range Garbage Disposal Receptacles Water Heater 1 ' Dishwasher Fixtures Air Conditioner i Dryer Amp. Service Equipment Burner,Wiring &Controls for Amp. Receptacle Amp. Service Conductors Pump Vent Fans MOTORS H.P. 1/20 1/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 11/2 2 3 5 71/2 10 15 20 25 30 40 50 75 100 Mark Number of Each Size I Elect. Heat 500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000 ` CERTIFICATIONS USE FOR INITIAL VISIT ONLY NOTIFIED DATE CORRECT FEE PAID FE ❑ RW Progress: Inc.❑ LKD❑ Contractor ❑ CFT Violation: Work Comp.❑ Inc. n n L/A Owner CASH ❑ ' El L/A Fee CHK # Due MO # n IPA Municipal INV # Applicant ❑ Date: i Other Side Utility - Owner El Cut in Card n Temp # Date n Final # Date INSPECTORS SIGNATURE } APPI IC'ATIhN FC1PM NCl 75n PI 6/RQ TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 1280i TELEPHONE (518) 792-5832 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED /A/y/ NAME •� l�'[5a4 /� - LOCA TION l O`� /Qg g44.) -1 4"1 0✓I.fe a ee, )/6// p DATE //3 9� "PERMIT # 7n A O 11, 1 , - APPROVED �v� YES NO FOOTING/PIERS 1 MONOLITHIC POUR FORMS f FOUNDATION/DAMP-PROOFING / BACKFILL APPROVAL ti I ROUGH PLUMBING • . • ' I' FRAMING I ELECTRICAL ROUGH-IN A / . .. INSULATION: 14 /1 FOUNDATION FLOORS . . WALLS ' . . . . CEILING • tf XFINAL INSPECTION: V CHIMNEY HEIGHT f ROOFING I i SIDING fi EXTERNAL PORCHES/ TEPS, STAIRS-CLEARANCE & RAILS / PLUMBING FIXTURE /RELIkF VALVE �/ INTERIOR TRIM/P IVACY D°ORS FINISHED FLOOR k _ GARAGE FIREPR FING I DOOR CLOSER(S 1 SMOKE DETECT° S 6 FINAL ELECTRIC L INSPECTION ' " ' _F LINA A_PPROVAL OF CONSTRUCTION OK TO ISSUE C O OR •C/C E A SIGNED CERT FICATE OF OCCUPANCY MUST BE OBTAINED FRO THE BUILDING DEPARTMENT BEFORE THESE PREMIS S ARE OCCUPIE if REMARKS: �/� 1?-iir,. /14:--- )I At'4244; • r-- 4v . ARRIVE / .r / DEPART.' - (:::44i4/ T RT C D L'f"7't D TOWN OF QUEENSBURY . . BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 12801- TELEPHONE -(518) 792-5832 BUILDING INSPECTOR'S REPORT • REQUEST FOR* INSPECTION RECEIVED /NW 4 NAME L ,J / ni2J '1#Six1 L i sq #Attaa Q LOCATION ,7 D DATE 1/ 91 PERM A 7`"0IT # 9Q C�/(/O i. APPROVED YES nNO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING $ BACKFILL APPROVAL i ROUGH PLUMBING • 4, r M. ? FRAMING 't, j ELECTRICAL ROUGH-IN " j f ' INSULATION: r FOUNDATION ( c FLOORS .! 1 as WALLS 1? .lam/I . CEILING `v) betq' FINAL INSPECTION: 'y. > / CHIMNEY HEIGHT , / I' ROOFING 1T SIDING • • 'rig V. EXTERNAL PORCHES/STEPS " ' ;ti STAIRS-CLEARANCE & RAILS :' ti;, t PLUMBING FIXTURES/RELIEF VALVE INTERIOR TRIM/PRIVACY DOORS / FINISHED FLOORS • `` ti GARAGE FIREPROOFING DOOR CLOSER(S) SMOKE DETECTORS • \ ✓' ' FINAL ELECTRICAL INSPECTION" . " . . . . .0/ _FINAL APPROVAL OF CONSTRUCTION " \: .i/ ' OK TO ISSUE C/O OR C/C V r/ A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS:''4 'eon /,. - 'j ,02 -ii4z.le,-. ) /.0,-/./-qo . geoto ,/..4p4t . P O a‘ 3i6 Rfic57/T s ARRIVE ICiy sr va36 DEPART 3 �'v IN PECTOR • • • `;'\ •"` •s -• • MIDDLE DEPARTMENT INSPECTION AGENCY, INC. - 'Electrical-Building-Plumbing-Fire Inspections Date AI *Auk„ 111PAtin • • , T •constitutes certification that the above:installation, but not:the equip-• • ment i1sei ,has been visually inspected as of this-date pursuant to the_apPlic-• able codes...If additional equipment 4 Should be introduced or alterations•, made to the existing system or struC,J., . ture, application'for:inspection shoUld be submitted promptIV,to this Agency s• - . • . • • „ • • • • • ,,, • • (--\ • ...I:10,-r' i tr. ,.. . ,II ..• unplill • . - • - • . • rt :Ira CRP_ 1:1 Ui 0 • • i t .--Pf ;116 . • • . . =;0 le * ": . . . . t 2s - * . g * . • - . • i ... . t I 0 : i-• .i.. •'. •••. , • ;.•; : 1 & t re) . .• . ., . it I lift. .• , ter= :is • . • i . n iii ..• _: ma • . sewn g -FL ^• . :Willi 4 IP ' 1 . ..";: - - II < c,2 i •- I . . - ..4 016.giillt 1 r IMO, , . - , *--. . . 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