1991-059 , .
CERTIFICATE_ OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date Ma re h 13 19 01
This is to certify that work requested to be done as shown by Permit No. 91-058
has been completed.
This structure may be occupied as a Single Family Mobile Home
Location #26 Northwinds, Luzerne Rd
Owner Lamplighter Homes
-
By Order Town Board
TOWN OF QUEENSBURY
/)..?
Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-059 �x
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Lamplighter Homes
OWNER of property located at #26 Northwinds Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Mobile Home t9
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
Rt 9, R0#2
Ft Edward, PAY
2. CONTRACTOR or BUILDER'S Name
I—
a
9
3. CONTRACTOR or BUILDER'S Address
r+
rD
4. ARCHITECT'S Name
O
to
412
h1
5. ARCHITECT'S Address
O
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
0
No. 14' x 70' Single Wide Mobile Home as per plot plan specifications a-
and application
8. Proposed Use
O
Single Family Mobile Home fD
$ 35.00 PERMIT FEE PAID —THIS PERMIT EXPIRES March 4, 19 92
(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 4th Day of March 19 97
SIGNED BY for the Town of Queensbury
Building and Zoning Inspector
r .�"� cc'�� TO BE COMPLETED BY I1LGG. DEPT.
9 ( --OS-9 .
_/uwi1 o19 Queeisilury Application No:
Permit. Issued 39
BUILDING sine ZONING DEPARTMENT C i I N,
• Permit •Expired 19
di] � �� 4' -k'•
Bay una Haviland Road, R.D. 1 Box 08 Zoning Designation
Quuun5cury, Nuw York 12801 Variance No.. q
Site Plan Review No. B.Z� IQ��
APPLICATION FOR �•=-_•r,:q• by e a G �3lllL.D1 Sc CODE DEFT
. MOBILE HOME M, _ •
.
P.UILDING AND ZONING PERMIT
• . . f . f . . . f . f f f • • ••f •
• • . • f • f f f f f. * • f f * * * f::f
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 dune 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:
P.O. AddX.47/ -j
t2/C�
rend Tel. '7 •5"P9�
Property Locations - (?�
Tax Map No. / /
Street. Lumber- or building lot number
:.'uLdivision name (if applicable)
TH ' PERSON RESPONSIBLE FOR SUPERVISION QF WORK AS ARDS BUILDING CODES dIJS: •
tJ. meO(/ v �/ - �J
// P.O. Address Tel. No.
Name of Installer Aldred$Alrkee,li,
Nume off plumber I� 1Sf 1. / ` ,�(� � Tel. J�/���y3-�."
Address Tel. • «Njnal of mason /1 "" Address Tel.
MOBILE HOME INFORMATION: • ZONING INFORMATION:
New Home Placement � _ ' ° A PLOT PLAN MUST BE PREPARED AND SUBMITTED,
-' drawn reasonably to scale and attached hereto,
Replacing existing Home , ' showing clearly and distinctly all buildings,
Size of new Home / ft X 96 ft . . • , * whether existing or proposed and indicate .a11
' setback-dimensions from property lines. Give
Single w 1e • Double wide ' street and number or lot number and indicate
• • whether interior or corner lot. Show location
No, of rooms (excluding baths)
' of water supply and location and configuration
No. of bedrooms ' of septic disposal area.
No. of bathrooms oZ •
• COMPLETE INFORMATION REQUIRED BELOW.
Fireplace? /14) Wood' stove? AD ' Size of
property //Q ft X .55- ft.
Foundation style and size: ' Existing buildingly) Sizeft.
ft X
r .
Piers- No.of Size- •• ft x ft. • Existing building(S) Use
•
Depth below grade ft.
FOUNDATION Footing size X .� ▪ Proposed building, distance trout property line
•
• Front yard , ,r ft Rear yard /3- ft
Wall material • Side yards .1/ ft and
ft
Wall thickness " Height ft. r If on corner, setback from side dtru ft •
Total depth, below grade ft. • OCCUPANCY 1NFORMATI0N
r
Grade to Home floor level ft. • PRI Y BUILDING -
• One family dwelling
Two family dwelling
Proposed date of placement /. S" / �f/ Multiple dwelling / Number of units
Aprox. Value. of Home $�5 V, g,fd ► Permanent occupancy
'Transient occupancy
Water supply - Well Municipal • Business
▪ Industrial
Septic Permit required? • 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
•
APPLICATIbN• FOR MOBILE HOME PERMIT, •(CONTINUED)
State .of! "N'ew York Division of Housing and Community Renewal
•
INSIGNIA - OF APP OVAL OF THE' STATE . BUILDING CODE
1 . INSIGNIA SERIAL NUMBER S oa s_3a A
2 . NAME OF MANUFACTURER ^' -,
,141-4-77
. 0
3 . PLAN APPROVAL NUMBER
4 . MODEL OR COMPONENT DESIGNATION o�'D I
•
5 . MANUFACTURER ' S. SERIAL NUMBER (5 / a '5�.3,--2--%--
6 . DATE OF MANUFACTURE / .i/qI • •.
.
All 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.
4 a 4 4 4 4 4 4 4 4 4 4 4 * 4 A 4 A 4 4 4 A ' A 4 4 4 4 A 4 * 4 4 A 4 4 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 'BUILDINC CODE, THE ZONING ORDINANCE, and all other laws pertaining to
ehe proposed work shall be complied with, whether spacificd or not, and that-'such work 'is.
authorized by the owner. . . . . . •
Signature _ • -- 4111g4K4E/204,6d=''' eTr
Owner, 'o 'sagent,'a i�i.te_t, ontractor
•
a a a a a a * a a a * * * a * a * * • • • • * * it • * • * a * ,r * • * • • a * a * a * * * 'a
SPECIAL CONDITIONS OF THE PERMIT:
•
. . ... . By•
•
•
•
•
•
•
•
•
d°' ' MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
v. — / National Headquarters
900 Haddon Ave., Collingswood, N.J. 08108
APPLICANT COMPLETES THIS SECTION Date: r
City, Town or Township C'+ �- '' '�"� 't�� • County '/J'�� L2� State
r
Location/Address -
�, (If Located in Rural Area - Please Attach Directions) Pole #
'f•
Owner I'/ "-✓�-f.../•--";r:;c -- "rL"-:J " - Permit #
Occupied As i4---sue'•"`'IV !"?t"'' � it�U`.e_`-!,(°a;-r��__fy Building: New Old
tom,-7 , _fi '%1, l +f
Occupant`,-. .�,;-_-�1-•s'• �.'r.�- ;_f-?r'-�.��t-
N Work Area in Building (Floor #,etc.):
App. for: Wiring❑ Service or: .— Ready for Inspection:
Fee Remitted -$ - Cash n Check I M.O. ❑ 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 1+k 2 3 5 71/2 10 15 20 25 30 40 50 75 100
Mark Number -
of Each Size
Applicant's 1) „ /
Signature • �y..6-(4,44 �� 4 /'fl,! `Aft.--/ License # Permit #
T/A / `ems / i ' Utility: (NAME) (OFFICE LOCATION)
Applica_n 's Address: '��/,.,/ /� /i.-( -`1 ' �'."' c,•6.,-t- ;
(City)�r L'r',4*.+-'l y..� _-• (State) I— (Zip) j-! L Service Request #
Phone # , .. /J 7. /--' !c< / Electrician:
MDIA USE ONLY DATE RECEIVED: DATE INSPECTED:
Correct Location: Same as Above! I or:
Red Notice Label 1
Rough Wiring Outlets Surface Unit Oven
Switches Range Garbage Disposal
Receptacles Water Heater Dishwasher
Fixtures Air Conditioner Dryer
Amp. Service Equipment Burner,Wiring & Controls for Amp. Receptacle
Amp. Service Conductors Pump 11 Vent Fans
MOTORS H.P. 1/20 1/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 P/2 2 3 5 7+/2 10 15 20 25 30 40 50 75 100
Mark Number
of Each Size
500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000
Elect. Heat
CERTIFICATIONS USE FOR INITIAL VISIT ONLY NOTIFIED DATE COFEECT FEE PAID
RW Progress: Inc.❑ LKD n Contractor
❑ CFT Violation: Work Comp. I I Inc. n
L/A Owner CASH
Fee CHK #
L/A
Due MO #
❑ IPA Municipal
INV #
Date: Other Side I 1 Utility Applicant ❑i Owner
Cut in Card Temp # Date
❑ Final # Date INSPECTORS SIGNATURE
APPLICATION FORM NO.250 EL 4/89 -
01)1
TO NI OF QUEENSBURY
• -Aft-
, 531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED 3 //--/q/
LOCATION - .Ne11
DATE -3/tV CJ (• PEINIT¢ --05q
TYPE OF STRUC RE `l`nl1;1- I-
RECHECK
FIRE MARSHAL A PROVAL (CO ERCIAL STRUCTURE)
_FOOTING FOUNDATION B CKFILL FRAMING
ROUGH PLUMBING FINATT LECTRICAL— SEPTIC
INSULATION W 0U STOVE/ IREPLACE
SITE PLAN/VARIANC• REQUIR MENTS YES NO
REMARKS
1
APPROVAL
N/A YES NO
CHIMNEY HEIGHT/LOCATON
B VENT/LOCATION t
PLUMBING VENT
ROOFING y
SIDING 9
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES ,
FURNACE/HOT WATER/OPERATING
BASEMENT INSULATION/DUCTWORK
INTERIOR TRIM/PRIVACY1DOORS
FINISH FLOORS:/
BATH/KITCHEN7WATERTIGHT
OTHER FLOORS SWEEPA LE
OTHER FLOQdS CARPETED
STAIR CLEARANCE/RAILIcGS
HANDICAPPED ACCESS
SMOKE DETECTORS
BATHROOM FANS/WHOLEHOUSE FANS
ALL PLUMBING.FIXTURES bPERATING
GARAGE FIRE PROOFING
DOOR CLOSERS
OTHER FIRE SEPARATrON
FIRE/DEMISE WALLS
DUMPSTER
FINAL ELECTRICAL X
OK TO ISSUE C/O OR C/C yS
COMMENTS:
ARRIVE
DEPART f j:t' -
ELECTRICAL INSPECTIONS
DUPLICATE MUNICIPAL RECORD
Permit No
Owner ka_hdp itc ,1/74D
Occupant
Location 4 6 Al s:2 /.::4CL)/let Ce...S. Z:g-1.14_:e ied
Ca. Street.k e
Town or City State
Installation as itemized on reverse side has been visually inspected pursuant to applicable
codes.
Installed by
Date 3 - Inspector
MIDDLE DEPARTMENT INSPECTION AGENCY INC.
FORM NO.18 EL. 900 Haddon Ave.,Collingswood,NJ 08108
ROUGH WIRING OUTLETS H.P.AIR CONDITIONER
OUTLETS WIRING &CONTROLS FOR BURNER
RECEPTACLES H.P.PUMP
FIXTURES K.W.OVEN
' AMP.SERVICE EQUIPMENT H.P. GARBAGE DISPOSAL UNIT
AMP.SERVICE CONDUCTORS K.W. DISHWASHER
K.W.SURFACE UNIT K.W. DRYER v •
K.W.RANGE AMP. RECEPTACLE
K.W.WATER HEATER FRAC. H.P.VENT FANS
MOTORS H.P. I/20 I/I2 I/IO '/ 1/ 1/e 1/2 1/2 1/2 1 11h 2 3 5 7' 10 15 20 25 30 40 50 75 100
MARK NUMBER -
OF EACH SIZE -
APPARATUS
. .
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•..... ..— N,
.:,.
)/711.11A17.42j
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'(s..10,41 ‘- -•-•1—.11 • '' t t,.1/ 1
1001 1470 2CK F & R 2BA RB UTL Approx . 933 sq. ft.. .
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TO ,,Aj ill 0 iii.' ci,u L!fr.'.'h q C.Le,iii rb y
„..4,.i i6 L g..cj„.2) 01° ,, dst,
.* •
BUILDING CODES, -DEPT.
_. _. ..
•
_._.. _... ,
• REVIEWED BY •
DATE
._... _ _
......._. _______..,.,
....
. .
0(a-ry-fr-4:j/A./4-iyi-e•
a �
25
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7/i l
6 >" \r
110
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—
TOWN OF QUEEN sB RY
Zoning ADate �istrato.r •
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LJ l� $ �QC�� �
FEB 2
BUILDING & CODE DEPT
• PRI VA rE A)09 D
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