1991-118 CERTIFICATE' OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 127CliY.r' . (0 19
Pa5-8 1 1 "
This is to certify that work requested to be done as shown by Permit No. 91-118
has been completed.
This structure may be occupied as a Mobile Home
Lot # 17
Location Mtn V1ew Trailer Park.. Aviation Rd
Owner Ivan Barsukoff
Tenant: Timothy O'Hare
• By Order Town Board
TOWN OF QUEENSBURY
v
Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY X
No. 91-118
WARREN COUNTY, NEW YORK
0
PERMISSION is hereby granted to Ivan Barsukoff/Tenant Timothy O'hare
00
OWNER of property located at Mtn View Trailer Park Street, Road or Ave. cri
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.
1. OWNER'S Address is
rri
PO Box 613 ate►
Glens Falls, NY 12801 ; EP
2. CONTRACTOR or BUILDER'S Name
Reliable Mobile Home Service
3. CONTRACTOR or BUILDER'S Address
RDJ2
Ft. Edward 4
m
4. ARCHITECT'S Name
1
CD
5. ARCHITECT'S Address -1
6. TYPE of Construction—(Please indicate by X)
.a.
( )Wood Frame ( ) Masonry ( ) Steel ( )
O
7. PLANS and Specifications
d
No. 14')(70' Mobile Home as per plot plan specifications and application
• 3
O
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8. Proposed Use
fD
Mobile Home =
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$ 29_00 PERMIT FEE PAID —THIS PERMIT EXPIRES March 27, 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 27th Da _of March 19 91
SIGNED BY ' Z2i,4 i for the Town of Queensbury
Building and Zoning Inspector
TO BE COMPLETED BY BLDG. DEPT. 9/ //C?
awn o� QI Application No.
BUILDING and ZONING DEPARTMENT Permit Issued 19 TOWN OF OUEENSBURY
Permit Expires 19 RECEIVED
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation .
• Oueensbury, New York 12801 Variance No., •
Site Plan Review No. 'MAR 2 7 1991
APPL 1 CATION FOR - Approved by: .
MOBILE HOME .BLDG. & CODE DEPT.
PUILDING AND ZONING PERMIT ` %r /
* * * * * * * * * * * * * * * * * * * ..* *- * * * * .* * * * * * * * * * *:;*
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 ;descr-iption, plans and specifications submitted, and -such
special conditions as` may be indicated on the Permit.
The owner of this property is: -V— . j4i(( ,1 cj Kv fJ .
P.O. Address Pv is() Y. (9(') `-,� F �S
1 07,(C4.1
— G �/`� /Z U/ Tel.
Property Location: /14(/i, ( 7 r(.v /(24-lLe,e Paw( Tax Map No. / /
• it/7' Street :;umber or bui mot number
Subdivision name (if applicable) f..*7�gi l//�Z/ _ ��(�� •
TIDE PERSON RESPONSIBLE FOR SUPE SI_Q�LO REGARDS UIJ:DING CODES Iz
Name Y.O. Add ess
A/4/p,� Z .� ,/GJc� 1 Tel. Na.
Name of Installer LL(A'/5� --r Address t2 r G�
Name of plumber < '�-�� ���L�Qc.�JC�,, l Tel. ��v--�(ZC� •
� /VL., Address - cf}'JNL� Tel. ,5,elifl
AZ
Name of mason Sly-YYLf, Address 5;' 't Tel. f} -
S
MOBILE HOME INFORMATION: * ZONING INFORMATION:
New Home Placement . * A PLOT PLAN RUST BE PREPARED AND SUBMITTED,
-* drawn reasonably to scale and attached hereto,
Replacing existing Home l * showing- clearly and distinctly all buildings,
Size of new Home �`�'- ft x -�V ft - * whether -existing- or 'proposed and indicate all
/ * set-back dimensions from property lines. Give
Single wile • G, Double wide * street and number or lot number and•indicate
No. of rooms (excluding_ baths)
No. of bedrooms * whether interior or corner lot. Show location
5 * of water supply. and location and configuration
* of septic disposal area.
*
No. of bathrooms �,/ *COMPLETE INFORMATION REQUIRED� BELOW.
W(
Fireplace? 110 Wood stove? ) * Size of property ST) ft X 7 ft.
Foundation style and size: * Existing building(s) Size ,c./ ft X -70 . ft.
Piers- No.of / 9 Size- ft x Z ft. w y p2(I. //7-21l�f/i/ c,Ltic[G
Existing building(s) Use
Depth below grade V ft.
FOUNDATION _ Footing size " X * Proposed building, distance from property line
, Front yard ft Rear yard 7 ft
Wall material , Side yards c ft and (e, ft
Wall thickness " Height ft. * If on corner, setback from side street ft
* OCCUPANCY INFORMATION .
Total depth below grade ' ft. ' •,�
Grade to Home floor level ft. * PP.1 RY BUILDING -
* * * * * * * * * '* * * * * * * * * * * * //One family dwelling
* Two family dwelling
Proposed date of placementcc��/ Zf/ y/ * Multiple dwelling / Number of units
Aprox. Value. of Home $ t�iC 16C0 * _l' a anent occupancy
* transient occupancy
Water supply - Well Municipal i/ ` Business
Industrial
Septic Permit required? e,0/3;h l'7, . * Other
, If addition, what will use be?
FURTHER INFORMATION REQUESTED w
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 MUP 5/B6 and-vl
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 IN 6V
2 . NAME OF MANUFACTURER tkfltgo. pow 1c ierec,
3 . PLAN APPROVAL NUMBER ►1 ! , . ; 1 :\ 19111 - '
4 . MODEL OR COMPONENT DESIGNATION of i 7 ` ' `� ? J'( 3$ f F3 2 61A•
. £f
v,�
5 . MANUFACTURER 'S SERIAL NUMBER �.141 �{. r77
6 . DATE OF MANUFACTURE Z` 42QQ.'
•
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 * * * * * 4 * * * * * * * * * * * .* * * * * * * * * * * * * * ** * * *
•
Town of Queensen A F F I D A V . I T STATE OF NEW YORK
County of Warren
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 such work is
authorized by the owner. .
Signatur`c
, er's agent,architect,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
TEMP# DATE 6J l _/ /5'
CffY OR VILLAGE l'-.) TOWNSHIP _
COUNTY
STREET AND NO.OR ROAD 1 / rr7
POLE NUMBER
BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? . SECTION - BLOCK LOT
OCCUPANTS_NAME - BUILDING OCCUPANCY. ,
//;A•. !I/rf J L,1 //.` . t'�v /rf/.:_,`.f'.!° i/. f..`.t'
OWNER'S NAME AND ADDRESS/ • - —HOME TELEPHONE NUMBER
"
CURRENT SUPPLIED BY FROM THEIR OFFICE WORKTELEPHONENUMBER - ,, -,
l tf r~" `
BUILDING IS •_ -
NEWQ OLD❑ WORK IS NEW❑ ADDITIONAL❑ DEFECTS REMOVED❑
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.
•
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 • ❑ EXPOSED GAS TUBE SIGN/TRANSFORMERS OF - VA
❑ CONCEALED
DATE WORK TO BE STARTED DATE COMPLETED SIZE OF SIGN(NUMBER) CAPACITY
SERVICE ENTERS BUILDING -- . MANUFACTURER OF SIGN _ ' '
❑ OVERHEAD ❑'UNDERGROUND
DATE INSPECTION REQUESTED ON(OR AS NEAR AS POSSIBLE) MUST DENT FNTE A NUMBER
•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 . DATEOF APPLICATION SIGNATUREJ OF APPLICANT 7 ,
?/:,' v 1. X��"" `
STREET ADDRESS - . - C - ,TELEPHONE NO.
CITY OR POST OFFICE - . ZIP CODE LICENSE NO.WHEN APPLICABLE
❑ 85 John Street ❑ 41 State Street • ❑570 Delaware Avenue ❑ 217 Lake Avenue - 202 Arterial Road
LJ
NEW YORK,NY 10038 ALBANY,NY 12207 BUFFALO,NY'14202 _SROCHESTER,NY•14608 SYRACUSE,NY 13206
(212)227-3700 (518)463-2122 - --"'(716)884-1155 ,":` (716)254-0141 (315)463-8552
THE NEW YORK BOARD CIF ,F'-1 -1ND R.WRITERS /
;
..,. .9•).a R).Rc . •191--.,.,..,.,.a.,..•,.ia:..A.).•..A,RJ. .,,-1•!..1`.tia.J.a•,..,•,.a•,... a.a,.•ia.,.)•i..91-1.4 •.l.a•,.a•c�• aa,-1•,. •i.a ta•,.A.'.- k.,..1-5/...,,.,.,•,.,•,.ay..i.,,,..',.,,.,,•,.).,.-.
_ THE NEW YORK BOARD. O� E UNDERWRITERS PAGE 1
8017354 BUREAU 07ELECTRICITY
41 STATE STREET ALBANY,NEW YOR 12207 •
Date APRIL 29,1991 Appl'Eation No.onfille,06 r j691 J1 . H 411085
THIS CERTIFIES THAT PER.1'1' 30.21-I ..'[i
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of ..1"
TIMOTHY O'HARE, 17 MOUNTIAN VIEW TRAILER PARK, OUEENSBUR'i, N.Y.
in the following location; ElBasement ❑ 1st Fl. ❑ 2nd Fl. Section Block . Lot .I.
was examined on APRIL 2 2, .I 991 and found to be in compliance with the requirements of this Board. l
FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT-FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
-
DRYERS FURNACE MOTORS FUTURE APPUANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. SYSTEMS
NO.OF FEET AMP WATTS
i
SERVICE DISCONNECT NO.OF S E R V I C E
AMT. AMP. TYPE METER 1,8,2W 1 if 3W 3 0 3W 3,9'4W NO.OF CC.COND. A.W.G. NO.OF HI-LEG A•W G• NO.OF NEUTRALS A.W.G. .•
EQUIP. PER B OF CC.COND.. OF HI-LEG OF NEUTRAL
2 1 -.I : El
r.
OTHER APPARATUS: io
1
to F
a . , . . ,:,...f: '\..).„..„.,_ ( 2 :...:
..,..
`I'I4 O'HARE
17 MOUNTAIN VIEW
T
. BRANCH MANAGER P
TRAILER PLR}:
p
��,UEr,��SB fti`c", NY, 12804 239
Per
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.
® ® 0 ® ® ® 0019 ® 0 ® 0 ® 0551112/1000000e0000 ® ® 0000
Y COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
TOWN OF QUEENSBURY
'`A► Y ' 531 BAY ROAD
s ", ; QUEENSBURY, NEW YORK 12804
, TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION 2//, ��, /; be.) /&&
DATE , �- �a PERMIT# Q/-//f
TYPE OF STRUCTURE V16t-4 ! `49-7,7q_/,.---
RECHECK,.A1!-7-1 l//9t .OA!'�/Aip,,%u/i/Y�!/..&
FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
FOOTING FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING FINAL ELECTRICAL--_SEPTIC
INSULATION WOODSTOVE/FIREPLACE
REMARKS
•
APPROVAL
N/A YES NO
CHIMNEY HEIGHT/LOCATION
B VENT/LOCATION !i
PLUMBING VENT p
ROOFING `, t
SIDING :'; �Y
DECK/PORCH/STEPS/RAILING'S jC
RELIEF VALVES \ /i
FURNACE/HOT WATER OPERATING
BASEMENT INSULATION/DUC';TWORK
INTERIOR TRIM/PRIVACY,1fDQORS
FINISH FLOORS:
BATH/KITCHEN WATERTIGHTT
OTHER FLOORS SWEEPABLE 'n1
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
HANDICAPPED ACCESS!
SMOKE DETECTORS
BATHROOM FANS/WHOLEHOUSE FANS
ALL PLUMBING FIXTURES OPERATING
GARAGE FIRE PROOFING "i
DOOR CLOSERS I
OTHER FIRE SEPARATION
FIRE/DEMISE WALS
DUMPS TER
SITE PLAN/VARIANCE REQUIREMENT
FINAL ELECTRI AL
OK TO ISSUE /0 OR C/C
COMMENTS: `'�
S'6=P ii(�i1�LLi
eLos 1.7; 0 cir P111.61-17--
ARRIVE /1:7 i
DEPART /CA. 4.1
I SP
Val
TOWN OF QUEENSBURY
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTORS REPORT
FINAL INSPECTIO4
REQUEST FOR INSPECTION RECEIVED//
j7r-raf-t-ky UNatiz-
LOCATION 7Z/Ln 7 U c�d CL � p l 7
DATE a/ l g/ PERMIT'
TYPE OF STRUCTURE /y .b. i67,7/Le---
RECHECK per/ i ' 'i ai✓r ca D -
FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
FOOTING FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING FINAL ELECTRICAL--_SEPTIC
INSULATION WOODSTO+E/FIREPLACE
REMARKS
i
! APPROVAL
; N/A YES NO
CHIMNEY HEIGHT/LOCATION 1 ,`'
B VENT/LOCATION t '
PLUMBING VENT
ROOFING
SIDING
DECK/PORCH/STEPS/RAILINGS •,.
RELIEF VALVES
FURNACE/HOT WATER OPERATING
BASEMENT INSULATION/DUCTWORK
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
HANDICAPPED ACCESS A
SMOKE DETECTORS '
BATHROOM FANS/WHOLEHOUSE FANS \
ALL PLUMBING FIXTURES OPERATING !,
GARAGE FIRE PROOFING
DOOR CLOSERS
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS
DUMPSTER
SITE PLAN/VARIANCE REQUIREMENTS
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C
COMMENTS: •
(:rS i Bed- d c' Ui1L�2 1 lCD1 -
[A-iJ 2-i
71 /Y ARRIVE ; i()
DEPART 1/1L
INS T
TOWN OF QUEENSBURY
.v 531 BAY ROAD
QUEENSBURY, NEW YORK 12804
*4:r4),14 TELEPHONE (518) 745-4447
BUILDING INSPECTORS REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED
E JI/I-Y /-b y 71.6h_
LOCATION IX >tcfz.ri e`Crc.a
DATE 9// (,1/Gl. / PERI2IT#
TYPE OF STRUCTURE_G'1L gL
RECHECK
FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
FOOTING FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING L - 1—NAL ELECTRICAL _SEPTIC
INSULATION WOODSTOVE/FIREPLACE
REMARKS
APPROVAL'
N/A) YES,;%'NO
CHIMNEY HEIGHT/LOCATION
B VENT/LOCATION
PLUMBING VENT
ROOFING
SIDING '
DECK/PORCH/STEPS/RAILINGS\
RELIEF VALVES
FURNACE/HOT WATER OPERATING\
BASEMENT INSULATION/DUCTWOR /
INTERIOR TRIM/PRIVACY DOORS \ I
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE S
OTHER FLOORS CARPETED f°
STAIR CLEARANCE/RAILINGS it'
HANDICAPPED ACCESS e '�
SMOKE DETECTORS
BATHROOM FANS/WHOLEHOUSE FANS
ALL PLUMBING FIXTURES OPERATING
GARAGE FIRE PROOFING !'
DOOR CLOSERS r'
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS
DUMPSTER I
SITE PLAN/VARIANCE REQUIREMENTS
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/RC
MENTS:
V(0 620 p -c-76 p s - Eo-6?Ai L
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TOWN OF QUEENSBURY
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MAR 27 1991
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