1992-034 Y
ERTIFIATE OF 0
TOWN OF QUEENSSURY
WARREN COUNTY , NEW YORK
Daoe___ Febru a 19 19 92
permit No4
This is to certify that work requested to be done as ahown by
has been completed.
a IS
This structure may be occupied a `
r-illA ' gat 82 Northwinds
Location Diane Fitzgerald
[7wtter
By [?rder Town Board
TOWN OF QUEEN'SSURY
f
Director if Bldg, be Code Enforcement
BUILDING PERMIT
>K
TOWN OF QUEENSBURY No. 921111111034
WARREN COUNTY, NEW PORK a
PERMISSION is hereby granted to re
Street, Road or Ave-
OWNER of property located at
in the Town of Queensbury. To Construct or place a
MobilP
cation in accordance to application together with plot plans and other information hereto filed and
at the above to
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. r I
,r.
1 . OWNER'S Address is
rn
r
0
g, CONTRACTOR or BUILOER'S Name
I�
Today' s Modern Hoes
3. CONTRACTOR or BUILDER'S Address
#54 Rte 9
Gansevoorts MY IJ
4. ARCHITECT'S Name
!D
S
S. ARCHITECT'S Address
6, TYPE of Construction — (Please indicate by X) * ~
I l Wood Frame i ) Masonry I I Steel
7. PLANS and Specificatiarvs
No. 14' x 56 ' Mobile Home as per plot plan specifications and
application
8. Proposed use
Mobile Home
$ 23. 00 PERMIT FEE PAID — THIS PERMIT EXPIRES
January 31s 19 93
(If town longer
period ibury ubared a the expiration application die extension must be made to the Building and Zoning inspector of the
Queen
-. Day of _ January is 92
Dated at the Town of Queensbury th—
for the Town of Queensbury
SIGNED BY Building end Z ing inspector
TOWN OF QUEENSSURY
TOWN OF QUEEN'SBURY RECEIVED
# 301992
REVIEWED BY :
E 'DEFT.
FEE PAID :
PERMIT N0 .
APPLICATION FOR MOBILE HOME PERMIT
A BUILDING PERMIT MUST BE OBTAINED BEFORE PLACEMENT OF MOBILE HOME ,
NO INSPECTIONS WILL BE MADE UNTIL A VALID BUILDING PERMIT HAS BEEN ISSUED . .
. . . . . . . . . . . . 1 . . . . . . . . . . . 6 . . . .
The owner of this property i s : / {-'o c 7 1AZ
Phone Number NA0Z
P . O . Address :
Property Location _ &074- , Tax Map No . / /.
NAME OF APPLICANT :
Address of Applicant :
All applicants spaces on this application MUST be completed and the
signature of the applicant MUST appear on the reverse side of this application .
PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES : cite,
MOBILE HOME INFORMATION APPROXIMATE VALUE OF HOME : $ Ir
New Home es No � ZONING INFORMATION :
Replacement Home No Size of Property . .S7Sf ft x /f ft
Size of mobile home Lftx--5'6ft Existing Buildings :
Singlewide Doublewide
Proposed buildinjq-dlstance from property line :
No . of rooms ( exclude baths ) Y_ Front Yard ft Rear Yard ft .
Side Yards :;I of ft and _ f0 ft .
No . bedrooms
Occupancy Information :
No . of bathrooms ]— Primary dwelling : Yes No
Fireplace Woodstove Accessory Building ( s ) :
Detached garage ( one car /two car car )
Foundation style and size : N4 Attached garage ( one car'/two car car )
Storage building
Piers-No . of Size ft x ft — 'Other
Depth below grade ft * �,
Foundation- Footing size It
x to proposed date of placement :
wall material 1r
Wall thickness." Height Water Supply : Well Municipal
Total depth below grade ft . Septic permit required ?
Grade to home floor level ft .
FURTHER INFORMATION REQUESTED ON THE REVERSE SIDE OF THIS SHEET
NAME OF; II+fSTALLER/MOBILE HOME DEALER : Lr 'J o�
ADDRESS/PHONE NUMBER `/ r� ' / tc ,q ,,+�+ y/Gr �^,r�a �,' t,�l yr �,/� �i ,•
. 7rCB - rc
STATE OF NEW YORK DIVISION OF HOUSING AND COMMUNITY RENEWAL
INSIGNIA OF APPROVAL OF THE STATE BUILDING CODE
1 . Insignia serial number 41 L. :L Z 3 01
2 . Name of Manufacturer ,
3 . Plan Approval Number e: !z7P
4 . Model or Component Designation
5 . Date of Manufacture /
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 .
Town of +Queensbury State of New York
County of Warren
AFFIDAVIT
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 autho ' zed by the wner . �
Signature /' 4 �I,J/ � ..• �1
pwner ; n as gent , architect ,
/ ` contracto7
SPECIAL CONDITIONS OF PERMIT :
By
Code Enforcement Officer
ANEW JIME&
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY �� ✓
61 STATE STREET, ALBANY. NEW YORK 12207
Date . . - Application No. on fife
THIS CERTIFIES THAT v
only the electrical eq=41pment as described below and introdwrwd by the opplirant nosed eras the aboae application number in the prerniees of
in the following location; 0 Basement ❑ lst Fl. ❑ and Ff. Section Black Lot
toas examined on ] I I4 Iq"1 2 andfenand to be in compliance with the regrairements of this Board.
HXTUlE ACLES SWITCHES FIXTURES RANGES COCiKW4 tllCKS 01fFH15 015H WASHERS EXHAUST FANS
OUTLETS INCANbtSCt PIT PLIlORESC:tM 4T}IEfl AMT,
DRYERS FURNACE MOTORS FU►UEE APMANCE 1°EEeEIS SPECIAL 012COPTI TIME CLOMS I Ept I UNIT HEATEIS MU1LUF TLRT DiiMMI M
SYSTEMS
AMT. K. W. OIL H, P. GAS H, P. AMT- NO. A. W. G. AMT. AM►, AMT, Amn, TRANS. Ad M. P. No, # pfflff xMT. WAttS
SERVICE DISCONNECT OF S E A V I C E
AMT, AM►. TY►t METE! } X 2W 1 J� 7W 3 Ar sw 3.t Aw NO, 17F cC. cONp. A. W, G. ND. OF HI-IEG A. W, G- N4. CW Haun ALs A, W. a.
EQ11Mh. PER t cw cc. CONo- OF HI-LEG OF NEUTIIAL
WHER APPARAn*dd
AN
40 G
�A+ + BRANCH MANAGER
�}�9 ` Per
This certificate must not be altered in any manner, return to the office of the Board if incorrect. Inspectors may be ide"fied by their cmdentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
TOWN OF QUEURY oz
531 BAY ROAD
TELEPHONEY � ( 51$ )NEW0745- 4447
BUILDII46 INSPECTOR` S REPORT
FINAL INSPECTION ,rI
REQUEST FOR INSPECTION RECEIVED��,1 FIVZ=
MAKE r
LOCATION '
OuAITE ��,;L.PERNIT#
TYPE OF STRUCTURE
RECHECK
FIRE MARSHAL APPROVAL ( COMMERCIAL STRUCTURE )
�FOOTING FOUNDATION BACKFILL NAL ELECTRICAL
AMING
ROUGH PLUMBING _
_ INSULATION �WOUDSTOVE/ FIREPLA�C,E/
REMARKS_ , 10A
APPROVAL
N/A } YES ' NO
CHIMNEY HEIGHT/LOCATION
B VENT/LOCATION
PLUMBING VEN f'
ROOFING
SIDING
DECK/ PORCH/STEPS RAILI . S
RELIEF VALVES
FURNACE/HOT WA E OP TING� — —
BASEMENT INSULATI N/ JCTWORK
INTERIOR TRIM/ PR"
DOORS
FINISH FLOORS :
BATH/KITCHEN WAT TIGHT
OTHER FLOORS SW
OTHER FLOORS CA PLABLTEDE
STAIR CLEARANCE/ ILYNGS
HANDICAPPED ACCE S
SMOKE DETECTORS S
BATHROOM FANS/ALL PLUMBING FI TURES 6RERATING
GARAGE FIRE PR FING
DOOR CLOSERS
OTHERFIRE SEP RA ION
FIRE/DEMISE W LS
DUMPSTER
SITE PLAN/VAR ANC REQUIREMEN S
FINAL ELECTRI AL
OK TO ISSUE C D OR C/C
COMMENTS :
/ep Ole') ��'. 4_. a6
ARRIVE
DEPART / S
YOU ARE HEREBY REQUESTED TO
INSPECT AND ISSUE CERTIFICATES
FOR THE FOLLOWING ELECTRICAL
EQUIPMENT TO BE INSTALLED BY
THE UNDERSIGNED
D7
cFiw oR»I"C.E TOWNSHIP ODI.JNTv
/ iJ 1I� lY+7 f
sraEEr dlFi�AD- r oL.e NUMeER's
SE'rWEEN%NHa TWO CROSS STREETS IS PREMISES I.U04EO7 SECTION E4.OrK LOT
OCCI.AVm-S NAME BULDING CK=PANCr
OMME WS NAME AND ADDRESS + rr HOME TELEPHONE NUMBER
N J54
CURAr" r FKw THEIR OFFICE
{
BUI.DINCa IS
NEW mo ❑ V"K IS NEW ❑ AOpI'M3N1/1L DF3T are REMm7m ❑
LIST BEU:)W ALL EQUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETS No. of Fixtures & MOR3RS HEATERS BRANCH OFFICE USE
Lamp Receptacles CIRCUITS ONLY
IIOn Slde AAlech't H.P. VAsm AW.G.
cemRSl 1NT11 mwep'lT swrocn PeTxIBIQ BrBcbsl Ma .Type Each Na Each NLL C3Buge I 8pFiC.TION
OUT-
SIDE
SUB-
BASE
BASE-
MENT
tet
FL.
PFId
FL.
and
FL.
REMAR1f8; 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 LISTEQ YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE TO COVER
THE ADDITIONAL EQUIPMENT, AS PROVIDED BY THE APPLICANT:
SIZE QF MAINS FEEDERS ELECTRIC SIrf4SM-AMPS "OPAL VW% TS
G�ARAT:lER yunR ❑ EXPOSED O+ S TUBE SKTNIrRANSFnW"AF.RS OF w
❑ CONGEALED
D4E WORK TO D"F COMPtjETED 'SIZE OF SOBN (NUMBER" cAFAC.frV
RS RUIEDMIG. MANUFnG ACM OF SIGN
❑ CNERCIEAD ❑ UNnemmn umo
PA'E INSPECTION REQUESTED ON(OR AS NEAR AS POSSIBLE" 00160%* ��'
1
FIIH r AM ACBIJ FILLM N Wi APPUV TICINl
PRINT NAME AND ADDRESS
NAME OF APPLICANT OJRE OF CATION souniplum Or
POST ZIP m—o A PL"BLE
John Street ❑ 41 State Street ❑ 570 Delaware Avenue 21 Lake Avenue ❑ 202 Arterial Road
NEW YORK, NY 10038 E ALBANY, NY 12207 BUFFALO, NY 14202 I ROCHESTER, NY 14608 { SYRACUSE, NY 13208
(212) 227-3700 (518) 483-21 22 (71 6) 884-1 1 55 (71 B) 254-0141 1 (315) 46"552
THE NEW YORK BOARD OF FIRE UNDERWRITERS
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Luzerne Ad, Phone:
Queensbury, NY 12801 79M838
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• * YWiyRT •CtW6 uLWaR4 Ctaµ6- _ _ _ „ . — Iw,Y) { ERR _ _ _ _ _ _ _ _ _ __ __ _ _
431oBL. 56x14
2 BEDROOM * CENTER MASTER
KITCHEHt LIVING ROOM BEDROOM 'i
- KITCHEN • SNACK BEryQflOM (y7i1, = DINING t8"• S0 " No-2
BAR t CATHEDRAL ;' 12. A "` 4,. '2 °
CEILING (765 SQ, FT.) 4 t
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T WN OF QUEENSBURY
RECEIVED
JAN 0 1992
B & DEPr,
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