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1992-033
CERTIFICATE OF +� cCUPAN C� TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Datc_ / AZ2 _ , go 19 �u Q ^ _ � 9Z-033 This is to certify that work requested to be done as shown by Permit No. has been completed. Mo1ri 7 e Home This structure may be occupied as a locstion Corner of Vermont & Central Avenue Owner Today is Modern Humes /28 rf'" l By Order Town Board C?wW OF QUF;ENSBURY E Director of Bldg. & +Code Enforcement BUILDING PERMIT TOWN OF QUEENSBURY No. 92_033 WARREN COUNTY. NEW YORK c PERMISSION is hereby granted to cio Street, Road or Ave. OWNER of property located at Cf]trner of �*Y"�1n'�' � rpRtral `a in the Town of Queensbury. To Construct or place a „ Mnhi a H 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. t. OW"ER'S Address is 61 5C 54Rt9 r„ Ganse�oort , Fit 2_ CONTRACTOR or BUILDER'S Name fD 3 AM 3. CONTRACTOR or BUILDER S Address N n O 4. ARCHITECT'S Name .cz fD O s-r fi. ARCHITECVS Address as K'i tD a rt 6. TYPE of Construction — (Please indicate by X) I[ ) Wood Frame l 1 Masonry l } Steel f } +4 M s 7. PLANS and Specifications No 24 ' ' ' Mobile Houle as per plot plan specifications and i aCr pplication m B_ Proposed u�a Mobile Home $ 72 0 PERMIT FEE PAID — THIS PERMIT 'EXPIRES January 31 ig 93 (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the town of Ctueenslwry before the expiration date.) Dated at the Town of Queensbury XLSt 0 of January is 92 SIGNED BY az for the Town of Queensbury $us`Iding a Zaniny Inspector ct TOWN OF QUEEN B UR Y TOWNR EECEEIVEDI RECEIVED BURY R REVIEWED B - A N 2 9 1992 FEE PAfD : $ CODE DEPT, PERMIT NO . WJ L APPLICATION FOR Mf1BILE 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 . . . . . . . . . . . . . . . . . . . . . .,,,./ . . . . . . , /. . . . . . . . . . The owner of this property is : OZaifC ':S , " I© c.�rZP4f /`tt7 .� ES P . O . Address : i�L Co I✓7.S+Ef'"C*4Q % ,/!./ Phone Number Property LocatianC of� enQ1►m t�,+^Q {1*1a � Tax Map No . J G L/ 1 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 : S06 A)'UP1 MOBILE HOME INFORMATION APPROXIMATE VALUE OF HOME : $ �� L DO New Home Yes No ZONING INFORMATION . Replacement Home Yes of ///,SZ? Sg Size of Property : � jq0 ft x ft Size of mobile homea,24/ ftx YSft Existing Buildings - Singlewide Doublewide No . of rooms ( exclude baths ) Proposed building-distance from property Tine : Front Yard .30 ft Rear Yard ft . Side Yards 4;?O ft and 3 , 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 st le and size : T Attached garage ( one car /two car car ) (0 it "TH f az C o ^> C2r-7`E' Storage building Piers-No . of Size ft x ft Other Depth below grade ft Foundation- Footing size "" x "" Proposed date of placement : Wall material P21L — q '°k Z ' . Wall thickness." Height "" Water Supply : Well Municipa l 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 INSTALLER/MOBILE HOME DEALER : ADDRESS/PHONE NUMBER , Y Q+ ' ^ ,` .4tA.L1C r/&)a � +'�' � � �� S3 / 7 0 - / oz ;2 .. STATE OF NEW YORK DIVISION OF HOUSING AND COMMUNITY RENEWAL INSIGNIA OF APPROVAL OF THE STATE BUILDING CODE 1 . Insignia serial number 2 . Name of Manufacturer 3 . Plan Approval Number 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 . / 0 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 auth rized by the owner . Signature Owner , own ' s agent , architect , contractor SPECIAL CONDITIONS OF PERMIT : By Code Enforcement Officer TC%.hu°1 OF QUEEWBURY RECEIVED TOWN OF QUEENSBURY APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit # -JAM44 1992 Fee Paid BLOC. 41L c4Dui= k3rcPT. Date : _ G 9 Z Reviewed By�^� LOCATION OF PROPERTY FOR INSTALLATION : C4009,�/G��✓� Y �/r".rs,�[7.�7� d` f-- ew Owner ' s Name : _ .,�rS�'9' eS A?29 ,&7t?eL1 . 6-XI07 de�w f Owner ' s Mailing Address ; d /c' 7 Installer ' s Name : ,,,j`y- �,5 __-- Phone # : 250 /C23��. Number of bedrooms ( if residential ) : sL3 I Total daily flow ( residential - compute @ 150 galw per bedroom ) : _ f Topography- Circle One : la Rolling Steep Slope % of Slope Soil Mature-Circle One : San Loam Clay Other /Depth : 2,� Ground Water-At What Depth ? Feet Bedrock or Impervious Material -At What Depth ? Feet Percolation Test- Circle One : Not Re u ' ed Required/ Rate Min . Per Inch Domestic Water Supply-Circle One : nici Well Other If domestic water supply is a w Separation : Water supply from any septic absorption feet PROPOSED SYSTEM: Septic Tank /000 gal . ( Minimum size : 1 , 000 gal . ) Tile Field : Each Trench / feet//Total System Length feet Seepage Pit ( s ) : Number of 4 / Size each : ft . x ft . Size of Stone to be used : # Z.�. -/ Depth or Thickness — rZ� HOLDING TANK SYSTEM IF REQUIRED No . of Tanks Sizelof Each Gal . Alarm system and associated electrical work to be inspected by a certified agency. �r**** * I have read the regulation on the reverse side of this sheet and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance . SIGNATURE OF RESPONSIBLE PERSON = DATE Lk2 = �� ✓own Of QGLE'¢1t3� L/rt� BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R,C7 . 1 Box 98 ©ueensbury. New Yor 28d1 SEPTIC DISPOSAL_ SYSTEM INSPECTION LOCATION DATE PERMIT NO. SOIL Sand - Loam - Clay - Percolation Test Required? YES - NO Percolation rate - 2uWinch _ TYPE of SYSTEM: f Absorption field , total length•- OO Length of each trench_ Depth of trenches;_ �2- . - Size of gravel_ SEEPAGE PITS4Number of) PAY �.. Size- ft. X _ Gravel size - - PIPING : Si Type Bldgo to tank & r- Tank to dist . box ... 5 ��- Dist. box to field/ ey - Openings sealed? Y NO Partial LOCATION/SEPARATION ; Foundation to tank � v/4 ft �,�j Foundation to abs ,, tion ft . v610r' Absorption to 10 1ine ft V ,RAJ Separation of pi s '+�PR- - WE I LOCATION OF SYS ON PR - - E ircle one) Front - Rear - ft side ight sz - c S = n, SYSTEM USE AppRCV'ED YES K N r Bui1 ing Ins ctor 01/86 and vl � /©tvn oueen36ure Pf BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. i Box 98 pueensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION LOCAT I DATE ._ _/_ ERMIT NO* SOIL TYPE - Sand - Loam - Clay - Percolation Test Required? YES - , NO Percolation rate - Min/Inch - TYPE of SYSTEM: � r Absorption field , total length 1 � Length of each trench_` Depth of trenches � 7 - Size of gravel -- SEEPAGE PITS Et3lxmher of) Size^ ftw X Gravel size z Type Bldgw to tank "I 1 - � G� _, Tank to disc. box. Dist. box to field/pit Openings sealed? Y NO Partial LOCATION/SEFARATI C) ) Z� _ Foundation to tan Foundation to ab orption ft- Absorption to 1 t line ft . Separation of its ft. LOCATION OF STEM ON PROP RTY (circle one) Front - Rear - Left side ^ fight side CCHKE S : _ F , A SYSTEM USE APPROVED SuIldin I Spector 01/86 and vl TOWN OF QUEENSBURY 531 BAY ROAD QUEENSBURY , NEW YORK 12804 TELEPHONE ( 518) 745- 4447 BUILDING INSPECTOR' S REPORT FINAL INSPECTION REQUEST FOR INSPECTION RECEIVED i I LOCATION 44 DATE ��"PERMIT# �� "d �� TYPE OF STRUCTURE !fG'` RECHECK FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE ) '-FOOTING FOUNDATION BACKFILL _FRAMING �IROUGH NSULATION BIN� FINA�LELECTRICAL — SEPTIC W60DSTOVE/FTREPLACE REMARKS APPROVAL N/A YES NO CHIMNEY HEIGHT/LOC TIO B VENT/LOCATION PLUMBING VENT ROOFING SIDING )( DECK/PORCH/ST /R I INGS RELIEF VALVE FURNACE/HOT A1`ER OP RATING BASEMENT I SULATION/ CTWORK INTERIOR RIM/ PRVACY DOORS FINISH FLOORS : BATH/KITCHEN WATERTI HT OTHER FLOORS SWEEPAB OTHER FLOORS CARPETED STAIR CLEARANCE/RAILING HANDICAPPED ACCESS jr,,,SMOK£ DETECTORS BATHROOM FANS/WHO EHOUSE FANS ALL PLUMBING FIXTURES OPERATING GARAGE FIRE PROOFING DOOR CLOSERS OTHER FIRE SEP RA ION FIRE/DEMISE WALLS DUMPSTER SITE PLAN/VARIANCE REQUIREMENTS FINAL ELECTRICAL , 6 OK TO ISSUE C/O OR C/C COMMENTS : ARRIVE 2 � DEPART �� S T T OF U EENSB�UR BUILDING N CODES DEPARTMENT TELEPHONEQUEENSBURY } ( 518 )NEW 0745- 4447 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVES} NAME_ LZ o0v �+ LOCATION SLATE` I� � _PERMIT TYPE OF STRUCTURE APPROVED RECHECK N/A YES NO F00TINGS/ PIERS — MONOLITHIC POUR FORDS REINFORCEMENT IN PLACE THE CONTRACTOR IS RESPONSIBLE FOR PROVIDING PROTECTION FROM FREEZING FOR 48 HOURS FOLLOWING THE PLACEMENT OF THE CONCRETE . MATERIALS FOR THIS PURPOSE ON SITE FOUNDATION/WALL POUR REINFORCEMENT IN PLACE FOUNDATION/DAMPROOFING BACKFILL APPROVAL ROUGH PLUMBING PLUMBING VENT/VE S IN LACE PLUMBING UNDER S B FRAMING : JACK STUDS /HEAD — BRACING/BRIDGIN JOIST HANGERS -- JACK POST /MAI EAM HEATING ROU H— I INSULATION ' FOUNDAT ON ALLS I ERIOR R— FOUNDATION ALLS EX RIOR RR_ FLOORS R— WALLS R— CEILING DUCT WORK OR PIPING IN UN TES} SPACES R EMARKS : ARRIVE DEPART INSPECTO 414 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE I BUREAU OF ELECT 41 STATE STREET, ALBAN EW YO 12207 Date Application on file TFIIS. CERTIFIES TH^T only the electrical agrsiprnent ae deecrlbed below and introduced the scant nai I on the above application number in the promises of in thefollowinR tocoti n; ❑ Iat Fl. ❑ Zrtd FT. *"""' section Block Lot W05 examined on �14 V cared found to be in compliance with the MatPonal Electrical Code. MIXTUM RANifES COOKiN6 DECKS CiYEEiS dSM WASMEES EXHAUST FANS ,OUTLETS ACIES SWITCHES HCANDFSEfW ttuoMMCVW OTHER AMr, K. W. MAT, K, W. AMT, R.W. A/NT, K, W. AMT, H, P. DRYERS FURNACE MOTORS MMM AFRIANCE M MWft 15ftaAL WC`FVj TIME CLOCKS WU UNIT NEATERS MMV" WTM OVAMER'S MNT. K. W. OIL H. ►. GAS H. r, ApAT. Ha. A. W. G. AMT. AM►. AM7, AMr'S. TRANf. AMT. H. t. N OF�T AMT. WAFTS SERYiCE WSC%X+Nk:T NO. OF S E R Y I C E AMr. AAv, 7YrE x err 1 r 3w 3 r 3W 3 x nW r.o. CPER SCaao, OF cc ccrw o. . t+o. os H+ LtG of+'� UEG wv. or ritLm�ALs of n unilu i e b I OTNHt AMFARwTi/s: i1F.f 'Fiilad [ a k": � 111 1'{ •i.T 1',I:k?I''s}..} ? . I'1'ti I .'.; BRANCH MANAGER i, Per This certificate must not be ahered in any manner, return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER, TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT �f 531 BAY ROAD QUEENSBURY , NEW YORK 12804 TELEPHONE ( 518) 745- 4447 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED ',e//a/� NAME. - / ''J aol�'!� r LOCATION e DATE .#�l -i PERMIT TYPE OF STRUCTURE — RECHECK APPROVED N/A IYES1 NO FOOTINGS/PIERS MONOLITHIC POUR FORM REINFORCEMENT IN PLACE THE CONTRACTOR IS RESPONSIBLE FOR PROVIDING PROTECTION FROM FREEZING FOR 48 HOURS FOLLOWING THE PLACEMENT OF THE CO BETE _ MATERIALS FOR THIS PURP SE ON SITE FOUNDATION/WALL POUR REINFORCEMENT IN PLACE FOUNDATION/DAMPROOFING " BACKFILL APPROVAL ROUGH PLUMBING PLUMBING VENT/VENTS IN LAC PLUMBING TINDER SLAB FRAMING : JACK STUDS/HEADERS BRACING/BRIDGING JOIST HANGERS -- JACK POSTS /MAIN BEA HEATING ROUGH- IN INSULATION ; a FOUNDATION WALLS TERIO ; R- FOUNDATION WALLS XTERIOR '%R- FLOORS WALLS CEILING R�> DUCT WORK OR PIPING IN UNHEATED SPACES /� REKAP ARRIVE `-f �f30 ZINSP D E PART-Cl `�[ C) CTO YOU ARE HERESY REQUESTED TO INSPECT AND ISSUE CERTIFICATES FOR THE FOLLOWING ELECTRICAL EQUIPMENT TO 8E INSTALLED BY THE UNDERSIGNED TEMP. IF plpE _ ti- ,.r /f,C.yOI 7 SmEET AND NO OR Fr,1AO �"j"E/'i y r ^�� J+✓ FCILE NUMBER iJ BETWEEN �..................�,.a .�, PREMISES _. o L�w..w clsr,.fir /,r SECTIpN �� OCCUPANT'S NAME �f'Y BUILDING OCCUPANCY OWNEA'S N1WtE AND ADDRESS HARE TELEPHONE NUMBER CURRENT SU IED BY I-Flum THEIR OFFk'.:E 4VRYTK 7EL6pH1',INE NUMBER r BuwunNG Is "'I - t NEW OLD ❑ WORK IS NEW ADDTfgNAL ❑ DEFECTS REMWED ❑ LI5T BELOW ALL EQUIPMENT WHICH YOU IN LED LI NUMBER OF OUTLETS am of I cepac l3 MOORS HEATERS OFFICE USE Lam Race BRANCH EhLISTOTH e Attach't P �� CIACUITS ONLY all Recal3Ys swiCch Pandam Bracket Na III Each Na Each No. Gaul INSPECTION ; IT OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE. -------- WWI AV Ct r' r C THIS APPLICATION IS INTENDED TO COWER 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. S12E OF III FEEDERS EI.ECIRIC SIGN' PS QTOTAL ViAETS CHARACTER OF NAJRK /r ❑ EXPOSED GAS TUBE SIGW TRANSFORMERS OF W El coNCEM-Eo DATE VRORK TO BE SLVT'ED DATE COMPLETED SIZE OF SIGN (NUMII I / CAPAOTY SERVICE ENTERS BUILDING MANUFACTURER OF SIGN ❑ OVERHEAD UNDERGROUND AKfE INBPECTgN gEOUEgTiED ON(OR AS NEAR AS F'GSFJBLE) SNIP_ IL D 81Y HO TE AT IL MION. ALL PACE MIUJiT W AP CATI MAY BE PRINT NAME AND ADDRESS NAME OF APPLICJ+4N7 DATE F APPL ION STREET ADDRESS LE H CITY OR P OFFICE IC N NET CABLE ❑ 88 John Street IIf ❑ 41 State Street `` ❑ 670 Delaware Avenue � 217 Lake Avenue + 202 Arterial Road NEW YORK NY 10038 I ALBANY, NY 12207 1 BUFFALO, NY 14202 � ROCHESTER, NY 14608 I � SYRACUSE, NY 13206 (212) 227-3700 I (518) 463-2122 1111 (718) 884-11 B5 (718) 254-0141 (315} 463-8652 THE NEW YORK BOARD OF FIRE UNDERWRITERS wm uv i LAv i = A MASTER 8 �7 i BEDROOM BEDROOM FURN i LINEN' No. 1 wASWORr I Wit I 16'- V" OPT, No. 3 i 1U'- 8" od UTILITY CATHEDRAL CEILING CATHEDRAL CEILING LL - -- - CATHEDRAL CEILING PANTRY _ __ flEF CAFE DOORS IDTCHEWDININGILIVING ROOM 11 CATHEDRAL CEILING LIVING ROOM KITCHEN/DINING = ; �o BEDROOM 18'- 0" 17'- 6" s No. 2 ItI 9'- 6!' I1 lit OPT. \ i FIREPLACEall 0 Q DPT. BtIffET 5367CTI * 4424 3 BEDROOM • CENTER KITCHEN • 2 BATHS • .''� RE flI�EENSb` GARDEN TUB # RECEIVED n CATHEDRAL CEILING THROUGHOUT APR ?B3 (990 SQ. FT) . & LODE DEPT- distribution boat 1000 gal. E-t0" min. septic tank to Building at 11 +F 20' min. —� 11 to. on I 164 696 24" T 6" min. 1&11 I'll 63F `t 12" max. builders paper 2" min. SDR35 PVC 0 12" min. :tRot #2 stoneo too 6" min. no lo. It SEPTIC SYSTEM DETAILS m 2 od Q zm m r' m w4 G ro In a ro 3 TOWN C1F ClUEE'M8BLIRY � rkECEIVED '� m -�, s AM 2 9 1992 7, �l �� Lea S r CL �C�. & CODE 0EF T. Howard Sr Min"viafa AV Well Dr ^� WISCanfln AV 10 Mic Ilif]an AV EQS1 Dr r Illinois AV Wintergreen Rd Indiana AV a Ol,ia AV n Lupine La H c_ C.anneclicul AV �' Arbutus Or SP Big $'0}r Rd ARhode Island a Av Maxsoiks AV --.+ rr'f Vc;m6nonl D AV c New HOmpshire A Mrinc AV .'� P>j 111009 Sig r 7 0 lsi a1�ala m ♦ J Zi 3 1 3 v4 3 C] N lr ` SSt7C744r4`1'�f 15 M r r � • n IDS j v+ � %i. C:r If ^- tib Richardson 51 0 l y JF n i 4 My 3 45 041Y ,f 4. ) R ? s �„ ?' AV aasunS y, RiPle ■ j r _ 9 A AV rai10W c's: v •4y lS yLL AV ,, uaPlaf..l 3 Id sawV �' D { lb r Sllv3 SN110 d0 hlt ] �5 sowoy wV ula4saM ! 4z A [� C > apu �oui �aP4"•74 ,,� Q sawo(• a Ayr 6104 DID { � rt. s5 asaaol .s s '" +S ar avik S+ 5rn los Sy N 45 s�aAa�S 45 P 'a onD u0 uas;lag04S . 1 Q� +5 p J4jc:> .S I o_'j n n 11 a !5u0410+ol _0 A74lA r 4!1 r ►S } a tm W Zp 4 W a Wtu 15 , 2 a' LL 4 otl � v ° m ----- 30' ----�► c E Qby N Water 100 , T 24 X 48 R A 6 3 ' L o*� 22' �-- A VrE--- 30 ' ---- E 20 X 2s Driveway 32' 4 is M 120' 1 " TODA rS MODERN HOMES JDENl1DJ