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1992-055 .:: :A.� �,,. .e..a. �.... .y..... i CERTIFICATE OF O CCUI'A.NCY ` TOWN 4f QUEEN58URY WARREN COUNTY, NEW YORK Date- March 3, 1992 ,t ■ r ~ This is to certify that work requested to be done as shown by Permit IS 92-055 has been completed. This structure may be occupied as st atiozs Lot 035 Hmestead Yl a " , 47wner Richard Hurle Fireplace cannot be used until approved by Fire MarshAl By Order Town Board PrOWN OF QVEENSSiJRy s �- Director of Bldg. & Code Enforcement BUILDING PERMIT TOWN OF QUEENSBURY No. 92-055 0 WARREN COUNTY, NEW YORK ela ro PERMISSION) is hereby granted to Ri chard Hurley � OWNER of property located at Lot V5 Homestead Vl g Street, Road or Ave, in the Town of Oueensbury. To Construct or place a Mobile Hose M7 th ! reRl aCe x at the above location in accordance W application together with plot plans and other information hereto filed and `. approved and in compliance with the Town of Oueensbury Building and Zoning Ordinance. *�C M 1. OWNER'S Address is �• Mendel & Lavin 12 Colchester, Vermont 05446 2. CONTRACTOR or BUILDER'S Name Tom Case r 3_ CONTRACTOR or BUILDER'S Address C7 fr.1 4. ARCHITECT'S Name LA 9 OC . S. ARCHITECT'S Address sC� 6. TYPE of Construction — (Please indicate by X) O ( } Wood Frame ( 1 Masonry I } Steel ( 1 Cr rp 7_ PLANS and Specifications x No, 14' x 66 ' Mobile Home with Fireplace as per plot plan specifications if and application 8. Proposed Use Mobile Hose with Fireplace 54oOO PERMIT FEE PAID — THIS PERMIT EXPIRES _ February 26 , is ' 3 (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 h Day of,_ Febr#JarY 1g 92 SIGNET] BYt s" for the Town of Queensbury Building and Zo Inspector 110 DE . COMPLETED BY nt-r D'EPTe. // Application No. BUILU+Un+G u rnO tu�ktlsLarr� 1'cirmat Isnued) 9 TOWN OF OUEENSBURV ZGINirVG []EPALiTlrltNT Pawsait F.Upirou ID RECEIVEQ flay una Huriland Road" R.D. I Box 08 Zoning Duaignation Quuvnstiury. Now York 12601 Variance No., �� � � *� T992 Sato Plan Preview No . APPLICATION FOR A. +i r y ��� BLDG.MOBILE HOME & CODE DEPT. PUILDIN; AND ZONING PERMIT L,.=. 'g4'e L w ♦ r x r 7r M ♦ M • M t► it w +F r M R w iF r w w w M • +r w• w M r w w t M M N w :: w A PERMIT MUST RE 08TAINED BEFORE BEGINNING CONSTRUCTION . ANSWER ALL OF THE FOLLOWING . The underaignod hereby applies for a Building Permit to do the following work which will Y,e dame In accordance with the dascription , plane and upecificati mno uubauitted , and • such x.jasci:ai ranrlitions as uray be indicated on the Parmite Ttw owner of tlxis propa:r y r r ,r �! P W OO Ralairas:es8 rJ ( C.. Tel , d ;2 I — tiff Prorc. rty Location : Tax Map Ha .��i^� 5tr, a:t +"uuaUUr or bkAildiny lot nuuJoer I / ��'name (If applicable) ��. C� ? CE � .L� �/f • �ii�tt Tile pm ON fuzS ONSIBLE FOR SUPLRV'ISION OF WORK AS f"MARDS BUILDING CODL IS = -- tl.aury r AcWrCsu 401 0 No . r/ ' �N ' of Installer ' .� .a.rica hd ss Sf - 4 ,cL -� .N"Illu 41 F.lundra:r l . N.."raa; ui awivaesa Rdetreaa •l'cal . MOB I LE HOME INFORMATION : rs� ZONING 1NFORMATIONO Now Slotnc Placement � � 5� PLOT P1*M*5JHUST DE PREPARED AND SUBMITTED8 drawn roason"bly to scaLio ,and att:acha3d haarato, Replacing csxisting Home �. + uhowing clearly and distinctly :all t,u.ildings , sixes of new Rome ft x;�ft * whother existing or proposed and indicate all ~ sat-back dimensions from property lame" . Give Single w ' le Double wide ► utrcnt And nunaL,ur ur loL nuuabor and andicaLo No . Of rooms ( excluding ba ths ) � who Char interior or corner late :'show location " of water supply and location and configuration No , of bedrooms * of septic disapossal arena . No , of bathrooms x COMPLETE: INFORMATION =- QLf I11ED DEI.UW . F i replacewood stove? Size of property f t X f t . Foundation style and - size : "luting building ( u) Size ft X ft " piers- Ho . of Size- ft x ft . E:xiutinq building is ! U"a Depth below grade ft . NOW FOuttDA'I'ION - footing size m• x N * Proposed buildiraal , diu1.4nce trout property line a Front yard ft Rear yard ft Wall material r Side yurda tt and ft Wall thickness " Height ft. • it on corner , sLtivac:k from ,reside. atra:ot ft 'Total depth below grade ft . OCCUPAL:Y INFORMATION Grade to 'Home floor level ft. . PRIMARY BUILDING men • ■ • w a f w ■ w w a w e w w r r e s one family dwelling Two family dwelling proposed date of place�ey .-- �� �� 0ftmmmmmmX_ liultiplu dwelling / Number of units Aprox . Value, o 'H � 6 Home S 6) 1 :�^!'+erm:ancnt occuisancy - ``- r J* Tx"nslcnt occupancy Water supply -- Well Municipal � r 1lusiness ,,, Industrial Septic Permit required? other 4 if additioesr , what will usn be? FURTHER INFORMATION REQUESTED ACCESSORY LiUILDTfIt.:- ON THE5 REVERSE SIDE OF THIS SHEET * * ootached garage/one car/ two car/ car 0 mmmmmmmmAttached garage/one car/ two car/ ear Private storagu building " Other Form mHP 5 / 06 mdmavl APPLICATION FOR MOBILE HOME PERMIT, CCONTINVED) State of New York Division Of Housing and Commun=j. ty Renewal INSIGNIA OF APPI%OVAL OF THE STATE , BUILDING CODE I . INSIGNIA SERIAL NUMBER Z . NAME OF MANUFACTURER ] 3 . PLAN APPROVAL NUMBER 46 MODEL OR COMPONENT DESIGNATION 5 . MANUFACTURER ' Sm SERIAL NUMBER y�,• �--d G . DATE OF MANUFACTURE AZZ the above inf6rmatsoxr 'LB to be found on a Plata or atickev Wh ' Oh n hou Ld be affixed xed to ` t10 he Mobi Ze Nome . COmp1eta,.above eom:th that %nfoxw= tt:on, e e x w w r t .►` w • +t 4 +r ♦. .t +r * 4 .0 ,1 A w r! a a A w x # t +t Town aL QuOa.nabury County of Warren AFFI D A V . I T STATE OF NEW yO]RIC I swear that to the bast of fay knowledga and belief the statements contained in thj s application , togethyr with the 'Plane ,snd bpa,cifications aubm' Ztud, Ayer a true and comPlcce statesnont of ,all. propoaed work to be done on the described premises and that all provisj.onu of the BUILDING CODE ,, THE ZONING ORDINANCES and all ether laws pertaining to the PrOPosed work &hull be complied with„ whsther spucified or not , And that such work is authorized by the owner, ar. • owner • s agent , arcn�.>Gect, contractor ■ w ■ w r ■ w w w. w w w w w rr * • w w w .w w w w w w * w w w w w w w w w * ■ w u w w w • w ' w SPECIAL. CONOITIONS OF THE PERMIT : r A .. .. . • Y •s" , �� Ate____..;___�._.I�y___�.__ _.4____....__i_ . r • _ _ • • • m . TOWN OF Q► UEENSBURY 584 Bay Rd., Qusensbury, NY 12804 APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS r Permit Noe �'4 i? -,61'�L DAWAPPLICATION"IS'HER '' bl to A* B'odtnyVz?APL ofr<tbp iptYce a44U ld'a a d3v4Wjr*rv* pursuant to the New York State Fire Prevention and Building Cade. The applicant or owner agroes to comply with all applicable laws, ordinances, regulations, and all conditions that are pert of these requirements and also will allow all inspectors to enter promises to perform required inspections. Please fill out additional form N more threw one ep pfiance endlor chimney. Applloant 'e", , ` . , r f� c,�/X4' a- � APPLIANCE (check appropriate boxes) Address / � rf - >':. , � �s +� ❑ STOVE: C1 Wood ❑ C+Oai ❑ Pe13et .' ❑ FI,EEPLACE INSERT f c, t. ' - r Zip �:�' p'FI REPLACE, FACTORY-BUILT: RY-BUILT: ❑ Gas Phone _ A, l ' rir /E 2 " d ❑ FIREPLACE, MASONRY: ❑ Wood o Gas Owner � �` � c �!r ..t S z� � / �'�� ,r❑ FURNACE: [3 Wood o Gras o Oil O dress -- j "� z Lc1 _C ,/ - ' ` IF NUN-IIMSC3NRY: Manufacturer: Zip Model: By : t]uti iInchesN Number: Phone CHIMNEY (check appropriate boxes) Exact address of proposed construction © MASONRY: o Block ❑ Brick 'o Stone FLUE: ❑ Tile o Steel Sixe: Inches CONSTRUCTION/IN ArTIATION MUST o FACTORY-BUILT: CONFORM T© NYS IRE PREVENTION �It Manufacturer: Model: BUILDING CODE. CONSULT TOWN OF Listed By: Number: QUEENSBURY HANDOUTS PROVIDED ❑ Double Wall o Triple Wall REGARDING REQUIRED INSPECTION& r3 i nsulated Cashier's Department Town of Queensbury, New York Dept: Fire Marshal Amount Collected Amount Received Code Number Title A 173 3389 (190) Public Safety A 233 2655 (230) Minor Sales Fee llected From or efitnded to: — ' 1 Addxcm Dated: "" C Town Clerk or Depu crldertrod: Craahler's Daps ~e: Appllcraru Green: Fire Marshal Yellow: Bldg. Dept, G TOWN OF QUEENSBURY IV e FIRE MARSHAL QUEENSBURY , NEW YORK 12804 TELEPHONE ( 518 ) 792- 5832 FIRE MARSHAL INSPECTION REPORT REQUEST FOR INSPECTION RECEIVED NAME xc LA LOCATION DATE !q,' PERMIT# Q APPROVED N/A YES NO EXITS AISLE WID HS EXIT SIGNS EMERGENCY LIGHTING FIRE EXTINGUISHERS AUTO , EXTINGUISHING SYSTEM HOOD INSTALLATION AUTO . SPRINKLER SYSTEM ALARM SYSTEM INTERIOR FINISHES STORAGE : CLEARANCE T S INKLERS CLEARANCE TO HE TING UNITS REQUIRED SIGHAGE CHIMNEY WOODSTOVE FIREPLACE-MASONRY ✓FIREPLACE- FACTORY BUILT REMARKS : OK TO THIS DATE eoe i9 ARRIVE DEPART E OR TOWN OF QUEENSBU 531 BAY ROAD QUEENSBURY , NEW YORK 12804 TELEPHONE ( 518 ) 745- 4447 BUILDING INSPECTOR ' S REPORT FINAL INSPECTION '} REQUEST FOR INSPECTIONS RECEIVED_ c NAME LOCATION o ' DATE �',� j �PERMIT# 1 TYPE OF 5JJTR"UCTURE RECHECK FIRE MARSHAL APPROVAL ( COMMERCIAL STRUCTURE ) FOOTING FOUNDATION BACKFILL FRAMING ROUGH PLUMBING FINAL ELECTRICAL FSEPTIC INSULATION W STOVE/FIREPLACE REMARKS APPROVAL N /A YES ND CHIMNEY HEIGHT/L ATION B VENT/LOCATION PLUMBING VENT ROOFING SIDING DECK/ PORCH/STEPS/RAIL NGS RELIEF VALVES _ FURNACE/ HOT WRY OPERA NG BASEMENT INSULATION/DUC INTERIOR TRIM/ PRIVACY DOOR FINISH FLOORS : BATH/ KITCHEN WATERTIGHT OTHER FLOORS SWEEPABLE OTHER FLOORS CARPETED STAIR CLEARANCE/RAILINGS HANDICAPPED ACCESS � SMOKE DETECTORS BATHROOM FANS/W =-- ALL PLUMBING FIXTURES ERATING GARAGE FIRE PROOFING DOOR CLOSERS OTHER FIRE SEPARA I N FIRE/DEMISE WALLS DUMPSTER SITE PLAN/ VARIAN REQU EM NTS FINAL ELECTRICAL OK TO ISSUE C /O OR C/C COMMEN 141 ARRIVE DEPART �" 5 THE NEW YORK BOARD OF FIRE UNDERWRITERS lY'wrc';L,E BUREAU OF ELECTRICITY 41 STATE STREET. ALB, N RK 12207 c;. 3" ,1 PsFIlJ1-7FL'r 1 ; , i. + _; APPticution N n fife i;i3?3'. '��' �` Clete F' }Ii 'I' pii_ T HIS CERTIFIES THAT tips wurnber in the Pee+ of only Cite erlectrieal egttfp»sent as doscribed be&~ and intradaced 'by acarat Warned an the abwoe application f [ ri ltt fllJ�lr 't: li+ E1;iS'F#ii . l .tfi:} };k4FI FtL7 . �' I L7 AC:E; Fili1; 1..5:'r t:l F. lt : F'A1.Tr :% . PS ❑ Basement ❑ !at Ft. 0 End Fi. !)Y i'1' Section Block Lot ?r' in the foiiouuin,g location; _ was examiruad on �I At]1. 4J�FiZ and found to be in complisnLcsJ with the requirements of this Board. RXTUR#S RANGES COOKINti CIECKS 4V INS 015H WASHERS EXHAUST FA AMT. K, w. AMT. NS OtlTLETS ACUPS SWITCHES INCANDESCENT PLuortESCENT 0-rHER AMT. K. W. AMT- K- W. TI. P- FUT1lEE AlFLtANCE FN.!DERS SF#CtAL REC'FT TtEAE CLOSCKS EKL UNIT HEATERS AWL "in tNM/NERS DRYERS FURNACE MOTORS SVSTAMS AMT. WATTS AMT. K. W- 01L H- ►. GAS H. P. AMT. No. A. W. G. AMT. AMP. AMT. AMPS. TRANS. AMT- H. ♦. Ho. OF PM *1 I S # R Y t C # SERVICE DISCO 04NECT' NO. OF A. w, a. NG. OF NEUTRALS LT�ifAL AMT. AMP. rTre EQ �. r X 2W 1 9w a Ir aw 3 X 4w " PER CC. Gs Cc, ' n. s�o. ttt rLIAEG r. rM-LE[s or HE OTHER A"ARATLM #'H};Uk;l;a : i - 7 # Lik1£�kJ%IIAT T+? �3A 'd4F31'3' fi S A * 210�r\/fJ fir . :'4 l•l AI M W'I Uhl BRANCH MANAGER Per I! This certificate must not be altered in any manner, return to the office of the $card if incorrect. Inspeciars may be identified by Tfia'ir credentials. BE ALTERED IN ANY MANNER. FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT - — - CEHIIrR = THE NEW YORK BOARD OF FIRE UNDERWRfTERS DO NOT WRITE HERE - FOR OF"CE USE ONLY BUILYriNGa PERMIT NO. TEMP. M DIA1'E � 4 _ - caouNTv 7t]WNSIIIP ,r �. CrrY OR ,JILL.M+£ PK1LE NUMBER ti sTREt r .i R ° B EN WFI/V TWO GROSS STREETS IS PREMLW-,9 LDCwPI EP BUILdNG DOGLrrVIIJCY Or;+OUwNTS NAME "OME TELEPHONE NUMBER 17WN£R"S NAME AND ADORESS C ..� r/; �jr'~ yyOF1K TEI-EPI' E NUMBER u oPErcE F1iOL1 THEIR GURRET7T SUPPLIEb BY BUIL91IJ615 WORK NEW � A.ADRION.AI- �� pEFEG1'" REMOVED ❑ OLD MEW �l 1_fST 'B7= E'OUIPMENT WHICH YOU IhiSTA1..LEBBRANCH OFFICE USE NUMBER OF CrUTLETS No. of Fixtures TO & MOTORS HEATERS CIRCUIT'S ONLY Lcxa Larnp R cOPMdes H-P Na Warm No, cam INSPECTION EaChtian SIII AAach't S-' C PC K6- r 6rackiER Na TYPs Each Cei4in9 Wall Rmaols OUT- SIDE SUB- EASE BASE- MENT xst FL- 2nd FL. 3rd FL. REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FOR7H ABOVE, ION, E LISTED, YOU ARE AUTHORIZED TO MAKE THE INSPECT AND ADJUST THE FEE TO COVER THIS APPLICATION IS INTENDED TO COVER THE RgOVE-LISSt:D EQUIPMENT TO Be INSPECTED, BUT IF AT TIME OF 4NSPEGE FEE THERE FOUND ADDITIONAL EQUIPMENT NOT ABO'�+'D BY THE APPLICANTTOTAL WA11x THE ADDITIONAL EQUIPMENT, AS PROVIDEE PS EI-ECrRIDsIGNRn..AMPs w. SIZF OF MAINS GAS TUBE^dGNfTRANc„FpgMERR OF ExIP(xSED GAF'AGTfY GHpRpGT£P OF WdRK DATE QnMPLETEb 512E OF SIGN CNUMaERx PACE yµpRK TO BE STARTED M U ANUFp4'rRER OP SIGN SERVICE EN7ER58U1LDING OVER"EAD L� UNDERGROUND ` I AS NEAP s5 POS,r�IBLE) i k t [WE INSPECTION RMIJESTEO ON M1OMUST R NAIf f '�E RE7URNED- AVOID DELA BY GIVING' LL AND 'RATE A71ON. ALL ML1S7 FILLED IN OR APPLICATION PRINT NAME AND ADDRESS DAT OF APPL ON _ NAME OF APPLICANT . Y '� TELEPF„ION NO- STREET ADDRESS '� LICENSE NO. WHEN APPLICABLE .. '.j A . ZIP CODE CITY OR .r 202 Arterial Road 41 State Street ` O Delaware Avenue 217 Lake Avenue 85 John Street ` `} Lr] CI ROCHESTi=R4 NY i 460$ 315R)463-8 52 13206 E) NEW YORK, NY 10038 ` ALBANY, NY 12207 1 BUFFALO, U 61 AS.B44-1 Y 55 42D2 {71412 54-0141 { (212) 227-3700 11 (518) 463-2122 111 RK BOARD OF FIRE UNDERWRITER THE NEW YC} TOWN OF QUEENSSUWY RECEIVED FEB A 1992 400 BLDG. & CODE DEpTm Iy 00, on COS, B& n KITCHEN A4ASTER f 3 -4" BEDROOM LIVING ROOM 11 BED RO*„OAI BEDRO,OAN DIMING WH 3 Bedroom Mode/ 972-V, x 70". SM SQ. P4 TOWN OF QUEENSBURY RECEIVED FEB 2 4 1992 BLDG. & CODE DEPT. 3rd O Bath BEDRQDAI covonal AfodW 969-V so~ to" DINING 1 Jrd �A�q 2nd ED�RA! w LIVING rROOAf BE�DRO�OAI BE3DR3QOAI 13 -4 Syr, .- rr it KITCHEN F. wry rQ 3 Bedroom Model" Mq6 Y, l!' x AaA SQ. F#.