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1991-155
CERTIFICATE OF OCCUPANCY - TOWN OF QUEENSBURY WARREN :COUNTY, EW YORK Date September 4 19 91 { This is to certify that work requested to be done as shown by Permit No. 91-1 55 ' has been completed. This structure may be occupied as a mobi 1 e'.home .. Location Box 11R, MinnQcota AUPn19P Kathryn Stark and Batrick Brockway,, Owner , By Order Town Board TOWN OF QUEENSBURY 0,7,th_eit 4-..e,(*Z,, Director of Bldg. & Code Enforcement BUILDING PERMIT TOWN OF QUEENSBURY No. 91-155 WARREN COUNTY, NEW YORK 0 PERMISSION is hereby granted to Kathryn Stark, Patrick Brockway N OWNER of property located at Box 118 Minnesota Avenue Street, Road or Ave. i v rd 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 r approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. N 1. OWNER'S Address is t-F RD#4Box 114 , MinnesotaAvenue 0 Queensbury, NY 12804 -s 0 2. CONTRACTOR or BUILDER'S Name f� Today's Modern Home a 3. CONTRACTOR or BUILDER'S Address —� fD N 0 rh 4. ARCHITECT'S Name fD 5. ARCHITECT'S Address 0 fD 6. TYPE of Construction—(Please indicate by X) 2 fD ( )Wood Frame ( ) Masonry ( ) Steel ( I 4' 7. PLANS and Specifications No. 40' x 222' Mobile Home as per plot plan specifications and application 8. Proposed Use Mobile Home $ 29.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 9, 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 9th Day ofApri-1 19 91 SIGNED BY l C1 C Y for the Town of Queensbury Building and oning Inspec[gr J:, Ta DE COMPLETED BY BLDG. DEPT. T ----/5���/// � -(7uwn of Application No. Queesaury Permit Issued ]9 TOWN OF BUILDING and ZONING DEPARTMENT Permit •Expires19 RECEIVED • �RY Bay and.Haviland Road, R.D. 1 Box 98 Zoning Designation Oueensbury, New York 12801 Vari•. c_ No.. lipSite Plan Re ew - APR 51991 • APPLICATION FOR4't =, ;:;'z '�• BLDG. & CODE DEFT MOBILE HOME q2A N., ,,...i: _ _t_ i ' HIDING AND ZONING PERMIT \ . • * * * * * * * * * * * * * * * * * * * * * * * * '- * * .* * * * a * * * * * *;:* 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 description, plans and specifications submitted, and such special conditions as may be indicated on the Permit. 1 R3- l77b The owner of this property is: Kq-VI- %y\ .1-•nak Ierli_cm-,...K.- B � P.U. AddresBfkx //Al /J7,nn�Ini-n a ,e ncJe,_, i #�/ 3 311?o � ��.¢,�nsbcv�-• Tel. Property Location: /b7i / j2 m/nns O/-g �t u.� nn I �rz��`'J j �Y �► dt�eru r ax Map No. . ( / Street i.umber or building lot number !�$oy Subdivision name (if applicable) _ - TILE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS: 1jh1cK 44e.c.r ,.,),/ 11//`l /Winne list-, /?.),,, ....._ , . &A,n.c -1'/;'1 k / 2%c>-/ `7 131.79O Name P.O. Address' Tel. No. Name of Installer /01:2Ah_'J/ylp,6-&/L99ddress Sy /21 / (q,t1JE/OD/27 Tel. 7Ig-/cam, Name of plumber,�y Address -Tel. Name of mason 1\t`iea4.- (5 1r,N qiN Address L./141 5i..,xj-, /e,)XV 7771i zzepTel. '2933 GO I MOBILE HOME INFORMATION: * ZONING INFORMATION: New Home Placement Ups . * 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 qD ft X2 ft . * whether existing or proposed and indicate all �. . *. set-back diiaensions from property lines. Give Single wily' • Double wide Al- * 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 * COMPLETE INFORMATION REQUIRED BELOW. Fireplace?/1/19 Wood stove? NO * Size of property /1) 3 ft X /Q 3 ft. Foundation style and size: * Existing building(s) Size ft X ft. Piers- No.of •' Size-2'y _rift x _"//it. * �0�� Existing buildiny(s) Use /'t1/1�- Depth below grade .�L y '1 ft. * * Proposed building, distance from property line FOUNDATION _ Footing size2s .' " XIUD4' •* * Front yard aci ft Rear yard ft Wall material `p" A46... * Side yards 00 ft and 4!-,T ft * If on corner, setback from side street ft Wall thickness 1CS " Height -i ' ft. Total depth below grade g1‘1 11 ft. * OCCUPANCY INFORMATION * Grade to Home floor level 11 8 " ft. * PRIMARY BUILDING - * * * * * * * * * * * * * * * * * * * * * ODe family dwelling * Two- family dwelling Proposed date of placement / / * Multiple dwelling / Number of units Aprox. Value- of Home $ eO .�Ud * Permanent occupancy * Transient occupancy _Water supply - Well Municipal x * Business * Industrial Septic Permit required? //I - * 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 TOWN OF QUEENSOUNY SUMO DEPARTMENT • Other ■ad•fit Mlw!esmiiiiwt, * aslkew sib ear s»eseleels slid .adIe I>sMlnsd as Iodating the • _ Pier spd specifications ere in WWll. compliance with the code. Form MIIP 5/86 and-vl • • . APPLICATION FOR MOBILE HOME PERMIT, (CONTINUED) State of New York Division of Housing and Community Renewal • INSIGNIA OF APPKOVAL OF THE STATE BUILDING CODE I . INSIGNIA SERIAL NUMBER 2 . NAME OF MANUFACTURER 3 . PLAN APPROVAL NUMBER • .• . • , • 4 . MODEL OR COMPONENT DESIGNATION • 5 . MANUFACTURER 'S SERIAL NUMBER 6 . DATE OF MANUFACTURE • /qq/ // C- 0•63.6 1-16 /Lc • 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 * * * * * 4 * _** * * * Town of Queensbury AFFIDAV . 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. • • • • • Sigaature_ er, owner's a ent,arcnitect,contractor • • • * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * a * * * * * * * •* ' • SPECIAL CONDITIONS OF THE PERMIT: . . • • • • • • ' ' By • • 'nokkV003011011MOIRWOMAR • • Aftwassol Oliva irmo kaid • AA*sow vit witsieterh fg,phesti as Swaim too . • sti vtitalbiqg boy 1414* . • f•4 • TOWN OF QUEENSIURY • APPLICATION FOR 1' I OWN`OF QUEENS8UR'( �l, > , SEPTIC DISPOSAL PERMIT FIcuCl ED I! 41,41/ JUN 14,'1991 DATE. 1 / ���� BLDG..& CODE DEPT. LOCATION OF PROPERTY FOR INSTALLATION 11ii7 ?pc-Old L .. r 1. Owner's Name:, &/li 516ef�G Telephone: Address: i"/%Ji);�15)(-ow, /U:C!_ ±" Installer's Name: (; �/?�/ fJ Telephone: `18/83 Number of bedrooms (residential only) .L./ Total daily flow (compute (d 150 gal per bedroom) C/ Topography: Circle one: flax . Rolling Steep Slope % of Slope Soil Nature: Circle one a a Loam Clay Other /Depth: Feet Ground Water: At what depth? Feet Bedrock or Impervious Material: At what depth? Feet Percolation test: Circle one: not required required rate min. inch. Domestic water supply: circle one: 'Iunicipal Well Other If domestic water supply is a well: Separation: Water supply from.septic absorption feet PROPOSED SYSTEM: Septic Tank iiJ4() gal. (minimum size: 1,000 gal.) TILE FIELD: Each Trench 63 'feet/Total system length 19? feet SEEPAGE PIT(S):" Number of / Size each feet by feet // . Size of stone to be used # c /Depth or Thickness feet ************************* 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 Sewa a Disposal Ordinance. SIGNATUR OF RESPONSIBLE PERSON: . 1,4/a/j r� DATE: /3�9f OVER f-YM TOM OF QQ'IYJEENSSBURY 5,N. BA ROAD `S = QU, ENSBURY. NEW YORK 12804 TELEPHONE (518) 792-5832 BUILDING INSPECTOR'S REPORT FINAL INSPECTIONf t) n1 REQUEST FOR INSPECTION RECEIVED "� NAME k LOCATION 11 NI,l/}MP0 DATE 900/ PERMITI C 11 `,s3 TYPE OF STRUCTURE oilob,), pehtsz, RECHECK C� ,,,L�l! _FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE) FOOTING FOUNDATION BACKFILL FRAMING ROUGH PLUMBING'(FINAL ELECTRICAL SEPTIC INSULATION WOi�DSTOVE/FIREPLACE SITE PLAN/VARIANCE REQUIREMENTS YES NO 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/DUCTWORK INTERIOR TRIM/PRIVACY DOORS FINISH FLOORS: BATH/KITCHEN WATERTIGHT ;( OTHER FLOORS SWEEPABLE OTHER FLOORS CARPETED e STAIR CLEARANCE/RAILINGS_ HANDICAPPED ACCESS SMOKE DETECTORS BATHROOM FANS/WHOLEHOUSE FANS ; ALL PLUMBING FIXTURES OPERATING GARAGE FIRE PROOFING DOOR CLOSERS OTHER FIRE SEPARATION FIRE/DEMISE WALLS DUMPSTER FINAL ELECTRICAL OK TO ISSUE C/O OR C/C l COMMENTS: u_.., I` y ;c,K v v L/C) OI . . S uL_ o C� ARRIVE /1:2<- DEPART //., :>0 ELECTRICAL INSPECTIONS .DUPLICATE MUNICIPAL RECORD Permit No. ----j-�� Owner .•.,, !C✓/`4 &/ Occupant Location. lViti No. j Street Town or City State Installation as itemized on reverse side has been visually inspected pursuant to applicable codes. Installed by Date // s7A / o. t/ 1 !/',r� v for MIDDLE DEPARTMENT INSPECTION AGENCY,INC. FORM NO.18 EL. 1337 West Chester Pike,West Chester,PA 19380 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 VAMP.SERVICE CONDUCTORS K.W. DISHWASHER: K.W.SURFACE UNIT K.W. DRYER K.W.RANGE AMP. RECEPTACLE K.W.WATER HEATER FRAC. H.P.VENT FANS /11O60uLn-/a ? 1 MOTORS N.P. I/20 1/12 I/10 Ye '/s % '% %z 'A 1 1%z 2 3 5 7A 10 15 20 25 30 40 50 75 100 MARK NUMBER OF EACH SIZE APPARATUS TOWN OF QUEENSBURY2 ) ;401k 531 BAY ROAD a � � QUEENSBURY, NEW YORK 12804 7)7 ,_; - � TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT FINAL INSPECTION REQUEST FOR INSPECTION RECEIVED LOUT/0Nygollf DATE /ge)/qf _PERMIT# 9/--/jr TYPE OF STRUCTURE RECHECK/d /C - (7aL S12I J'/ 1112 Qbi; FIRE MARSHAL APPROVAL ,(COMMERCIAL STRUCTURE) .00TING i.-PtJUNDATION FRAMING ROUGH PLUMBING FINAL ELECTRICAL SEPTIC ) INSULATION WOODSTOVE/FIREPLACE REMARKS APPROVAL N/As YES NO CHIMNEY HEIGHT/LOCATION '' �r B VENT/LOCATIONi: Iy PLUMBING VENT ROOFING SIDING DECK/PORCH/STEPS/RAILINGS . , RELIEF—VALVES �? FURNACE/HOT WATER OPERATI 00' BASEMENT INSULATION/DUCTWORK INTERIOR TRIM/PRIVACY D00'F2S FINISH FLOORS: BATH/KITCHEN WATER T IG`4Tr OTHER FLOORS SWEEPAB'LE OTHER FLOORS CARPE1'ED STAIR CLEARANCE/RAIL4NGS „. HANDICAPPED ACCESS, SMOKE DETECTORS / X BATHROOM FANS/WHOLEHOUSE FANS ALL PLUMBING FIXtORES OPERATING GARAGE FIRE PROOFING DOOR CLOSERS_/ ;y OTHER FIRE SEPARATION FIRE/DEMISE CALLSti DUMPSTER i SITE PLAN/V RIANCE REQUIREMENTS FINAL ELEC ICAL OK TO ISSUE C/O OR C/C , COMMENTS: U.& -i� C3i ? jAtt 51- Ps TOGTI+6-Y2S i O E. - CAL S r Qa 0 S i `�- 5 r3 >4 ukif l wr cL rz.ov&D ARRIVE BrArDEPART I. J -. INSP 1' ., !'Lillr C�77 // Down of Qu.eenibar y BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98. . Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME ., C;CI:.)AA4,-S:A-Z,c LOCATION ,A 1. 1.A�AJ1 c .i/kl\-"v(,- DATE CGS PERMIT NO. p I S , SOIL TYPE - Saner Loam - Clay - Percolation Test Required? YES NO' Percolation rate - Min/Inch TYPE of SYSTEM: i Absorption field, total length I , Length of each trench ' - (2, '*- Depth of trenches ` -z,_:;!' f r Size of gravel ,, ' ;�''-ter- SEEPAGE PITS{Numb'er of,) Size- ft. X fit.— / t — Gravelsiz.e- PIPING: 40 Size Type Bldg. to tank +i f— (,!f_ Tank to dist. box ) i..4 ,nf! Dist. box to field/pit 4- . f,N__ Openings sealed? fj'YES NO Partial P i LOCATION/SEPARATIONS: Foundation to tank ft. Foundation to absorption ft. Absorption to lot line ft(__ Off _ 1 Separation of pits fit: LOCATION OF SYSTEM ON PROPERTY(circle one) Front ((iea Left side = Right side - COMMENTS'� ' , ®IL 1-6 5vl re. q .ram i�•1 -- E On c `+ O 0,.A.f i=J9 ��L LA.is/ice CALL .�;2 110 r L-ei-toe c a!r, i/- SYSTEM USE APPROVED YES ' `1/.,Z(.' O 9 Building fnsg'ector 01/86 and vl TOWN OF QUEENSBURYC /"j BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 792-5832 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED '//- ,( / NAME ..DTJ.IJ I J /11L1 / �r LOCATION ./IV/17.,,4f/!) " ,/ DATE 7/:5 f C// PERMIT I 9/— TYPE OF STRUCTURE la¢i da.4ezidt )22(/✓- RECHECK APPROVED N/A YES 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 CONCRETE. MATERIALS FOR THIS PURPOSE ON SITE FOUNDATION/WALL POUR REINFORCEMENT IN PLACE )(FOUNDATION/DAMPROOFING )G BACKFILL APPROVAL 3� / ROUGH PLUMBING PLUMBING VENT/VENTS IN PLACE .,' PLUMBING UNDER SLAB FRAMING: JACK STUDS/HEADERS BRACING/BRIDGING ' JOIST HANGERS JACK POSTS/MAIN BEAM:.' FIRESTOPPING WALLS CEILING FIREWALLS HEATING ROUGH-IN INSULATION: FOUNDATION WALLS INTERIOR R- FOUNDATION WALLS EXTERIOR R- FLOORS R- WALLS R- CEILING R- DUCT WORKOR PIPING IN UNHEATED << SPACES REMARKS: jLO CIS %.it.7Al n>ral V ry Vf_5� caL .1-1;L ARRIVE L(',r • DEPART /(.-15 (rk,) _ INSPECTOR vro TOWN OF QUEENSBURY �� Bay at Haviland Road, Queensbury,NY 12804-9725-518-792-5832 Building & Codes Department INSPECTOR'S REPORT 19 9/ ,4/if/163DTA- M-- PROPERTY LOCATION OWNER OR TEN 1 BUILDING SEWAGE SIGN OTHER REMARKS 3 © r--- 2-e4 6.6- 9er2Z— P00 ARo Cc6,vGra CONTACT THIS OFFICE WITHIN IN EC R "HOME OF NATURAL BEAUTY. ..A GOOD PLACE TO LIVE" SETTLED 1763 TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT 1/$ 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 792-5832 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED 6/4/4iyi NAME hi9ChliZt,701-124- LOCATION `,")(L4 A?.!;-e .) i' DATE O.*/ PERMIT # 9/-/5, TYPE OF STRUCTURE `0(911,(,!I-_64-GtC. , RECHECK APPROVED • N/A _ YES 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 CONCRETE. MATERIALS FOR THIS PURPOSE ON SITE FOUNDATION/WALL POUR REINFORCEMENT IN PLACE FOUNDATION/DAMPROOFING BACKFILL APPROVAL ROUGH PLUMBING PLUMBING VENT/VENTS IN PLACE PLUMBING UNDER SLAB FRAMING: JACK STUDS/HEADERS BRACING/BRIDGING ?, JOIST HANGERS JACK POSTS/MAIN BEAM FIRESTOPPING WALLS t CEILING FIREWALLS f HEATING ROUGH-IN / INSULATION: FOUNDATION WALLS INTERIOR R- FOUNDATION WALLS EXTERIOR R- 4, FLOORS I R- WALLS R- CEILING R- DUCT-WORK OR PIPING IN UNHEATED SPACES , REMARKS / /"ip,av L-1,1 r 1 i2fri. o (FL 2fil 4 12t-R06 I i%/ LNG S-6 T1o/V 313A-, F/1-q71 lU rN Pr F n-�r s ARRIVE Z;.S.3-- /( DEPART 5 SP TOR -:! i , IZ A CATHEDRAL CEILING [ ) 7——j ID 01 I_— —— r UI I 1 I [ I 1 TILITYZ-71i ' GARDEN LII U.! F—') L . , , .., I • DOOR I 1.—ma P— IrD C BEDROOM —A' I 0 _ - ...win = .... 4.1,61 ,=`''' E , No.' 3 —pi ' KITCHEN/DINING Ingo I vim ih. 13' 21' •••13 ... o cc ri.„, 'X 'IV- 0" 'A I CC C CORNER ® _ — OPT '_____CORNER— I I I --4CURIOI BREAKFAST ICURID 1.4 li , rBOVII. 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