1991-584 'CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY-
WARREN COUNTY,, NEW YORK .',.
Date �/�l, �14 g 119
This is to certify that work requested to be done as shown by Permit No.
91-584
has been completed.
This structure may be occupied as a mobil P hOrgP
Lot 28 Northwinds Park
Location
Northwinds Inc.
' Owner Baiifll ii
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY No. 91-584
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to
NORTHWINDS INC.
ry
OWNER of property located at Lot 28 Street, Road or Ave.
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
PO Box 224
Glens Falls NY 12801-0224
2. CONTRACTOR or BUILDER'S Name CD
Today's Modern
3. CONTRACTOR or BUILDER'S Address
54 Route 9
Gansevoort NY 12831
4. ARCHITECT'S Name
5. ARCHITECT'S Address
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0
6. TYPE of Construction— (Please indicate by X) oo
Iv
( I Wood Frame ( ) Masonry ( )Steel (
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7. PLANS and Specifications
A
No. 52')(26' Mobile home as per plot plan, specifications and application
8. Proposed Use
Single family mobile home
$ 59.00 PERMIT FEE PAID —THIS PERMIT EXPIREScr
August 19 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.) rp
19th August 91 0
Dated at the Town of Queensbury thisy of i i_ g 19
/SIGNED BY - -207 / for the Town of Queensbury
Building and Zonir ,Inspector
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c� TO BE'COMPLETED .BY fLDC. DEPT. T(r):� i r
/uw�� u� Quee,aj ,. ,•
Application No.Permit Issued I9 � y'fai '-
BUILDING anu ZONING DEPARTMENT 4 ''`:.' "s*. 15''
Permit •Expirea 19___ �_ ' " I
Bay and Haviland Road, R.D. 1 Box 00 �'' In
QuuenSDury, Now York 12801 Zoning Designation �� 'i
Variance No. UC 991 �C
Site Plan vie o.
•
• APPLICATION FOR Ap ro b • 1LD NCB;& DO[3',
by •
EPT.
•
MOBILE HOME qi
5gif
P•UILDING AND ZONING PERMIT -
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 s
:.peciul conditions as may be indicated'on the Permit. pe.eificationa submitted, and .such
The owner of this property is: /U027,//.t1/4/vs i/A4G
P.O. Address f1r 0. O X y !�LE/VS rAccs t /2. SO = .
ref. �9oZ-58�3 .
Property Location: e- UUcJ2NE 20/1e )
street 6uiiiber or Duildiny lot number Tax Map No. /_f
Subdivision name (if applicable) ND2 T#w/,tip1
THE PERSON RESPONSIBLE FOR,SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
`T-017.4 i ,y.D0E2i11 (706 ivUdi 5-4 24 G 4 it)S6'A0Orel N y l Z83 1 798 `�—/ 2 a
Name
P.O. Address ,
• Tel. No.
. Name of Installer S ,q•wt.e
Name Of plumber Address Tel.
N:�iui. of :u.;aon — S Addruaa Tel.
•
g _ Addr`au
Tel
.ol.
MOBILE HOME INFORMATION: * . ZONING INFORMATION:
New Home Placement yes • * A PLOT PLAN MUST BE PREPARED' AND SUBMITTED,
Replacing existing NY;,_ NQ drawn reasonably to. scalN and attached hereto,
* showing clearly and distinctly all buildings,
Size of new Home s- ft X o2 ft . . whether existing or proposed and indicate :all
*
Single wile Double wide * set-back dimensions from property lines. Give
street •and number or lot number and indicate
" No, of rooms (excluding baths) * whether interior or corner lot. Show location
No. of'bedrooms -it .of Water supply and location and configuration
* of septic disposal area.
No. of bathrooms 2 "
COMPLETE INFORMATION REQUIRED BELOW.
Fireplace? ///9Wood stove? /vQ
• Size of property ft X ft.
Foundations/ty a and• size• * Existing building(y) Size ft X ft.
Pi�nd (l'[�i=�= o�f �G Si.zes - f x ft. •
Existing buildings) Use
•
Depth below grade ft.
FOUNDATION - Footing size " X .� •* Proposedbuildirl, distance fromproperty line
Wall material * Front yard ft Rear yard ft
, Side yards ft and ft
ft. " If on corner, setback from side street ft •
Wall ,thickness " Height
Total depth below grade ft. OCCUPANCY INFORMATION
r
Grade to Home floor level ft. . PRIMARY BUILDING -
* * " One family dwelling
Proposed date Of placement /( " Two family dwelling
0 / / ( . Multiple dwelling / Number of units
Aprox. Value. of Home S...57 WO • Permanent occupancy
al " 'Transient occupancy
Water supply - Well Municipal . Business
* ' Industrial
Septic Permit required? 100 Other
*
Al( a41 u'. y. IA s p�L.-P.QLQ• •
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
`PrII ' Attached garage/one car/ two car/__ car
`D0r- pl Lz/A * Private storage building
O ,Q,Q�-Pr I Gat • •" other
Form MIIP _ S/BG and-v1
, APPLICATION FOR 'MOBILE HOME PERMIT, (CONTINUED) •
• •
State: of New York Division of Housing and Community Renewal
INSIGNIA OF `APP OVAL OF THE STATE . BUILDING CODE
1 . INSIGNIA SERIAL NUMBER U -- �.� OOSG S
2 . NAME OF MANUFACTURER cSkYc(
3 . PLAN APPROVAL NUMBER 0E `-53 •
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Lt . MODEL OR COMPONENT DESIGNATION & eF '7 7 . O #t GA570 9S7/
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5 . MANUFACTURER ' S, SERIAL NUMBER IS70 /46 •
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�1
6 . DATE OF 'MANUFACTURE •.s Ai/RI' •
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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 4 4 4 * 4 4 4 4 4 4 4 # 4 4 4 4 4 4 '4 • 4 4 4 4 4 4 4 * 4 4 4 44 4 4 4
•
Town of Qucensbury
County of Warren A F F I D A V • I T STATE OF NEW YORK
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 ep cified or not, an tha such work is
authorized by the owner. , . . . •
Signature �f
• Owner, • er' gent,arcnitect,co ractor
•
•
• * * • • • • • • • • • • * * * • * • * .• • • • * • * * * • • * • • • • • • * • * • • * * '•
SPECIAL CONDITIONS OF THE PERMIT:
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• • , By
YOU ARE HEREBY REQUESTED TO
INSPECT AND ISSUE CERTIFICATES
FOR THE FOLLOWING ELECTRICAL
EQUIPMENT TO BE INSTALLED BY
THE UNDERSIGNED TEMP. 9 �
N DATE �! G..•({
' CRY OR VILLAGE /-�� TOWNSHIP COUNTY
C./�()�f`/1). JcJ-' 1 li.'./ (/'
STREET AND NO.OR ROAD POLE NUMBER
,G. () l ()ei?/C K2(..7/Tf-
BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? SECTION BLOCK LOT
OCCUPANTS NAME BUILDING OCCUPANCY
l;�^�,fir,-/(f 1
OWNER'S NAME AND ADDRESS HOME TELEPHONE NUMBER
/i,)7f!L Ijr.—l r>.� `v<r tj C/ -J5 1i(1 41V/.25l 7 9= - a
CURRENT SUPPLIED BY FROM THEIR r+ OFFICE WORK TELEPHONE NUMBER
BUILDING IS
NEW V OLD❑ WORK IS NEW❑ ADDRIONAL l 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
tlon 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.
1
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
/0 0
CHARACTER OF WORK EXPOSED GAS TUBE SIGN/TRANSFORMERS OF VA
CONCEALED
DATE WORK E STARTED DATE COMPLETED SIZE OF SIGN(NUMBER) CAPACITY
r,1BCO
SERVICE ENTrRS BUILDING MANUFACTURER OF SIGN
❑ OVERHEAD $UNDERGROUND
DATE INSPECT ON REQUESTED ON(OR AS NEAR AS POSSIBLE) MUST ENTER APPLICANTS
YI i I ( / I �I ZGJ J/!7- IDENTIFICATION NUMBER �
AV D 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 / DATE OFAPPP IC ION SIG'AT E 9F APPLICANT
I-ro /V (! / 911-51 1 X t) .,,:' ,-,'6...�
STREET ADDRESS ,! /TELEPHONE NO.
`I /III( !.( 4 E. L /e� 1 -,-Ci'Y:-/ G
CITY OR—POST OFFICE ZIP CODE LICENSE NO.WHEN APPLICABLE
J(
❑ 85 John Street ❑ 41 State Street ❑ 570 Delaware Avenue ❑ 217 Lake Avenue 202 Arterial Road
NEW YORK,NY 10038 ALBANY,NY 12207 BUFFALO,NY 14202 ROCHESTER,NY 14608 SYRACUSE,NY 13206
(212)227-3700 (518)463-2122 (716)884-1155 (716)254-0141 (315)463-8552
TI-IP NFW YORK RnARD OF FIRE UNDERWRITERS
I
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J.",!-"/:liPICe/:)9(a/.Ttl-In In.1./At.:1t/-),,I-9,I-190,9.-191 9P_•l,In-1,71-9!•1t/ t,F..\e!--1.!.t..?t/.-?!.. t/,.\t/."4"(4ti.!tk)t/.1t/,fit/.1t/,T}I-t/)..tl 1-",-1ti.)tl,)tl 1t/,1t/,\ti)ti.)t/,1t.19 t/i1t., .
-ti .THE NEW YORK BOARD. OF FIRE UNDERWRITERS 1A E 1
1. 4 I}9 '5 BUREAU OF ELECTRICITY .1
: p 41 STATE STREET.AL3AN.Y.NEW YORK 12207
re' it; . Date SEPTEMBER 03;1991. Applicat' nNo.on rl 769)391/91 A 05794
_
1 THIS CERTIFIES THAT PER'IIT \0. 91.--581
only the electrical equipment as described below and introduced b the applic tr[ named on the above application number in the premises of t
\�/ •.
_ \ORT1-Ilti'INTDS; LUZ.IIR.�I'; RD. , RA�Nr' ' , UUEENSBURi; r. .
' in the folowing location; Li Basement ❑ 1st Fl. ❑ 2nd Fl. OUT Section Block Lot r'8
p •
.4.
was examined on AUGUST '�3,1991 and found to be in compliance with the requirements of this Board. •
�. ,'i
• FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS '':
i' OUTLETS SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. •'
ii
11MM.
• DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS E
Via STEMS
1, AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS.® H.P. NO OF FEET AMT. WATTS ;
14
is
' SERVICE DISCONNECT NO.OF
III
.- S E R V I C E . `:
METER
1� AMP. TYPE EQUIP. 1,e'2W 1,9'3W 3,B'3W 3,B'4W NO.OFFnR$COND. OF CC.COND.. NO.OP HI-LEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL •''
r
i-S. OTHER APPARATUS: .:
• P\NELBOARDS:1-3 CIR. 100
?;
..T
'�
Sr
1,
K'
,70E IUDT 77
l ' 51 MICHAEL ROAD
FORT EDIc'ARD, N5 , 12828 BRANCH MANAGER
•
239
1-0 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. :':
if-41 iii-i.i`Yti i i-iii-itYYti'Yti"isi-its`iti-it1 Yr♦i-7ti'itiiti'7t le—ia7Y•-rl i--4,(1AY'i4!-ids-ias-ei-iifYe'iai-iei-ie-ie ie-riai-i.- iii iii-iwY iii-ie{1.3-4;-43-l.f &,ap--4,",. rey.i',t 1,,. r.,'-y '�.
5 COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
PP)
-TOWN OF QUEENSBURY
531
QUEENSBURY,BAY NEWRYAD YORK 12804
- TELEPHONE (518) 792-5832
BUILDING INSPECYOR'S :REPORT
FINAL INSPECTIOIO �� � /
REQUEST FOR INSPECTION RECEIVED
NAME 6\ 1 _(A2
LOCATION 2
DATE PERHITO 9 I-- U q
TYPE ' STR TURE IY\ , 1,f /
RECHECK %
_FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
FOOTING FOUNDATION BACKFILL FRAMING
ROUGH PLLMBING FINAL ELECTRICAL.---
INSULATION WOODSTOVE/FIREPLACE
SITE PLAN/VARIANCE REQUIREMENTS YES NO
REMARKS
V APPROVAL
• CHIMNEY HEIGHT/LOCATION L IN/A YES NO
B VENT/LOCATION ,e
PLUMBING VENT ', ;
ROOFING a'E'
SIDING P
DECK/PORCH/STEPS/RAILINGS d x
RELIEF VALVES ;4i r
FURNACE/HOT WATER OPERATING
BASEMENT INSULATION/DUCTWORK
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS: ./'
BATH/KITCHEN WATERTIGHT }�
OTHER FLOORS SWEEPABLE
OTHER FLOORS:'CARPETED 56
STAIR CLEARANCE/RAILINGS jS
HANDICAPPED ACCESS X.
SMOKE DETECTORS 1{'
BATHROOM FANS/WHO1 EHOUgE EAhS x.
ALL PLUMBING.FIXTURES OPERATING
GARAGE FIRE PROOFING )c
DOOR CLOSERS
OTHER FIRE SEPARATION '
FIRE/DEMISE WALLS
DUMPSTER K
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C .
CURRENTS:
ARRIVE A)
DEPART 72c)
fOR
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