1991-630 -i- - ':':?" ''''' tl''''T' 1l("-'15'.1." ;. "4,•
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CERTIFICATE OF OCCUPANCY
' TOWN OF QUEENSBURY
- - WARRE, . COUNTY, NEW YORK
•
Date 001-440.1 /0 19 qi
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This is to certify that work requested to be done as shown by Permit No. 91-630
,...-1,
— ' - has been completed.
-=,
Mobile HOme
This structure may be occupied as a
Location Lot 14 Northwinds
Owner John & Lori Wortnn f ,
By Order Town Board
TOWN F QUEENSBURY
, 1
Director of Bldg. & Code Enforcement
BUILDING PERMIT r
TOWN OF QUEENSBURY
No. 91-630 0
WARREN COUNTY, NEW YORK
as
PERMISSION is hereby granted to John & Lori Norton
OWNER of property located at Lot #14 Northwi nds Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Mobil eHome
at the above location in accordance to application together with plot plans and other information hereto filed and C
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. 1-I
1-6
1. OWNER'S Address is
John & Lori Norton o
63 First St
Glens Falls, NY 12801
2. CONTRACTOR or BUILDER'S Name a
Lamplighter Homes
3. CONTRACTOR or BUILDER'S Address
RD#2 Rte 9 Fort Edward, NY a
4. ARCHITECT'S Name 0
rD
5. ARCHITECT'S Address —(
Du
x
6. TYPE of Construction— (Please indicate by X) ,+e,
O
( )Wood Frame ( ) Masonry ( ) Steel ( )
WO
W
I
7. PLANS and Specifications r
Lc'
No. 28' x 60' Mobile Home as per plot plan specifications and
application
8. Proposed Use
Mobile Home
$ 77.00 PERMIT FEE PAID —THIS PERMIT EXPIRES September 5, 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 5th, Day of / September 19 91
SIGNED BY for the Town of Queensbury
Building and Zoning Inspector
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c� TO DE LD
COMPLETED BY nG. DEPT.
_ ouin di Queeiiilury Application No.
BUILDING tins ZONING DEPARTMENT • Permit Issued 19
Day una Hsviland Road, R.O. I Box 08 Permit •Expires 19 ?/— 630
Ouuunsela NuwRea Zoning Designation
Y, York 12801 Variance No.. •
Site Plan Review No. -..
APPLICATION FOR ov d b Ira ei F E,,;;, ,k2'' 'ts`a
MOBILE HOME F''' 4 • k.,,, \ ,r .: r.,�.
1LDIN; AND ZONING PERMITcj `. '" �.... .. , j '
, 41
• . . . * r . • * . • r • r • • • • • * •
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A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSI420ION:CMISWCR 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
::j)ecial conditions as may be indicated on .the Permit.
Mc owner of this property is: py- N3 i 1.0pP_( 00
P.G. Ac1Jre:�s La�j PC2Sa`� 6� `j r' �� 1� p
s h(�C.�S -(�'1 Tel. 79G 3 7
Property Locations l I `•& 00(1.7 •LWCNOS
Street I.umber or building lot number
Sny �y Tax Map No, l_._..l
Subdivision name (if applicable) •L.)0(2_71--\-\W (aJ 0S •
ATHE PERSON RESPONS BLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
A m,e t i,si f A — P-- - eat. -4 f2 �-
P.O. Address Tel. No.
Name of Installer 4, p499' I4I Address Rya / a�� ��Te
Name ul` plumber - /�! �-I l.`='Gd ' �43 '� �2.
Address Tel.
Nave of unison .
Address ____________ Tel. ---
MOD I LE HOME INFORMATION: • ZONING INFORMATION:
New h otne Placement • . ' A PLOT PLAN MUST BE PREPARED' AND SUBMITTED, '
Replacing existing Home — drawn reasonably to scale and attached hereto,
showing clearly and distinctly all buildings,
Size of new Home At ft X 1p.e) ft . • . * whether existing or proposed and indicate all
Single wile / • set-back dimensions from property lines. Give
Double wide ✓ • street and number or lot number and indicate
No, of rooms (excluding baths) ' whether interior or corner lot. Show location
No. of bedrooms • of water supply and location and configuration
' of septic disposal area.
No. of 'bath rooms ' /�
• COMPLETE INFORMATION REQUIRED BELOW. SCT pi 1914Al .
Fireplace? 00 Wood stove? J(j • Size of property ft X ft.
Foundation style and size: • Existing building(s) Size WA ft X /a%q ft.
Piers- No.of Size- ft x ft. •
Existing building (s) Use 80/4
Depth below grade ft.
FOUNDATION •_ Footing size „ X Proposed building, distance from property line
• Front yard ft Rear /o� p/� ft ,
Wall material , Side yards
Et and ft
Wall thickness Height ft. •• If on corner, setback from side street ft
•
' Total depth below grade ft. OCCUPANCY INFORMATION
•
Grade to Home floor level ft. • PRI Y BUILDING -
• One family dwelling
. __Two family dwelling •
Proposed date of placement//_ / 4 / a( •
. Multiple dwelling / Number of units
Aprox. Value. of Home $ `i -i .g • Permanent occupancy
• Transient occupancy •
Water supply - Well Municipal • Business
- - T,nd,,ctri l
S itic Permit required? 0 • Other
P/�.k_ . If addition, what will use be?
•
FURTHER INFORMATION REQUESTED
• ACCESSORY BUILDING •
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ON THE REVERSE SIDE OF THIS SHEET.' Detached garage/one car/ two car/ car
* Attached garage/one car/ two car/ car
•
• _Private storage building
• Other
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Form MIIP 5/86 and-vl
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APPLICATION `FOR MOBILE HOME PERM'IT,- CCONTINUED)
State of New York Division of Housing and Community Renewal
. . •
INSIGNIA OF APPKOVAL OF THE;.STATE.. . BUILDING CODE
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1 . INSIGNIA SERIAL' NUMBER .• •
2 . NAME. OF MANUFACTURER n7000At1
3 . PLAN APPROVAL NUMBER •
4 ; MODEL OR COMPONENT DESIGNATION /k
5 .- MANUFACTURERS SERIAL NUMBER
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6. DATE OF MANUFACTURE . g1 • • •
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,
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it-ll the above information is to be found on a plate ,or aticker which
3hou.td._ be . affixed to, the Mobile Home. Complete..above with that information. ,
+ -_ A 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 #
Town of Queen4bury A F F I D A V . I T
County of• Warren 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
provjsjonu'•of the' BUILDING CODE; THE:ZONING ORDINANCE, and all other laws pertaining 'to
the proposed work shall be complied with, whether speicificd or not, -and t a•t- such work 'is•• •
• authorized b., the owner. • p /
&. / •
•
LlellfLkd
• Signature �, e ti /. 4 / ,�
' Owner, •own •s ageT:t,•a cnicect, ont actor
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SPECIAL CONDITIONS OF THE PERMIT:
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• • , By
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YOU ARE HEREBY REQUESTED TO •
INSPECT AND ISSUE CERTIFICATES
FOR THE FOLLOWING ELECTRICAL
EQUIPMENT TO BE INSTALLED BY
THE UNDERSIGNED
..-. 36.)
TEMP.itDATE
r _.
.. CITY Oil VILLNGE - ^TOWNSHIP COUNTY
•
0( s.ttt t) Gx,t--,-i • 6-04i- .Xf /_J
STREET AND NO OR ROAD POLE NUMBER
`BETWEEN WHAT TWO STREETS IS PREMISESL.00ATED71 r.. i 9 SECTION BLOCK LOT
OCCUPANT'S NAME • ! , �- BUILDING OCCUPAN��.',p\ 'A /1
J1.7)_,1,t 1 ri,� 1 0C-1j-c- •- i t-/1.l(, Tff,l(,(•Lcv,1 I L l C ielf.'-�
OWNER'S NAME AND AO�tl`i6SI > / /_ _ // HOME TELEPHONE NUMBER
17,4" _, .. J�1�LC._ /J o/C_. ? -0- -— (c 3 1 (il_S I ( F i 3 '7 C `7 3 / —
CURRENt SUPPLIED BY FROM THEIR OFFICE WORK TELEPHONE NUMBER
tti_(
BUILDING IS ^� '
NEW I OLD CI WORK IS NEW I ADDITIONAL El DEFECTS REMOVED El11111 LIST BELOW ALL EQUIPMENT WHICH YOU INSTAL ED
NUMBER OF OUTLETS No.of Fixtures& MOTORS HEATERS BRANCH OFFICE USE
LOB- Lamp Receptacles CIRCUITS ONLY
tion Side Attach't H.P. Watts A.W.G.
Ceiling Wall Recep'Is SwitchPendant Bracket No. Type Each No. Each No. Gauge INSPECTION
OUT-
SIDE
SUB-
BASE
BASE-
MENT
1st
FL
2nd
FL
3rd
FL
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
CHARACTER OF WORK ❑ EXPOSED GAS TUBE SIGN/TRANSFORMERS OF •VA
• ❑ CONCEALED
DATE WORK TO BE STARTED . DATE COMPLETED SIZE OF SIGN(NUMBER) .CAPACITY
SERVICE ENTERS BUILDING MANUFACTURER OF SIGN
❑ OVERHEAD El UNDERGROUND
DATE INSPECTION REQUESTED ON(OR AS NEAR AS POSSIBLE) MUST DENT ENTER
PLICANTS
AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
PRINT NAME AND ADDRESS ,s,
NAME OF APPLICANT DATE OF APPLICATION SIGNATURE OF PLICA,
i. A-,_,--T,9"- 101 - c��.,-A..., s� cl- 3 -7 1 X : ` -� /\ .
STREET ADDRESS TELE/PHONE...Ka
COR POST(OF C� n `(/ Il �(�[/ZIP CODE,. LIC EN SE NO.WHEN A PLICABLE
YL-A- (....J.,- I Gk 9-- l U
❑ 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
. : THE NEW YORK BOAFRD-OF FIRE UNDERWRITERS
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12801-
TELEPHONE (518) 792-5832
BUILDING INSPECTOR`S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME Ak itrCr i
LOCATION 17
CT
%-n {kcu LIO S / �(
DATE rUJ((� Qi PERMIT # ' -( c
Ft� I_JIJJc-1 L6-C i� APPROVED
. YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING '
ELECTRICAL ROUGH-IN '
INSULATION:
FOUNDATION
FLOORS
WALLS •
CEILING 1
FINAL INSPECTION: I .
CHIMNEY HEIGHT •
ROOFING
SIDING
)(EXTERNAL PORCHES/ST�PS / X.
' STAIRS-CLEARANCE & lI ,S
PLUMBING FIXTURES/REIIEF VALVE
INTERIOR TRIM/PRIVAC^, DOORS
FINISHED FLOORS
GARAGE FIREPROOFING. .\
DOOR CLOSER(S) ,,F
SMOKE DETECTORS
XFINAL ELECTRICAL t NSPECTION, K
FINAL APPROVAL OF CONSTRUCTION
1
I
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
Y
THESE PREMISES ARE OCCUPIED!
REMARKS: ) E;gyp, S'42S j C i —/V d'I)
4/ -.vp 1 /;-1(.._ I d157 k -[Z.Q
DC)vPZ aZe.2-c_rt-J-- .
I._ iZ) ( SS06 Q
( i 3C) r
I SPE TOR
TOWN OF QUEENSBURY
531 BAY ROAD
i QUEENSBURY, NEW YORK 12847)121
vpfrwir TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED
NAME � l`�� V" �1 `� �7���
LOCATION
DATE N c/7 r7,/ PERMIT# 0--6.3e
TYPE OF STRUCTURE 6- 4
RECHECK
FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
FOOTING FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING FINAL ELECTRICAL _SEPTIC
INSULATION WOODSTOVE/FIREPLACE
REMARKS j
APPROVAL
N/A YES NO
CHIMNEY HEIGHT/LOCATION
B VENT/LOCATION j
PLUMBING VENT N
ROOFING
SIDING 1 •
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES
FURNACE/HOT WATER OPERATING
BASEMENT INSULATION/pDUCTWORK
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS:
BATH/KITCHEN WATERTItGHT
OTHER FLOORS SWEEPABLo
OTHER FLOORS CARPETED
STAIR CLEARANCE%RAILINGS\
HANDICAPPED ACCESS
SMOKE DETECTORS jc
BATHROOM FANS/ )S
. ALL PLUMBING FIXTURES OPERATING
GARAGE FIRE PROOFING
DOOR CLOSERS
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS
DUMPS TER
SITE PLAN/VARIANCE REQUIREMENTS _
FINAL ELECTRICAL yL
OK TO ISSUE C/O OR C/C y�
COMMENTS:LA_Lwolz4 (2ooM 060 R Tb KrL-.rz�o/'Z
S77 C,il S 13 A-0 L'L/ v5 i OP /}S i ..-(B o i t( 2 6-A S.i LpS 1-k kip PM L S
1:74S-T A) 17:zo,v,— S i EPS S cu rzL C,1 LCY
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ARRIVE _z`co.
DEPART 10
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