1991-319 v ,
_ A
- CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY,. NEW YORK -;
/
Date / June 10 19 91
This is to certify that work requested to be done as shown by;Permit No. _ 91-319
has been completed.
• This structure may be occupied as a single family mobile home
Luzerne Road
Location
Sandra Maille Wood Beattie
Owner
By Order Town Board
TOWN OF QUEENSBURY •
j
j
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Director of Bldg. & Code Enforcement
•
BUILDING PERMIT .74
TOWN OF QUEENSBURY
No. 91-319
WARREN COUNTY, NEW YORK ro
PERMISSION is hereby granted to SANDRA MAILLE WOOD BEATTIE r
OWNER of property located at Box 268 Luzerne Road Street, Road or Ave. co
in the Town of Queensbury,To Construct or place a Doublewide 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
tT.7
RD#3 Box 268 Luzerne Road
Queensbury NY 12804 -i
2. CONTRACTOR or BUILDER'S Name
N
Sunset Homes
0_
3. CONTRACTOR or BUILDER'S Address
Saratoga Road
S. Glens Falls NY 12803
4. ARCHITECT'S Name p`
0
5. ARCHITECT'S Address
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6. TYPE of Construction— (Please indicate by X) 3
co
( )Wood Frame ( I Masonry ( )Steel ( ) 0
co
•
7. PLANS and Specifications
No. 24'x60' Doublewide Mobile Home as per plot plan, specifications and
application and in accordance with Resolution # 191, 1991.
8. Proposed Use
0
Single family mobile home
J
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CD
$ 59.00 PERMIT FEE PAID —THIS PERMIT EXPIRES May 17 92 19
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the o-
town of Queensbury before the expiration date.) �•
ro
Dated at the Town of Queensbury this 17th Day of May19 91 oz
SIGNED BY �//,/ �� for the Town of Queensbury
Build &Zo ni ng Inspector
i. f _ h
n TO DE COMPLETED BY BLDG. DEPT.
awn O/ Queenilitr Application No.
BUILDING and ZONING DEPARTMENT Permit Issued 19 I-OWN OF QUEENSBUR'Y
Permit Expires 19 RECEIVED
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation
Oueensbury, New York 12801 Variance No..
Site Plan Review No. MAY 16 1991
APPLICATION FOR Approv_ed by: .
MOBILE HOME BLDG. & CODE DEPT.
PUILDING AND ZONING PERMIT /J q
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.
The owner of this property is: J�,,,124Q 7I ;OP.e , Lo,„_„,
P.O. Address 13v;? , (',n#3 kr( 2_E RNE Re,Ad rep t1 , eJlvshz,r2, 4• Tel. >t/-0)go
Property Location: /Uc RTh a 1a rF n7 bet. J p) ) J ,.,,,IJ hld, s^,L/4 Tax Map No. 7'7// / /a>-E:AY
Street litimber or building lot number
Subdivision name (if applicable)
TUE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
57 U 4.; se-Ybr�l-F
Name P.O. Address Tel. No.
Name of Installers S J//* j S Address 8.4-/QCi re1,4 C Tel. >9 3`,' 4
Name of plumber 5 744/ Address Tel.
Name of mason 5:9t Address Tel.
MOBILE HOME INFORMATION: * ZONING INFORMATION:
New Home Placement .. * A PLOT PLAN MUST BE PREPARED AND SUBMITTED,
" drawn reasonably to scale and attached hereto,
Replacing existing Home . ,•, * showing clearly and distinctly all buildings,
ft * whether existing or proposed and indicate all
Size of new Home a2`/ ft X
* set-back dimensions from property lines. Give
Single w•• le•• Double wide i/ • street and number or lot number and indicate
No. of rooms (excluding baths) 7
* whether interior or corner lot. Show location
* of water supply and location and configuration
No. of bedrooms � • * of septic disposal area.
No. of bathrooms f * COMPLETE INFORMATION REQUIRED BELOW.
Fireplace? /0- Wood stove? 01//p9-- * Size of property a b 6. ft X oo a ft.
Foundation style and size: * Existing building(s) Size p.y ft X o2 41 ft.
rI * •
Pier.s- No.of ' Size-�ft x r ft. * r14 9
Existing building(s) Use c•A ,�_d_ /y�//[i
*
Depth below grade P ft. .. /o k.e- Y ,�
FOUNDATION - Footing size " X �� * Proposed building, distance from property line
* Front yard ft Rear yard ft
Wall material * Side yards ft and ft
Wall thickness " Height ft. * If on corner, setback from side street ft
* OCCUPANCY INFORMATION •
Total depth below grade ft. r
Grade to Home floor level ft. * PRIMARY BUILDING -
* * * * * * * * * * * * * * * * * * * * e One family dwelling
* family dwelling
Proposed date of placement 5/,2-c{/ y ( * Multiple dwelling / Number of units
Aprox. Value. of Home $ a irre) • , Permanent occupancy
• Transient occupancy
Water supply - Well Municipal l- * Business
// _ r Industrial
Septic Permit required? /v * Other
* If addition, what will use be?
*
FURTHER INFORMATION REQUESTED
ON TH RE SE= $,I .;p EET,* ACCESSORY BUILDING-
ON � 6 tt: r pt * _kitached garage/one car/ two car/_� car
Attached garage/one car/ two car/ car
Bu
r y `.. � "' M9 * rivate storage building
• Other
r ----
._ -
REVIEWED B •
DATE •
Form MIIP 5/86 and-vl
0
APPLICATION FOR MOBILE HOME PERMIT, (CONTINUED)
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 C Patk_
3 . PLAN APPROVAL NUMBER ' • .
•
4 . MODEL OR COMPONENT DESIGNATION 4 v4
•
•
5 . MANUFACTURER ' S SERIAL NUMBER
6. 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.
# 4 4 4 # 4 * ♦ 4 4 * * * 4 * 4 * * * 4 * # • 4 4 * 4 4 4 4 4 4 4 4 ## 4 * #
•
Town of Queensbury
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 specified or -not, and that such work is
authorized by the owner. - .
•
Owner, owner's a ent,architect,contractor
* * * * * * * * * * * *• * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * '*
SPECIAL CONDITIONS OF THE-PERMIT:
•
•
•
•
•
By
•
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•
•
r:_ TOWNtO1 QUEENSBURY '1 �1 -0`7�
�s� ti,,. 4
Bay at:Hay.land Road, Que nnsbury,-.NY 128049725-518-792-583
AM II.
APPLICATI•' 0N FOR ,�.�' 1
A MOBILE�HOME ''OUTSIDE''OF A xMOBILE HOME 'COURT:;
'//,
n
Mail or.I Bri ng`This Applicatio• n To "'� j9yJ ,
�}° < fi>`t s t 7 a,-• !� 3, } ie: r1.' i lIF;S' ..
; BUILDING & ZONING DEPARTMENT i
Qteensbury Town Office Building ,a.. :f -.,„,.,,-k-•-.,•.
U C
.{ Bay{'at,'Haviland Roads . t' `. ,• 4 -A io,
•
-
Queensbury, 'New York :12804 '_1"1
9 i
9
r r! 7 r'x Zaf,'LS, Fj�
r -This application fora Mobile ;Home <Permit shall be accompanied by a plot
plan 'drawn .''reasonably ton:.scaleh 'showing ,'all dimensions,`: the. .size - of ;the lot,
>` ;the -location on'`:the 'lot `of theMobi.Te Home, thewater supply-.and sewage system.'- •
`If the`'applicant is not:'the •owner i n `feet'"of they premises,:-_then ,the: application. .
•,, tie1accompanied by the''written acknowledged consent of the .'owner ' '
must _
• 1:}' '�17cRrA dh ,�,'/'/' " 9/ 1.7i", :
NAME:,•:OF' APPLICANT "
•
.C3,�' ,, �S ,D#�3 Z Gt. Jed, 1�'d (a � �y6 ccr>/, 11 /�.�a/
ADDRESS
'`.. --.."-:-..,•: •••:.":;','',1?,:i':'..P:'',• :-.".:;1!•,,-;''''..- ' . -''''"--'.- ' - . ;*.1'-'•'-'''. • - •--•-•,-.-; '' :' . .''•'.1:f:,',1,...•-•::•••• • C: :,..: : - ':- ''. •','' - •
tALOCATION OF;MOBILE HOME PREMISES BY :'STREETORROAD, :ETC. 1
, r 3
•
• f GIVEt)iNEAREST:'CROSS 'STREET ;
. ' •':-:;':'.'''..'',••••.",-'''n'-',1:..'. "..:,-5,",.;::'-;-'",!/.: ._,,j:„,..:,'•- ,..„..,:.:,;.-,•_:.,.•...,,i/ ,',-,:.,..i;.,.1,,!. ..'-...... ...,.. ..,..,4..--: .;:',..":.!.';'i;,.,1...";,,,,..... .....-.',.,...-..7--.:- ...'.:2.--0. . -. -. .
i• NAME1 OF:.OWNER :.OF- LAND
OWNER5. R , 3. L:4 >.t,QA) .. �:E •A).s; . & r . . )
-ADDRESS y �'
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4: State 'ful l the reasons for this re uest N t P � ,
y • q ���a.e�:-r, �-
C/ I Vl A'V''`.'''. s''. ;..' '' .... . '.11'; '- '�/1 J f'- . -L-[ - ��!• !/�-'c-./R Y
gl ^ ) • `/L/ . •( ' ./lLlpy/LNJ i✓Li_n�[iY_A '
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' st !'?YL/ ` YLJ -KKA+tn�•�A' -up-- Pam• -v/�l.arC VV �!J•
▪ (Use 'extra; sheets if: necessary)
• 1 5 De scei pti on, of mobile..home ` . . . . _
•
'Year , , ,-,. / . Model h ... •
.,,;?Make:'.-,- Q:e_ ' -c,J.ire-c, - Serial'` :•O 1p ram. ` j r . e-;r' ;
Dimensions c .X5C, 1-0
• ,4.,../z.:z4t._ .
-:.- ---: ,..,,,,- 'l: t�:-, .. - -,+ ,,,,,, ,,,;,,, � :r,f .• APPLICANT'S e...--- ie --i& . .
SIG
... . ... . . ..
Addresses $,''.�s4= 3
•
THIS SIDE FOR GOVERNMENT USE ONLY
Report of the investigation of Zoning Administrator and recommendations.
Approved
Disapproved
Other
Recommendations
(x.
Signed: /eierc�% G C 1 \
Z NING ADMINISTRATOR
ACTION OF THE TOWN'BOARD
Approved
Disapproved
_ , Other\.
By Resolution Number ` of the Town Board of the Town of
Queensbury, Warren County, New York.
Dated this day of , 19
Signed:
TOWN CLERK, TOWN OF QUEENSBURY
�4.�l.\.¢a-- k?.11. !....1,!....1.1.4 C 1.!�...?.LJ..C.l!.a,.'4!,a.k.)9!.�.!4.9?.atl,�1...),!4•9,—,.C 1!-a!.,1 i.a.!„.1,9i..�9i.1 4-.1.J.A(.a04?9_Cah?.[.�t(.,�il"a�(.J•9i,�9i k ia�(.:O.,ti , ,..1.i• (:�9i:, 4 A/ L.I.1 r, �-. r
f' THE NEW YORK HOARD, OF FIRE UNDERWRITERS a
1' I AGE 1
_ A1 BUREAU OF ELECTRICITY
, °
j; Ilv^18?08
41 STATE STREET,ALBANY,NEW YORK 12207 _
Date �1UNE 21,1991 Application, e u 66991/91 (-141f 411867
THIS CERTIFIES THAT PERMIT NO. 91-311 '
�; only the electrical equipment as described below and introduced b5'the-aAbhcant named on the above application number in the premises of
�S ANDRA MAILLE BEATTI- LUZERNE RD. , G?=NS FALLS, N.Y. .
in the following location; LI Basement ❑ 1st Fl. LJ 2nd Fl. OUTR. Section Block Lot
�;1 was examined on JUKE 13, 19 91 • and found to be in compliance with the requirements of this Board.
1 FIXTURE ECEPTACLESI SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS :'
OUTLETS INCANDESCENT.FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. •' &
-C
< DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS SELL UNIT HEATERS MULTI-OUTLET DIMMERS
- SYSTEMS
AMT. K.W. OIL H.P. GAS H.P. AMT. Na A.W.G. AMT. AMP.. AMT. AMPS. TRANS. AMT. H.P. t,�,OF FEET AMT. WATTS
j
SERVICE DISCONNECT NO.OF . _ _ . _ . -_-- S - E - .R --V---. I. - C. E
r. t Q
AMT. AMP. TYPE EMEtTJ�P 1..t 2W 1/B-3W 3/B'3W 3. 4W Na OFF CC-BCOND. OF CG COND.. Na OF HI-LEG OF.HI.LEG Na OF NEUTRALS OF NEUTGRAL
4
OTHER APPARATUS: • ;L
4
-!,, °3i :ELBO-RDS:1-1 CIR, 100
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1; SANDRA MAILLE BEATTIE • UT��'
11 1, BOX 268 RD3 BRANCH MANAGER '' -'
LUZERNE RD.
OUEENSBURV, NY, 12801 Per239 .. ''a ..
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.i- 1 YY Y' Y7\'i YY Y'i Y' f'i i'`i i''i-'i'Ci(Y YY '(Y YY YY Y'i YY YY 1 7 YY YY YY 1'1 YY C-7 f'i i' ?'i i"i 7'i Y'i f'i i"'i f'i Y'i Y'i Y'i C'i i''i f'i i—i-"i f'i,'71;-'i'-- ..f'i i, . . ._
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
YOU ARE HEREBY REQUESTED TO
. INSPECT AND ISSUE CERTIFICATES
• FOR THE FOLLOWING ELECTRICAL
• - EQUIPMENT TO BE INSTALLED BY
• THE UNDERSIGNED .- "t
- TEMP.# DATE (Jj i - ( l'+
I
CITY OR VILLAGE TOWNSHIP .. COUNTY `
C'//- //S11--:nli{ 5 C0 LIE C -%`i 7Lroy. (ayir-)Jelei P)
STREET AND NO.OR ROAD / ' POLE NUMBER
) Li Z c_rii) - !;'zL, .
BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? SECTION BLOCK LOT
OCCUPANTS NAME BUILDING OCCUPANCY - -.
5,4 /,, J,;',.4 ///,z %fit .1, 'i 'i i •
J_�) , I: l'y
OWNER'S NAME AND ADDRESS - HOME TELEPHONE NUMBER .
.S.,',1,; P?LI JCd. r1!/ ;'//r 64a I t_: ; /i : - . 1// 'o ?$(I
CURRENT SUPPLIED BY FROM THEIR OFFICE WORK TELEPHONE NUMBER
' 4J,'r-q �f >) ik)F:4 /`/()4t t-t t-tJ/CC" ,
`i.
BUILDING IS " . .
NEW 13J OLD❑ WORK IS NEW IJ ADDmONAL❑ DEFECTS REMOVED❑
• - LIST BELOW ALL EQUIPMENT WHICH YOU.INSTALLED
NUMBER OF OUTLETS No.of Fixtures& MOTORS HEATERS BRANCH OFFICE USE
• Ica Lamp Receptacles CIRCUITS ONLY
• tion 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.
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 "e DATE COMPLETED SIZE OF SIGN(NUMBER) - • CAPACITY '
SERVICE ENTERS BUILDING - MANUFACTURER OF SIGN '
❑ OVERHEAD ❑ UNDERGROUND • - •
DATE INSPECTION REQUESTED ON(OR AS NEAR AS POSSIBLE) MUST DENT E CAT ENTER NUMBER I I I I I I I ,
AVOID 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 OF APPLICATION SIGNATU E OF APPP,LICANI / ��A `,f.
5")ii,t14f'1-1 /1//A1/ 1 - 11 //i - X -•2,.-,:�:Rec /-, s- --vim Ls u f c-
slqET
ADDRESS - TELEPHONE NO. •
- �;a' 7 \ d_i ; A � :r r i cJ: . 7l -
) 3 -%1
CITY OR POST OFFICE - - - - , ZIP CODE LICENSE NO.WHEN APPLICABLE
85 John Street • ❑ 41 State Street 0 570 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
• -rum FIPW V(1RK PinARil (IF .FIRE•I INf1FRWRITFRS
TOWN OF QUEENSBURY
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
FINAL INSPECTIONS
REQUEST FOR INSPECTION RECEIVED
NAME et-f-_-_JNI:V1-1
LOCATION 2
DATE 6/(01 qi PERMIT, 91•-3 f
TYPE OF STRUCTURE D,1,0, MO 5 i L& " 'A--
RECHECK
_FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
_FOOTING FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING FINAL ELECTRICAL_SEPTIC
INSULATION WOONSTOVE/FIREPLACE
SITE PLAN/VARIANCE REQUIREMENTS YES _ NO
REMARKS I.
}
APPROVAL
N/A YES NO
CHIMNEY HEIGHT/LOCATION
B VENT/LOCATION
PLUMBING VENT
ROOFING
SIDING
DECK/PORCH/STEPS/RAILINGS X
RELIEF VALVES i X
FURNACE/HOT WATER OPERATING ?
BASEMENT INSULATION/DUCTWORK.r •
INTERIOR TRIM/PRIVACY DOORS ;
FINISH FLOORS: f /
BATH/KITCHEN WATERTIGHT r ,/' K
OTHER FLOORS SWEEPABLE y r
OTHER FLOORS CARPETED t X
STAIR CLEARANCE/RAILINGS r �.
HANDICAPPED ACCESS 'A"
SMOKE DETECTORS ;(
BATHROOM FANS/WHOLEHOUSE` FANS
ALL PLUMBING .FIXTURES,?.OPERATING
GARAGE FIRE PROOFING,/ I
DOOR CLOSERS
OTHER FIRE SEPARATION 1
FIRE/DEMISE WALLS
DUMPSTER f
FINAL ELECTRICAL } , }�
OK TO ISSUE ,9/O OR C/C 1
COMMENTS:
SSU& Gc� ,
AT -/3-c L S fel tVG f
ARRIVEf:[
•
/47
EPART
,
Q -1- r )0 '30 e: e
TOWN OF QUEENSBURY VcbBUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED 5 0-Lticll
NAME Ir. C� 1 _ ) - r�
LOCATION cptr) 7 Pam' rl 9 -' ON(-)
DATE •5/4 //9/ PERMIT # —3/1
TYPE OF STRUCTURE e_. 1� .
RECHECK APPROVED
N/A Y
}(O ESTINGS./ ;j
' 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 '. i
FOUNDATION/DAMPROOFING I
BACKFILL APPROVAL
ROUGH PLUMBING • /
PLUMBING VENT/VENTS IN PLACE i
PLUMBING UNDER SLAB
FRAMING: / :
JACK STUDS/HEADERS /
BRACING/BRIDGING
JOIST HANGERS /
JACK POSTS/MAIN BEAM /
HEATING ROUGH-IN /
INSULATION: d
FOUNDATION WALLS INTERrIOR R- `a
FOUNDATION WALLS EXTERIOR R-
FLOORS / R-
WALLS i R-
CtILING / R-
DUCT WORK OR PIPINQ IN UNHEATED
SPACES °
REMARKS:
ARRIVE //.-'r c7
DEPART :c
INSPECTOR
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