1991-412 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date giP,e 'pirr91?h Z 19 9/
3OS 4 (a
This is to,certify that work requested to be done as shown by Permit No. 97.®412
• has been completed.
Home
This structure may be occupied as a " obi
le
Location — Burch Rd t
Owner Robert & Gloria Quinlan
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
I\�
BUILDING PERMIT .�
TOWN OF QUEENSBURY No 91-412
17
WARREN COUNTY, NEW YORK
0
Iv -
PERMISSION is hereby granted to Robert & Gloria Quinlan t �'
I
OWNER of property located at Corner Burrh Rd & Dean_Rd 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. IT
-s
. et
1. OWNER'S Address is
RD#2 Box 610
Hudson Falls, NY
. w
2. CONTRACTOR or BUILDER'S Name
Lenard. Sipoiocz -s
3. CONTRACTOR or BUILDER'S Address
4 Fairview St
S. Glens Falls, NY a
$19
4. ARCHITECT'S Name
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a
Pt,
5. ARCHITECT'S Address
O
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6. TYPE of Construction—(Please indicate by X)
O
( )Wood Frame ( I Masonry ( )Steel ( )
7. PLANS.and Specifications
• No. 12' x 60' 1972 Mobile Home as per plot plan specifications and
application
8. Proposed Use
Mobile Home
$ 42_00 PERMIT FEE PAID —THIS PERMIT EXPIRES June 17, 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 17th Day of June 19 91
SIGNED BY for the Town of Queensbury
Building and Zoni ` Inspector
s#it'''-' 1' �'iF QI� Ei'1S11F',i
A � TOWN OF QUEE�JSi1Y��OiVEC}
-APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit #
JUN 131991 Fee Paid
Date: 4,10141 BLDG. & CODE DiMiewed By
LOCATION OF PROPERTY FOR INSTALLATION: Ng -3ctE0.0 d _+V
Owner' s Name: C�oYir�, ' tYL�aty
Owner' s Mailing Address: D2 3,4 ( /0 1-/(156y, IS (1\(y
Installer' s Name: an p Phone #: 'ia2 -(oc1, (
Number of bedrooms (if residential ):
Total daily flow (residential-compute @ 150 gal . per bedroom) : 45 0
Topography-Circle One. Flat. Rolling Steep Slope % of Slope
Soil Nature-Circle One)- and) Loam Clay Other /Depth:
Ground Water-At What Depth? Feet
Bedrock or Impervious Material-At What Depth? Feet
Percolation Test-Circle One: Not Required Required/Rate Min. Per Inch
Domestic Water Supply-Circle One Munici a Well Other
If domestic water supply is a el -
Separation: Water supply from any septic absorption feet
PROPOSED SYSTEM: Septic Tank /o 0 O gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench ,�U feet//Total System Length feet
Seepage Pit(s): Number of / Size each: ft. x ft.
Size of Stone to be used: # / Depth or Thickness feet
**************
HOLDING TANK SYSTEM IF REQUIRED
No. of Tanks Size of Each Gal .
Alarm system and associated electrical work to be inspected by a certified
agency.
****************
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 Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: ( `�, ; 67 DATE: (,Gl/F3Iq
Septic System Inspections:
A. All applications for septic system installation, alteration or repair,
as required by the Town of. Queensbury Sanitary Sewage Ordinance, shall
be submitted to the Building Department at least 24 hours before start
of construction and shall include a plot plan showing:
1) the proposed location of the system
2) location and distance to lot lines
3) location and distance to structures
4) location and distance to any water supply
5) size and dimensions of all tanks, distribution boxes, tile fields
and/or drywells
B. No system shall be covered before inspection and approval by the Building
Inspector. Failure to comply with this requirement may result in the
uncovering of the system by the installer and a fine of up to $250.00.
C. An approved copy of the plot plan shall be available on the construction
site. Failure to produce said plot plan at time of inspection may result
in an immediate work stoppage.
D. Should unforeseen problems during construction prevent proper installation,
alteration or repair of an approved system, a new proposal must be submitted
to the Queensbury Building Department before further construction.
Town of Queensbury
Building & Code Enforcement
Department
531 Bay Road
Queensbury NY 12804
Remarks:
v .
t 1) - TO BE COMPLETED BY BLDG. DEPT. - q7/ LACa
vn oIQueeqitury Application No.
Permit Issued 19 TOWN OF QUEES3UR1
..,,L(JiNG and ZONING.DEPARTMENT Permit Expires • 19 RECEIVED
,bay and Haviland Road, R.D. 1 Box 98 Zoning Designation
Queensbury, New York 12801 Variance No.. JUN 131991
Site Plan Re • •w • .
APPLICATION FOR Appr•v-• . //' • BLDG. 8: CODE DEpT,
MOBILE HOME .% iir
FUILDING AND ZONING PERMIT .4/1
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 i:: 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: ;-00e4-1 c i- d (211 0C 1Ck GICXYl\n `k__
P.O. Address I ,\ a („lc, 4„khr-) 1" 1--, \\:1 \I "A 40 ? Tel. (6--) )7(47.7o� T
Property Location: 6rre,T 6Ltreh U1c1. 44•• .Je-Qn R.I. Tax Map No. ( /
Street :;umber or building lot number 5 3 y eo )a 1. I - I
Subdivision name (if applicable) ,/4//,
TUE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
Name E % -P.O. Address vkl Tel. No. d
Name of Installer ��15' C0 ' Address Tel.
Name of plumber! - Address Tel. 1q -69&(
Name of mason - Address Tel.
MOBILE HOME INFORMATION: * . ZONING INFORMATION:
New 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,
Size of new Home•+a,ft Xft . • * whether existing or proposed and indicate all
• * set-back diwensions from property lines. Give
Single w• 1e • Double wide . • street and number or lot number and indicate
No. of rooms (excluding baths) 5 * whether interior or corner lot. Show location
• * of water supply and location and configuration
5No. of bedrooms ' • of septic disposal area.
*
No. of bathrooms 1 • COMPLETE INFORMATION REQUIRED BELOW.
Fireplace?4 0 Wood stove? 0 o * Size of property 1 -TS ft X 10 Oft.
Foundation style and size: * Existing building(s) Size ft X ft.
Piers- No.of Size- ft x ft. * Existing building(s) Use
•
Depth below grade ft. * •
a * Proposed building, distance from property line
FOUNDATION _ Footing size " X 0 "- *
• 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 •
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 / / • Multiple dwelling / Number of units
Aprox. Value, of Home $ :1- � ( * Permanent occupancy
�
• Transient occupancy
. - Water supply - Well Municipal * Business •
* Industrial
Septic Permit required? )1 * _-_.Ocher _.
* 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
• * Other
. . *•
Form MIIP 5/86 and-vl. . •
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 — S."k.
2 . NAME OF MANUFACTURER � Cy
3 . PLAN APPROVAL NUMBER /9 � '' � 3
•
•
4 . MODEL OR COMPONENT DESIGNATION 1� v . _06 • .,Afti
y nr ..,
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
Town of Queensbury 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
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. . . . - • . • .
,f
Signature •_ � _
. cam^
Owner, owner s agent,arnitect,contractor
* * * * * * * * * * * a * * * * * * * a ,a * a * a a * * a a * a * * a * * a * * * * * * * .*
SPECIAL CONDITIONS OF THE PERMIT:
•
•
•
•
•
. • . By
•
•
•
•
•
• YOU ARE HEREBY REQUESTED TO
INSPECT AND ISSUE CERTIFICATES
• FOR THE FOLLOWING ELECTRICAL
EQUIPMENT TO BE INSTALLED BY
•
THE UNDERSIGNED
TEMP.# DATE • '( t _
f 1 t -
1
CRY OR VILLAGE TOWNSHIP COUNTY
C7itFFYA�.\.11c.c'( nI •
Y( � � ��
STREET AND NO.OR ROAD V • POLE NUMBER
. Lk t T\ IN Y\ `r
ET BWEEN WHAT`TWO CROSS STREETS PREMISES LOCATED? SECTION BLOCK LOT
1 ` : 4:'t ,.i�)il-.Q..---- •
OCCUPANTS NAME BUILDING OC 4 •
A
u-''�"�
OWNER'S AND ADDRESS 'HOME TELEPHONE NUMBER UMBER
� - - _
—v-A-v,}4 Ak'+ilkC: '`� Y ' _ A - (- I _ ift.i/f ., N•C_ , lc , 7(1
CURRENT SUPPLIED
BY FROM THEIR OFFICE WORK TELEPHONE NUMBER
BUILDING IS
-NEW❑ ow❑ WORK IS NEW,I 1" ADDITIONAL❑ DEFECTS REMOVED❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETS No.of Fixtures& BRANCH OFFICE USE
Loca- Lamp Receptacles MOTORS HEATERS CIRCUITS ONLY
tion Side Attach't H.P. Watts A.W.G.
Ceiling Wall Finely!, 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 ,
DARE WORK TO BE STARTED 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 ENTER DENT F CATION PUMANTS •
AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
PRINT NAME AND ADDRESS '
NA OF APPLICANT ,}} . DATE OF APPLICATION SIGILATURE OF APPLICANT T ,
q' FA")v NA �Y l,t. i r,- ,;.� !r/i /// % / X ( .�',q..}%';, //f;< , r .., _,
- STREET ADDRESS )' — �/ {t TELEPHONECNO"
t:',r-1�,.-7 �•'/ Y 1. i \�� �' f i\ li,i..} . I -1"`i i�I(-\( ! F C t
CITY ORFOSTOFFICE (� . ',) ZIP CODE LICENSE NO.WHEN APPLICABLE
` `;,\
85 John Street 0 41 State Street Is 0 570 Delaware Avenue 0 217 Lake Avenue 0 202 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 BOARD OF FIRE UNDERWRITERS •
-
°''00� *no
MIDDLE DEPARTMENT INSPECTION AGENCY, INC. -c
t., -....4. National Headquarters � 1- fi,Lc :-v,,,4 ,
'•, •oa- 1337 West Chester Pike,West Chester, PA 19380 l `
•
APPLICANT COMPLETES THIS SECTION _ Date:7_ / z -' f
•
j
r ) j
City, Town or Township Ou f'{-'C'7 S�i1°' lc County r�/"�'� ✓J`? State // 'I
Location/Address P,+.I ,- c 1,-• 12(. /
(If Located in Rural Area-Please-Attach Directions) /'1 tile # •
Owner (' hP rb P ,—fO C, 4.r )/ C ? -.. )/
Owner Permit #
Occupied As v 1-' /r.., r=.v ✓( �r 1 Building: New[-cr. Old❑
Occupant
Work Area in Building (Floor #,etc.):
App. for: Wiring❑ Service Fr or: Ready'for Inspection: 7- / -? rj 1
Fee Remitted $ 7 4; Cash n Check n M.O. ri Make Payable To: M.D.I.A.
500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000
Number of-Rough Wiring Outlets Elect. Heat
Switches
Lighting Amp. Service _ _ Surface'Unit Dishwasher Range
Receptacles Water Heater Air Conditioner Dryer _ Pump J
Number of Fixtures" Oven Garbage Disposal- Wiring and Controls for Burner
-
Amp. Receptacles Fractional H.P. Vent Fans
Other Equipment:
MOTORS H.P. 1/201/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 11/2 2 3 5 71/2 10 15 20 25 30 40 50 75 100
Mark Number
of Each Size
I i ,
Applicant's Y Jf
Signature r l .I `� ' C' v‘.— License # Permit # r
T/A Utility: / /' G'N/t: (n. /n/..r I --.V# 5.
Applican 's Address: s lc, `f ` ' ) - ,, — )1 / j (NAME) (OFFICE LOCATION)
i t, r� cave ( n l` 1 Service Request # 67 9 55-2
(City) (State) t`T,' (Zip)'r� ` c q t
Phone # i`/7— I •(-1 ' Electrician:
MDIA USE ONLY DATE RECEIVED: 7 -- O 9/ DATE INSPECTED: -2 - / j 57
- Correct Location: Same as Above 0 or:
Red Notice Label n •
Rough Wiring Outlets Surface Unit Oven
Switches Range Garbage Disposal
Receptacles Water Heater Dishwasher
Fixtures Air Conditioner Dryer
:r2 CI cD Amp. Service Equipment Burner, Wiring &Controls for Amp. Receptacle ' Jr
Amp. Service Conductors Pump Vent Fans '
MOTORS H.P. 11/20 1/12 1/10 1/8,1/6 1/4 1/3 1/2 3/4 1 11/2 2 3 5 71/2 10 15 20 25 30 40 50 75 100
Mark Number •
— --of-Each Size - - -- - - ---- -
500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000
Elect. Heat
CERTIFICATIONS USE FOR INITIAL VISIT ONLY NOTIFIED DATE CORRECT FEE PAID
9 R Progress: Inc.❑ LKD I I Contractor
LJ"CFT Violation: Work Comp
.❑ Inc. ❑
n L/A _ Owner CASH .. --.
[1] I /A Fee CHK #
Due • MO #
n IPA Municipal .
INV #
Date: Other Side El Utility • Applicant `-}-1—...._
Owner i
Cut in Card - ❑ Temp # • Date _> 1 // �,
Final # �-
��6)-_�1U ' rS '- Date 7 - / 1' .5-7 INSPECTORS SIGNATURE
�
i-N, •
\PLICATION FORM NO.250 EL 11/89
l ,
--TOWN OF QUEENSBURY
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
A. of TELEPHONE (518) 745-4447
•'"- 'r BUILDING INSPECTOR°S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED 1 1 \ Ci' C� `
NAME r-1/L9 a n ,;,1 j 1c4V1„ � 4. L 6-'q
L OCATION CRYT VI VYCt 1, �•c`J C2 6CV 1
DATE /*/6 1 PERMITP / — / / �_
TYPE OF STRUCTURE �0 O) )461.
RECHECK
FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
FOOTING FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING )(FINAL ELECTRICAL_ SEPTIC
INSULATION WOODSTOVE/FIREPLACE
REMARKS
f
/ci
I APPROVAL
J4 / N/A YES NO
CHIMNEY HEIGHT/LOCATION
B VENT/LOCATION \ /
PLUMBING VENT
ROOFING A
SIDING >q
DECK/PORCH/STEPS/RAILINGS}, i/
RELIEF VALVES ,,
FURNACE/HOT WATER OPERATING
BASEMENT INSULATION/DUCTWOFfK-
INTERIOR TRIM/PRIVACY DOORS \
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED x.
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
SITE PLAN/VARIANCE REQUIREMENTS .
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C
COMMENTS:
ARRIVE
DEPART
INSP- T
14
TOWN OF QUEENSBURY ////4
M 531 BAY ROAD � D `0
;S QUEENSBURY, NEW YORK 12 64 7
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED
NAME A.1-X1 / 14°a 7zfz 42�ieJ
LOCATION 1 , \Lae,g P /lO/%(. '&C
DATE ii/ q /cii PERMIT! /-z-a,;
TYPE OF STRUCTURE A'�itt - 4-7. 2-e___.--"
RECHECK
FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
(FOOTING FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING efFTNAL ELECTRICAL _SEPTIC
_INSULATION _WOODSTOVE/FIREPLACE
REMARKSy4-0,.e;— 7,, ./7�1./'/�-e/zei
/
7 / APPROVAL
N/A YES NO
CHIMNEY HEIGHT/LOCATION /
B VENT/LOCATION \ f
PLUMBING VENT `, /
ROOFING \
SIDING \/
DECK/PORCH/STEPS/RAILING'S
RELIEF VALVES i \
FURNACE/HOT WATER OPERATING_
BASEMENT INSULATION/DUCTWORK,
INTERIOR TRIM/PRIVACY DOORS \
FINISH FLOORS:
BATH/KITCHEN WAT RTIGHT \\,
OTHER FLOORS SWWEPABLE \
OTHER FLOORS CARPETED
STAIR CLEARANCE/MAILINGS
HANDICAPPED ACC SS
SMOKE DETECTOR
BATHROOM FANS/ HOLEHOUSE FANS \
ALL PLUMBING IXTURES OPERATING
GARAGE FIRE P OOFING
DOOR CLOSERS
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS
DUMPSTER
SITE PLAN/VARIANCE REQUIREMENTS
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C
COMMENTS: �I 5 ups A?
'-o k' ;C 1� 0 .i 2 c:%f e-� Do i G,1
/',Al L 16 1z I. ,� P ��=�-io t)
L
f
ARRIVE i (MO 724
if- /.
DEPART )L /0 G`-,,/'— �'t �
h INSPECTOR
..'�� TOWN qi_40,
Fi� OF Q UEENS B UR Y
Bay at Haviland Road, Queensbury, NY 12804-9725-518-792-5832
Building & Codes Department
INSPECTOR'S REP RT
(?)() LS19C
rci,/,)i.:_v_.. ...Jrz.:(7.4 `I- ,Z,A-Al2r),177.E 5'
PROPERTY LOCATION
OWNER OR TENANT
BUILDING SEWAGE SIGN OTHER
REMARKS: p /d
t7/Ll/4-L / /p( l( o Li is D Ez(-
0 c_(< i ) P.r AiC--/,
CONTACT THIS OFFICE WITHIN 4 R UCI� j
77
4"."-Z, Z.-}4.....-4.....,. ,....„
NSPECTOR
"HOME OF NATURAL BEAUTY.. .A GOOD PLACE TO LIVE"
SETTLED 1763
TOWN OF QUEENSBURY
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED
NAE TC / !GAF
LOCATION r) LI�'�,C,�- �— 7 L/ A
DATE Jq f ( PERMIT# 9 '
TYPE OF STRUCTURE
RECHECK
_FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE) ('
_FOOTING FOUNDATION BACKFILL FRAMING
ROUGH PLUJIBING FINAL ELECTRICAL_SEPTIC
INSULATION WOODSTOVE/FIREPLACE
SITE PLAN/VARIA CE REQUIREMENTSi YES NO
J I.
REMARKS
1 APPROVAL .
N/A YES NO
CHIMNEY HEIGHT/LOCATION +'
B VENT/LOCATION
PLUMBING VENT 1
ROOFING
SIDING ,
DECK/PORCH/STEPS/RAILINGS,
RELIEF VALVES
FURNACE/HOT WATER OPERATING.
BASEMENT INSULATION/DUCTWORK
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS: d
BATH/KITCHEN WATERTIGHT i
OTHER FLOORS St4EEPABLE
OTHER FLOORS CARPETED
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 •
COMMENTS/:
. -9S 02OMI c2/ ji- oo�-___
O C (4&--I___T-H--tth1 S To CbM 'LI—j-
ARRIVE
L:///2
- DEPART
ELECTRICAL INSPECTIONS
r -_ w' DUPLICATE MUNICIPAL RECORD
Permit No.
Owner C.k [ t, cc 0020/ C`Z_ �^
Occupant Pc1P SScem, t� l rc ( v
Location �J CI A._ rad-
o. Street
Town or City State f
Installation as Itemized on reverse side has been visually inspected pursuant to applicable codes.
?CJl d
Installed by pt?tf ✓� fi�l C"��e
J ,, No. a( 3
Date 7-(/3 ^9/ i2z( 1 Inspector
MIDDLE DEPARTMENT INSPECTION AGENCY INC.
FORM NO.18 EL. 900 Haddon Ave.,Collingswood, NJ 08108
ROUGH WIRING OUTLETS H.P.AIR CONDITIONER
, OUTLETS WIRING &CONTROLS FOR `BURNER
RECEPTACLES H.P.PUMP
FIXTURES K.W.OVLN
oLCCD \ AMP.SERVICE EQUIPMENT H.P.GARBAGE DISPOSAL UNIT
AMP.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
MOTORS R.P. 1/20 1/12 1/10 % '/s % Ih ' '/ 1 11/ 2 3 5 71/2 10 15 20 25 30 40 50 75 100
MARK NUMBER
OF EACH SIZE
APPARATUS
Cyr ) fil
Down of Queen3rhurt,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME )i (1 � /�VO\Q-12-\\-- +Gto
LOCATION A:C1\ ISUI1\- (
DATE V / 9 PERMIT NO. ci f f
SOIL TYPE Sand - Loam - Clay -
Percolation st Required? YESO —
Percolation rate - Min/Inch ``
TYPE of SYSTEM:
Absorption field, total length 2_,_c_rp
Length of each trench ' Sb
Depth of trenches 2-3(-1---
Size of gravel
SEEPAGE PITS4Number of)
Size- ft. X ft.
Gravel si e
PIPING: Size Type
Bldg. to tank AX01—`467,77`
Tank to dist. box PG/
Dist. box to field/pit
Openings sealed? \YES NO Partial'
LOCATION/SEPARATIONS• •
�w' !� 1
Foundation to tank . ,(;"''
Foundation to absorption, f .
Absorption to lot line ..1 -NN,_ ft C)/&
Separation of pits /1,
LOCATION OF SYST u 0► •,ROPE TY' ircle one)
Front - Rear Left side - Right side -
COMMENTS: /r
C.Pr-LL Qt7C4-1 if) (0 r_
-C-121)4--FpvuiL
0 tn. Co varz-roticr)
SYSTEM USE APPROVED Y NO
B ilding In pec or
•
•
01/86 and vl
TOWN OF QUEENSBURY %
BUILDING AND CODES DEPARTMENT "
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME (i(_.(X./ '`).1.( 1e.7J ,(/.U/12,1 ?/Na
LOCATION ( N' ///I u1 14 4(19/r / -
DATE 7/5//9/ PERMIT if 9/—
TYPE OF STRUCTURE
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS • {
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE sd.
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
REINFORCEMENTO PLACE /
FOUNDATION/DAMR.ROOFING /
BACKFILL APPROVAL /
ROUGH PLUMBING \ /
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB /
FRAMING: \ ;'
JACK STUDS/HEADERS`
BRACING/BRIDGING d' \
JOIST HANGERS s \,
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 WORK OR PIPING IN UNHEATED
SPACES
REMARKS.i� a'
ARRIVE /0 20
DEPART /ft �i) A. -4 , � 1
INS. ETR
(11./A(6,
at \()2p: Ci913A--t— ,
TOWN OF QUEENSBURY
0 a' cYa ® 01# Bay at Haviland Road, Queensbury, NY 12804-9725-518-792-5832
Cue-," g es TOWN OF QUEENSBURY BUILDING DEPT.
PROPER METHOD FOR SUPPORTING A MOBILE HOME a , an
------------------
SHOWN FOR USE WITH A SINGLE WIDE MOBILE HOME ONLY
FOR USE WITH A DOUBLE WIDE USE SAME METHOD UNDER EACH SIDE.
TRAILER BODY
,
TRAILER I BEAM TRAILER FRAME r
•
WOOD BLOCKING
•
II
CEMENT BLOCKS
_THT(K STAR -- -
. a d
\ i
FINISH GRADE ,.
- . -- �#
/ ____ _4 —
REINFORCNT ROD 6-6-10 WIRE MESH
REINFORCEMENT ROD AND MESH AS PER CONDITIONS
SLAB TO RUN FULL LENGTH OF THE TRAILER AS SHOWN