1991-558 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date - -/
This is to certify that work requested to be done as shown by Permit No. 91-558
• - has been completed.
This structure may be occupied as a Mobile Home
Location 96 Briwood Circle. Forest Park
•
Owner Linda A. Parker & James A. Jones
By Order Town Board
TOWN OF QUEENSBURY
• Director of'Bldg. & Code Enforcement
--I
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-558
WARREN COUNTY, NEW YORK
1-1
GJ7
PERMISSION is hereby granted to Parker, Linda, Jones James
OWNER of property located at 96 Briwood Circle, Forest Park Street, Road or Ave. 1-1
w
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.
Cu
1. OWNER'S Address is
11 Main Street
Glens Falls, NY
2. CONTRACTOR or BUILDER'S Name G=1
LL
P.V. Sales
0
3. CONTRACTOR or BUILDER'S Address fD
Rt 50 to
Saratoga, NY
ro
4. ARCHITECT'S Name
5. ARCHITECT'S Address
O
CD
6. TYPE of Construction—(Please indicate by X) to
e+
( )Wood Frame ( ) Masonry ( I Steel ( )
7. PLANS and Specifications
14' x 80' Mobile Home as per plot plan specifications and
application 0
0
8. Proposed Use fD
Mobile Home
9
m
$ 41.00 PERMIT FEE PAID -THIS PERMIT EXPIRES August 6, 1g 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 thi 6th Dp of August 19 91
i
SIGNED BY �/ / j for the Town of Queensbury
Building andYoiiing Inspector
i '
/T1.
1:OiW N OF QUEENSI3U h,
TO DE COMPLETED BY BLDG. DEPT. RECEIVED
/uwn of Qu 'enit Wr Application No.
y Permit Issued 19 AUG 2 1991
BUILDING and ZONING DEPARTMENT . . Permit -Expires 19
Bay and Haviland Road, R.O. 1 Box 98 Zoning Designation
Oueensbury, New York 12801 ' Variance No.. BLDG CODE DEPT.
Site Plan Re few No. �1 rr 3 3/� )
APPLICATION FOR A ved b : AL' , r^J�
MOBILE HOME
PUILDING 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 specifications submitted, and such
special conditions as may be indicated on the Permit.
The owner of this ro ert is: A
P P- Y //1�OR FI. �R ��,P J A rr1 s �6/i e S
P.U. Address �✓ p�•�'
- �i�:-fi'I22111, � :.. c //S-i '/ (4 Tel.794 76 �/
Property Location: 96 6-1 /-)D Q' CiR�,(e/ 0,./e6/5"R/.I�// 4,r1 Y. Tax Map Nod. 3(c 3/ •
Street :;umber or building lot number� ! .
Subdivision name '(if applicable) jQ iQ .T/ PARk'
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS: (�eu dej
Name - P.O. Address
- Tel. No:
Name of Installer Pa,-)7 LpS Address ,'it `fy,ey� 6-H �, , Tel. 62.ier,- P�,f'L- �O.*o
Name of plumber Address / Tel.
Name of mason Address Tel.
MOBILE HOME INFORMATION: r ZONING INFORMATION:
•* RH1✓K HER, (.-0 d
New Home Placement A PLOT PLAN MUST BE PREPARED AND SUBMITTED, ley/
' drawn reasonably to scale and attached hereto,
Replacing existing Home •. . r showing clearly and distinctly all buildings,
Size of new Homed/4/ ft X "a ft . * whether existing or proposed and indicate all
*_ set-back dimensions from property lines. Give
Single w 1e .. /."-- Double wide * street and number or lot number and indicate
No. of rooms (excluding baths) * whether interior or -corner lot. Show location
* of water supply and location and configuration
No. of bedrooms * of septic disposal area.
No. of bathrooms . * COMPLETE INFORMATION REQUIRED BELOW. ,
Fireplace? -Wood stove? * Size of property ft X ft.
Foundation style andt� size: * Existing building(s) Size ft X ft.
Piers- No of Pe e- Size- fte&s ft. *
Existing building(s) Use
I.
Depth below p grade ft.
FOUNDATION - Footing size X • * proposed building, distance from property line
ll material * Front yard ft Rear yard ft
Wa
/G oil y * Side yards ft and ft
Wall thickness Xlo " Height 7 ft. * If on corner, setback from side street ft
* OCCUPANCY INFORMATION .
Total depth below grade A/A ft. *
Grade to Home floor. level Oy, - ft.., r PRIMARY BUILDING -
* * * * * * * * * * * * * * * * * * * * * VOne family dwelling
Q * Two family dwelling
Proposed date: of placement I / / / 91 • Multiple dwelling / Number of units
Aprox. Value. of Home $.762Ou • Wj} •
Permanent occupancy
I * Transient occupancy
Water supply - Well Municipal f— * Business
✓ Industrial
Septic Permit required? IA * 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
* v Private storage building
• * Other
r
•
-; Form MIIP 5/86 and-vl -
T
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 ,-y/,q and ./Y)
3 . PLAN APPROVAL NUMBER 7P .2-.
4 . MODEL OR COMPONENT DESIGNATION ?6•7 y '
5 . MANUFACTURER 'S SERIAL NUMBER (7I Y5 7
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 * +F s * 4 * * * * * * * * +t 4 * A +t A * * 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, area 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.
/ nn Q �'Signature /� `,l'�u•� A. d�r✓ �S' GLIC,2 f•
e , owner's agent,arcnitec , tractor
•
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
SPECIAL CONDITIONS OF THE PERMIT:
• • By
•
MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
. National Headquarters ' ^`
1337 West Chester Pike,West Chesto,' PA' 1B38O '
APPLICANT COMPLETES THIS SECTION � .` � Date: � � y/
O�� Town orTown hip )/�/ / �v/� /� �/ /7./ . County St�o/7�
' -
Location/Address
(if Located in Rural Area Please Attach bimvtipn,) po|v #
Owner -T� / Permit #
Occupied As � ' . ' � ' Building: New[ Old��
Occupant - ` �
'Work Area in Building (Floor #, etc.):
App. for VNhngF� SomicoF� or: Ready for Inspection: '
Fee Remitted'$ `-j 00 ' Cash F-1 Check F-1 m.[\ F-1 Make Payable To: M.D1A.
am rm 1mm zsm 1am zrn mo ,00 ,�o uo° ,�o
Number of Rough Wiring Outlets Elect. Ho�u
Switches Amp. Som d Service Surface Unit Dishwasher / ^Range
Lighting /~ Water Heater Air Conditioner Dryer ~Pump
Rocmptuo|oo
Oven Garbage Disposal Wiring and Controls for Burner
Number ufFixtures
Amp. Receptacles Fractional H.P. Vent Fans
Other Equipment:
MOTORS1/e01/1e1/10 z u' z/o 1/4 1/3 z/e a/o z zm 2 s , r* m zs eo eu ao 40 oo rn um
Mark Number
m Each Size
Applicant's. / /} ~`�^ License # Ponn� #
n�nuum �`' ' ' � '` \�'/'�'�, '/ ��//� '- mm
T/A / ` |ity� '
-- (mmws> (o��ms �on��mm)
App �ant� Addmo: / '
(3tY) � /� `� ` � ` (State) ' ' (z]p) ' Service Request #
Phone #�' � ' ' ° ' Electrician:
K8D|A USE ONLY
oxrs nsCswso: DATE /mspsnrso.
Correct Location: Same ao Above F-1 o,: '
Red Notice Label F-1
. Rough Wiring' Outlets / Surfao�Unit , Oven
Switches Range � ` Garbage Disposal '
�
Receptacles Water Heater Dishwasher
\ ` Fixtures
Air Conditioner Dryerq Burner, Wiring &Controls for Amp.A Service Receptacle o|o
�nn Pump Vent Funs 2n1 ozm zxp�pv-1-/o z/e 3/4'�11-� e�^c o u r* m zo ev un so 40 oo ro mv
'
ervice Mark Number
of Each_ize
_ �
Boot Heat mo ,m 1000 um 1500 17502=02250 25002750 m°"
nqscr
CERTIFICATIONS USE FOR INITIAL VISIT ONLY mmr/p/so owrs cOrss FEE PAID
�-1 RVV Progress: Inc. LKD[l Contractor '
E:1 CFT Violation: �� Comp.� \� � ' �
� � -- -- CASH
O
F-| L/A mmo' F CAS'
ov CHK �
�-1 L/A � Duo�� ` KxO #
IPA Municipal
' ' |NV #
Applicant LJ
Date: Other Exda Utility / Owner
- '
Cut inCard Temp # Date
- . INSPECTORS SIGNATURE
�� Final �* Date. ' '
. . /
-
APPLICATION ponm NO.250 EL 11/89
5cLvk
TOM OF QUEENSBURY
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDIG INSPECTOR'S REPORT
FINAL INSPECTION REQUEST FOR INSPECTION RECEIVED_F I/L//
NAHOKA
(�! � (�� t `
LOCATION i � 1 %p fin r). Q- -CQ
DATE I tl C) PERMIT#
TYPE OF STRUCTURE_2,I D C-lt.PJ rP % /c
RECHECK
_FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
FOOTING FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING FINAL ELECTRICAL SEPTIC
INSULATION WOMSTOVE/FIREPLACE
SITE PLAN/VARIANCE ;REQUIREM ENTS YES NO
REMARKS .�
I
ti / APPROVAL
7 f N/A YES NO
CHIMNEY HEIGHT/LOCATION
B VENT/LOCATION I
PLUMBING VENT
ROOFING /
SIDING
DECK/PORCH/STEPS/FAILINGS
RELIEF VALVES s
FURNACE/HOT WATER OPERATING
BASEMENT INSULATION/DUCTWORK
INTERIOR TRIM/PRI ACY DOORS
FINISH FLOORS:r�
BATH/KITCHEN WA ERTIGHT
OTHER FLOORS SWEgPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAjLINGS
HANDICAPPED ACCESS
SMOKE DEFECTORS
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 r/ F
•
ARRIVE
DEPART
TO
4rkP/27
TOUR OF QUEEI6SBURY
531
:``,4j ; QUEENSBURY,BNE ROAD
NEW YORK 12804
TELEPHONE (518) 792-5832
MG--I - CTOR'S REPORT
NAL INSPECTION
REQUEST FOR INSPEC �e"[/�!
NAME ROI\J\te4 ) )-,.\ G.1_
1 O QQ UYv1/4.122 C
LOCATION _9�nYU _
DATE griii PERMIT# 9 1-5 )
TYPE OF STRUCTURE 1'1�10 ,) /e. po,,L.,...._
RECHECK
_FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
_FOOTING FOUNDATION BACKFILL FRAMING
_ROUGH PLUMBING FI AL ELECTRICAL _SEPTIC
INSULATION WOODSTOVE/FIREPLACE
SITE PLAN/VARIANCE REQUIREMENTS: YES NO
REMARKS
/
ji
APPROVAL
N/A YES NO
CHIMNEY HEIGHT/LOCATION /^
B VENT/LOCATION ✓
PLUMBIN VENT
ROOFIN
SIDIN.
DECK/,ORCH/STEPS/RAILINGS',
RELIE VALVES ,t V
FURNACE/HOT WATER OPERATING,
BASEMENT INSULATION/DUCTWORK..
INTERIOR TRIM/PRIVACY DOORS •t/
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE i.
OTHER FLOORS CARPETED /
STAIR CLEARANCE/RAILINGS_
HANDICAPPED ACCESS
SMOKE DETECTORS f/
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: ,
;"7z,,,ztoa iycw, c___,c..)... f/
IleelA)47 11--464 4;12.d ekt217 11/114‘'
ARRIVE
DEPART
11
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F ,I MON,, HOMES, INC. , , A t.a t .NeSOS °t. c(
r,O.lion . 0'N a �,t ea OJAI Sao +aO J$a1M► ►,a*rri• 10041LACCI 101 MLASAT-
NATPAa1l3, IND1ANNA 44540 wily; rca )4421mar ubvClipit. 111M i 1141" SAY' „w
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Plxoa: n*-'PPS-71041 SAY IS olMaruu. CPA 4 oibilt4111.414 WIT CO iS tilmilirrso i"► 111101/4. Yea.
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RECEIVED
, ..,
' 2 AUG 6 1991
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GO , BLDG. & CODE DEPT.
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60,Q_Q..k.D burl t ',Ey
LI',Jptypc(-4,<Q1-7,' TO ON OF QUEENS
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*".-.---I'rvl 3-0 1•32-3 , ;2,„/;9
Zoning Administrator
Date./.1711.--
,