1991-665 (. I
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY v•
WARREN COUNTY, NEW YORK
Date (i_b9-l-P.b /D 19
This is to certify that work requested to be done as shown by Permit No. 91-665
has been completed:
This structure may be occupied as.a E�obi flee
LocationLot 73 Horth i nds
Owner Albert Provost
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. do Code Enforcement
--I
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-665 0
WARREN COUNTY, NEW YORK
w
N
PERMISSION is hereby granted to Albert Provost 4.0
OWNER of property located at Lot 73 Northwinds Street, Road or Ave. -s
O
in the Town of Queensbury,To Construct or place a Mobile Home H
at the above location in accordance to application together with plot plans and other information hereto filed and e+
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
LT
1. OWNER'S Address is ID
3 Hammond Lane -s
Gansevoort, NY
I—
O
2. CONTRACTOR or BUILDER'S Name
Lamplighter Homes
RD#2 Rt 9
Fort Edward, NY a
3. CONTRACTOR or BUILDER'S Address 7'
a
n.
V
4. ARCHITECT'S Name
O
5. ARCHITECT'S Address C'
fD
6. TYPE of Construction—(Please indicate by X) fD
( I Wood Frame ( ) Masonry ( I Steel ( )
7. PLANS and Specifications
No. 14' x 70' Mobile Home as per plot plan specifications and application
8. Proposed Use
Mobile Home
$ 35.00 PERMIT FEE PAID —THIS PERMIT EXPIRES September 20, 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 Day f September 19 91
SIGNED BY — i for the Town of Queensbury
Building and o Inspector
•
1-43"
'I0 DE COMPLETED BY BLDG. DEPT. --� .; .
s,�
is E.;.;
�'•' a �t r�yam` -x,Y:
��u„n 0/ Quee,,,Zury Application No. 117 "� r" ! in ,P5 "
N ..r..�:�4 .s_., 111
Permit Issued 19 itaf;
) _,
BUILDING rna ZONING DEPARTMENT Permit Expires 1') ' �=y ijo
Day uric) Huviland Road, R.D. 1 Box 08 zoning Dtaignation SE/V 1991
OueunsOuty, Now York 12801 Variance No..
Site Plan Review No. . BUILDING & CODE D"PT.
APPLICATION FOR App d by: 0 S, l
MOBILE HOME . qi,...,-- /0 (o-)
-
FU l _D I NG AND ZONING PERMIT
• • • • • • * • • * • • • * • • • • • • * • • * • • • *• * * • • • • • * • • ::*
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. ANSWER ALL OF THE FOLLOWING.
The underuignud hereby applies for a Building Pormit to .do the following work which will
be don.: in accordance with the description, plans and specifications submitted, and such
,j)ec>.ai conditions au uey be indicated on the Permit.
'1'tw owner of this property is: J9h' e,-/ /'/rood S' I
P.0. Addreuu 3 -(-d(vkate.Don 24
, 63
'4i!/ oR7- N>• T u 1.5 -3/6PP
Property Locations )moo c-13 (i O tZ .-t w ( i BS QL.1._ee-(-D S.L.L.Cy Tax Map N o. / /
Street ',umber or buildiny lot nuuIber
Subdivision name (if applicable) .6v 0 (L� - I I'--3 .0
THE PEILION RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
J'A` j) I "fir- " aCMA-e.o R•0 a. -� R i q 4-6,-P,7 �, w,i) R 0 ,c-) V I 2_ .S`/�--7g3-?3 tL
It,ime - Y.O. Address Tel. No.
N,une of Ins talle rthytij( L t ( zi Address ► b z' I't"9. g-nd-2Lv�J Ny(Tel..67S- 293-23 FZ
r7,.iiie (if Idumbcr Addreuu Tel.
N;,nu of mauon Addreuu Tel.
MOD I LE HOME INFORMATION : • ZONING INFORMATION;
New Iloune 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 ti`k ft X -1 v £t , . • whether existing or proposed and indicate all
� • set-back 'dimensions from property lines. Give
Single w le • 1.- 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 -21 • of septic disposal area.
•
No. of bathrooms t 3/ • COMPLETE INFORMATION REQUIRED BELOW.
Fireplace? I?Wood stove? PO ' Size of property a° ft X L6-0 ft.
Foundation style and size: • txiuting building(s) Size �l ft X �(f`Ey ft.
Piers- llo.of Size-_ft x ft. ' existing building (s) Uue
•
Depth below grade ft.
• Proposed building, diuLance from property line
F'OUNDA'I'ION - Footing size " X • 5' o y---
• Front yard ft Rear yard ft
wall material • Side yards ft and ft
wall thickness Height ft. • If on corner, setback from side etreut ft •
['or.31 depth below grade ft. •
• OCCUPA LY INFORMATION •
• PRIRY BUILDING -
Grade to Home floor level ft `':` PRIMARY
family dwelling
• • +
nn . Two family dwelling
Proposed date of placement _ / e%Zr/ 611 ( • Multiple dwelling / Number of units
p
Aprox . Vales, of Home $ ? !.7 ,i f �3 • Permanent occupancy
• 'transient occupancy
water supply - Well Municipal - - , Business.
• Industrial
Septic Permit rLquired? (2AZ ui_na:i
• If addition, what will use be:i
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/BG and-vl
•
APPLICATION FOR MOBILE HOME PERMIT, (CONTINUED)
State of New York Division of Housing and Community Renewal
•
INSIGNIA OF APH OVAL OF THE STATE BUILDING CODE
1 . INSIGNIA SERIAL NUMBER
2 . NAME OF MANUFACTURER a o 7 .
3 . PLAN APPROVAL NUMBER 01. (\
I . MODEL OR COMPONENT DESIGNATION • A:11) ••
�
• . .
5.. MANUFACTURER ' S. SERIAL NUMBER
S . DATE OF MANUFACTURE 2
be
•
•
All the above information is to be found on a plate or sticker which
lhouid 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 A AA # # A
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 ocher laws pertaining to
Lhe proposed work shall be complied with, whether specified or not, and that- such work is••
authorized b. the owner. • . . . . • •
•
Signature • 6--c&._
' Owner, • owner's gent,arcn .tect,contractor
•
•
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 �'\ IJ
TEMP.H DATE /' ,_J 1.,�---,
CRY OR VILLAGE TOWNSHIP ' COUNTY ((••,,JJ(�/-J`
(kur A.)C 6 of f (A__) A -iLL,N ..
STREET AND NO.OR ROAD T1 POLE NUMBER
BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? - SECTION - BLOCK LOT
OCCUPANTS NAME ( }� BUILDING OCCUPANCY
13l- ..'i I✓tQt)O 2 -s t tJ(a c- F-�c,-1 >1 , ( ( L.f 1(--7C) i1'1 i:?>'� ! :...c 'ui 2...
OWNER'S NAME AND ADDRESS HOME TELEPHONE NUMBER
At/5E fz R.(Ajos ; Pd f, k,.. G,s,os t), -,2T Tu/ ; - ma y- /E-:
CUR a ENT SUPPLIED BY FROM THEIR OFFICE WORK TELEPHONE NUMBER
BUILDING IS
NEW utt. OLD❑ WORK IS NEW ADDITIONAL El DEFECTS REMOVED D
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETS No.of Fixtures& MOTORS HEATERS BRANCH OFFICE USE
Loca- Lamp Receptacles CIRCUITS ONLY
lion 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 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 F CAT ENTER NUMBER
PP— 1111111
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 SIG ATURE OF APPLII NT ,
r, rT,-j1`yc) t!t.r ti l/` ! ! X�i{. L
BEET AD RESS TELEPHONE NO.
l:)2. AA a( "
CITY OR POST OFFICE ZIP CODE LICENSE NO.WHEN APPLICABLE
F-:.,'r,- .1 fr9�= r"�J /`3 ` f�> j� ` -.
❑ 85 John Street ❑ 41 State Street ❑570 Delaware Avenue iti 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 N4FW YnRK BOARD OF FIRE UNDERWRITERS
,� `4-1,!•.\1,.1-.d P.,14.1 1; Vi(1_P t../-1,.. l_C.\_l.1—P.Via,P PJ P,.P.P.1.1.,P,,P.-4 1./.`P.P.,{J_P.4-1_.4 J 1:PAP!.?/_.J.!.a1t.fs"-1}/.1.!?.,!,a!.7t."i.).!--1 P.P.!--1,P.i.L!--1 I ! 1 P.
-
• THE NEW YORK BOARD. OF FIRE UNDERWRITERS PAGE 1
11''.9�'15
BUREAU OF ELECTRICITY.
o, I 41 STATE STREET,ALBANY.NEW YORK 12207 .
Date OCTOBER 21,1991 ApplicationNO.on- ite37939391-/91 A 060154
THIS CERTIFIES THAT PI R?•IIT' NO 91-665 ®0
only the electrical equipment as described below and introduced by he applica med on the above application number in the premises of Io
ALBERT PROVOST: NORTHIcINDS, QUEEN SBURY, N,V.
v
0 in the following location; ❑ Basement ❑ 1st Fl. ❑ 2nd Fl. OUT Section Block Lot 7 3
0 was examined on OC I OBEr< 1=�;1�}91 and found to be in compliance with the requirements of this Board.
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.
pi
1, DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
11
k AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. • AMT. AMP. AMT.. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS
0
SERVICE DISCONNECT NO.OF S E R • V I C E
AMT. AMP. TYPE METER
1.B'2W 1,ff 3W 9,9 3W 3,2/4W NO.OR C;COND. OF CC COND.. NO.OF HI-LEG .OF.HILEG NO.OF NEUTRALS Of NEUTRAL
OTHER APPARATUS:
PANELBOARDS:1 CIR. 100 .
51®
_ • O M
LAMPLIGHTER HOMES • I F-
RD ' RT. 9 -- - _ crux
FORT EDIT'ARD; NY, 12828 • ..
i':,.i BRANCH MANAGERirr.
239 I.„
.1.: .
. '
Per
t 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.
oo ® Mirtinifii0121851ffl aoo EGO ® MEI WERE COMM 511Egniinin ® ! Mr ® e; ;•;.}
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 1280�
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME WpC)L '(—
LOCATION ' V ` L'O S //
DATE (� CO PERMIT # ! I -(p(q 5
t2t t*��l.,)( APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN '
INSULATION: v
FOUNDATION ii'
FLOORS j ,{'
WALLS ' •
CEILING j
FINAL INSPECTION:
CHIMNEY HEIGHT `I
ROOFING
SIDING /
EXTERNAL PORCHES/STEP \ /
STAIRS-CLEARANCE & RAILS \
PLUMBING FIXTURES/RF!LIEF VALVE
INTERIOR TRIM/PRIV4CY DOORS\
FINISHED FLOORS (J
GARAGE FIREPROOFING
DOOR CLOSER(S) 0 p Via
SMOKE DETECTORS/
FINAL ELECTRICAL /NSPECTION ' \ 7�
FINAL APPROVAL i
CONSTRUCTION
A SIGNED CERTIF CATE OF OCCUPANCY MUST BE
OBTAINED FROM HE BUILDING DEPARTMENT�iBEFORE
THESE PREMISES ARE OCCUPIED! ,•.
REMARKS:
'1.
D\� TO (Sau& q CS
,\
INSPECTO
_-40-z-e , -,2,4
..A G�� 4-40b ITV EE I k&RY
/A►, 531 BAY ROAD ;00)2
�01: QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED //0 /
NAME .beU .�/1�7/ 2tJ
LOCATION (}-/ :_gi /,61/4-( o
DATE `6 Y,9/ PERMIT# 0-60,&-5
TYPE OF STRUCTURE ('-"&,41-1. iJ 7/24'__
RECHECK, >
_FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
FOOTING FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING FINAL ELECTRICAL SEPTIC
INSULATION WOODSTOVE/FIREPLACE
REMARKS ,(/) . I _ / C'' O?c ,-t�-IC
I
I APPROVAL
N/A YES NO
CHIMNEY HEIGHT/LOCATION
B VENT/LOCATION a
PLUMBING VENT
ROOFING 4,
SIDING
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES V _
FURNACE/HOT WATER OPERATING __
BASEMENT INSULATION/DUCTWORK
INTERIOR TRIM/PRIVACY' DOORS
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT\
OTHER FLOORS SWEEPABLE \
OTHER FLOORS CARPETED \
STAIR CLEARANCE/R'AILINGS \
HANDICAPPED ACCESS \
SMOKE DETECTORS ..
BATHROOM FANS/WHOLEHOUSE FANS
ALL PLUMBING /FIXTURES OPERATING
GARAGE FIRE PROOFING
DOOR CLOSER.
OTHER FIRE/SEPARATION
FIRE/DEMIS'E WALLS
DUMPSTER <
SITE PLAN/VARIANCE REQUIREMENTS
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C
COMMENTS:
G-6 i0 Ril-iLIA/G ad i-nS'i t'7S
fan (,c'if Loci Tz.is -6- (.CSC
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DEPART -3r) /A.
INSP T
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li i'''''''' ':1:•,91Tpeq.,Approx. 911 Sq. Ft. 01102 1470 3CK 2FB 28A FIB UTL Approx. 911 Sq. Ft.
- ‘,2,1 I.:0 .OPTION 471. Is'OPTION
V2 BATH 3/4 BATH
'
1
88,8"
1
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ROOM , BED0R004.M 2 1
BED1700A4
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t--. .- ,..8.
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.. ....
Approx. 911 Sq. Ft
. 01121-• 1470 2CK F&R Approx. 911 Sq. Ft.
.,.... ,..,
. ,
•
---- -- il; .'4,4,4,4 , ,ii., %,•,1 4 t;3-3 54 „,
----...._ . : • livii:::::fr,ii?t'71.i-,4`7,:i:.•i:',.:(:;!:_?.;,i:C:?.../1,11,4_,;:rzi,.2.:L.::::::.;:,••:;:sci,:...;:::,1:1-,c.t.,J\\
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. N.! • • i SEP 16 1991
OPTION Ei OPT70A;
66,8'
I/2 BATH' - 3/4 BATH.
BUILDING DEPT.
• ,
. ...,. ---- 0i4110tc . .''''""''.—.'' ''"•'' t''':117 1..1iiill 1 li 1,1-IT!-7 --
••• BEDROOM 2 • -
. C\,/„;!.:I%n' t-s., ta r ' .• 7o—noo '
(.-'l'l:4.[ tf:4:i:1 t)-H12 7-•
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1 i.
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01123 1470 2FK Approx. 911 Sq. Ft.
Approx. 911 Sq. Ft.
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— t 1.,.:..,:F....U.5 14 4:i.52 kr; „„.., .......:
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MASTER *1- i0 . 1 ' ' LIVING
-',IKITCHEN DINING,
,CNENt. ROOM ROOM
WING L • ' BEDROOM {-1:14 -„ '' 1 ;,1:. I
t8'a- 1 r2.8. BEDROOM 2 BEDROOM 3 . 18'0' i -1111ili;
ll-111 1.rtiT1'''"
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. Approx. 911 Sq. Ft. ...... 01126 1470 3FK Approx. 911 Sq.:Ft.
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4-KITCHEN DINING.
,:.Z. r ..i.;,i;V.,: ; BEDROOM 7
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• .., ..I'tt.i
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