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1986-846 CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK July 29 Date 19 _87 31:1)1 This is to certify that work requested to be done as shown by Permit No. 86-846 has been completed. This structure may be occupied as L _ One-Family Dwelling (Modular) Lot 10 10 West Mountain Park Subdivision - Corner West Mountain Road Location _ and Bronk Drive Lawrence Larson Owner By Order Town Board TOWN OF QUEENSBURY Building & Zoning Inspector TEMPORARY CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date JULY 23,. 19 87 This is to certify that work requested to be done as shown by Permit No. has been completed. This structure may be occupied as a ONE-FAMILY DWELLING (MODULAR) Incation LOT 10 WEST MOUNTAIN PARK SUBDIVISION - CORNER WEST MOUNTAIN RD AND BRONK DRIVE Owner LAWRENCE LARSON TEMPORARY C/O ISSUR13DFOR 30 DAYS By Order Town Board PENDING FINAL ELECTRICAL INSPECTION TOWN OF QUEENSBURY Building & Zoning Inspector BUILDING PERMIT TOWN OF QUEENSBURY No. 86-846 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Lawrence R. Larson OWNER of property located at Lot 10 West Mountain Park Subdivision Street,Road or Ave. Corner West Mountain Road and Bronk Drive rs in the Town of Queensbury,To Construct or place a One—Family Modular Dwelling 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. ;d 1. OWNER'S Address is 26 LaFayette St. Hudson Falls, New York 12839 2. CONTRACTOR or BUILDER'S Name A. D. Tellier/Custom Crafted Homes 0 3. CONTRACTOR or BUILDER'S Address o rt P. 0. Box 1183 o 20 Saratoga Avenue ro 1-1 South Glens Falls, New York N 4. ARCHITECT'S Name to 0 � >r O 0 • rt O w 5. ARCHITECT'S Address rti p p F'• n 0 P3 6. TYPE of Construction—(Please indicate by X) Wood Frame ( ) Masonry ( I Steel ( ) p` trJ ri 7. PLANS and Specifications p 24')60' per plot plan, specifications and application submitted No. including sewage system. d 8. Proposed Use THE ATTACHMENT OF THE TWO PARTS MUST BE APPROVED BY A LICENSED PROFESSIONAL ENGINEER. One—Family Modular Dwelling P3 $5.00 C/O 94.00 EXPIRES JULY 1 87 $ PERMIT FEE PAID—THIS PERMIT 19 (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.) F-' w - 10th December 86 Dated at the Town of Queensbury this Day of 19 t7 SIGNED BY /Y� a -,,0O..r , for the Town of Queensbury H. Building and Zoning Inspect r Oq TO BE COMPLETED BY BLDG. DEPT. ' �] / Application No. ' .JOwn Ol Queen ibury ,Permit Issued 19 - whim CIIKLUEEMAINOW BUILDING and ZONING DEPARTMENT Permit Expires 19 Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation 5R._020 EIVEIVElf Queensbury, New York 12801 Variance No. ,I C . Site P1- - '-view No.� ,; aR • �� .. a I Appr. -d . %' 45 q9-� .,i . APPLICATION FORLrt/ r/i ; �:i' �` r .1 •at4'-�ti& EUILDING AND ZONING PERMIT i� �� * * * * * * * * * * * * * * * * * ••* * * * * * * 1* * * * * * * # * * * * * *I.* 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: L4A-u011, 1JC R. I if) RcS0 4) P.O. Address G 4 it F-IA 1 CUP c T. licidco4) ,i`-4-LLs ij.' Tel. -747 -97.20 Property Location: [i7 n 1,J, , _ (.�c-,fi 7 /sin- .. ' 13 a13 A) 7-), ., Tax Map No.3t7 /;�_ / e Zaino Street number or building lot number Subdivision name; (if applicable) , !0 -7 1 P i , THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS: A - •"l? o.I Ili P;� ' /9 / Ci► ec• f 11��3_r �q C 7 7 Name P.O. Ad ress Tel. No. Name of ,builder e (_ ,(-i Address •1) 13 J _ Tel. -2c —-3/ q/•36. Name' of plumber .,gyp p- Fozi.n,� IT Address ' Tel. f(;r(a.-. iv-, i, Name of mason;!;, ¢VA%iky )a] 1j 2) Address ' ,, LF N 7 n : Ci-+:1'�./ Tel. ?y 3 - 35 3 NATURE OF PROPOSED WORK: * ZONING INFORMATION: Construction of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED, • Addition to a building * drawn reasonably to scale and attached hereto, Alteration to a building * showing clearly and distinctly all buildings, (no change to' exterior dimensions) ' * whether existing or proposed and indicate all Other work (describe) * set-back dimensions from property lines. Give * street and number or lot number and indicate .* whether interior or corner lot. Show location yy 4 i * of water supply and location and configuration oou L ) AA s . of septic disposal area. +� * COMPLETE INFORMATION REQUIRED BELOW. 0Q G COal r4kiS PUT . '* Size of property l l' ft, X /610 ft. * Existing building(s) Size ft X ft. * PROPOSED' BUILDING AND USE: * Existing building(s) Use Size of new structure ft X, ft * Foundation-pier/slab/crawl/partial ull * Proposed building, distance from property line (circle one) * Front yard �7nr' ft Rear yard 5"/ r ft No. of stories (habitable space) I Height (grade to ridge) ft. * Side yards ark ft and ' ,6 ft t/� * If on corner, setback from side street 0G ' ft If residential, no. of families i No., of rooms(excluding baths) . . 6 * OCCUPANCY INFORMATION No. of bedrooms ' ' " ' ' ' ' ' * * PRIMARY BUILDING - ' No. of bathrooms . . . . .I" . / Primar heatings stem �, ** One family dwelling y y �, �-' f�''`�$ * Two family dwelling Type of. fuel >A .ti.:-‘,_ ' ' No. of fireplaces to be installed * Multiple dwelling / Number of units Will a wood stove be installed? ' * Permanent occupancy Central Air conditioning? * Transient occupancy Business BUILDING STYLE,, PRIMARY STRUCTURE *' '• Industrial Ranch • Contemporary Log cabin * Other. sed ranch Mansion Duplex * If addition, what will use be? Split level Old style Bungalow * Cape Cod Cottage Other * ACCESSORY BUILDING- Colonial Row Town House * ' Detached garage/one _car two car/ car ( CIRCLE ONE PLEASE ) * _ ,; """ .ram:..s.. •. - -` * * * * * *' * * * * * * * * * * * * . 1. `e s wage building ESTIMATED MARKET VALUE OF • 'Other CONSTRUCT]ON * INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED! Form BPA 4/86 and-vl . 1 • BUILDING PERMIT APPLICATION CONTINUED - BUILDING 'SPECIFICATIONS: Type of construction, wood frame, fire safe,etc. ( 0 FIZAAQ C ©daLITZ) Will any second-hand or ungraded lumber be used? If so, for what? Pv Foundation wall material Psi C..m ] a Thickness C Depth of foundation below grade (to bottom of footing) 7 Will there be a cellar? Heated or unheated? 0/14,;; , Floor sq. footage I-,1,"c) sq ft Will there be a basement? Will any portion be used as living space? pty (If so, what portion? sq.ft. - - Type of use? Type of roof - slcped/flat/shed/other ci6 ,, Material- of roof ,< , ,'.t • ;.�, �s� Size, ,wood studs"X (, " spacing "o.c. length 3 ft. Joists(floor beams) 1st. floor "X , " spacing 16 "o.c. span• ft. Joists (floor beams) 2nd. floor • "X ;" spacing "o.c. span ft. Overlays(ceiling beams) "X " spacing "o.c. span ft. Roof rafters 'X " spacing o.c. span ft. Roof trusses(pre-engineered) spacing /G "o.c. span; ft. Exterior wall finiE h ;f J j L 4/ r ji& Of what material? e) �3 Interior wall finish i/® If a garage is, to be attached, describe materials to bemused for FIRE SEPARATION: (Is there to be dn opening between garage and dwelling?. Lw.g_ If so *ill a Fire-rated door, enclosure, and self-closing device be 'provided? y C Will a flue-lined chimney be installed? Height above roof ft. Depth of chimney foundation below grade ft. Depth of fireplace hearth ft. in. Water supply - Municipal or private well 'ram, �� ( V> SEPTIC SYSTEM Distance from ANY private well(includ( ng adjoining properties ft. (A separate application is necessary for any repair or new installation of septic system) Town of Queensbury AFFIDAVIT STATE OF NEW YORK County of Warren •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. • SWORN TO BEFORE ME THIS Signature_ap Owner, ow -& 's agent,arcnitect,contractor day of ' 19 Notary Public, Warren .County, N.Y. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * SPECIAL CONDITIONS OF THE PERMIT: • • • By TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Application for : BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK STATE ENERGY CONSERVATION CODE , A permit must be obtained before beginning work. ANSWER ALL of the following: / . 1. Gross floor area / O� / / c)CD 2 . Type of heat 470,42 ,47 t " c 3 . Is the building mechanically cooled? 4 . Percentage of area of windows and doors ,'),3 A. Over 16% Only 1. Uo value of grossarea of walls , roof/ceiling and floors . exposed to ambient conditions 2 . Floor over heated spaces YES a. Are foundation walls insulated - YES ,MW 1. If YES , what is the R value? 3. Slab on grade YES O' a. If YES, what is the R value of insulation around perimeter of floor? 4. Is basement heated? YES a. R value of insulation '5. Type of insulation B. Under 16% Only 1. R value of roof and floors exposed to ambient conditions40 2 . R value of exterior walls — I ci a,1( 6. , 3 . R value of glazed area If9 ), 4. R value of doors g) 5. R value of floors over unheated spaces CY 6. R value of slab edge insulation - unheated slab 7. R value of slab insulation - heated slab 8. R value of heated basement/cellar walls (above grade) 9 . R value of heated basement/cellar walls (below grade) 10. Type o'f insulation F ebo,44.41.41 ,Z ` C1 g Q C. Controls 1 . Thermostat maximum heat setting 75� D. Duct Systems 1. Is duct system installed in unheated spaces? YES CIEO a. If YES , R value Of 4uct irIsta11 ation b. R value of dugt in other areas F. piping InEiulation 1. Size of hot water or cooling carrying agent pipe 2 . R value of pipe insulation F. Service Water Heating 1 . Performance efficiency 2. Temperature control setting maximum G. For Swimming Pool Only 1. Maximum heating Telephone No. 7177-- 7N(1 (applica ' s signature) `Down' of Qugen3tury APPLICATION FOR SEPTIC DISPOSAL PERMIT ' BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 , Oueensbury, New York 12801 • DATE /0 / 4,6 . LOCATION OF PROPERTY ROR INSTALLATION T3RO BJ,,K vies c, bicSc- ittiA1 OWNER' S NAME LiA.5Ketuce x . , h 44(e_s01-,/ ADDRESS , gG ct—r aci P f / .. Nu- cbs`64,� inc., TEL 79 '-( .)— INSTALLER' S NAME �� I R4 y r S k i C _ U e TEL '7. ,,a-�G`•(g cri Number of bedrooms (residential only); 3 Total daily flow (compute @ 150 gal per bedroom). 4( D, Topography: la Rolling - Steep slope - (circle one) % of slope !" (.83 Soil nature Loam - Clay - Other Depth ft. Ground water r-At what depth? ft. 1)- -L. . Ita -f' . Bed-rock or impervious material - At what depth? ft. Percolation test - Not required - Required - -Rate 'min-inch. Domestic water supply - Municipal • Well - Other 41.4r6AA.Lea Separation - Watersupply(if well) from Sept'ic. absorption ft. Proposed System: Septic tank toe-, .; gal. ( Minimun size, 1000 gal.') Tile Field - Each trench ft. Total system legnth ft. Seepage pit(s) Number of . Size each • ft X 8 ft Size of stone to be used # Ir Depth or thickness ' ft. . IMPORTANT ! '. ' On a separate piece of paper, submit a diagram of the proposed system with all dimensions shown; including distance from any structure , distance from property 10ines and from ANY DOMESTIC WATER SUPPLY or shore-line of lake, stream,pond or wet-lands. Include all dimensions of the system, itself . * * * * * * * * * * *. * * * * * * * * * * * *. * * * .* *_ * * * * * * * * * I have read the regulations on the reverse side of this sheet and agree to abide by these and aZZ requirements of The Town of Queensbury Sanitary Sewage Disposal Ordinance. Signature, of responsible person ' ) ' ' Date 02 05/86 and/vl Section II Septic System Inspections: • A. All applicationg, for septid 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. BUILDING DEPT.COPY OF APPLICATION FORM 46-EL,NEW YORK BOARD OF FIRE UNDERWRITERS. FILE THIS COPY WITH BUILDING DEPT.WHEN REQUIRED. (TEMP.# IDATE/ ,!. , , r(e f f !1/(./. CITY OR /--�� (_-l_ if- -- i- /1 { 1 VILLAGE i \)(J J?„1 ,/li!/7 f,�P-',�.,/I�.,... T. f TOWNSHIP -I-JI 11...P_--r-.•�:-{/i-,r-t • COUNTY (� ( �11 _�z STREET AND NO.OR V ROAD AND POLE NO. ':f 3&) J:4 !} , ,I :;- //i/A_.vA POLE NO. BETWEEN WHAT TWO •. CROSS STREETS IS } (� PREMISES LOCATED? . .-,..--,..&" ''= f'.- --='i-+.-.f i(-+ ---:.-.. SECTION /j BLOCK 02- LOT � OCCUPANT'S .� 1 i/ BUILDING '� i NAME I_(..e..v`--?�=-f...�_.� q V./ )- ._JJJ. . ,., OCCUPANCY i if(i__ I/--!—"""-'-11.1)1 -- OWNER'S NAME <' J' ) AND ADDRESS -:•.';rs, S0_ ;�(..n '-l'>-?/--1- '-,..a_.-1j _.U .)/ 7.r� f,-- ., 7T TEL.# 2 tl .7 .. `•^•/ -7 .Z::, CURRENT I- r9 SUPPLIED BY F_!1_ A'iA I: FROM THEIR OFFICE BUILDING WORK DEFECTS IS NEW�''''1111 /t OLD El IS NEW El ADDITIONAL ID REMOVED ❑ LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED NUMBER OF OUTLETS LampfReceptacles MOTORS HEATERS BRANCH CIRCUITS OFFICE USE Loca- ONLY tion Side Attach't H.P. Watts A.W.G. Ceiling Wall Recep'Is Switch Pendant Bracket No. Type Eaeh No. Each No. Gauge INSPECTION Out- side Sub- base • Base- ment d�' 1st Fl. - 2nd Fl. 3rd Fl. REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: DO NOT USE THIS SPACE. r 0 t.l�.��, _ iu , ;'ra 0o-I (,,.t-ram. ` 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 •_ } ELECTRIC SIGN TOTAL MAINS o �� . I,n.-,�:i0 FEEDERS LAMPS WATTS CHARACTER ,t ^� t /7 ! I EXPOSED GAS TUBE SIGN OF WORK y{•;j!'f!: 4 "i-'Lt?i i 16..A.._4 7,0 CONCEALED TRANSFORMERS OF VA WORK TO BE ii )_ (NUMBER) (CAPACITY) STARTED r) , /0 COMPLETED i/) ),,-/ SIZE OF SIGN SERVICE OVERHEAD UNDERGROUND MAKER ENTERS BUILDING OF SIGN INSPECTION REQUESTED ON OR AS NEAR AS n POSSIBLE NEW l l OLD AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES DATE OF - MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. APPLICATION "- --- :j ' PRINT NAME AND ADDRESS NAME OF 1,. -- -7 n( s 7 i SIGNATURE f. r j� APPLICANT t i 6'3: :? >'Ijicr -. '- l r'- % XOFAPPLICANT F _ . f'1 ':-'-:'. - / t,.J,J ,-> F STREET ADDRESS TELEPHONE# CITY OR ZIP LICENSE NO. POST OFFICE CODE WHEN APPLICABLE 46 EL (REV. 1/86) - A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING cA'11) Jown of Queenurty 161 , BUILDING and ZONING DEPARTMENT . 0 Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 a/Pr . e1, BUILDING INSPECTOR' S REPORT i NAME �cza, %7e �/d 21 ' LOCATION gp_ /z7 ,��,� /`F r✓ • Date �,// / /7 Permit No: �L, -,V 6 * * * * * * * * * * * * * * * * * * * * .* * * ✓ = APPROVED - YES / NO Footing/Pier Forms _ Foundation Waterproofing Backfill ' Framing Roofing Siding Masonry Venee ' • Rough Plumbing Relief Valves Rs Ext. Porches s'4 Finished Floors Interior Trim K Stairs & Railings X Cellar Drain Tile Concrete Floors Plbg. Fixtures x Gar. Fireproofing ;/ r{ Door Closers /VfA Smoke Detectors Chimney , INSULATION: Foundation R Floors ' • , Walls Ceiling ' FINAL ELECTRICA INSPECTION ' DRIVEWAY APPROV , )(-\ XFinal Building urvey • Next scheduled pLnspection (call when reac'y) Remarks- if cp) ._.,,,,,,,,„ . fi j°,'"-i--------- (9 iccy 71 7,'&01 (.7-%AC/ Building Inspector 6/86 and-vl ✓� w flown of Queeniur, BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME (iLLI ) LOCATION K. W r R Date 7 6 / O 7 Permit No. * * * * * * * * * * * * * * * * * * * * * * * ✓ = APPROVED - YES / NO Footing/Pier Forms Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext. Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg. Fixtures Gar. Fireproofing Door Closers Smoke Detectors Chimney INSULATION: Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection (call when ready) Remarks- Building Inspector 6/86 and-vl _Jocuii of Q een.i urcy BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME ,(7-74.�t LOCATION [34..,ely.S2., :).,.._ DATE / S7PERMIT NO. gc - y p SOIL TYPE Sand Loam - Clay - Percolation st Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM: Absorption field, total length Length of each trench Depth of trenches Size of gravel SEEPAGE PITS{Nuinber of) Size- ft. X ft. Gravel size PIPING: Siz\ Typ Bldg. to tank Tank to dist. box Dist. box to field it Openings sealed? YES NO tial LOCATION/SEPARATIONS: Foundation to tank t. Foundation to absorption ft. Absorption to lot line ft. Separation of pits ft. LOCATION OF SYSTEM ON PROPERTY(circle one) Front - Rear - Left side - Right side - COMMENTSlerc :/6 .,, ),,,..1._—, ..... 1/7 SYSTEM USE APPROVED YE NO C� Building Inspector 01/86 and vl if) sown of QuQeniur y tiIgl iici �►� BUILDING and ZONING DEPARTMENT '�- Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME L.., r ,.0 I,-2,.. Q — A /ci. 5 0li LOCATION Cc'1-. W e>7• /Yl .1-- V- r. A--‘14,A k , DATE di" / k 7 PERMIT NO. Ri_ Y V SOIL TYPE - Sand - Loam - Clay - Percolation Test Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM: Absorption field, total length (° 0 Length of each trench026 CAI '; @ SO Depth of trenches ' 2 ` Size of gravelYT SEEPAGE PITS{Number of) Size- ft. X _ ft. Gravel size PIPING: S.ze Type Bldg. to tank Tank to dist. box Dist. box to field/pi _� Openings sealed? Y S Partial LOCATION/SEPARATIONS: Foundation to tank /)_ ft. Foundation to absorption .v) ft. Absorption to lot line /0 ft Separation of pits ft. LOCATIONC7) SYSTEM ON PROPERTY(circle one) Front - Left side - Right side - COMMENTS: D' Q U ..0-,...,p44,_e- 1--,,.„„ 1,-,-,4-e_ x„. ,4/„1 ,,-x4,„-,-- pcJeo SYSTEM USE APPROVED YES NO Building Inspector 01/86 and vl flown of Queeniar, BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME ` - V�� LOLk5671 LOCATION Nt _-t =, _0 .L, A & c[( Date q(2-1' /I-7- Permit No. �* * * * * * * * * * * * * * * * * * * * * * * elovED / NO ing/Pier Forms G Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext. Porches Finished Floors Interior Trim '. Stairs & Railings Cellar Drain Tile Concrete Floors • , Plbg. Fixtures j \ Gar. Fireproofing 1 \ Door Closers Smoke Detectors �. Chimney INSULATION: Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection (call when ready) Remarks- 754--aP11"-a-'-jb - O. l2 (,‘7r/43 Building Inspector 6/86 and-vl Call'- c-e 3/3cc/r? C/h?-114 Jown of Queenihur1 BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME / uw�P�,C2 w ear mr. - /9)-oh/5 LOCATION z_Jr /o ‘ei r, p�^k Date 3/3 /k7 Permit No. h * * * * * * * * * * * * * * * * * * * * * * * APPROVED - YES / NO Footing/Pier Forms Foundation Waterproofing )C Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing `f) Relief Valves Ext. Porches Finished Floors Interior Trim Stairs & Railings ' Cellar Drain Tile Concrete Floors Plbg. Fixtures Gar. Fireproofing Door Closers Smoke Detectors Chimney INSULATION: Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION Final Building Survey Next scheduled Inspection(call when ready) Remarks- C(//Ritt, 19 o- jr',(, ©/C I v, ,-rWo.,rl PEA(Il q",44,p —6. Buil ing Insp ct 6/86 and-vl _/own of Queeniur1 BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME /A1,2-9 at/ LOCATION Jn F0,Jhe) Q ti ,I At- G�19 Date -/h.-G/ �7 Permit No.S6- 44 * * * * * * * * * * * * * * * * * * * * * * * ✓ = APPROVED - YES / NO Footing/Pier Forms Foundation Waterproofing / yBackfill t/ Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext. Porches Finished Floors ‘ ,- Interior Trim \ Stairs & Railings \ Cellar Drain Tile '' Concrete Floors / \ Plbg. Fixtures / Gar. Fireproofing ,/ \ Door Closers Smoke Detectors Chimney INSULATION: Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey r Next scheduled inspection (call when ready) Remar s- /V Arr-w6 (oit t-r6 t 'Leo fi ic wilding / nsp ctor 6/86 and-vl 1!0-0-'470(-7_own of Queeni /ur, BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR' S REPORT NAME LOCATION 5z..tra Date 2/28 / s 1 Permit No. (J( - c1 LI L * * * * * * * * * * * * * * * * * * * * * * * / ✓ = APPROVED - YS / NO V Footing/Pier Forms C), Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves • Ext. Porches Finished Floors Interior Trim Stairs & Railings \ Cellar Drain Tile Concrete Floors Plbg. Fixtures \ / Gar. Fireproofing $<� Door Closers %�,- Smoke Detectors / Chimney INSULATION: Foundation // Floors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection (call when ready) Remarks- Z/./4/i/5 Building Inspector 6/86 and-vl cift GEORGE KURDSAKA JR. ll CONSULTING ENGINEER 13 ARBUTUS DRIVE QUEENSBURY, N.Y. 12801 PHONE 51B 792-1522 BUILDING INSPECTOR Town of Queensbury re: Factory Manufactured Home Town Hall _ Installation Certification. Queensbury, New York 12801 Attention: Mack Dean Dear sir, This is to certify that I have observed and inspected the installation of a "Factory Manufactured Home"; as defined by the New York State Uniform Fire Prevention and Building Code, Chapter D - MANUFACTURED HOUSING, Article 2 - FACTORY MANUFACTURED HC4ES, as applicable to your local building regulations; there appeared to be no apparent structural damage to the units, due to or attributable to the transportation or loading/unloading of the units, herein- , after described as follows: Ra v, Z-R• Date of Installation: /°lam-�L.c- ,/ 6, Site Location: S g4-040(Jgr/Z Community: Town of Queensbury � � 9��� County: Warren Manufacturer/Supplier: /044j11 aDg A9dJ«,®,goer- Address: ,g o,44154 - 3 3 - • Insignia Serial No. z-3 Z-0/ Plan Approval No. I / 6 Manufacturer"s Model/Component No.: Date of Manufacture: /2-/ /O42 C' �+ Installer/Supplier: CLi723• 1 a .S74g-5 /�7J I have also examined the approved Plans & Specifications for the abovementioned "Factory Manufactured Home", and to the best of my knowledge and belief, this "Home" has been installed in accordance with these approved Plans & Specifications, and all other applicable laws codes, ordinances,standards &/or regulations. ,`� uAo�� Res c, tfull s mit ed; c^ o(t -33 1. 1 GEORGE KUROSAKA A., P.E. zs � NYS PE Lic. No. 35869 cc: FOA O.35869 Fad .Op£r$1oNP"