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2009-182 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20090182 Application Number. A20090182 Tax Map No: 523400-304-013-0001-008-000-0000 Permission is hereby granted to: ALVERTA SAWYER ESTATE For property located at: 1 I KATHERINE Ave in the Town of Queensbury,to construct or place at the above location in accordance with application together with plot plans and other information hereto filed and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning Ordinance. Tyne of Construction Value Owner Address: ALVERTA SAWYER ESTATE C/O RICHARD SAWYER Mobile Home Out of Park $40,000.00 11 KATHERINE St Total value $40,000.00 QUEENSBURY, NY 12804-0000 Contractor or Builder's Name/Address Electrical Inspection Agency Plans &Specifications 2009-182 William Whipple 1280 SQ FT MOBILE HOME $76.80 PERMIT FEE PAID- THIS PERMIT EXPIRES: Tuesday, December 14, 2010 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the Town of Queensbury; Monday, December 14,2009 SIGNED B for the Town of Queensbury. '"�&ctor of LilE & e Enforcement p AE-C-E-Irv'E APPLICATION FOR PLACING A MOBILE HOME EOF OUTSIDE OF A MOBILE HOME CO URT: , This application for a Mobile Home Permit shall be accompanied by a plot plan SOWN QUE2009ENSBU,RY drawn reasonably to scale showing all dimensions,the size of the lot, the location r`"gJ:l LNNG&Et3DES the lot of the Mobile Home, the water supply and sewage system. If the applicant is not the owner of the premises,then the application must be accompanied by the written acknowledged consent of the owner. Applicant Information Property Owner Information Name: Za) 164LM (jk OQQ 'e. Name: 14 e.4-1c.. sacjver Address: 900 C7eC„j Qd Address: 1(4Ae.r•Ne -)f /--'l<s W e-e-^1,S N t 28v1-( Phone No: Jr t 8- 7116-o c)6 / Phone No: 5/8 7 y 7 - `i 5 yS Parcel Information Property Location: Tax Map Number: Road,Street,Avenue T w� �4�C Mobile Home Information Approximate Value of Home: $ 7� ®vim. New Home: Ye No Replacement Home: Yes No Size of Mobile Home: 16 ft. by 80 ft. Singlewide: x Doublewide: Year: 100'�'( Make: 7',d A Model: Serial # r ssj'o eN�: do�fs J �►dc��s �..� l d nrr State fully the reasons for this request: Mobile. (10.kE c3'-j P.,%0r s <<v t e-e- o- t 'adlsJe.. r %1a ei�' 4)e 6t',e 6,j e�-�i•kC.�cs �14� h�ci� Ci(/�-caSt e-XC-eec��c� 1��ie cds� C cs &A e- of n Ce Ijet.4e / e e cJ�. Q�e.• v eNet'ji0a, 4 k gpp�,St/. ApprfcanCs Signa re Date Town of Queensbury■ Community Development Office ■ 742 Bay Roan, Queensburtl, IVY 12804 r AFFIDAVIT 5 ; Town of Queensbury State of New York County of Warren ; S 1 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 o ot, and that such work is authorized by the ow Signature: 5 Owner, Owner s Agent,A chit ontractor Date 1 .J.J.J.J.J.J.J.J.J.J.J.J.J.J✓.J.Jw.J.J.J.J.J.J.J.J.J.J.J.J.J.J.J.J.J.J.J.J.J.J.J.J.J.J.J.J.J.J.J.J.J.J.J.J.J.J.J.J.J.J✓.J.J.i FOR TOWN USE ONLY Report of the investigation of a Zoning Administrator and recommendations: APPROVED: DISAPPROVED: OTHER RECOMMENDATIONS: ACTION OF THE TOWN BOARD: APPROVED: DISAPPROVED: OTHER RECOMMENDATIONS: By Resolution Number: of the Town Board of the Town of Queensbury, Warren County, New York. Dated this day of , 20 Town Clerk, Town of Queensbury QToaut of Queensbury• Community Development Office - 742 Bay Road, Queensbury, NY 12804 Community Development Office Town of Queensbury • 742 Bay Road • Queensbury, New York-12804 Marilyn Ryba,Executive Director•David Hatin,Director of Building&Codes Craig Brown,Zoning Administrator PROCEDURE FOR PLACING AND OCCUPYING A MOBILE HOME OR MODULAR HOME: 1. Application is submitted and reviewed. a. Two(2) copies of plot plan and two (2)copies Of layout must accompany application, along with septic application (if needed). 2. Permit is issued. a. Permit card is placed on property. 3. Footing forms are inspected before pouring concrete (Outside mobile home park). a. Home is placed on foundation or piers. 4. Arrange for electrical inspection (see Electrical Inspectors on reverse) 5. Septic Inspection if needed. 6. Final Electrical Inspection. 7. Stairs and platform covering door width and door swing with handrails on both sides of platform and stairs are required for all exterior doors. 8. Final Inspection by Building & Codes Department. 9. All mobile/manufactured housing must be anchored to the ground upon which they are sited per manufacture requirements. 10.If anchoring is not possible due to weather conditions or any other item, a Temporary Certificate of Occupancy will be issued. a. Fee: $10.00 b. Deposit: $100 (refunded when all items are complete) QUESTIONS? CALL 761-8256 OR EMAIL codesCc�Queensburr.net VISIT OUR WEBSITE FOR MORE INFORMATION www.Quensburv.net Community Development Office V999own of Queensbury- 742 Bay Road- Queensbury, New York 12804 Marilyn Ryba,Executive Director-David Hatin,Director of Building&Codes Craig Brown,Zoning Administrator Electrical Inspectors THE FOLLOWING ELECTRICAL INSPECTION AGENCIES ARE CERTIFIED BY THE TOWN OF QUEENSBURY TO PERFORM ELECTRICAL INSPECTIONS: NAME 8 ADDRESS OF BUSINESS INSPECTOR CONTACT NUMBER(S) Commonwealth Electrical Inspection Services Donald Loveland Main Office: 1-800-732-0043 357 Elwyn Terrace Ron Mumblo Local Office:1-800-562-9934 Manheim, PA 17545 Ron: 518-798-0905 Middle Department Main Office: 1-800-873-6432 143 Troy Schenectady Road Joseph Holmes Local Office: 1-800-479-4504 Watervliet, NY 12189 Joe: 518-273-0861 The Inspector, LLC Main Office: 1-800-487.-0535 4755 McConchie Rd. Richard Moon Local Office: (518)882-6140 Galway, NY 12074 Richard:518-857-6233 New York Board of Fire Underwriters 40 Fulton Street-6*Street Walter Sonntag Local Office:{518)463-2122 New York, New York 12210 PLEASE NOTE: WE CANNOT RECOMMEND AN INSPECTOR, HOWEVER,PLEASE ASK YOUR CONTRACTOR WHO HE PREFERS TO INSPECT HIS WORK. t TOWN OF QUEENSBURY 742 Bay Road, Queensbury, NY 12804-5902 518-761-8201 AFFIDAVIT TOWN OF QUEENSBURY STATE OF NEW YORK COUNTY OF WARREN I swear that the following sW mobile home that will be transported into the Town of Queensbury for placement will have the following. A building permit approved and issued, meet all zoning requirements, the mobile home's HUD sticker affixed to mobile home and meet HUD requirements for the Middle Zone. As the person responsible for the transport and placement of this mobile home, I accept total responsibility for removal of the mobile home from The Town of Queensbury, if it does not meet the requirements for placement. Signature: Dater o ile Home Ow wner's Agent, Mobile Home Contractor Signature: Date: Town of Queensbury Code Enforcement Officer "HOME OF NATURAL BEAUTY . . . A GOOD PLACE TO LIVE" SETTLED 1763 r r r r r r r r r r r r r r r r r r r r r , f OFFICE USE ONLY PERMIT NO, DATE ISSUED: TAX MAP NO. _____ -- TOWN CLERK_ PERMIT FEE _.____ APPROVALS: ZONING , + r--.rrrrr , -.rrrr" irrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrt MOBILE HOME — APPLICATION of�FOR PERMIobile home on T:l. No inspections will be made until a A building permit must be obtained before placement valid building permit has been issued. A lieant In oryhation Property Owner Information �(e C Name: Cff 14�. ��� � ,•��. d Name: L Address: Address: �15 c)� ,� / Phone No. �� Phone No. 5`68 79 Parcel Information J Proposed Date of Placement: L) 12,ec Property Location: �l Roacl,Street,Avenue dv �3 �Z Map Number: 10ly f (f appiicadle) Tax (" Name of Mobile Home Park: !� ............................... . ......... ...........................................—._... .................. Mobile Home Infoation Zoning Information rm $ Zoning Classification: Approximate Value of Home: .J�, � �%� New Home:J9 Yes ❑No Size of Property: '�� ft. by ray ft. I Replacement Home: SYes ❑No Existing buildings: Setbacks: front yard /5 S ft. rear yard ft. Size of Mobile Home: /b ft. by %� ft• side yards iN. ft. and !O ft. Singlewide: �_ Doublewide: Number of Rooms: (exclude baths) el Accessory Building(s): Number of Bedrooms: ADetached garage:❑1-car ❑2-car ❑ car Number of Bathrooms: _ ❑Gas Fireplace❑Woodstove ❑Wood Fireplace Attached garage: Ell-car ❑2-car ❑ car Foundation Support: Storage building: ®Yes ❑No Type Size & De th Other: Piers Water Supply: ❑Well Municipal Runners �X� .v x d y Is Septic Permit Required? []Yes �No E�6� :....................................................................................................................................................................................................... ............................................................ Continued on page 2 Toum of Queensbury • Comrnaanity Development Office • 742 Bay Road, Queensomy, i.v.r J-16U Name of Installer or Mobile Home Dealer. ! 7e ._ t` , 1 or �l. Phone: Address: /1 4 5 lete information below found on a"Plate"or"Sticker"which is affixed to the 11 mobile home: Comp ✓ Insignia serial number: ✓ Name of manufacturer: ✓ Plan Approval Number: v ( �cy0-� — ✓ Model or Component Designation: � e,v hone only) ✓ Date of Manufacture_ _ _ _ ___________________________________________________________________________________________________ _ AFFIDAVIT State of New York Town of Queensbury County of Warren knowledge and belief the I swear that to the best of mY ether with the plans '• statements contained in this application, tog tions submitted, are a true and complete statement and specifications remises and of all proposed work to be done on the Od E the ZONING that all provisions of the BUILDING C to the proposed work ORDINANCE, and all other laws pertaining an such lied with, whether specified or not, shall be comp - - work is authorized by the owner. .: Signature:,Owner,Owner's Agent, Archi ct,Contractor SPECIAL CONDITIONS OF PERMIT By Code Enforcement Officer Queens bury • C:orn1nttnity DevelopmentO��ce ■ 74? Pelt Road, Qi�eensfanry, NY 12�0� T It� RESOLUTION AUTHORIZING REVOCABLE PERMIT TO LOCATE A MOBILE HOME OUTSIDE OF MOBILE HOME COURT FOR WILLIAM WHIPPLE RESOLUTION NO.: 208,2009 INTRODUCED BY: Mr.Tim Brewer WHO MOVED ITS ADOPTION SECONDED BY: Mr.Ronald Montesi WHEREAS, in accordance with Queensbury Town Code §113-12, the Queensbury Town Board is authorized to issue permits for mobile homes to be located outside of mobile home courts under certain circumstances, and WHEREAS, William Whipple filed a Town of Queensbury "Application for Placing a Mobile Home Outside of a Mobile Home Court" to replace his mobile home with a new, 2009 mobile home on his property located at 11 Katherine Street in the Town of Queensbury, and WHEREAS, the Town Board held a public hearing concerning this application on Monday, June 15ffi,2009 and heard all interested persons, NOW,THEREFORE,BE IT RESOLVED, that the Queensbury Town Board hereby authorizes the issuance of a revocable permit to William Whipple in accordance with the terms and provisions of Queensbury Town Code §113-12. Duly adopted this 15'b day of June, 2009,by the following vote: AYES : Mr. Strough,Mr. Brewer,Mr. Stec,Mr. Metivier,Mr. Montesi L 0 Queensbury Building & Code Enforcement— Manufactured / Modu r al Inspection Office No. (518)761-8256 Arrive: o a rt m a Pm Date Inspection request received: Inspector's Initials: q NAME: �. t�1��t-C_ PERMIT 1`rZ LOCATION: DATE: Manufactured Home Modular Home Footings_ Foundation_ Backfill_ Framing— Comments: Yes No M/A Foundation support,pier spacing, Per manufacturer Anchoring per manufacturer 2'from ends Water fine shut off Sewer line support @ 4 feet Heating Crossover[doublewide)off grd. Dryer vented outside Skirting ventilated 1 sq.ft.aer 1,500 sq.ft. Hot water relief valve piping outside Deck,porches,steps,railing Fumace/hot water operating Garage Fire proofing Fire Door/Door closers Plumbing Fixture/3'Vent through roof[Modular] Foundation insulation[f applicable] Smoke/Carbon Monoxide Detectors/Interceded Final Electrical Variance required Data Plate okay Manufactured HUD seal okay Warranty Seal after January 1,2006 Installers Warranty Seal 18'x 24'access or 22'x 30'attic access Vapor retarder under home 6 mil poly or other 911 Street number C Okay to issue C/C or CIO Model# Serial# Manufacturer Date of Manufacturer 1:1Pam Whiting\2010\Building Codes FormsWanufactured Modular Final Inspection_03 0410.doc i Ask for Minute Man Anchors (( Made In the U.S.A. Since 1965 Minute Man Lateral Anchors: Accessories: Longitudinal Bracing E-Z Drive Machines&Adapters System(LLB):Approved Difficult Soil Metal Piers -4 NuConcept Soil Probes Awning and tested for Wand Zones A . 1 Awning 1,If&III,on dirt or concrete EYE s. SHOWN HERE: `` t` Minute Man LLBS(U.S.Patent No.6622439)with It's uniyue ..« ,,.. Flat Pan design-eliminates 1 digging and pounding the pan into the earth #w 305 West King Street I���• Af" Anchors, East Flat Rock, NC 28726 1-800-438-7277 We keep things down to earth... www.minutemanproducts.com J. INSTALL NO. 13861 STATE OF NEW YORK DEPARTMENT OF STATE ONE COMMERCE PLAZA 99 WASHINGTON AVENUE ALBANY,NY 12231 INSTALLER'S WARRANTY SEAL THIS SEAL REMAINS THE PROPERTY OF THE DEPARTMENT OF STATE . NEW MANUFACTURED(HUD CODE) ❑ RELOCATED MANUFACTURED(HUD CODE) A. Manufacturer's name:&ham—j1Q __ B. HUD label number: D —/ N 7 7 6 Serial number: �L�(! .� C. Retailer's name: 1 (r� ,/� D. Retailer's address:, 1..�1�__Z ►'C�' ___ __ �UR� WNY 2"S 2 y E. Retailer's certificaXvCf #: � �� 1 cT � �� Telephone#: �J 7 5— 12-� - -- -- F. Installer's name: v&' O,\ G. Installer's address: 151 Z /Zf q C l 6%wA,-A_ A4Y /2A e a H. Installer's certification#: I / N 7—V b Z I ________Telephone#: Y)744 /2 I. Date installed: 4-7- l(2 Municipality issuing building permit: KQ Uh City, Town, Villa e) J. Customer name and physical address (911)where home is installed: fiq/�y r� 4n�*G It ZAP" Nt �^ r NY -_12 i0 -- ,New York. By attaching this SEAL to this manufactured home,the undersigned Installer of this manufactured home warrants as follows: 1. That the installation of this manufactured home meets the standards of the New York State Uniform Fire Prevention and Building Code. 2. That the Installer is certified as an installer by the New York State Department of State. The foregoing warranties are in addition to and not in derogation of all other rights and privileges which the consumer may have under any other law or instrument.The foregoing warranties are in addition to,and not in limitation of or substitution for,any and all other warran- ties,express or implied,given or made b the Install r,w ether contractually or by operation of law. Printed Name of Person Signing Seal: �� Signature of Installer or f Limited Installer: . If you have a problem with your home,you should first contact your installer or retailer.If the problem is not resolved by the Installer or Retailer you can contact the Department of State at(518)474-4073. DOS-1680(Rev.03/09) Yellow Copy—Department of State White Copy—Retain for Your Records Goldenrod Copy—Permitting Agency Seal—Affix to Home ILI --4 /90il- ISQueensbury Building & Code Enforcement— Manufactured odular Final Inspection ��jj�;� 4 Office No. (518)761-8256 Artiv a �rt 1 a Date Inspection request received: Insi s Initials: f� NAME: PERMIT# fJ LOCATION: I / _ / t to DATE: `/G.(� :A2 Manufactured Home Modular Home Footings— Foundation— Backfill— Framing Comments: Yes Ido WA Foundation support,pier spacing, Per manufacturer Anchoring per manufacturer 2'from ends �� Water fine shut off tA Sewer line support @ 4 feet Heating Crossover[doublewide)off grd. Dryer vented outside Skirting ventilated 1 sa.ft.per 1,500 sa.ft. Hot water relief valve piping outside Deck,porches,steps,railing Fumace/hot water operating Garage Fire proofing ��--- Fire Door/Door closers �-- Plumbing Fixture/3"Vent through roof[Modular] Foundation insulation[if applicable] Smoke/Carbon Monoxide Detectors/Interconnected Final Electrical Variance required LZ Data Plate okay Manufactured HUD seal okay Warranty Seal after January 1,2006 installers Warranty Seal 18"x 24"access or 22'x 3W attic access Vapor retarder under home 6 mil poly or other LA L4 3l 911 Street number 011 Okay to issue C/C or C/O[temp./Perm.] Model# Serial# Manufacturer Date of Manufacturer L:1Pam Whiting1201018uik ing Codes FormsWlanufactured Modular Fural Inspedwn_03 0410.doc FINAL INSPECTION REPORT MOBILE / MOOULAR � � Town of Queensbury ,� Building &Code Enforcement - �• 742 Bay Road Queensbury, NY 12804 (518) 761-8256 Q4 {Vt6a `( ARRIVE:.jbDEPART: NS Gat3 :' ,:'` ;•'` DATE INSPECTION REQUEST RECEIV NAME: 1� Soea sty�s ire LOCATION: gas 0 oa`Qsee DATE: '� Z��i " PERMIT# �. ark s ae`� -'N MOBILE HOME MODULAR HOME 4,ea`e' oo e�otr4`��s a` / rs gas ap FOOTINGS FOUNDATION ✓ BACKFILL_ FRAMING _ ; q Q N/A , YES NO ,oS4���t`°� 1. foundation support, pier spacing res�orti per manuf 2. anchoring per manuf. 1-W. _ 'G,"oIL 3, water line shut off ................... _ 4. sewer line support Q 4 feet ....... _ 5. heating crossover (dblewide) off grd. 6. dryer vented outside ...:......h 7. skirting ventilated :T C..co _ — 8. hot water relief valve piping outside 9. deck, porches, steps, railing ........ 10. furnace/hot water operating ........ I f. garage fire proofing .................. 12. door closers ........................... _ — 13. plumbing fixture ...................... 14. foundation insulation (if appl.)...... 15. smoke detectors ....................... �— 16. final electrical ................ .... 17. variance required :���Y.. — 18. data plate okay ....................... 19. mobile HUD seal okay .............. r- Model # Serial # J L-jqptjq (� Manufacturer C•. -)tA 7� . Date of Manufacturer J /' OKAY TO ISSUE C/ ES NO 11 o o 0 v �� Comments:jit�Ey—:X) -M kya)-Smu— ID 1JC-�Q TO E4Z\�•� �� 1 a t� ►3 E�� Tp MDOE Mc�Qi\�.Sc. No 'r'c'� � � l P F'1©C3 LF— Rky—3DRcK�6 i U31LE VAOME v►Fn�TE 4� \Pcit -'j _� o 5• y� ��f Va`�e� � �j j 40 low 1 t 'scams' / 1�, a�Gcs 'ice -ate(� 12•J�,�pbu`� �`'� 5 SOP �A L �,6yy l`1 .0 Q�'&sue' e I J /�� FINAL INSPE N RE RT MOBILE / M00UI To" of Quemwfy BWkNrQ &Gm% Enforcement 742 flay Road Quomtsix". NY 12804 (518) 761-8256 ARRIVE-Z:qDDEPART: 3:,CW)bINS DATE INSPECTION REQUEST RECEII r--- NAME: X LOCATION: I 1-v VC p- DATE: PERMIT 4NZ 1 MOBILE HOUR MODULAR HOME FOOTH40S FOUNDATION BACKFILL FRAMING N/A YES NO L foundation support, pier spacing per manuf. ........................ 2. anchoring per manUf ............... 3. water line Sind off ................... 4. sewer line support a 4 feet ....... S. heating crossover(dblewide) off grd. 6. dryer vented outside ..-c................... 7. skirting ventdaW .................... 8. hot water relief valve piping outside 9. deck, porches, steps, railing ........ 10. furnacelhot water operating ........ 11. garage fire proofing .................. t2. door closers ........................... 13. plumbing fixture ...................... 14. foundation insulation (if appl.)...... 15. smoke detectors ....................... 16. final electrical ........................ 17. variance required ..................... 18. data plate okay ....................... 119. mobile HUD seal okay .............. Model# Serial# Manufacturer Date of Manufacturer OKAY TO ISSUE CIO YES NO Comments: i Septic Inspection Report Office No. (518) 761-8256 Date In coon r st eiv Queensbury Building &Code Enforcement Arrive: p epart: Y Zh am m 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: /p NAME: 5 -'q S PERMIT NO.: cl ! 4 LOCATION: v MSPECT ON: Z RECHECK: Comments and/or diagram Soil Ty oam / Cla Type of Wate • unici Well Water Wate ra ion distance ft. `1c' c->R C- Well separation distance ft• L_ " Other wells: (?:)oY— Well Casing Length 50' + - Y N_N/A Absorrition Field: Total len th ft• Length of each trench ft• Depth of trenches ft. Size of Stone `�� Seepage Pits: Number Size: x 0e e Stone Size: PinBox Size T Building to �' Tank to Distribution Lk 1, Distribution Box to Field T Opening Sealed: Y N 6V End Ca N Inlet/Outlet Pipes&Baffles Y N Location Separations Foundation to tank ft. Foundation to absorption ft. Se ration of Pits ft. Conforms as per Plot Plan _Y_ N Engineer Report and As-Built _Y—N Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear System Use Status: Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Last revised 06/18/07 L:\Building&Codes Forms-OLD\Building&Codes\Inspection Forms\Septic Inspection Report.doc $7 AL INSPECTION 1FiMPcim-r PAGE: 1 MOBILE / MODULAR PER PERMIT Town of Queensbury 97,583 Building &Code Enforcement 742 Bay Road "ION RESP APPR/DENIED Queensbury, NY 12804 PERSON DATE (518) 761-8256 / ---------------------------------------- f D 07/02/1998 1SPECTION JOB ARRIVE. QACCDEPART. ]= MS hung in place for footing ing in footing. DATE INSPECTION REQUEST RECEI IW; NSPECTION JOB D 07/02/1998 NAME: --� ,::_'- u_. �. f _ �-= ort, pier spacing per manuf. LOCATION: S/PIERS JOB A 07/06/1998 DATE: PERMIT PERMIT# M*Bnx now MODUL A soME JOB A 0 7/2 3/19 9 8 FOOT94M_ FOUNDATION BACKFUL FRAMING -- :LECTRICAL COMMONWEA A 07/30/1998 N/A YES NO 1. foundation support, Pier spacing permanuf. ........................ 2. anchoring per 3. water line shut-off � . .. 4. sewer line support 0 4 feet .. 5. heating crossover(dblewide) off grd.. 6. dryer vented outside . ta.. : T• skirting ventilated . vLW A Q. - 8. hot water relief valvp>p _ _ 9. deck, porches, steps, railing .. ..... 19 rnaceJliot water operating ... .... 11 gauge fire Proofing _ — 12. door closers ........................... 13. plumbing fixture ..... .. 14, foundation insulation (if appl.)...... 15. smoke detecirnsf — 16. final electrical ........................ 17. variance required .................. �... 18. data plate.okay ....................... 19. mobile HUD seal okay ............. T � — Model# � �, Serial# Manufacturer Date of Manufacturer OKAY TO ISSUE CIO YES NO Commeats: -L998 PAGE: 1 INSPECTIONS PER PERMIT PERMIT # 97583 i SCHEDULE SEQ. NO INSPECTION DESCRIPTION RESP APPR/DENIED DATE TYPE PERSON DATE --------------------------------------------------------------------------------- 37/02/1998 17 .00 MOBILE FINAL. INSPECTION JOB D 07/02/1998 COMMENTS: Reinforcing must be. hung in place for footing inspection not laying in footing. D7/02/1998 17 .00 MOBILE FINAL INSPECTION JOB D 07/02/1998 COMMENTS: 1. Foundation support, pier spacing per manuf. i runners - NO 6 37/06/1998 1 .00 MOBILE FOOTINGS/PIERS JOB A 07/06/1998 COMMENTS: 2-#4`S 37/23/1998 16.00 MOBILE SEPTIC JOB A 07/23/1998 COMMENTS: D7/30/1998 18.00 MOBILE FINAL ELECTRICAL COMMONWEA A 07/30/1998 COMMENTS: i s c, TOWN OF QUEENSBURY BUILDING b CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name _RtC_ Fl �� J-)A Location _ �� �'�¢)j 6V-p— Date , Permit # SOIL TYP ana oam-Clay- Results of Percolation Test- (if applicable) Rate-Minute/Inch TYPE OF SYSTEM: ABSORPTION FIELD: Total Le h Length of each trench Depth of trences Size of stone SEEPAGE PITS: ber- Size - t. x ft. Stone size PIPING: Size Type Bldg. to T nk Tank to Dom— _� ►f �_ Di Openings Sealed? —Y No Partial LOCATION/SEPARATIONS: Foundation to Tank 1 y feet Foundation to Absorption F A&eet Separation of Pits _ feet Conforms as per Plot Plan No LOCATION OF SYSTEM ON PROPERTY: (circle one) Front - Rear - Left Side - Right Side Middle Front -cMddTe Rear COMMENTS: TA Li CAL SYSTEM USE APPROVED: NO Arriv v. Depa f Buildin ector t� . ,,r•lv c '1 dui � �fK 70 kill n r' JON 2 41998 � U ..I E �'' t1 } II f • •• �• IIIV l�1 tli tl\JI.1�. {. ar`—/ / ^__ Modc1 tensions X ►�~-~'�-- Serial H: 6_ 7