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2009-313
TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number. P20090313 Date Issued: Monday, November 08, 2010 This is to certify that work requested to be done as shown by Permit Number P20090313 has been completed. Location: 60 CONNECTICUT Ave Tax Map Number. 523400-309-009-0003-037-000-0000 Owner. CHRISTOPHER & DONNA MC KINNEY Applicant: CHRISTOPHER& DONNA MC KINNEY This structure may be occupied as a: Mobile Home Out of Park By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the r 1 owner of the responsibility for compliance with Site Plan / property P tY P Variance, or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement Planning Board or Zoning Board of Appeals. TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20090313 Application Number: A20090313 Tax Map No: 523400-309-009-0003-037-000-0000 Permission is hereby granted to: CHRISTOPHER&DONNA MC KINNEY For property located at: 60 CONNECTICUT 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. Type of Construction Value Owner Address: CHRISTOPHER&DONNA MC KI 54 CONNECTICUT Ave Mobile Home Out of Park $50,000.00 QUEENSBURY, NY 12804-0000 Total value $50,000.00 Contractor or Builder's Name /Address Electrical Inspection Agency Plans&Specifications 2009-313 1456 SQ FT MOBILE HOME $90.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday, September 25, 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 Quee bury Fri li, ptember 25, 2009 SIGNED BY `'`eT r V for the Town of Queensbury. Director of Building&Code Enforcement l _ -36 4�7 Ine � !APPLICATION FOR PLACING A MOBILE HOME OUTSIDE OF A MOBILE HOME COURT: JUL 0 "7 2�0This application for a Mobile Home Permit shall be accompanied by a plot planWN OF QUEEN' BURYdrawn reasonably to scale showing all dimensions,the size of the lot,the location on 'ly0TCDndEr -GGxUESthe lot of the Mobile Home, the water supply and sewage system. If the applicant is owner of the premises, then the application must be accompanied by the written acknowledged consent of the owner. Applicant Information l� Property Owner Information Name: /� 1 PC Name: ney Address: O Address: ` h n < 2ss U Phone No: / / Phone No: S(� � Parcel Information Property Location:ho Z) G n 1 e-C /)CCJ aV? Tax Map Number. Road,Street,Avenue Mobile Home Information Approximate Value of Home: $ Jrd, DOO New Home- ?Z0 No Replacement Home: Yes No Size of Mobile Home: ft. by ft. S� �1 Singlewide: Doublewide: Year: Make: Model: Q/�©(l> Serial # State fully the reasons for this request: 6 /.S D9 cant's Signa to xi= Town of Queerisbuty Community Development Office• 742 Bay Road, Queensbury, NY 12804 AFFIDAVIT 5 5 Town of Queensbury State of New York County of Warren 5 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. 5 Signature: 7 ) Owner, Owner's Agent,Architect, ctor Date .r.r.....�.,...r.r.,.,....�...,.s.r.....r.s.r.r.�.,.....r.s.s.s...�.s.�.�.s.,.,.,.r.r.....s.�.,.,.s.r....r.,.s.s.s....s.s.,...r.,i FOR TOWN USE ONLY Report of the investigation of the 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 1 ozan of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804 - ' .............----------------------------------- UU),y� OFFICE USE ONLY , TAX MAP NO. PERMIT NO. PERMIT FEE APPROVALS: ZONING TOWN CLERK , APPLICATION FOR SEPTIC DISPOSAL SYST N 13UILDIN za g_3/3 A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO RE A VALI PERMIT. / OWNER: 6RiSa DoQAA I'(�(� (� 'N/Ur-!l INSTALLER: ADDRESS: ADDRESS: PHONE NOS. PHONE NOS. Sri S`o? 1 3/ LOCATION OF INSTALLATION: RESIDENCE INFORMATION: YEAR BUILT NO.OF X COMPUTATION= TOTAL DAILY FLOW BEDROOMS GARBAGE GRIND � 1980 or older X 150 gallon per bedroom = INSTALLED? 1981 -1991 X 130 gallon per bedroom = SPA OR HOT TUB_C, 1992-present X 110 gallon per bedr m = 3�jd INSTALLED? ��// PARCEL INFORMATION: ✓ TOPOGRAPHY: Flat rolling b Steep slope %Slope ✓ SOIL NATURE: Sand Loam Clay Other ✓ GROUNDWATER: At what depth? & ✓ BEDROCMMPERVIOUS MATERIAL: At w depth? ✓ DOMESTIC WATER SUPLY: Municipal Well (If well: Water supply from any septic system absorption is ft.) ✓ PERCOLATION TEST: Rate is per minute per inch. (Test to be completed by a licensed professional engineer or architect.) PROPOSED SYSTEM FOR NEW CONSTRUCTION: All individual sewage disposal systems must be designed by a licensed professional,engineer or architect(unless installed in a Planning Board approved subdivision). TANK SIZE: ld Un GALLON (MIN. SIZE IS 1,000 GAL.) Add 250 gallons to the size of the septic tank for each garbage grinder, spa or whirlpool tub. SYSTEM TYPE: ; ABSORPTION FIELD (WITH NO. 2 STONE) Total length/�!� ft. Each trench X ❑ SEEPAGE PIT(S) (WITH NO. 3 STONE) How many? Size? ❑ ALTERNATIVE SYSTEM Bed or other type? ❑ HOLDING TANK SYSTEM Total required capacity? Tank size? Number of tanks? .....,....................:...........................::....:.............:..............:..............s.......................,...:.....,...,.,.,•........,.....,...........,.,.......:....,.........:....:..,................ ..............,.,..,.......... .. ....... ,........................•, '•: NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE R1=vIPXA► i (c,- -- ( o© l� r �(' Queensbury BuilJing & ode Enforcement;— M aCtured / Modular Final Inspection Office No. (518)761-8256 Arrive: a p ram_ r arr�j } Date Inspection req t received. Inspector's Initials: NAME: 1 T PERMIT#: LOCATION: DATE: Manufactured Home Modular Home Footings—. Foundation_ BaGdill, Framing_ Comments: Y No WA 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 so.ft.oer 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 13'Vent through roof[Modular] Foundation insulation[if applicable] Smoke/Carbon Monoxide Detectors/Interconnected 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 Okay to issue C/C or CIO[Temp /Perm.] Model# Serial# Manufacturer Date of Manufacturer L:1Pam Whiting120101Bulding Codes FormsNMmufactured Modular Final Inspection_03 04 10.doc AL INSPECTION REPOT MOBILE / MOOULAR Town of Queensbury Building &Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 76141256 ARRIVE: VJs gEPART: U'0 I DATE INSPECTION/REQUEST RECEIVED: NAME: y^�n P LOCATION: l�� {� UV1 0 (' y ^�� DATE: 1 Z 1 l PERMIT# 0 f ?j 1<1 MOBB.E HOME Ir[ODi7LAR HOME FOOTINGS— FOUNDATION RACKFILL FRAMING N/A . YES NO 1. foundation support, Pier spacing / per manuf. ........................ 2. anchoring per manuf. ............... _ 3. water line shut off ................... _ 4. sewer line support 0 4 feet ....... _S. heating crossover(dblewule) off . _ 6. dryer vented outside ......:'(�t't ...... _ 7. skirting ventilated ..........'1 tA? 8. hot water relief valve piping outside — ✓ —✓ 9. deck, porches, steps, railing ....... - 10. furnace/hot water operating ........ 11. .................. — —_ 12. dQpc�etesurs ........................... — 13. plumbing fixture ...................... _ — — 14. foundation insulation (if appl.). .... — _ — 15. smoke detectors ....................... — 16. final electrical ........................ 17. variance required ..................... — — 18.data plate okay ....................... 19. mobile HUD seal okay .............. — Model # Serial# Manufacturer Date of Manufacturer OKAY TO ISSUE GO YES NO Comments: G CAD1-\PV--1ETE R-k-y-- K KI�-ti 6Kt RTi�6 _ 1�1iTA L1` �F'�Mta tJ E�' �Yi s.c ►c�cQ "'�'I FINAL INSPECTION REPORT MOBILE r / MOOLLMLAR Town of Quee►axxy Building &Code Enforcement 742 Bay Road Queensbury. NY 12804 (518)) 761-8256 ARRIVE:�6 DEPART: 1 DATE INSPECTION REQUEST RECEIV NAME: LOCATION. DATE: PERMIT Ii osuz HOIitE MO K LAR HOKIR FOOTOKM_ FOUNDATION— BACKFUL_ FRAMM N/A , YES NO I. foundation suppmt• pier spacing j per manuf. ..........�...,•.�R _ _ _ 2. anchoring per manuf 3. water line shut off ................... _ 1 4. sewer fine support®4 feet ....... _ s/ S. heating crossover(dbiewide) off grd. 6. dryer vented outside ...�. — s7:ir ven'its..:ted .... 8. hot water relief valve piping outside _ 9. deck, porches, steps, railing ........ _ 10. furnace/hot water operating ........ 11. 12. ........................ .. 13. plumbing future ..!Af6v'e?,.9;.ji �_ _ 14. foundation insulation (if appl.)...... IS. smoke detectors ....................... 16. final electrical ............ _..... 17. variance required ...... ?. 18. data plate okay ....................... , 19, mobile HUD seal okay .............. Model# Serial# O 1 (9bb Manufacturer Date of Manufacturer 'i = OKAY TO ISSUE CIO YES NO comments: 'fib of� l l J C t Foundation Inspection Report Office No.(518)761-8256 Date Inspection•on req t Queensbury Building&Code Enforcement Arrive: Depart: 742 Bay Rd.,Queensbury,NY 12804 Inspector's Initi NAME: tyY � V► ✓�VAP T#: d ' LOCATION: �� C oft rt t C(;)t- Are - SPELT ON: G TYPE OF STRUCTURE: AP-1 I Con,Imenta Y N N/A Piers Monolithic Slab Reinforcement in Place 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/Wallpour Reinforcement in Place Footing Dowels or Keyway in place Foundation Dampproofing Foundation Waterproofing Footing Drain Daylight or Sump Footing Drain Stone: 12 inch width 6 inches above footing 6 mil poly for wet areas under slab Backfill Approval Plumbing Under Slab PVC/Cast/Copper Foundation Insulation Interior/Exterior R- Rough Grade 6 inch drop within 10 ft. L:\Building&Codes Forms\Building&Codes\Inspection FormsWoundatlon Inspection Report doc Last printed 12/20/2005 9:24:00 AM Septic Inspection Report Office No. (518) 761-8256 Date Inspection r e Queensbury Building &Code Enforcement Arrive: ` rt: a m 742 Bay Rd., Queeen"sb�ury, NY 12804 Inspector's Initials: NAME: PE 7 ERMIT NO.: LOCATION: h NSPECT ON: o RECHECK: Mo�m Le Comments and/or diagram Soil Ty am/ Clay Type of Water: unici 1 Well Water Waterline se ration distance - ft. Well separation distance ft. Other wells: ft. Well Casing Length 50' + / - Y N N/A / Absorption Field: Total length -Length of each trench ft. Depth of trenches Size of Stone Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tank LA" ! L Tw Tank to Distribution Box ` , IA03 I%-F- Distribution Box to Field Pit kk C- Opening Sealed: N End Ca N Inlet/Outlet Pipes&Baffles Y N Location Separations Foundation to tank Foundation to absor tiont, Separation of Pits ft. _ Conforms as per Plot Plan =Y�i N Engineer Report and As-Built Y N Location of System on Property: Front IR ar L eft Side \ Right Side Middle Front Middle Rear } � - Apixtived artial Ap ro d needs to be re-inspected, please call the Building &Codes Office Last revised 06/18/07 L:\Building&Codes Forms-OLD\Building&Codes\Inspection Forms\Septic Inspection Report e 9 01, I a4Ot _� � i 3! i f j a I 1� 8 t f 4IT { rued, or believe 1 save r�r{ F /--3 wlesak� Foundation Inspection Report Office No.(518)761-8256 Date Inspection st_ i}ced: Queensbury Building&Code Enforcement Arrive: Depart: am/pm 742 Bay Rd.,Queensbury,NY 12804 inspector's Initials. NAME: KA PERMIT#: LOCATION: INSPECT ON: -- TYPE OF STRUCTURE: 7 v— Con moment Y N N/A Footings Monolithic Slab �Z chy- 5 m Place The contractor is responsible for providing protection from freezing for 48 hours following the placement ,-�MateriaWlbr this purpose on site. Foundation/ allpour einfo entin Place Footing Dowels or Keyway in place Foundation Dampproofing \ � Foundation Waterproofing Footing Drain Daylight or Sump W� Footing Drain Stone: t7 12 inch width 6 inches above footing 6 mil poly for wet areas under slab Backfill Approval Plumbing Under Slab PVC/Cast/Copper Foundation Insulation Interior/Exterior R- Rough Grade 6 inch drop within 10 ft. L:\Buliding&Codes Forms\Building&Codes\lnspection Forms\Foundation InspeccUm Report.doc Last printed 12/20/2005 9:24:00 AM