92-089 1469,41
or-
€ERT/FIcATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 01 I 19 t
This is to certify that work requested to be done as shown by Permit No. 92-089
has been completed.
This structure may be occupied as a Mobile Home
Location Jay Road
Owner Charles O. Sicard
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
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BUILDING PERMIT .
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TOWN OF QUEENSBURY No. 92_089 v
WARREN COUNTY, NEW YORK ilk
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Sicard 0. .Is
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PERMISSION is hereby granted to CharlesI
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OWNER of property located at JayRoad Street,Road or Ave. fv
in the Town of Queensbury,To Construct or place a M
at the above location in accordance to application together with plot plans and other information hereto filed and
Hance with the Town of Queensbury Building and Zoning Ordinance. a
approved and in comp 1. OWNER'S Address is a.
RD#1 Box 1676 V
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Lake George, NY 12845 en
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2. CONTRACTOR or BUILDER'S Name o
Matthew L. Sicard
3. CONTRACTOR or BUILDER'S Address
v
W
70
C.
5. ARCHITECT'S Address 3O
C.
6. TYPE of Construction—(Please indicate by X) r
( )Wood Frame ( I Masonry ( )Steel ( ) •
7. PLANS and Specifications
No. 14' x 56' Mobile Home as per plot plan specifications and
application
8. Proposed Use
Mobile Home
$ 48 00 PERMIT FEE PAID —THIS PERMIT EXPIRES
March 24, is 93
(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 t
24th Da ; March is 92
for the Town of Queensbury
SIGNED BY Building and ning Inspector
." T9WZT. oF QUEENSBURY BURY
il
Tloymy b
REVIEWED BY: 111,f_/02i,/
II MAR31992 FEE PAID: $' 41k, D�'�
BUfl DING & CODE DEPT. PERMIT NO. Q.*::2 - OYC/
APPLICATION FOR MOBILE HOME PERMIT
A BUILDING PERMIT MUST BE OBTAINED BEFORE PLACEMENT OF MOBILE HOME.
NO INSPECTIONS WILL BE MADE UNTIL A VALID BUILDING PERMIT HAS BEEN ISSUED.
The owner of this property i s: C it a r(es O. S e'cet rcl
P.O. Address: R 0:9 e 14 /b '?b LA'Cc- hcAjt. Phone Number 7'7 2-S U 3'
Property Location i ad C-Ith t•c Its. acie Tax Map No. '73 / / / 23
NAME OF APPLICANT: /K4 - itA... i... cc`cw ed
Address of Applicant: R.4I #/ 13 ax /4.72 1.-4 t.... t,.
All applicants spaces on this application MUST be completed and the
signature of the applicant MUST appear on the reverse side of this application.
PERSON RESPONSIBLE Fprk SL1P RVISION OF WORK AS REGARDS BUILDING CODES:
,%
MOBILE HOME INFORMATION APPROXIMATE VALUE OF HOME: $ /6 04:76
New Home 421f No ZONING INFORMATION:
Replacement Home Ye No Size of Property: ft x ft
Size of mobile home Pi ftxS6 ft`784 Sx fi sting Buildings:
Singlewide X Doublewide
Proposed building-distance from property line:
No. of rooms (exclude baths) 9 Front Yard ft Rear Yard ft.
Side Yards ft and ft.
No. bedrooms 2.
No. of bathrooms 1 Occupancy Information:
Primary dwelling: Yes No
Fireplace IVc' Woodstove M o Accessory Building(s) :
Detached garage (one car /two car car)
Foundation style and size: —_Attached garage (one car_/two car car)
Storage building
Piers-No. of 1, Size 2. ft x Pift Other
Depth below grade .8 fit * * * * * * *
Foundation-Footing size s " x 2'f "
Wall material
Proposed date of placement:
r'
Wall thickness ' iigh Water Supply: Well )C Municipal_
Total depth below grade ft. Septic permit required? yeS
Grade to home floor level 2- ft.
FURTHER INFORMATION REQUESTED ON THE. REVERSE SIDE OF THIS SHEET
, 1
NAME OF INSTALLER/MOBILE HOME DEALER:
ADDRESS/PHONE NUMBER
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
3. Plan Approval Number
4. Model or Component Designation ASIt'G e4
5. Date of Manufacture \q ct 4
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.
Town of Queensbury State of New York
County of Warren
AFFIDAVIT
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.
Signature 4041+. 44 ,
Owner, owner' s agent, architect,
contractor
SPECIAL CONDITIONS OF PERMIT:
By
Code Enforcement Officer
1 /ihTOWN 0
APPLICATION FOR SEPTIC + . '," ` AL PERMIT Permit #
MAR 2 1992
Fee Paid
Date• BUILDING & CODE DEP Reviewed By
LOCATION OF PROPERTY FOR INSTALLATION: J ay rid Oa' /eh L 't L
Owner' s Name: /t1q ►er,.✓ L.. J,,Go rd
Owner' s Mailing Address: R 0 t ( cox if" 7z Le,4'c., 6-ear � hJ< `!. iz fX
Installer' s Name: M0' {'1ec✓ L.. Src-4;rcif Phone #: 76 /-OP”.
Number of bedrooms (if residential ) : Z
• Total daily flow (residential-compute @ 150 gal . per bedroom): 3 C> C..�
Topography-Circle One: Rolling Steep Slope % of Slope
Soil Nature-Circle One: 400 Loam Clay Other /Depth:
Ground Water-At What Depth? N/A- Feet
Bedrock or Impervious Material-At What Depth? N//fi Feet
Percolation Test-Circle One: Require' Required/Rate Min. Per Inch
Domestic Water Supply-Circle One: Municipal (Well) Other
If domestic water supply is a well -
Separation: Water supply from any septic absorption /SO feet
PROPOSED SYSTEM: Septic Tank 12o d gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench feet//Total System Length feet
Seepage Pit(s): Number of / / Size each: it) ft. x8)0' ft.
Size of Stone to be used: # / Depth or Thickness 7-- feet
**************
HOLDING TANK SYSTEM IF REQUIRED
No. of Tanks Size\of Each Gal .
Alarm system and associated electrical work to be inspected by a certified
agency.
****************
I have read the regulation on the reverse side of this sheet and agree to abide
by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal
Ordinance.
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SIGNATURE OF RESPONSIBLE PERSON: DATE: 92.
Septic System Inspections:
A. All applications for septic 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.
Town of Queensbury
Building & Code Enforcement
Department
531 Bay Road
Queensbury NY 12804
Remarks:
TOWN OF QUEENSBURY
Ibik
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED
NAME EIS_
LOCATION
DATE ,��'?d,/
PERMITS 9.0.?Weir
TYPE OF STRUCTURE 1W S JL
RECHECK
FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
XFOOTING FOUNDATION BACKFILL _FRAMING
ROUGH PLUMBING FINAL ELECTRICAL SEPTIC
INSULATION WOODSTOVE/FIREPLACE
REMARKS ��.'Z/ l !..
APPROVAL
N/A YES NO
CHIMNEY HEIGHT/LOCATION
B VENT/LOCATION ✓
PLUMBING VENT
ROOFING
SIDING
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES
FURNACE/HOT WATER OPERATING
BASEMENT INSULATION/DUCTWORK\
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED s/
STAIR CLEARANCE/RAILINGS ✓
HANDICAPPED ACCESS
SMOKE DETECTORS :./
BATHROOM FANS/WHOLEHOUSE FANS ✓
ALL PLUMBING FIXTURES OPERATING
GARAGE FIRE PROOFING
DOOR CLOSERS
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS
DUMPS TER
SITE PLAN/VARIANCE REQUIREMENTS
FINAL ELEC TRI
OK TO ISSUE 4 IR C/C
COMMENTS:
ARRIVE .3, S('-'
DEPART Y/te ---`
IN
awn ot Queenitury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYST INSPECTION
NAME 71 i_C_,'\.,k 1, C Wk."
LOCATION .-aC'
DATE / : PERMIT NO. 08(
SOIL TYPE Sand Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total le
Length of each tre
Depth of tr
Size of gravel_
SEEPAGE PITS{Number of)
Size- 'Y ft. X 1 ft. _f TOfV6-
Gravel size
PIPING: Siz ype
Bldg. to tank
Tank to dist. box
Dist. box to field/pit
Openings sealed? YES 0 Partial
LOCATION/SEPARATION$':
Foundation to tank/ ft.
Foundation to absorption f 4
Absorption to 14 line ft.
Separation of pts ft.
LOCATION OF SYSTEM ON PRO one)
Front - Rear -` Left side - Right si. -
COMMENTS:
CY- A}C)
co )2
cJ -
SYSTEM USE APPROVE Y S
Building I spector
01/86 and vl
0\f\'\-)-6N ) rcx\- Q--'sxn
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED 1 II ,j � 9 2.
NAME \ %l ) .L feS
LOCATION T3 CL A-• ()
DATE Lill 3 9 PERMIT #
Ci
TYPE OF STRUCTURE
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
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/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTSIN PLACE
PLUMBING UNDER SLAB`
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS IIT:ERIOR R- -
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILINGf R-
DUCT WORK OR PIPING IN UNHEATED
SPACES `
t
REMARKS:
ARRIVE •
DEPART
r�PETOR
1
RESOLUTION APPROVING MOBILE HOME
RESOLUTION NO. 184, 92, Introduced by Mr. Michel Brandt who moved
for it' s adoption, seconded by Mr. Nick Caimano.
WHEREAS, Mr. Matthew Sicard has petitioned the Town Board of the
Town of Queensbury for the necessary permission to replace an old
mobile home with a new mobile home and a formal application has
been submitted to the Town Board, and
WHEREAS, Chapter 113 of the Code of the Town of Queensbury
provides that the Town Board shall have the authority to grant a
permit to substitute a mobile home it may request a public
hearing,
NOW, THEREFORE BE IT
RESOLVED, the Town Board of the Town of Queensbury after
examining the matter and after speaking with the applicant and
considering the fact that adjoining property owners except for
one owner has been notified and have voiced no objections, the
Town Board of the Town of Queensbury hereby determines that it is
not necessary to call a public hearing on this issue and further
determines that this is just a substitution of one home which is
of better quality for an older home and be it further
RESOLVED, that the Town Board of the Town of Queensbury hereby
authorizes that a permit be issued to Mr. Sicard to exchange or
substitute the mobile homes and be it further
RESOLVED, that because this is a substitution of mobile homes is
considered to be a Type II action under SEQRA.
Duly adopted this 16th day of March, 1992 by the following vote:
AYES:Mrs. Goetz, Mr. Caimano, Mr. Tucker, Mrs. Monahan, Mr. Brandt
NOES: None
ABSENT: None Cordite Moo ladII.Depw beelleikdie Toss eflismuddy+W'Ien
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