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2000-492 TOWN OF QUEENSBURY 742 Bay Road, Queensbury, NY 12804-5902 (518) 761-8201 Community Development - BuiIding & Codes (518) 761=8256 HE �F CERTIFR Permit Number. P20000492 Date Issued. Tuesday, December 12, 2000 This is to certify that work requested to be done as shown by Permit Number P20000492 has been completed. ) #�) _1_-� Tax Map Number. 523400430-000-0001-008-000-0000 Location, h t9i10 ck �S Pink Owner. WILLIAM ST JOHN This structure may be occupied as a, Mobile Horne Out of Park By Order of Town Board TOWN OF QUEENSBURY Director of Building & Code Enforcement TOWN OF QUEENSBURY 10 742 Bay Road, Queensbury, NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20000492 Application Number: A20000494 Tax NIap No: 523400- 130-000-0001 -008-000-0000 Permission is hereby granted to: RICHARD & JEANETTE FINCH Owner of property located at: 4 NEWCOMB St in the Town of Queensbury, to construct or place a Mobile Horne Out of Park 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_ Owner Address: + RICHARD & JEANETTE FINCH 4 NEWCOMB St QUEENSBURY, NY 12804 Contractor or Builder's Name / Address Electrical Inspection Agency GLENS FALLS MOBILE HOME NEW Y©RK BOARD 39 SARATOGA ROAD GANSEVOORT, NY Type of Construction: Mobile Home Out of Park Value : $ 35,000.00 Plans & Specifications $41.00 PERMIT FEE PAIL] - THIS PERMIT EXPIRES: Sunday, July 21, 2002 (Ifa longer period is required, an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the Tow ens 'd , July 21 , 2000 400* SIGNED BY for the Town of Queensbury. Director of Building & Code Enforcement Application for Permit — Mobile Nome Town of Queensbury, 742 Bay Road , Oueensbury, NY I2804 (5I8) 761-8256 A building permit must be obtained before placement of mobile home on parcel. No inspections will be made until a valid building permit has been issued_ Applicant Information Office Use Name: Wt%I�� 4!� 13. 57�• �h ► iR • � File Permit No,r,>2^00 ` T Address: 6 S �4 c R•"-e Fee Paid Qcwcesv5 +1+* per Reviewed By: ` f Phone No. �747vI _ 6/$/ C�i Property Owner Information Parcel Information r, 7�� y JJ�] /' /J Proposed Date of Placement: >pr`S ? r,..�e+e_ r.�,cf �w -•�,•�-{ s Name:tame.. t c t%F rC o �^C4[ 7� • - Property Location: Address: 'y /�.z e co.o e c.� " is s� Road, Street, Avenue Name of Mobile Home Park: /✓ A EJ� �'��� .✓ '� � .7 (if applicable) Phone No. Tax Map Number. Mobile Home Information Zoning Information Approximate Value of Horne: p sq Zoning Classification: New Home: Yes No � f.� Y, Size of Property: ] L7 ` ft_ by LL6 fl. Replacement Home: es No Existing buildings: Size of Mobile Home: ;Z.q . ft, by W ft, Setbacks: front yard ft. ; rear yard ft. Singlewide: Doublewide: X _.. Side yards ft. and ft_ Number of Rooms : (exclude baths) b Number of Bedrooms: Accessory Building(s): circle Number of Bathrooms: al- Detached garage: 1 car; 2 car, car circle: Gas Fireplace / Woodstove / Wood Fireplace Attached garage: 1 car; 2 car, car Storage building: Yes No Foundation Support: Other: TYPE SLZE & DEPTH Water Supply: well or municipal Piers x Runners x Is Septic Permit Required? Yes or No Slab x Further information requested on the reverse side of this sheet �► Name of installer or Mobile Horne Dealer: f ev5 f-i,//s L1,& Address: A 4- g Y=4,l/S Phone No. t�sG7 f Complete information below found on a "plate" or "sticker" which is affixed to the mobile home. 1 . Insignia serial number: /02 � - 3/ 1 6 Za !A' 2. Name of manufacturer: .0 &da // 44g AtAo.„ rS 3_ Plan Approval Number : P F5 (fc� t rp 4. Model or Component Designation: (New Home ONLY) 5_ Date of Manufacture: AFFIDAVIT Town. of Queensbury 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 BU L,DING 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: owner, owner's ag t, contractor 5pe "crI Conditions of Permit . .r}y b . Cv By: Form, 11/19/1999sh Code Enforcement Officer TOWN OF QUEEl NSB URY 742 Bay Road, Queensbury, NY 12604-5902 518-761-8201 A P P L I C A T I O m F O R A MOBILE IIOM£ OUTSIDE OF A MOBILE 11014E COURT Mail or Bring This Application To : BUILDING & ZONING DEPARTMENT Queensbury Town Office Building Bay at Haviland Roads Queensbury , New York 12804 This application for a Mobile home Permit shall be accompanied by a plot Plan drawn reasonably to scale shoving all dimensions , the size of the lots the location on the lot of the Mobile liame , the water supply and sewage system_ If the applicant is not the owner in fee of the premises , then the application must .be accompanied by the written acknowledged consent of the owner, NAME/ OF APPLIC/fANT` �-'' / ' C.- +' • E' ,re4j/ a2 'l_ •+-/�'/'9•r P_ C"G G>'" G"�! �' l ADDRESS : LOCATION OF MOBILE HOME PREMISES BY STREET OR ROAD, ETC , c-) 2 •ev- 0 e )?C1. GIVE NEAREST CROSS STREET NAME OF OWNER OF LAND owNER S ADDRESS 4 . State fully the reasons for this request �5c> C/ s -el- .;5 f.cr. dr- rPr�ytS �55/ S,'�. +7 +w rf'7' n /+G.S/J fc -"'+y /C+yr/r'(.�' Q C�a ,�� T P/' i:�'k? . 'rT �'�'77" T'�r;..- _i°"''y„r ���l r`,e�r'� •.. '�' "i GY ._ se extra sheets if necessary - 5 . Description of mobile home : Year /'� r Model Make Serial Dimensions_ cX �{ APPLICANTS SIGNATURE Address HIS SIDE FOR GOVERNMENT USE ONLY Report of the investigation of Zoning Administrator- and recommendations . Approved Disapproved Other Recommendations c L Chov.. 113 ^L. I- (b 0 k z� 1 u� [ S4eWjLA a;ram ILA Mii,74d c Signed .A G ADMINISTRATOR ACTION OF PPE TOWN BOARD Approved Disapproved Other Resolution Number Qu of the Town Board of the ;Town ofeensbury , Warren County , New York . _ Dated this day of 19 Signed : TOWN CLERK , TOWN OF QUEENSBt)R COMMONWEALTH ELECTRICAL INSPECTION SERVICE, INC. �3 Main Office 176 Doe Run Road - Manheim, PA 17545 e" r � MUNICIPAL CERTIFICATE - ELECTRICAL APPR ;'AI Panel Soard No. .. Cert' Np 6 9 5 Cut-in Card No. ...................................... ,c Owner.......... .... �..lr G ......,, ..f.., a.. ` l�..4Y.. ..._......_......_........._...,.................,................ ......_......... Location ...:L C-- �.�-'"�LJa':"sq"r3!t;.:�.....,,­.. .............................._............_... ............. installation Consisting of ... .....,,.....1, .....�.....lT " "" •.........,,. ..........I.............................................. .......................... Insta!!ed I3 Lie. No. .................................................. By............... ..... ................I...,.........I....,_...... ............... .. The conditions following governed the issuance of this certificate, and any certificate previously issued is cancelled:This certificate only covers the electrical equipment and installation conditions as of date_ Upon the introduction of additional equipment or alterations, application shall he promptly made for inspection. Inspectors of this Company shall have the privilege of makin specuons at any time, and if its rules are violated, the Company shall have the right to re e t Jcc ficate_ .If G- ' , ,_ _...., ...... SPdSPF.CTl7R. ....� .,..a"-.:........-„•••••.--.•.,........"""".'"'".................. Cl ate.................. "' Member "V.F-P.A., 1.A - . iP1NAL 1NS'P'1ECT110N IftaloCiAT MC301LE / Mc3c3 1L.AA Town of G}ueensbury Building & Cade Enforcement 742 Bey Road +Queensbury. NY 12804 (518) 761-8256 4A,1UUV-E: i EPART. DATE INSPECTf V EQ T RECE E17: b � NAME: WCKnON: "'1 C DATE: tJ P RMIT # M01"LE HOME I M0 t a HOME F()Orr r,,S mUNPA"MN SA FRAMING N/A YES NO 1 . foundation support. pier spacing permanuf.. . . .. .. .: . .. .... .. . . . .. 2. anchoring per manuf. `t. .. .... .. .. .. 3. water line shut off' .. .. ...» . . ..... .. 4. sewer line support (1p 4 fi wA .. .. .4 5. heating crossover (dblewide) oftYgrd. 6. dryer vented outside . x. . . .`.. .. . . . . .. . ., � _ 7. skirting ventilated . . .. .. .. .. :• ...fi — — -- 8. hot water relief valve piping ep 9. deck, porches, sts, raising — io, fiunacelhot water operating 11 . garage fire proofing •• •• •• •- . , » — -- 12. door closers .. . .. .. .. .. .. .. . . .. .. . . _ — 13, plumbing fixture . . . . . . . .. . . . .. .. .. .:. 14. foundation insulation (if l.). .. .. .`' 15. smoke detectors . .. .. .. .. 16. final electrical t x 17. variance required •� 18. data plate okay 19. mobile 14UD seal � s Model # Serial # ' I � � Manufacturer r � Date of Manufacturef OKAY TO IS UE CIO YES N� Comments: � ''1 FINAL INSP�GTION RLsPORT MC30ILLL / yMC3E3ULAR Town of Queensbury Building S Code Errlorcerrtent 742 Bay Road Queensbury, NY 128t74 ,- (518) 761 -80% r NS �r ARRIVE: V ` IEPART: DATE INSPECTION REQUEST RECEIVED: {+ NAME: i /j + "� LOCATION. _S� i DATE: FERMI # lwipSiLEC HOME M4 IL Hous FC OTINGS ✓ FOUNDATION FRAMING NIA . YES NO i, foundation support* prier ing per rnauuf. dr 2. anchoring per manuf. — 3. waterline Shut off .. , 4, sewer line support 0 feet .. , .. . . 5. heating crossover ( } off grd. 6. dryer vented outside ..:. .. .». .. .. .. .. .. . .. 7. skirting ventilated g. hot water relief va e piping outside 9. deck, parches, s , railing . . .. .. .. 10. fumaceftA wate operating 11, garage fire pros g . .. .. . . . . . ... . .. .. 12. door closers .. .. .. .. . . . .. .. .. .. .. .. .. 13. plumbing fixtur . . . . . .. .. .. .. .. .. . . . ». 14. foundation ins tion (if appl.).. .. .. 15. smoke deter .. .. .. . » . .. .. .. .. .. .. .. 16, final electrical 17. variance reel 18. data plate oka .. .. .. .. .. .. 19. mobile HUl7 1 okay .. . .. .. .. .. .. . - — Model # serial # manufacturer Date of Manufac r OKAY TO ISS CIO 1 YES NO Conu tints: iv TOWN OF QUEENSBURY BUILDING A _ CODE ENFORCEMENT 742 Bay Road QueensbUry NY_12804 (518) 7,61-8256 SEPTIC DISPOSAL SYSTEM~INSPECTION Name Location 1�3 �.� 'C F`3Ll� � '41 Date SOIL TYPE: Sand- Loam-Clay- Results of Percolation Test- ( if applicable ) Rate-Minute/ lpch TYPE OF SrYSTEM & ABSORPTION. FIELD : Total Length Length of each trench Depth of trepches Size of stone`, SEEPAGE PITS : '� Number- Size - t . x ft . Stone size PIPING: 1 ze ype Bldg . to Tank Tank to Dist . 'Box Dist . Sox to Field it Openings Sealed ? Yes No Partial LOCATION/SEPARATIONS Foundation to Tank feet Foundation to Absorpt n feet Separation of Pits feet Conforms as per Plot Pl n Yes Na LOCATION OF SYSTEM ON P PERTY : ( circle one ) Front - 'Rear Left Side Right Side Middle 'Front - Middle Rea COMMENTS : i SYSTEM USE APPROVED : No Arri ved w Depa uZ zng nspec r cc�i ,i, i TOXIN OF QUEENSSUR BUILDING A CODE ENFORCEMENT 742 Bay Road +Queen_s_bor_ry NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name 14�L4) Location I L Date ermit SOIL TYPECS r- & Loa -Cl ay- Resul is of Percol ati o%h Test- ( if applicable ) Rat 14:inute/ Inch TYPE OF SYSTEMS r ABSORPTION FIELD: To aA Length (� Length of each trenc Depth Of trenches Size of stone SEEPAGE PI Numb r. Size - _ ft . %4 ft . Stone size _ PIPIN&: Size ype Bldg . to Tank `_0,- e, Lt (D Tank to Dist . Box � < . Dist . Box to Field Pit Openings Sealed ? I Yes No art a LOCATION/SEPARATI S : Foundation to Tan feet Foundation to Abs rption feet Separation of Pi s _ - fee Conforms as per I of Plan ��es o } LOCATION OF SYS ON PROPERTY: ( circle on - - � Front Rear eft Side - Right Side Middle mar - ar COMMENTS : C:) C 1c SYSTEM USE APPROVED : YES �O Arrived: Depa ing n ctor " -` TOWN OF QllEEMSBURY BUILDING & CODE ENFORCEMENi� '742 Bay Road Queensbury MY _ 12864 fi, �Q (518) '751-8256 _ f 43 f'! SEPTIC DISPOSAL SYSTEM INSPECTION � s Name ;on Locatdate Pe it # SOIL Sand- Loam- lay- Resul is of Percol ati o Test- ( if applidable ) Rate- inute/ Inch TYPE OF SYSTEM: ABSORPTIOIC HELD : Total Length Length of each trench Depth of trenches Size of stone SEEPAGE PITS: umber Size - ft . ;c ft . Stone size PIPING: - SizeT-ype Bldg . to Tank Tank to Dist. Box Dist . Sox to Field/ ' t Openings Seal ed?l Yes Na a� rt-57 LOCATIOK/SEPARATION Foundation to Tank feet Foundation to Absd tion feet Separation of ' Pit feet Conforms as per P of Plan --� s NO LOCATION OF SY ON PROPERTY: ( circle one ) Front - Rear - ft Side - Right Side Middle Front - iddle' Rear COMMENTS : S -PJC�> A SYSTEM . USE APPROVED : YES NO Arrived Depa Bait ing Inspe or f � r 0r � 5 GENERAL LN,SPEC'TI©N REPORT ( 518 ) 761 - 82s6 Town of Queeusbury Dept.. of Community Development .Date inspection request received: Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 Arrive ° anVj&).�Depart �� inspector's initials r { NAME: �--� PERM T # LOCATION: - TYPE OF STRUC'['CTRE: RECHECK NO COMMENTS IrifA. Z--LA Monolithic Pour Forth t Reinforcement in Place The contractor is respo le for providing protection m nil for 48 hours followin the cement of the concrete. Materials for this pu on si Foundation/Wallpour Reinforcement in P .-Foundati0 n Backfill Approval Plumbin Under S ' Plumbing t/V in Place Rough Plumbi Heating Rough-In Insulation Foundation Wall Interior R- Foundation Wall Exterior R- Floors R- W alls 'R- Ceiling R- Duct work or pi 'ng m unheated R- Proper Vent, Attic Vent Frami Jack S rs Bracing/Bridgin Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1, 2, 3, hour Penetration Sealed Fire Wall 2. 3, 4 hour Firestoppin, GENERAL INSPECTION REPORT ( 518 ) 761 - 8256 Town of Queensberry Dept. of Community Development Date inspection request received: Building & Code Enforcement 742 Bay Road Queensberry, NY 12804 Arrive U�. m Depart -��-�- Inspector's Init' NAME: UJ 1 PERMIT # — LA LOCATION: Eft A--T' DATE : L I TYPE OF STRUCTURE: �r t V� 'FICA � RECHECK N/A YES NG COMMENTS FoatingsfPiers R�>�►��... . � R � ��EQ� i.�+CST Monolithic Pour Farm _ 'c , we Reinforcement in Place The contractor is responsible for proNridmg Protection from freezing for 48 hours following the placement + 1 [ 1�L ( -E t ►� ram - 1� of the concrete, r Materials for this purpose otx rr site � r VtA ` Foundation/Wallpour l Reinforcement in Place Foundation/Dam Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Place Rough Plumbing Heating Rough-In Insulation Foundation Walls Interior R- Foundation Walls Exterior R- Floors R- Walls R- Ceiling R- Duczt work or piping in unheated spaces R- Pr+oper Vent, Attic Vent Framing Jack Studs/Readers Bracing(Bridgi joist Hangers lack Posts/Main Beam Air Infiltration Barrier Fire Separation 1, 21 3, hour Penetration Sealed Fire Wail 2, 3, 4 hour. Firestopping R 7 VED 1 G ` JUL 2 1 2000 �SURY C7✓1 All S,OdJ of "i have seen or observed, or believe i saw evidence of, 5s/ _ kr• all objects such as houses, wells, trees, fences, etc., shown on this document. I also represent that I have peersonaIIy measured the list aces et forth on the � d/iagra+m." SIGNAtAE DATE r� "1 have seen or observed, or believe Y saw evidence of, �kE Objects as houses, wells, trees, fences, etc., on 'this document. I also represent that I have ,., 4;i ;easl.: red .he distances set forth on the diagF-qm ." i 4 q f ! rN _ G C �— � � �F lJtviG I�GGWti f, _ � J �y r 4 C �'7 G? ✓1 �s W ,,arc) vi �- Foy � �' G -< _ � c_'� v►-, 5 �`'. fjF 1 Qc7C� .�� " v' , i�c� +r✓ ' f / � t NN i E t Ca ev ' I � l + ■ler __ -. __ _ _ _ _ _ � - . lk _ ._-_-__ -- _._ _�__ � - - .. 3,. l _ .. ._..----,_._ _ _. ____ __ . . i } I I 1 E {1 ,Syr) G � �' X 15 YY - , � � J XCi C•� 0 ! �? fL ` /7Dcnr+ T E� QYJGI f QJ , Gj J -cle o n Ar'f ro..C, • r7 ,ay f e 1 G r c(S ) 1, o #- 144 .5 C> c.".f r7 S e p t c 1r, v, k.S � �j C. / `+ f t' r tC yye5 4gnd Pcri •a Fvr r1"apj f�. 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