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2000-776 TOWN OF QUEENSBURY (aw 742 Bay Road., Queensbury, NY 12804-5902 (519) 761 -8201 Community Development - Building & Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20000776 + f _ Application Number: A20000776 Tax Map No: 523400-121 -000-0006-059-001 -0000 Permission is hereby granted to: ROY GUILDER For property Iocated at: 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: ROBERTA CONVERSE Mobile Home In Park � 49,000.00 1 APRIL Ln Total Value 49�000,00 QUEENSBURY, NY 12804 Contractor or Builder's Name / Address Electrical Inspection Agency Plans &, Specifications 2000-776 33 PETRIE LANE DUUBLEWIbE MOBILE HOME- 1344 SQ.' $84.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Saturday, October 19, 2002 (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 Tow r f z nsb ; ,rJI h , October 19, 2000 SIGNED BY the Town of Queensbury. Director of Building & Code Enforcement Application for Permit -- Mobile Home .Town of Queensbury, 742 Bay Roag Queensbury, NY .12804 (5I8) 76I-8256 A building permit crust .be obtained before placement of mobile home on parcel. No inspections will be r , Ve until a valid building permit has been issued. [7Qp Appuoc Ix formcrlion Office Ilse Name: © File Permit No.61000 �7 (i Address: C1 � Fee Pad Reviewed By: T Phone No. _ ✓ 7,C) ' y Property Dwner InfO?VZ anion Parcel Iryorma ion Name: AA Proposed Date of Placement: SA Address: Property Locatio�• ! 4AAJ e t) Road, Street, Avenue Name of Mobile Home Park: Phone No. of applicable) Tax Map Number. _ ! �• f Mobile Home Information Zoning Irforma don Approximate Valve 4f Home: $ 1�- -'�� (� .. Q p Zoning assification_ New Home: � No Replacement Home: Yes ,� �5 4 4 Size of Property: $. by $. I�+ -SQo I � �t;}-- Existing buildings: Size of Mobile Home: . $, by ft. Singlewide: Doublevvide:: Setbacks: Sfrontide y yard 8 and ft. Number of Rooms: (exclude baths) a Number of Bedmocros: 3 Accessory Building(s): circle Number of Bathrooms: - Detached garage: 1 car-, 2 car, car circle: +Gas Fireplace or Woodstove .Attached garage: 1 car; 2 car, car Storage building: Yes No Foundation Support: other TYPE SIZE & I7 Hers f,4 5 Water Supply circle Rummers Slab well ; municipal Further information requested on the reverse side of this sheet � ' Name of Installer or Mobile Home Dealer: Address: c " Q2• � X IV • i ` o Phone No- w5r 2. go j State of New York Division of Housing & Community Renewal Insignia of Approval of the State Building Code Complete information below found on a "plate" or "sticker" which should be fixed to the mobile home- 1 . Insignia serial number: �� + 1 1r > 2. Name of manufacturer: 3 - Plan Approval Number : 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 BUILDING CODE, the ZONrNG 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 agent, architect, contractor Special Conditions of Permit By: d Form, ! IMV19sssh Code Enforcemen Officer 01/02/ 1994 20: 10 9187982802 GLENS FALLS M M HOMS y/� PAGE 01 Of ILL No .381 lu�;aa 100 i-TI Wz13 1V : I06N LF rx-E1M %Am: kY ►4w :Uj.::t : a!� a"+..,. • " � ., Apocation Fer Permit — BepUa Disposal 9yeterrn Qw11 reembury IVY IJ804 (Slit) ?6142_1e 1. 01A11M1e11 MFORMATIMi: ' .. .. . .. ._. .... ........ . .. __._.. ._.....1....._.._ M,--- -4, ," .-.. ... ... Lorerralen +I►!F Orrice Us* r fir.+ ,�r� 'iU�x Map me. _ _ ,/ -F�. Tile Pennit 146• / �p VM►rtite's aMb £1 pee paid A4 '^ 2. 114111"ALiAWS N+Ab11111 `^•..! e h ri (1� 4ec, P14ON9 NQ, 3. *UIPBMB I IMMATION: (srlydoi+rnrr of dwelling. rrrdtame ill f.Medn aw(t) and multiply' r ra1' beam "s with d"Heable Sallams per bredlrwanr to equal 1~1 eAr0JPJ1(rw) Year of Hettar: Nti_ f� "Rpili! x 1� Wil lip " ._.TAW I? il1r'�..F.lst�Y 19110 or emor x ISO VAAXIrm •M too* _ 1991 x 130 apt/Went 1991 — w, - -11 x 110 pallbdtrn Qirrbs*a 411wdsr bt akrrad yw ! no ✓ bhpr* er 7Yldrlpvd lmrrrlbd yoe t no 4" 1'ARCBL INVORMATHM; (croll applicable Jn#brrEtatiaec aL katonte ateeec.aarrtrnte) 1►1it Yibr!Mgd�1►ttl�t �t!4+�.stclv�ra!rrYlollo�i a�rl... Wrttor,Sa�lalr est�wVft rlO/rllh two Wrrr�rw/ryrlll rN1ir .�?'�..._..l"ter� yt.t• Iftt"ril; rtnrwrr taplIt" -- •AVW gear Prom raw aryff� .►y.�ear++ •" .....,.�.. rrbrtrrlrrfa►n ►.s __,� _J;r. tarlrer Ms000lrtl�on !le _ __c�leMd by 1rMctr�rel pf+ayRrtrslu+nwt eary(tneer art nrrhlncfr lliarre: ■rNwr►r prr rrrrJ+ 3. pl1,01011aD S'!i'll"t'1111�; � AI! ittdirldertl rewrrpo tilrperaf sysfwtae anon be datiincd br a llcen�ed �l ettglito�te 4rgr+t:Mi�c1 {tattl�ir Irtaltti'kd In ti lrlsnainR 17a+Nd al;trrrw:tl rawle!#ritinn). hc#r! xSri bnllurw3 srr fl►e: lrir.4 of Ow wf4k Irr+lk &M kwh Ikid for em* Qatbapo (hlm%r, %m ar Wlvlrlp ul •I`trU. lepiio 71m1c: ,f�O�" �/atwrwr I"�111. r�e I.Ot�,l{rnl.,/ '19N Field: each io+e wh ` � Total ffiyokern Latrptit: _ � � !+• /a a�- ItrHrtjet eqr #- ow eonoe *: of ' by 5 f Rr piss oltrtame to be used; I -- f tl yrHe rrr IlrilcA+hrex •�? !0 ;fir +f . .M Vote Sy~ Di"0 -.- ' *%CMDUft TANK 8Y'8T M: (Wrognkwo �M• Htratber Otte Ut 1 Saar ot'"Chs _ gonads /TOTAL Cepocky: gallons 1V416# Alttm B" Mil rend assotsiobrd electrical wank must be irrrpec4 d by a To%"% approved r P11VAL INBPIECT�ON REFsi,�RT NNEENIMW MOBfLE r Mv�ruL.aR Town of Queensbu►y Building & Code BnforcemeM 742 Say Road Queensbury, NY 12804 (518)��761-8256 ARRIVE; w DEPART: INSP BATE INSPECTION REQUEST RECEIV NAME: LOCA77ON:; r DATE: I t , 6Z) ,�►�y PERMIT # M013SLE I3l1ME F0017NGS � . F!UNDAnON . sACKFIJLL FRAMMG 1 , foundation support, prier spacing N/A YES No ,per manuf. .. .. ....,`�. . ,. .. .. ., 20 anchoring per nuunW. 3. water line shut off ., . :. ..., . . 4, sewer lime support 4 fe et . }� 5. heating crossover (dble►vide) p}� 6, dryer vented outside .. .. . r 7 ski :0. . . ... .. . rung ventilated 8, hot wafer relief valve P Ping out*de 9, deck, y Porches, steps, ratlapg . . .. .. .,. 10 furnace/hot water operat Cap I I garage fire proofing 12- door closers y + -- 13. plumbing fixture . .- ;, -- -�I 14. foundation insulati (if aPP, ••!, 1 . smoke def+acal )• . .. .. -� 16. final electrical ...,. . .. .. � . . ., .. .. . ��-- 17. variance requir . . .. . . .. .. .. ... . . .. 18* data plate oka I9• mobile HUD 1 okay .. .. . . . .. .. .. . - � -- Model # -� Serial # Manufactu Date of M ufacturer �]? _ _. OKAY To ISSUE C/o YES No Comments: f:. "• 'f" 1c rC'TRICRan INSPECTION' SERVICE, INC. Main Ofi7ce 1 76 floc Run oad - Manitehw, PA ! T54S MUNICIPAL CERTIFICATE _ ELECTRlCAI. AFPRpVAL Panel 13oard No.. p 4� Owner`... N+N .�f f aR � L3 8968 Cu;-in Card No ........... ........................ Location .4.0...... '�F> .._,.0 lrrsta!lationon ...,..�Cry C r C ^tin�� �rQ +�6'Z .. ...�r�-yC� •..,+"� .._.. 04 IN rN ................... U/e•+ ..,......,........ Installed Y..ite Alew rf/! r v The conditions foilnwin ic- No. .................................. cancelled; governed_ erned the issuance Of this certificate, and an This certificate on1 > '=crri ticatc previously issued is introduction of ad Y Covers the elect cquiptnent and installation addition a' ccluipmcnt or eUn ptions as oft l Inspectors of this Corn alterations, application shai! date- Upon the ' rules are violated, the pany shall have the prmiege of m4'hal hi prorreptiY made for inspection. F ampany shall have the right to r v K ections at an / ke t is - y" trme, and if its Date...<l—74 '-^�(�,/ •ate_ .................... . II INSPECTOR .... . i .. M1'tember lt'..F: ................... !'.A., !.A F7.L ...... �. TOM OF QUEENSBURY � BU][LDIN6 & CODE ENFORCEMENT 742 Bay Road Queensbury NY I2804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name Location Date mer SOIL. TYP r Sand!�Loam- _ lay- 7 .v Results of Percolation st- ( if applicable ) Rate--M7n a/Inch TYPE OF SYSTEM: ABSORPTION FIELD : Total Le th I{ Length of each trench Depth of trenches Size of stone SEEPAGE PITS * FITS : cl�rmb ei^- Size - PIPING JL Stone size Rldg . to Tank �- mwks Size 'hype Tank to [list . Boxy _ _ € Dist . Box to Field/Pi Openings Sealed? es .�` `0 art a LOCATION/SEPARATIm = Foundation to Tank � Z� '.. Foundation to Absorption �'"� feet feet Separation oi` Pits Conforms as feet LOCATION OF SYSTEMoOI PROPERlk7'.:t Planes. pFb ( circle one ) Front - Rear - Left.-.Side - Right Side Middle Front - . Mfddle Rear COWNENTS: -02 SYSTEM USE APPROVED : ,r" YES NO Arrived: Departed: j]/ 7 Bui rig InsP+ecttsr. TOWN OF QUEENSBURY BUILDING A CODE ENFORCEMENT 742 Bay Road !�1' f7 +n Queensbury Hr 12804 (518) 7+61-s256 SEPTIC DISPOSAL SYSTEM INSPECTION Name - -, QLt � S 6 c ��. � ��..r►r.. V 11 Date J 13 Permit # SOIL TYPE, Sanoam-C7ay Results of Percolation Te t- ( if aPp7icable ) Rate-Minu a/In h TYPE OF SYSTEM: ABSORPTION FIELD: Total L ngt Length of each tre h Depth of trenches ~� Size of stone SEEPAGE PITS:Size Number- - ft . x Stone size ft - PIPINGA Bldg . to Tank Size Bldg *Tank to Dist . Box ---_.� Dist . Box to Field/Pit Open i ngs Sealed ? Yep��o LOCATION/SEPARATIONS : artia Foundation to Tank Foundation to Absorption ----- feet Separation of pits --- feet Conforms as per Plot Plan feet LOCATION OF SYSTEM ON PROPERTY s No ( circle one) Front - Rear - Left Side - Right Side Middle Front - Middle bear Copp"TS : SYSTEM USE APPROVED: ~ YES Arrived; i Departed: Building InSPector ROc� 6nwI iclgl2w 0 1 2ao 1 1 Best Bargain NOTICEfMOAll Around FRAME 3S REQUIRED PER MANUFACTURMS SPMHCATIONS . 5T # 213 from ; Glens Falls Mobile Homes 798 - 2801 39 Saratoga Road Exit 17N off 87 Perfect family starter or retirement home .4R-ID" O 1. r'atFa aaar Ir p r IL d �j�i 1111ifr_ ;n, � r+s ; Somemonsoon1 ." •— ; bar r f ❑ �` ' Kitchen ` ram "r ua.. [J fr _I 7 r, , 0 opt. Glamour Bath i I.ir °'`� iA star BIR 3 L a~F I R Se roam «�� FILE Copy to..`S�.. 1Il.��rr T 1lCr�F ."'fir I %J V Ylv '�Jr VJUEENS-BUR i y 28x48 ( 44 ) Approx. 1173 Sq. Ft. BUILDING & REVIEWED BY � i ' ©ATE 4T r; ;: I . )„ ;alianrce with our c;cFmmeik, shall rin^t Ge construed as indicting the pans and speciiicattlans are if, full