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2000-806
TOWN fka)F QUEENSBURY 742 Bay Road, Queensbury, NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 7614256 CERTIFICATE �F OC UPANCY Permit Number. P20000806 Date Issued. Friday, December 01, 2000 This is to certify that work requested to be done as shown by Permit Number P20000806 has been completed. Tax Map Number: 523400-127-000-000&020-000-0000 Location: 15 INDIANA Ave Owner: BARBARA JONES This structure may be occupied as a: Mobile Home Out of Park By Orderof Town Board TOWN OF QUEENSBM Director of Building & Code EOforcetnt TOWN OF QUEENSBURY 742 Bay Road, Queensbury, NY 12804-5902 (518) 761-8201 Et Community Development - .Building & +Codes (518) 761 -8256 BUILDING PERMIT Permit Number: P20000806 Application Number: A20000806 Tax Map No: 523400- 127-000-0008-020-000-0000 Permission is hereby granted to; BARBA.R,A JONES For property located at: INDIANA 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; ELLA M DANAHY Mobile Home put of Park 22 4TH St 30,000.00 GLENS FALLS, NY 12801 Total Value 303000.00 Contractor or Builder's Name 1 Address Electrical Inspection Agency Plans & Specifications BP 2000-806 Barbara Jones Mobile Home 14 ft. by 66 ft. singlewide $35.00 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 of Q ens Th abet I9, 2000 SIGNED BY for the Town of Queensbury. Director of Building & Code Enforcement ' Application for Permit — Mobile Home Town of Queensbury, 742 Bay Roac4 Queensbury, NY 12804 (518) 7.61-8256 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 4,,{fice Use , Name: 6 '%owl File Permit No. - ,� ,r Address:, � r, jt[Psr Fee Paid ' € Reviewed Dy: -- ..... .... ... Phone No. Property Owner Information Parcel information Name: Proposed Date of Placement: AID V { Property Location: ;#�, c Address Road, Saver, Avenue Name of Mobile Home Park: E3 (f applfeable) Phone No. Tax Map Number: ," ` r _ '� r r ,U — Mobile Home In formation e Zoning Information Oc;Approximate 'Value of Horne: S '.) 02 4, c..i Zoning Classification: New Home: S No Size of Property: 'l ft. by it. Replacement Home: Yes Na Size of Mobile Home: /V ft. by #t. Existing buildings: Setbacks: front yard ,y 6 ft. ; rear yards ft- Singlewide: �y Doublewide: Side yards �/ / _ ft_ and l 3 ft_ Number of Rooms. (exclude baths) _ Number of Bedrooms: Accessory Building(s): circle Number of Bathrooms: „ Detached garage: 1 car; Z car, car circle: Gas Fireplace / Woodstove / Wood Fireplace Attached garage: l car; 2 car, car Storage building: Yes No Foundation Support: Other. TYPE SIZE & DEPTH Water Supply. well or unicipal Piers x Runners x SIab x Is Septic Permit Required? Yes or No Further information requested on the reverse side of this sheet 11100� % Name of Installer or Mobile Home Dealer: )k I ►14 IL 45� , yeZ64 ��e5 IWOG l Address: 3 `t 0 / A Phone No. va Corhplete" ih on below found on a "plate" or "sticker" which is affixed to the mobile home. 1 . Insignia serial number - r ,' �� f 2. Name of manufacturer: 7L"Le'e 3. Plan Approval Number 4. Model or Component Designation: (New Home DNLY) 5. Date of Manufacture: C) } C29 V. AFFIDAVIT Town of QueenAmry 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_ �'Aa cas4 g' O ^ ig,: owner, owner's a test, contractor Special Conditions of Permit BY Form_ 11119i1999sh Code Enforcement Officer Application for Permit - Septic Disposal System Town Of Q"ueerrsbury 742 Bay Road Queensbury, NY 12804 (518) 761-8256 1 . OWNER INFORMATION: �..............._.. _ _;:...„._............................................ ..._.,........ �._... ,,,_,.......... Location of installation—^ Office Lire Tax Map No. / / / C� File Permit Np. Owner's Name: Fee Paid Address; ............................ `. , , r' �.� -�/"�c. 2. INSTALLER'S NAME ] PHONE NO. 3. RESIDENCE INFORMATION: (circle year of dwelling, indicate # bedroom(s) and multiply # of bedrooms with applicable gallons per bedroom to equal total daily flow) )Lfmr Qf House No. of Bodrooms x o utation = TiAMI Daily Flow 1980 or odder x 150 gaVbdrrn = 1980 — 1991 x 130 gallbdrm = 1991 — Present -- x 110 gallbdrm = Garbage GrinderInstalled yes ! no .. Spa or Whirlpool Installed yes . / no 4. PARCEL INFORMATION: (circle applicable information &• indicate measurements) 'I N opmrand Wat r Bedrock Qr IMperviQus Material Do W ter Su 1 la g san at whW depth at w at depth municipal 11in Wane _f w Steep slope clay if well, water supply slope other from any septic-system depth. absorption is f7. other Percolation Task: (To be completed by licensed professional engineer or architec) Rate. ~'4 minute per Inch 5. PROPOSED SYSTEM: For New Construcligi n: All individual sewage disposal systems must be designed by a licensed professional engineer or architect (unless installer!in a Planning Board approved subdivision). Add 250 gallons to the size of the septic tank and leach field for each Garbage Grinder, Spa or 'Whirlpool Tub. Septic Tank; IM O gallon ('min. size 1, 000 ,gal..) Tile Field: each trench Total System Seepage Pit(s): number of �e,' size ofeach: _ _�f. by Size of Stone to be used: # / depth or thickness feet Bed System Size: x A mnative System; length and/or size 6. HOLDING TANK SYSTEM: (if required) Number of tanks: 1 Size of each: gallons 1 TOTAL Capacity: gallons Nate: Alarm System and associated electrical work must be inspected by a Town approved electrical inspection agency. 7. SIGNATURE &. INFORMATION FOR RESPONSIBLE PERSON (please read) For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Queensbury, any permit or approval granted which is based upon or is granted in reliance upon any material misrepresentation or failure to make a material fact or circumstance known by or on behalf of an applicant, shall be void. I have read the regulations with resp to this application and agree to abide by these and all requirements of the To een Sanitary Sewage Disposal Ordinance. 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I r r� lit i 1 U ( r 1-1 i 1.1 tIr P N le . 0 P1 i Of C1 �Y' • Dr to Eli �74 • � r•1* t-t f PMJAtk1� 1IywraECTrO14wi MC3C3ULWA ►rs Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 751-8256 ARRIVE: 1=�DEPAFtT; ZLL I DATE INSPECTION EI V NAME: LOCATION: DATE: — IT # MOBILE OME MO K HOME FOOTINGS FOUNDATION _ CKpII.I i FRAMING N/A YES NO I. foundation s rt, pier per rnanuf. _ 2. anchoring per uf. — 3. water line shut, o .. ., . . .. .. .. . — 4. sewer line support 4 S. heating crossover (d de) off grd 6» dryer vented outside .. ..... .. .».,. — 7. skirting vaatilated . . 8, hot water relief valve outside - 9. deck, poYches, steps, . 10. furnace/bot water rating 11. garage fire pmofutj4 *0111, 12. door closers .. .» .». — 13. plumbing fixture . _ — 14w foundation insula ' (if appl.).» . 15. smoke detectors .. .. .. .. ..... .. 16, final electrical . ..... . . ... .. . » ». . — 17. variance requir 18. data plate Oka 304P 19. mobile HUD okay . .. _. ... . . ..», Model # Serial. # Manufacturer Date of Manu cturer OKAY TO ISSUE CIO YE5 NO [Comments: i e r t CC)MMONWEALTH ELECTRICAL INSPECTION SERVICE, INC. MUNICIPAL CERTIFICATE Road - + lanheim, PA 17545 , & d � ELECTRICAL APPROVAL Panel Board No,, , Cert, � N_ 68981 Cut-in Card No. .......... ........... Installation Consisting of..l.(3[J r! /*G! .................................................... Installed By..... .....-#,.... G? i'° 1 R!F7?r� The conditions following governed rite is cancelled: suance of this certificate, and any cerriticate previously issued iv - This cenificate only covers the electrical equipment and installation lt conditionx as of date, Upon the introduction of additional equipment or aerations, application shai] be promptly made for inspection. Inspectors of this Company shall have the priviiege of making spectionv at any time, and if its ruicx are violated, the Company shall have the right o r cake cc SV Date..f.... ....7,.. INSPECTGIR ............. ........ .................................... lblemi M1',F.RA., f..A E.J. ��� rr. OF VUEENSBURY B�#I� DING A CODE ENFORCEMENT £ ' 42 Bay Road nsborry HY 12804 (519) 761-8256 SEP DISP0)9A'LSXSTEM INSPECTION Name Location rc- Date i t SOIL. TYPE(' Sand- Lo -c7ay Results of Per0lati on T t.. ( if applicable ) Rate- Min to/Inch TYPE OF SYSTEM: ABSORPTION FIELD Tatar ength r ` Length of each trench Depth of trenches Size of stone - SEEPAGE PITS: um Vr_ Size - ft , Stone size PIPING : Size Bldg , to Tan e Tank Tanis to Dist . Box � Dist . Box to Fie ? /Pit Openings Sealed ? e o art a �r(G LOCATI ON/SEPARAT ON . 1,VAke�Foundatlon to Foundation to T sorption --nk feet Separation of its -- feet Conforrrrs as p r Plot Plan eet LOCATION OF STEM ON PROPER o { circle one Front _- Left Side - Righ Side le Fro t . iddl a hear SYSTEM USE APPROVED: YES NO Arriv Dep ed uY ding ector t l TOM OF Q[lEQfSBURY BUILDING .-- CODE ENFORCEMENT 742 Bay 'Road Queensburp NY _12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Namea �t Location - v C Date 2 j Permit # SOIL TYPE: and- Loam-Clay- Results of Per 11 colation est- ( if applicable ) Rate- mute/Inch TYPE OF SYSTEM: ABSORPTION FIELD: T tal 'Length Length of each tre h Depth of trenches Size of st ne SEEPAGE PI : N etx Size - ------ f t . Stone size PIPING : __ i ze � �' e Bldg . to Tank Tank to Dist . Bo Dist . Box to Fie d/Pit Openings Sealed ? ' Yes o PartiaT LOCATION/SEPARATE ONS : Foundation to T nk feet 'Foundation to A sorption feet Separation of Pits feet Conforms as per Plot Plan es No LOCATION OF SYSTEM ON PROPER Y: one ) Fr - Rear - 'Left Side - Right Side dale Front - Middle Rear C-O-M�M'ENTS : I SYSTEM USE APPROVED: YES N Arrived: Departed : Building inspector""' GENERAL INSPF,CTIOJNREP©RT ( 538 ) 761 -8256 - Town of Queensbury Dept. of Community Development Date inspection request received: Building & Code Enforcement 742 Bay Load Queensbury, NY 12804 Arrive am/pm Depart?. c Inspector's Initials NAME- d. ✓ PERMIT # 0' D LOCATION )Or�> Gh Oor Cam- DATE - 2'.S-� o TYPE OF STRUCTURE: RECHECK N/A YES NO COMMENTS F ng (Piers vol4onofithic Pour Form Reinforcement in Place ':2L - The contractor is responsible for providing protection from frees g for 48 hours following the men of the concrete. Materials for this purpose on si Foundation/Wallpour Reinforcement in Place Foundation/C)ampproofin Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Place_ Rough Plumbing — - Heating Rough-In Insulation Foundation Walls Interior - Foundation Walls Exterior Floors R- Walls R- Ceiling Rj ]duct work or piping in ff unheated. spaces R Proper Vent, Attic Vent Framing Jack Studs/Mcaders Bracing/Bridging Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier Fire Separation I, 2, 3, hour Penetration Sealed Fire Wall 2, 3, 4 hour Firrestaplri ng FILE COPY I i— n r N r � p, TOWN ► F 1 r SBURY BUILDING & T- REVIEWED BY '.r •cp� r� DATE ' r/�'j 4 f Cf3!"1^,li':E?I i�.." s '-'�^'.ij (i j i:{3 r'ri�1Sf�{I�, II':i�i�.".8tInli PAC -•- �`.r� . .... �!iC] S'.R'{^lif J11.7 c iil rill ! 4TICE ANCHORIN OF MOBILE HOME FRAME I REQUIRED PER MANUFACTU ERS SPECIFICATIONS I i Cot e & ,e 96(:::2 r.. rr L. k. 0 . TRAILER BODY IF F IF TRAILER FRAME TRA IF WOOD BLOCKING FF CEMENT BLOCKS J =Al � J�.TUIrV 9TFAR 1 4. 1 FINISH GRADE .� ' { �-�„FF �. REINFORC IF 4 F. IF, - ACQ IF SLAB TO RUN MLL LENGTH OF THE TRAILER AS SHOWN __ r I _.P� .