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98-527 CERTIFICATE TE OF Cvf%"M.0CUPAN GY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK October 28 98 �^; ` 1Date 19 i ' 98527 This is to certify that work requested to be done as shown by Permit No. has been completed, MOBILE HOME This structure may be occupied as a 21 SUGARBUSH RD . Location MERWIN , ROBERT & EDNA Owner TAX MAP NO . 9 3 . - 2 - 9 . / 7 5 2 By Order "Town Board TOWN OF QUEEN'SBURY Director oof BIdg. Ze Code Enfor+eement BUILDING PERMIT VALUE $ 37273 TOWN OF QUEENSBURY moo. 98527 TAX MAP NO . 93 . - 2 - 9 . / 752 WARREN COUNTYr [NEW YORK PERMISSION is hereby granted to OWNER of property located at 21 ST,.UGARBUSH RD Street. Road or Ave. . in the Town of Oueensburi To Construct or Place a lYlO$ILE HOME at the above location in accordance to application together with plot Plans and other information hereto filled and approved and in compliance with the Town of Queerrsbury Building and Zoning Ordinance. 1. OWNER'S ACICIM s is 21 SUGARBUSH ROAD QUEENSBURYr NY 12804 2. CONTRACTOR or BUI LDERS Name TODAI MODERN HOMES M CONTRACTOR or Su1LDER'S Address 54 RT 9 GANSEVOORT , NY 12831 4 ARCHtTECT"S Nara NEW YORK BOARD 5. ARCHITECT"S Address NEW YORK BOARD OF FIRE UNDERWRITERS 6. TYPE or Construction — iPlaatse Indicate by Xl MOBILE NOME 1 1 Wood Frame t I Masonry 1 1 Steel f l T. PLANS and Specifications 23 + 489 MOBILE HOME AS PER PLOT PLAN SPECIFZCCATIQINS r Proposed Use MOBILE HOME 41 August 28 2000 $ PERMIT FEE PAID - THIS PERMIT EXPIRES . 19 t1f a lonysr p+r4od is npuired an agplirttbn fa an extension muse be made to tf+e f3uiWirq and Zonina inspector of the sown of Ousen stel before she aMplratlen date.l August 199 8 28 f)ay of x9 Dated at the Town of OueerlsburV this: ►,,�� ��,r�j SIGNED BY ��]�Kq 6� '1r for the Town of Que*nsbury 11dina artd Inspoetar TOWN 01 " QUEENSBURY l REVIEWED BY : FEE PAID : C `} PERMIT NO . APPLICATION FOR PERMIT MOBILE HOME OR MODULAR A BUILDING PERMIT MUST BE OBTAINED BEFORE PLACEMENT OF MOBILE IIOME . NO INSPECTIONS WILL BE MADE UNTIL A VALID BUILDING PERMIT iIAS BEEN ISSUED . . . . . . . . The owner of this property is . P . O . Address : G-. U7�! /i�� s•� L7`e Phone Number Property Location P- 0 &YX Z22L Tax Map No . NAME OF APPLICANT : Address of Applicant : �?J�'u rf /- 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 RESPONS113LE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES : DV� A,)J4r'} � 3 3 75J MOBILE 110ME INFjMM8T1ON APPROXIMATE VALUE OF ITOME : $ 07 .2 73 IMB New Hame Yes Na ZONING INFORMATION . Replacement acement Home Yes No r P Size of Property : �S ft x jt Size of mobile home ftxft� Existing Buildings : Singlewide Doublewide r - Proposed building-distance from property line : Now of rooms ( exclude baths ) Front Yard 31 ft Rear Yard C-3 / ft . No . bedrooms Side Yards z - ft and I G7 ft . No . of bathrooms Occupancy Iingot 3 Primary dwelllling . Y s No Fireplace Woodstove Accessory Building ( s ) . Foundation style and size : Detached garage one car / two car car y Attached garage one car'/ two car car �yt'r� -Tr� la tSL S �,/ " a"�-Storage building T' Piers- No . of Size ft x f t Other - .oft► 4 4 rV,c� ,G -� eooew -ns Depth below grade ft Foundation-- Footing size x " Proposed date frplacement : Wall material Wall thickness Height Water Supply : Well Municipa l Total depth below grade ft , Septic permit required ? Wa) C7 Grade to home floor. level ft . FURTIIER INFORMATION REQUESTED ON TIIE REVERSE SIDE OF TIIIS SHEET NAME OF INSTALLER/MOBILE 11OME DEALER : J � ✓Yt! f ADDRESS/PHONE NUMBER -at � lgyovsi Eyoi � `� � 29 J 71F6 STATE OF NEW YORK DIVISION OF HOUSING AND COMMUNITY RENEWAL INSIGNIA OF APPROVAL OF TIIE STATE BUILDING CODE I . Insignia serial number 2 . Name of Manufacturer ` '' � /..1 C 3 . Plan Approval number 4 . Model or Component Designation 5 . Date of Manufacture /'(} ? All the above information is to be found on a plate or sticker which should be affixed to the Mobile } tome . Complete above with that informaLion . ¢tiJ LJ / L L co co LSE 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 aLiLh ized by liq ownevy. Signature Owner , own p s anent , arcl tect , con tracLor SPECIAL CONDITIONS OF PERMIT : By Code Enforcement Officer DECLARATION.* Please sign below after you luxve carefully read t1te statenreat. To the best of my knowledge 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 noted, and that such work is authorized by the owner. Further, it is understood that I/we shall submit prior to a Certificate of Occupancy or Certificate of Compliance being issued, an AS BUILT PLAT PLAN by a lieensed surveyor; drawn to scale, showing actual location of project on premises. Signature: (owner, owner's agent, architect, contractor) RESIDENTIAL FINAL INSPECTION REPORT r Office No. (518) 761-8256 Date inspection request received: /Q Building & Code Enforcement Dept. of Community Development Arrive ff& amipm Depart aWpm Town of Queensbury Inspector's Initials 742 Bay Road Queensbury, New York 12804 NAME +"'_e 4�;; 4 s� � �1 ' PERMIT f0 6 / LOCATION DATE r s TYPE, OF s'iRUC'I E7RE NIA YES NO COMMENTS Chimney HeightP B" Vent/Direct Vent Location . Fresh Air Intake Plumb Vent through roof , Roof Complete Exterior Finish Complete fifi " Interior/Exterior Railings 30" to 3C1 Exterior Handrails, balconies, landing 18 im or more Interior Handrails stairs both sides 3 or more risers. Grade 2% awav from foundation 8" clearance to sill plate SA Gas Valve shut-off' exposed/regulator I ' above grade { Gas Furnace shut-off within 30 feet or with line of site f * /L e� �"'e Oil Furnace shut-off entraneE to �� Furnace/Hot Water Heater opera Relief Valve(s) installed Headroom, 6 fi. 6 in, on stairs Basement stairs, 6 f - 4 in. Handrail exterior stairs both sides more than 3 risers Interior privacy/trim/doors/mam entrance 36" � e /'J Z Floor Finish C^ �/ BathroonvRitchen watertight Interior Handrails Balconies/Landing 18 in. or more �� � e b e Railing across window in stairwells Smoke Detectors- every every level every bedroom outside every bedroom inter connected Bathroom fans Plumbing fixtures Foundation insulation 3/4 hour fire door/door closer Garage fireproofing Garage penetrations sealed Furnace in separate room protected (in garage) Light ventilation per morn Safety glazing 187' or less f-om floor Final Electrical Site Plan/Variance required Final Survey Plot Plan As Built Septic System layout required Okay to issue C/C (Certif. of-Compliance) Okav to issue temp. CIO (Certif. of Occupancy) Okay to issue permanent C/O (Certif. of Occupancy) 4149.) b;, THE NEW YO► RK BOARD OF FIRE UNDERWRITERS BUREAU OF EL TRICITY 111 WASHINGTON AVE., S E 70 ALBANY, NY 12210 Date OCT 13ER 06 , 1996 4262?69Po/ 98 A 1 :37e�45 Appppl:cation No. on }rre THIS CERTIFIES THAT L' R1iTT NU 3t3 5 -2 7 only the electrical equipment as described below and introduced by th applicant med on the above application number is in the premises of ROBERT & FTiNA 11RRWIN , 21 80GARI3USH , QEFf ENsBUR , NY in the following location, ❑ Basement ❑ 1st Fl. ❑ 2nd vi, OUT Section Block Lot was examined on OC".'l"C313E1t 01 , 1 G98 and found to be In compliance with the National Electrical G'ode, FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCE FLUORESCENT OTHER AM7. K,W. AMT. K.W- AMT. K.W, AMT. 11 K.W. AMT, H-P, DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC7T. TIME CLOCKS SELL UNIT HEATERS MULTI-OUTLET AMT. K.W. OIL H.P. GAS H.P- AMT. NO. A. W. G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. SYSTEMS DIMMERS s NO. OF FEET AMT, WATTS SERVICE DISCONNECT NO. OF S E � E METER R V I RMT. AMP, TYPE RQUIP. 1 B 2W 1 1 dW S B 3W 3 B /W NO- OF CC COND. A. W, G. HD- OF XI-LE6 A'- W. A. W. G. PER B OF CC. COLA, OF XI-LE6 NO, OF NEUTRALS OF NEUTRAL OTHER APPARATUS: FEEDER r #2 #4 FROM MCB TO 11H- 1 51 t11CHAk:D.. ROAD L L FORT EDWARD , Ny , 2. 2828 GENERAL. MANAGER 239 per This certificate must not be altered in any manner, return to The office of the Board if incorFacf_ Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. RIIVAL IIVSI�ECT'ICiIV +FSEr�r�r� r MOi@�ILL� / Mi7131.JLAR Town of Queensbury Building & Code Enforcement 742 Say Road " � 1 r '} Queensbury, NY 12804 ` - • Ji ! , (518) 761"8256 ARRIVE: JOLNIDEPART-. �j'IN5P: DATE INSPECTION REQUEST RECEIVED; NAME: LOCATION: + �•$ -y� ! � , PERMIT # , MOSII.E If011lL+ MOD=*AIlt Home FOOTINGS F NJNDATION $ACKFtLL i FRAMING N/A YES No 1, foundation pi spar per 2. anchoring per . . .. .. . . . _ 3. water line shut, o . .... . .. .. ... .. . 4. sewer line a 04 feet . . 5. heating crossov (dblewide) off grd. 6. dryer vented ou 71 skirting ventilated ..... .. .. .. ... .. .. ». 86 hot water relief valve piping_outside 9. deck, porches, s -7 10. furnace/hot water operating . ..... .. 11. garage fire proofing . ... .. .. .... . .... . 12. door clatCais 13. plumbing fixture . — 14. foundation insulation (if appl.). .. 15* smoke detectors ....Y� ). ft:ki _ 16# final electrical Y 00`d 17. variance required .. ....... .. .. . . . .. .. . 18. data plate okay ... .. ... .... .. .. .. . .. .. -- 19. mobile H M seal okay . .. .. ... .. .. .. — — Model # Serial # Manufacturer Date of Manufacturer OKAY TO ISSLTE CIO YES N(7 Comments: GENERAL IN,SPECTIQN „REPORT Town of Queensbury Dept. of Community Development Date inspection request received: Building & Code Enforcement 742 say Road Queensbary, NY 12804 Arrive 1 Z inL�.--fir Depart Inspector's In NAME: PERMIT # ~� 15 LOCATION: DATE TYPE OF STRUCTURE: RECHECK N/A YES NO COMMENTS Footings/Piers 0 1 Monol4iWc Pour Form orcement in Place The contractor is a for provj oYet' n from ing far foll g the t of thete. Materiis site Foundll ur Rei Foundation/Da fin BackSi — PlumbiSlab _ Plumbi ents in PlaceRough it Heating Rough4n lnsulation Foundation 'Walls Interior R- Foundation Walls Exterior R- Floors R- Walls R- Ceilin,g R- Duct work or piping in unheated spaces R- Proper Vent, Attic Vent Framin Jack 5tuds/I Leaders Bracing./Bridging, Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1, 2, 3, hour Penetration Sealed Fire Walt 2, 3, 4 hour Firestoppm GENERAL INSPECTION REPORT Town of Queensbury Dept. of Community Development Date inspection request received: Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 Arrlve�:7 �a�+rmt Dep Inspector's snit NAME: �V(` 1 (� PERMIT # I LC7CATIOR: 1`* DATE . TYPE OF STRU RECHFrcK NIA YES NO COMMENTS ocmings/Piers Monolithic Four Form D Reinforcement in Place _ '�� ► �b� t� �' Ede ' { Ht� The contractor is responsible for C--)L ., F c,�-- providing protection fro Mg for 48 hours Mowing p ment �' 1 '�►�� �1 kfij of the concrete. Materials for thus n si FoundationlWall Reinforcement in Place Foundabion/Dampproob pk;;ZZ� Backfill Approval Plumbing Under Slab Plumbing VcntlVcnts Place Rough Plumbing Heating Rough-In Insulation Foundation Walls Interior R- Foundation Waits Exterior R- Floors R- Walls R- Ceiling R- Duct work or piping in unheated spaces R- Pr,oper Vent, Attic Vent Framing Jack Studs/Headers Bracing/Bridging Joist hangers Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1 , 2, 3, hour Penetration Sealed Fire Wall 2, 3, 4 hour Firestoppin S FILE ' r AUG ,� i * ' UR1Y }�` >tJ .:�' S•'y f�}}},,,,,,��� TOW�lBul no- ! h R• + �. may, v tF• y s f � tM lc' DATE L- uzerne Rd. Phone: Queensbury, NY 12801 WOOF WMWMMWMET792-5838 Bssod oa� ! �a�nationi t =pha a with our eaaam►ts shall riot 5e w&uW as iwdbbng the in f I I,�.inn. --1—`- t 4� f i e Y F t t Lt t L } , I i r + I WASH/DRY MIR -- i L OPT. ITIi IT KITCHEN BEDROOM at 14`-8" A1a. 2 _ 9 4' T �.� DfNlNG o AREA o CATHEDRAL THRU-00 i N N } I Q LIVING ROOM $ MASTER 14'-$� BEDROOM BEDROOM No. 3 13'-2" � 6801CT/4824 BBEDRDDM - 2BATHS - CATHEDRAL THRU-OUT (1,096 SUT,1 551 New 1999 23' X 48' HUD Code Horne 31 Existing Septic Nip,I:wh . .. [ ` 4 Power 22 ' Existing 10 ' 110, 22 X 39 Slab 31 ' existing 0 driveway Wa er Details of the Merin Slab 0 21 Sugarbush addition to slab c� existing slab 112" rebar 22' X 40' 22' x -' existing slab to ab I i