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98-575 CERTIFICATE +C31JUL' 0 CCXJPAN CY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK October 19 911 Date 19 _ This is to certify that work requested to be done as shown by Permit No, 9 has been completed. MOBILE HOME This structure may be occupied as a 51 OHIO AVE . VAR30 - 1998 LAocation KING , ROBER.T Owner TAX MAP NO . 127 . - 5 - 9 By Order Town Board TOWN OF QUEENSBURY Director of Bldg- & +Code Enforcement BUILDING PERMIT VALUE $ 24000TOWN OF +QUEENSBUR.Y neo. 98575 TAX MAP NO . 127 . - 5 - 9 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to KING r RfJBERT OWNER of property located at OHIO AVE . VARIANCE 30~ 1998 Street. Road or Ave. in the Town of Oueensbury, To Construct or place a MOBILE HOME at the above location in accordance to application together with plot plans and other information hereto filed and approved and incompliance with the Town of Queensbury Building and Zoning Ordinance. 1. O VW8 d%rE QUEENSBURYr NY 12804 2. CONTRACTOR or SUIiLOER*S Name KINGSBROOK HOMES 3. CONTRACTOR or BUILDERS Address 4. ARCHITECT'S Name S. ARCHITECT'S Address B. TYPE of Construction — (Please indicste by Yt) MOBILE HOME l l wood Frame I I Masonry i I 'Steel l F 7. PLANS end SpecificatioM 14 ? X 70r MOBILE HOME AS PER PLOT PLAN SPECIFICATIONS No. S. Proposed Use MOBILE HOME 60 September 23 2000 S PERMIT FEE PAID - THIS PERMIT EXPIRES , 19 (If a longer period is required an apptication fer an eut*nsionn "%M be naade to the Buttrllrq And Zoning inspector of the town of auesnsbury before the expiration date.1 23 September 1998 Dated at the Town of Gueensbury this Day of t9 e SIGNED BY r _ for the Town of Ouensbury '"$uildinp Zonlnp Inspector goo REVIEWED BY : �� � r FEE PAID : PERMIT MOO ' APPLICATION FOR PERMIT MOBILE HOME OR MODULAR A BUILDING PERMIT MUST BE OBTAINED BEFORE PLACEMENT OF MOBILE FIOME , NO INSPECTIONS WILL BE MADE UNTIL A VALID BUILDING PERMIT IIAS BEEN ISSUED . The owner of this, property c i r l lY P . O . Address : z+'r-® " ri / Phone Number'���,,4__f:�; car Property Locatio" <: ornei Go ,� G NtC� tee, , Q ( Tax Map No . I.27 / 5-- NAME OF APPLICANT : Tihg Address of Applicant : All applicants spaces on this application MUST be completed and the signature of the applicant MUST appear on the reverse side of this appsEpation1% PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES : MOBILE } TOME INFORMATION APPROXIMATE VALUE OF NOME : 1" STCyr, New dome Yes ZONING INFORMATION : Replacement home es)No Size of Property : %6 ft x tCS ¢ ft Size of mobile home LVftx t Existing Buildings : Singlewide Doublewide --- No * of rooms ( exclude baths ) j Proposed building-distance from property line : Front Yard ft Rear Yard ft . No . bedroomsf Side Yards ft and ft , No . of bathrooms_ Occupancy Informati Primary dwelling : (Ya No Fireplace Woodstove Accessory Building ( s ) : Foundation style and size ; Detached garage ( one car / two car car ) Attached garage { one car"/ two car car ) Piers--No . of Size ft x 'ft Storage building Other Depth below grade ft Y\Foundation- Footing sizeZy x C4 !9 Wall material Proposed date of placement : �'-- allfr "� dY Wall thickness '" Height _"' Water Supply : Well Municipal Total depth below grade ft . Septic permit required ? y E! Grade to home floor. levei ft . FURTIJER INFORMATION REQUESTED ON THE REVERSE SIDE OF TIII S SHEET LL , LE OME DEALER : ftlr1c gaol/ DO SSM x �0 {+�cc , rncc .rfc7 �? Ca � STATE OF NEW YORK DIVISION OF I10U5ING AND COMMUNITY RENEWAL INSIGNIA OF APPROVAL OF THE STATE BUILDING CODE 1 , Insignia serial number l T"/ af ey 7 f I0 2 . Name of Manufacturer c ,Tey� of V 3 . Plan Approval Number 4 . Model or Component Designation ze. 5 , date of Manufacture All the above information is to be found on a plate or sticker which should be affixed to the Mobile Home . Complete above with LhaL 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 belL, 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 trh~�e- owner . Signature �r.�a r. ' Owner , owner ' s agent , architect , contractor SPECIAL CONDITIONS OF PERMIT : By Code Enforcement Officer DEC"RA77©N.• Please s'19 n below after you Itaue carefully read the statefirew. To the best of my knowledge the statements contained in this application , together with the plants 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 l/we shall submit prior to a Certificate of Occupancy or Certificate of Compliance being issued, an AS BUILT PLAT PLAN by a licensed surveyor; drawwn. t-o� scale, showing actual location of project on premises. Signature: ^�2 r fi��� (owner, owner' agent, architect, contractor) SEP - 22 - 1998 09 : 58 AH NCIRTHWINDS11091LEPARK 792 5838 P . 01 Application for SEPTIC DISPOSAL PERMIT Tov*z of Co=Miry porn t . ^: ,�75 tart. of Comssttteiity 1]evolopm+oac S E P�a 1998 Building & Codas Office 742 Buy Road Fee Pail S Qucansbuay, NY 12504 Location of property for installation: d 14 t o �- 2r,! 7XA Property Owner's Name: K .,. ry Property gutter's Mailing Address: H-" ^A e I, ,�/.A- t . Installer's Same: Re✓ L r Ay f Fsr« a{' Phrsne # 7 9 ' `? 0 S- 7 Number of bedrooms (if residential): � � _ Total daily flow: (residential - compute 50 gaLAArm.) Topogmphy- t, r0UinS, Steep slope of slope Sail Nature: ✓ und, loam clay, athw / depth; _ Ground wafer: at what depth? feet J Bedrock or Tmgervious IMi'aterizi. --•:iat depth? feet Percofaticaa test: ✓rust required, required ( ratemin. per i:: Taousestic wirer supply: e/ rnuniCCiP&L Weil, orker --- - __ If dotssestic water supply is a WELL, water supply from aay septic absorption _ feet. PROPOSED SYSTEM ,Septic tantr 2b? 70 SLUoo (Mb2imUm size: 1,000 gal.) Tile field: each tt h feet / Total system tength:w Seepage pit(s): number of ! size each: fL by _ ft. Size of some to be used: ' _ I depth or tf4c ernes HOLDING TANK SYSTEM: (if required) Number of tanks: Size of eacfi: A]axm apabm nod aesaoutbrd e1 wv%k to be rnapecvted by a cogUami3 *gva . For your psoteatpon. PIsaen ants thd puragme to Section 138-29 of the code of the Town of Q*R�el.. : : OW permit or qppcovsi gromted wbich is band upan or is a'r+xteci is retis=e upon +my =teairl ms•epye*.�.:, ;:,,,lose to maTov a mwtexigl frt or aircunutonve 'im va► by or au behalf of no sVptiosnt; &bail be Ngai& I have lewd the sepulakas with nwpmt as tLis apPL&Cm== a 0d nFroo to abide by dame and aU o As a the Town of quvec sb,uy &=&L y tia'°rr8e 19 Signature of responsible petsori: Late: FL'IVAL.; IIV'SP�EG"Tlf��nl IF��Pc�r-s r .MQBLL / MC10UL�A1M Xr3�.._. Town of Glueensbury ' /I Building & Code Enforcement 742 Bay Road Queensb 76 NY 12804 518) 7s1-8256 ARRIVE �:PZQ� DEPART: I �• DATE 1NSPE T10N REQUEST REC QED. Gf NAME-. LOCATION: DATE. C) + ' PERMIT # 11�148ILIi '�iQ1�. bit mneAR IKOME CGS PouNnA�nar� RAC1 FU-,L I~�MING NIA YES NO i. foundation suPPorU 'Fier sPacmg per tnanuf. .. .. .. ..... . . .. .. .. . 2, amt uaring per f 3. water line shut,Off 4. sewer line stWort t 5. heating crossover ( ewn e 6. dryer vented ..... .. .. ... .. .. .. .. .. 7. • skirting vea S. hot water re of valve piping outside 9. deck, porches• steps' railing -- 10, fiumcelhot water operating — - 11. garage fire proofing . .. 12. door closers 13, plumbing fixture .. . --- -- 14. foundation insulation (if aPPI.).. .. .. 15, smoke detectors .. ....... W. #A A 16. final electrical 17. variance required A . .. .. .... . .. . . . 118. data Plate Okay •• ••• 1. .. .. .. , .. -� 19. mobile HUD seal okay .. ... .. — �- Model # Serial # Manufacturer Date of Manufacturer �u~`~ OKAY TO ISSIJE C!O YES NO Colts: COMMONWEALTH ELECTRICAL INSPECTION SERVICE, INC. + Main Oftice 357 Ehvyn Terrace / MUNICIPAL CERTIFICATE Manhe"n, PA 17545 - ELECTRICAL APpRpyAL .� Panel Board No. . 59233 Cert, Owner , _ . .. .. .. . . ✓ �i � Cut-in Card No. Occupant . . . . . . . . .. . ... . . . Location ....."".. �I.. .................. ... ..... . . . . . ".. . . . .. . . . .." ", ..."" Installation Consisting of, ....... Installed By ✓ .............".....".._."_..... .. .... .,,.. . ., . . . The conditions fuUawin •-��-..".......-..". Lic. #." . .issued is cancelled; g governed the issuance Of this certificate, and "r1 -- " - ........... This certificate only Covers the electrical a ui anY certifica�e previuu.ly the introduction of additional equi q pment and installation c:c,nditi<in�: as or date- Upon tnsPe Patent w alterations, a 1 Inspectors of this Co pP [cation shall be prompilY made for rules are violated, the Co Company shall have the privilege of making inspections at an any shall have the right to revoke certificate y tmc• an d if its `" ".... FN$PECT Member N.F'.P„A.,, f.A.E,f. . . . . . . . . .- f=ff�tE+GTfON AEf�L7FlT MOEiILIE� / C3C3ULAR I �Queensbury Building & Cade Enfarcem I } 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: 11A> DEPART: '� t" ����INSP�DATE I CTION REQUEST RECEIV ` - w LOCATION: � G/ DATE: L) PERMIT # P40BILIC fo ,g 1140DU"lt *rou FOOTINGS � FOUNDATION y SACKFIL.L � IPRAN41NOs 1 . foundations support NIA YES No uppo pier spacing Per manuf. 20 anchoring per manuf. ~ 3, water line shut off . . .. .. .. .. .. . ,_ 4. sewer line suppo t� rl 5. heating crossover ( ) off — 6. dryer vented outsi -- 7. skirting ventilated 8. hot water relief valve piping outside 9* deck, porches, steps. railing . . . . . .. 10. furnace/hot water operating 11 . garage fire proofing , . _. . . . . . _ 120 door closers .. 13. plumbing fixture . .. . . . .. . . .. . ~ 14, foundation insulation (if appl.). .. .. . ~ 15. smoke detectors . . ~ 16. final electrical . . . .17. variance required .. .. .. .. . . . . . . . .. . . . . IS data plane okay — / ~ 19. mobile HUD seal okay . .. .. . . . . . . . . . ✓ Model # ix f K 1 tf 3 Fes' 9rai t Serial # Manufacturer Date of Manufacturer _ 2 t ='t .77 OKAY TO ISSUE CIO YES NO Comments: OWN P 1 �BUILDIING CODE ENFORC MM 742 Bay Rvad Queensberry NY 112804 (519) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name _ Location =1-d- Date 9faa/ eP Permit 4 98;J SOIL TYP a- CIay- Results f Percolation Test- ( if appli ble ) Rat MD Pe. Inch TYPE OF SYSABSORPTION FIEL'�T.-,� th Length of each ranch ,sly Depth of tre hes Size of stone s SEEPAGE PITS : Number- + Size - ft . x Stone size -- ft • PIPING: Size Bldg . to Tanis #-,� ype _ Tank to Dist . Box „-- „ L Dist . Box to Field/Pi ,,, _ Openings Sealear LO ATION/SEPARATIONS : Qi Partia Foundation to Tank Foundation to Absorption feet feet Separation o� Pits — Conforms as lan LOCATION OF er ( circle one ) SYSTEMoONpPROP ERTY , r Front - Rear - Left Side - Right Side Middle Front •- Middle Rear COMMENTS: II SYSTEM USE APPROVED; < O Arrived: ; j , Departed • rr ding Ins or fiilhfAL iNs3i�QCTiCi1V BRAS �'Di:3i1�E / M41L7LiL,rgq, Town of Queensbury Buifdi r<9 & Code Enforce+meM 742 Say ROW CkcO tnsbury, NY 12804 (S18) 761-8256 ARRIVE: ] INS �- DATE INSPE RE? �E57 _ j RECLIV NAME: i h I LOCA77ON: 1 ,BATE: PERMIT # l+srOBSL8 ors mic lrarop�rL,1►>tt �Fro>KE I'0077IVG3 ` FOUNDATION CICx7LL — l'RAMING _ I L4undsti on S C1[I N/A YES NO per per ��1ar+lt spacingwportv Pier �f- 2, anchoring 3, water line shut - — 4. sewer I- • 0. -- —_ S» heatin support 4 feet -- R saver (db 6• [fryer vet ¢outside . '�' -- 8. hot ter relief valve 1 .�P�B . .. .. .de -- IU. furuacelhot s ' ,reefing • .. .. .. . -- 11. garage frer&ting _ ^— --- _— 12, door closers 13. plumbing rixt� .y .. . .. .. .. . .. .. .. . .. . = -- -- 14w foundation insulation (if IS. smoke detectors 16. final electrical 17* variance requires! . -- 18. data plate okay --- 19. mobile HUD seal okay .. .. .. . Model # Serial # Manufacturer Date of Manufacturer OKAY TC) ISSUE C/o YES Nry Comments- �inrt�L rNe�ss��cr� Town of {Queensbury Building g Code Enforcerrtent 742 Bay now Qu (5188)j ?6i- NY 72&W zrvE: DEpARTt/Q. rtvsr�: n•',rE rnrspEc»rro REQUEST RECEIVED; NAME: A..s<^ LOCAT70 N`. i DATE; ' M08ILE 1t0allm PERMIT �p MOOULAit011[$ -�. FC1�.INUATICIN � RA ---'--- 7J t, I- foundation suPPort, pi Spat N!A YES NO Per manuf. ` z• anchoring per Manuf. » d 3» water line shut off --- -� 4. sewer lime • - - -- -� • Beating crosuPPort 0 4 Itssover dryer vented outside de) off 9rd. hot Water relief Valve 9. deck Ming outside I a garagee� Ovate Operating . .. .... proofing re ... .a ... .. -�12. door closers . .., ». .. ... .. . 13, Plumbing -» . .. .. . .. .. . .. .. . foundation insulation (if apPl•). ..1S 81110ke ors I5. final electrical . .. .. . .. .• . . .. .. . - 17. variance require.. .: ., . .. .. ... .. . . . .. .. . -" -� l data plate okay -� 19. mile FIZ3D seal okay . .. .». ..... .. . Model # `- --- -� Se='ial # Manuf ldbirer Date of Manufacturer OKAY To rsstiE C/o Ylrs Co,ru„�,ts: NO FINAL 1NSiA�CT1Cf� i4�pr��]k�.�-22�C?�y..-� Town of 'Queensburyr U Q- 8"ding S Code Enforcement 742 Bay Road Qu (esnsb 7tY. NYfi 72a04 i� ARRavE: j' 2ATE INSPECTION a+�— QUEST RECEIV r NAME: LOCAT7CIN: BATE: J 9 p 1 t� PERh+gI7' # MO$I'j„8 HOiAt$ --- 11lovwj.AR HOAR'& FOOnNGS FOuNDAT[ON >3ACHFAIL f'RAMIMG _ 1. foundation ou d tion 6 UPP f Ort, pier spacing NIA YES NO 2, anchoring per manuf .. .. », .. .. .. . 3. Waterline shut aft -- } sewer lutes rt 0 4 feet --- S• heatingc upper . .. .. .• rossover (dblervide) off grd• f 71 skirting ventilated I .IV bat water relief val94 deck, ve piping outside �- 10- We/hot water steper s. ranting I .. ... .. t 11. garage fire prao �rating fing plumbing 14,. 157ttwe .... .. .» ... .. .. . .. .. .. �-- - on 15. smoke detectors Cif app1.).. .... �' -- --- 16o final 17* i8. plate okay data electrical required . . .. .. ... .. .. . . . », .. »okay 14» mobile HUD �- .. .+ ..... .. .. .. . �Yox C a Manufactuuer '�_�� Trial Date of Manufacturer OKAY To YES NO Comments: 0/1 Fc+ Axew /c/ /9ececa too efe 204, Ale Ad 1p;rt,, ClKs ) t mot' y' tr•rr TjlC r J/ 4 JP _ n 06 tb RI c N (�j) 0 (9D a n71e Im p46 _ Z Olt on in ti _ . Orr .- o i ,. MASTER . / BEDROOM LIVING ROO'.�.5 �yH tl�C:1{EN BF.DRC3C?M #8 / f�f 12'-C7 . s t ;b'-C3" DUNING _ BEDRf.X1 M v2 T2'-8 - �YV 1 Y c.} III a, 00 44 � s r _ s 1998 M r- I- p m Q . 0 .� �`p as gX� x ` 4 w W, P O E o � p Y^�'}}�7 1 T R: L4 ry 1• r n � 444 N C) N y h +7J CP w 7job*bm rMed, or ber f sasr � , aeas, wek trees► at I also represent #hat I iwAve, the distances set forth o1 the do " Si�NATURE DATE