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97-334 CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date July 14 19 97 3Cq 161 - This is to certifytfiat work requested to be donebyPermit9' 33 q as shown No. has been completed. MOBILE HOME This structure may be occupied as a • 53 INDIANA AVE. Location Owner BAILEY, MICHAEL & KAREN TAX UAP NO. 127 . _4_9 By Order Town Board TOWN OF QUEENSBURY Director of Bldg. & Code Enforcement . BUILDING • PERMIT . . TOWN OF QUEENSBURY VALUE $ 0 Na • TAX MAP NO. 127 . —4-9 • WARREN COUNTY, NEW YORK • - 97334 PERMISSION is hereby granted to RAILEY, MICHAEL & KARE-N OWNER of property located at 94 TNDIANA AVEti. . Street,Road or Ave. in the Town of Queensbury,To Construct or place a MOBILE HOM • at the above location in accordance to application together with plot plans and other information hereto filed and approved and.in compliance with the Town of Queensbury Building and Zoning Ordinance. 1. OWNER'S Address is 8 PETRIE LANE QUEENSBURY, NY 12804 2. CONTRACTOR or BUILDER'S Name • 3. CONTRACTOR or BUILDER'S Address 4. ARCHITECT'S Name . 5. 'ARCHITECT'S Address • : • . 6. TYPE of Construction—(Please indicate by X) • M9BIIiE HOME ( )Wood Frame.- ( 1 Masonry ( )Stee 7. PLANS and Specifications . .• MOBILENOHOME WITWVARIANCE APPROVAL, PLACED ON THE' LOT AS PER PLOT . PLAN AND SPECIFICATIONS 8. Proposed Use . MOBILE HOME $ 66 • PERMIT FEE PAID —THIS PERMIT EXPIRES June 27 19 99 (If a longer periodis required an application for an extension must.be made to the Building and Zoning.inspector of the town of Oueensbury before the expiration date.) Dated at the Town of Queensbury this 27 - Day•of June 19. 97 SIGNED BY for the.Town of Queensbury Bus Ong and Zoning Inspector • • ,. JUN .2 3 1997 iOVE<< dablik • $111Plaik : • TOWN OF Q UEENS I3 UIZ Y REVIEWED BY: FEE PAID: $ PERMIT NO. q7-5347 APPLICATION FOR PERMIT MOBILE HOME OR MODULAR A BUILDING PERMIT MUST BE OBTAINED BEFORE PLACEMENT OF MOBILE HOME. NO INSPECTIONS WILL BE MADE UNTIL A VALID BUILDING PERMIT HAS BEEN ISSUED. The owner of this property i s: \l -\\ e L. C\. , AC t Q P.O. Address: Phone Number -71(0\—Uku,i ck Property Location 1 �$ P Y —c-,k Q\ �-�k,cs."r,, Tax Map N o. / / NAME OF APPLICANT: Address of Applicant: e=l 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 RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES: MOBILE HOME INFORMATION '1 (Q�l�✓ ob D' APPROXIMATE VALUE OF HOME: New Home -- No ZONING INFORMATION: Replacement Home Yes �' i 6/14 Size of Property: AO ft x /QD ft Size of mobile home /<(,ftx .74ft Met Existing Buildings: Singlewide &- Doublewide -- No. of rooms Proposed building-distance from property line: (exclude baths) . Front Yard ft Rear Yard 10 ft. No. bedrooms ' 3 Side Yards /0 ft and 36 ft. No. of bathrooms • Occupancy Information: Primary dwelling: No Fireplace Woodstove Accessory Building(s) : Foundation st 1 ra d size: � . Detached garage (one car /two car car),� � ' , 1 Attached garage (one car /two car car) PierNo:�o ' Size`-� qe, -torage building ft Other Depth below grade • ft * * * * * * * * * * •A• * * * Foundation-Footing size " x• " Pro osed date of placement: Wall material 3t \ �� Wall thickness " Height " Water Supply: Well Municipal Total depth below grade ft. Septic permit required? Grade to home floor. level ft. ' FURTHER INFORMATION REQUESTED ON THE REVERSE SIDE OF THIS SHEET NAME OF INSTALLER/MOBILE HOME DEALER: [ c ck !-SL ,�Cn Ivt nuvv ,,,, ADDRESS/PHONE; NUMBER ��—l� / ) • STATE OF NEW YORK DIVISION OF IIOUSING AND COMMUNITY RENEWAL INSIGNIA OF APPROVAL OF THE STATE BUILDING CODE 1. Insignia serial number S `N0% 'S.3( r 2. Name of Manufacturer C__.Ac-,k-\\\ . 3. Plan Approval. Number R(\ >c.C�� 4. Model o.r Component Designation -K 5.3-7 a 5. Date of Manufacture i 01- 0,5/ All the above information is to be found on a plate or sticker which should be affixed to the Mobile Home. Complete above with thatinformation. 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 bq. 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 the owner. Signature Owner, owner' s agent, rciitect, contractor SPECIAL CONDITIONS OF PERMIT: By Code Enforcement Officer DECLARATION: Please sign below after you have carefully read the statement. 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 PLOT PLAN by a licensed surveyor; drawn to scale, showing actual location of project on premises. Signature: Ot 4 - - e,, weer, wner's agent, architect, co tractor) Application for SEPTIC DISPOSAL PERMIT c(7- 3 /- Town of Queensbury 41'44.)-Li —3 / Dept. of Community Development Permit No. Building &Codes Office JUN ,2 3 1Q97 742 Bay Road Fee Paid $- Queensbury, NY 12804 TOWN OF CaJ,=,.--11•1: lOPy BUILDING AND CODE__ Location of property for installation: L-0-\- 1r- O Nve • Property Owner's Name: WI Pt--k P Property Own r's Mailing Address: histaller's Name: ( /.) Phone # Number of of bedrooms (if residential): Total daily flow: 4IS—D (residential - compute @ 150 gal./bdrm.) Topography: 2 -flat, rolling, steep slope % of slope Soil Nature: 011—land, loam, clay, other /depth: Ground water: at what depth? feet / Bedrock or Impervious Material: at what depth? feet Percolation test: not required, required [rate min. per inch ] Domestic water supply: Xrnunicipal, well, other If domestic water supply is a WELL, water supply from any serdc absorption is feet. PROPOSED SYSTEM Septic tanIc/DO gallon (minimum,size: 1,000 gal.) ro Tile field: each trench feet / Tcital system length: ° feet • Seepage pit(s): number of / size each: ft. by ft. Size of stone to be used: # / depth or thickness 1 feet • HOLDING TANK SYSTEM: (if required) Number of tanks: Size of each: gallons Alarm system and associated electrical work to be inspected by a certified agency. • 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 'cation and agree abide by these and all requirements of the Town of Queensbury Sanitary Sewage Dispos Signature of responsible person: _ Date: FINAL INSPECTION REPORT MOBILE / MODULAR VAO(vo pktA Town of Queensbury Building & Code Enforcement 742 Bay Road Oc Li1'Queensbury, NY 12804 �ii' (518) 761-8256 4. + ARRIVE: 2 • EPART: \'lam INS' .d � d", , DATE INSP'CTION REQUEST RECEIV -•ill C 1 NAME: VAC 1-4AE 1� c3i� �E.'i iii LOCATION: \. DATE: 7 I14--9 7 PER MIT# 1 MOBILE HOME M 1)LILAR HOME k FOOTINGS _ FOUNDATION BACKFILL FRAMING N/A , YES NO 1. foundation support,,pier pacing per manuf. t'i 1 — / #2.. anchoring per manui33 — — 3. water line shut off — _ 4. sewer line support @ 4 feet — — — 5. heating crossover (dblewide) off grd. — ,_. - 6. dryer vented outside , — — — 7. skirting ventilated — — — 8. hot water relief va ve_piping outside 9. deck, porches, s lips, railing — — — 10. furnace/hot watoperating 1 — — — 11. garage fire pro9fing — — — 12. door closers , — — — 13. plumbing fixtdre '... — — — 14. foundation insulation (if appl.) „, — — — 15. smoke detectors , — —. 16. finalelectric. - - 17. vaik cer ' '' ed ..E.VMOT:. erbpirl — 18. data plate kay 19. mobile J D seal okay 4, — Al .— r Model # Serial # . J �i ' Manufac r �©Lc) j \Ac) ) . \,\\ Date of anufacturer 1 OK Y TO ISSUE C/O YES NO Comments: FINAL INSPECTION REPORT MOBILE / MODULAR ` Town of Queensbury Building & Code Enforcement 3 4 % 742 Bay Road Queensbury, NY 12804 (518) 761-8256 • m ARRIVE:Z°4 CDEPART: 2,JINSP. i' DATE INSPECTION 1EQUEST RECEIV ` a is ,1 Tr �� a, NAME: 1 0.;. , LOCATION:,----•ti s , ` ` `' DATE: — PERMIT# ,1'/t— ,J it p, i MOBILE HOME E, MODUI,A,, IROMIZ I:. FOOTINGS FOUNDATION BACKFILL FRAMING I— ': • f N/A . YES NO 1. foundation support, pier spacing — per manuf. _ 2. anchoring per manuf. � _ �— 3. water line shut off `; I �- 4. sewer line support @ 4.,feet .. ... j5. heating crossover (dblewide) of grd. _ 6. dryer vented outside Fi i _ — 7. skirting ventilated — 1 — 8. hot water relief valve piping outside -- 9. deck, porches, steps, railing _ fi 10. furnace/hot water operat'ng` o 11. garage fire proofing Y / 12. door closers _ 13. plumbing fixture 4k 14. foundation insulation'(if appl. _ — 15. smoke detectors _ / 16. final electrical y` _ v `� � - 17. variance requir 18. data plate okay _ / 19. mobile HUD s 1 okay _ �( Model # L Serial# r Manufacturer _47749..6_----\ Date of Man facturer OKA TO ISSUE C/O YES VIO Comme N— ' Pt 0, a_ gr- -_IA-Vk 1 ,M., e t6 . COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC. (� Main Office 357 Elwyn Terrace — Manheim,.PA 17545 �LyJ MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL '` .32 Panel Board No.,. Cert. 4 4 17 4 Cut-in Card No. . Owner / r6eV Occupant Location . _N Yn///n_A e /0 1161 I a a NX Installation Consisting of.. d/3/me. /44 )i& 6,724/7 f d AiL/ Installed By...( 1Au 4% 8eI Lic. # 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 be promptly made for inspection. Inspectors of this Company shall have the privilege of making inspe i ns at any time,and if its rules are violated.,the om any shall have the right to revo th' ertifi ate. Date INSPECTOR ... Member N.F.P.A.,I.A.E.1. Pik V.,c\-c-C-'- TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT Nun 742 Bay Road Queensbury NY 12804 1 0--.. 'n�1 (518) 761-8256 °�'� SEPTIC DISPOSAL SYSTEM INSPECTION Name MiC4IAEI_ f3p14.E;A Location .15 4 t\3OtLtas, `\ili Date Permit #q-7--, 'I SOIL : Sand- ay- Results of Percolation - t- (if applicable) ir ate- 'nut- Inch TYPE OF S ABSORPTION . ot:l Length Z-zP Length of each tren _, Depth of trenches ZJ Size of stone Z SEEPAGE PITS: Number Size - t—x ft. Stone size _ PIPING: Size Type Bldg. to Tank /--°°1)04-11 - Tank to Dist. Box Dist. Box to Field/Pit 0t1 1�- Openings Sealed? s o Partial LOCATION/SEPARATION . Foundation to Tank ‘15 feet Foundation to Absorption t D feet Separation of Pits feet Conforms as per Plot-Plan CC es LOCATION OF SYSTEM ON PROPER (circle one) Front - Rear - Left Side - i ht Side Middle Front - Middle Rea COMMENTS: Pf -I-F\ E- V - \S _ 6Rvt VIV\---V___INA\___ _V_- co13 -cvv SYSTEM USE APPROVED: YES .NO Arrive. . ^ Aft Depa, ed: ^Ali �/.�// /.`1 /. : il .ing In.p=ctor PD C • # of C 9 e J-Diev/y , acIS ti 57 c. , 42005' (518) 761-8256 TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 742 BAY RD., QUEENSBURY NY 12804 INSPECTOR'S REPORT: ARR c/DEPART7 N- . REQUEST FOR INSPECTION RECEIVED: NAME V i- Lt. LOCATION L�� � �. t1i= DATE . 711 !7 PERMIT A 9-7 : v' TYPE OF STRUCTURE: 1` K)V3I1�-, �6`'IE RECHECK APPROVED N/A YES NO ` FOOTINGS/PIERS 0.4.N E\%21%-› ►MONOLITHIC POUR FORM REINFORCEMENT PLACE ' � ' % k//7 THE CONTRACTOR IS R' - NSIBLE OR PROVIDING PROTE TION FR'" "'ZING FOR 48 HOURS FOLLONILG THE PLACE- MENT OF THE CONCRET' . MATERIALS FOR THI• PURPOSE ON SITE FOUNDATION/WALLP.UR REINFORCEMENT IN PLACE �-- FOUNDATION/DAMPPROOFING `J BACKFILL-APPROVAL PLUMBING VENT/VENTS IN PLACE ROUGH PLUMBING PLUMBING UNDER SLAB FRAMING: JACK STUDS/HEADERS BRACING/BRIDGING _ •JOIST HANGERS JACK POSTS/MAIN BEAM AIR INFILTRATION BARRIER HEATING ROUGH-IN INSULATION: FOUNDATION WALLS INTERIOR R- FOUNDATION WALLS EXTERIOR .R- - - FLOORS R- WALLS R- ` CEILING R- DUCT WORK OR PIPING IN UNHEATED SPACES R- (518) 761-8256 TOWN OF QUEENSBURY r, BUILDING & CODE ENFORCEMENT 742 BAY RD., QUEENSBURY NY 12804 INSPECTOR'S REPORT: ARR DEPARTt7-Lt5I.` L^ REQUEST FOR INSPECTION RECEIVED: NAME -1; LOCATION �� \ ( � p Ve DATE 7 E 197 PERMIT A 91 3 \/. TYPE OF STRUCTURE: RECHECK APPROVED N/A YES NO FOOTINGS/PIERS cA 1 MONOLITHIC POUR FORM REINFORCEMENT IN PLACE THE CONTRACTOR IS RESPONS Bt FOR PROVIDING PROTE TION FRO FR` EZI FOR 48 HOURS FOLLOWING T•E P . CE MENT OF THE CONCRETE. MATERIALS FOR THIS PURPOSE ON SITE FOUNDATION/WALLPOUR REINFORCEMENT IN PLACE FOUNDATION/DAMPPROOFING BACKFILL APPROVAL PLUMBING VENT/VENTS IN PLACE ROUGH PLUMBING PLUMBING UNDER SLAB FRAMING: JACK STUDS/HEADERS _ BRACING/BRIDGING JOIST HANGERS JACK POSTS/MAIN BEAM AIR INFILTRATION BARRIER HEATING ROUGH-IN INSULATION: FOUNDATION WALLS INTERIOR R- _ FOUNDATION WALLS EXTERIOR R- FLOORS R- WALLS R- ' CEILING R- DUCT WORK OR PIPING IN UNHEATED SPACES R • - PI An 1(4 ix i 3 BED Roim • .2)A-r-t-j. ivol_t_c) e • ,i_ L /A% -r a)P,LE _.: L___________ .e"-tiz•,..t r'u- P—,.., _;-7,_ 01 Ii\-'\hth,gr,N.141 • JUN .2 3 1997 _.„ ' , I TovAi OF QUEZ,46::: URY & ..7J • 6 \., - BUILDING AND CODE I ; 7 i - - (<•... ' /\. nr\ C' (1 • . ‘,. 'b"."- ---I t ,,.... . !'l 1112 ..i...1'..z f\---: i.2... o: 41 j 7 otA i I : . ,,,,.0. : F..:jd, • 1 , .1' • . : 1 , _ ,, ,‘, • -...,, ; I : ...) 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'C-.,12:._. i . i . 4.. sl/ SCA!C. . __ __ _.... ______ „4- I = 101 LCI:Tr 9 s , 1 KDIR ski A A VE. . , . :-....- .........3 .a.k. . . _ iL D 1 pFer---ivf---.. . JUN .2 3 1997 _ 1 . . . • 1 TovvN OF QUE2:1•:!, ),RY -.9 i N;i . ilk . I I . ; i I I, 5 --7----4------>N I i 1 E . . . , _ . • • o i 1 . _ 1 I , . . . , . I . \I./ . . . I . . . . , . 1 • . I . . . 1 . . I . Q. . , ! I \'0. = \..0% . I . . i . I '. I . i 1 \L\ __.-- ,_____. . i f_-_- ,(..---.„---7 pc\J \_,.,,L_ W7 � �i� / it, /\ ,i _ ,..:. ci --.-7_ 3 4 JUN .23 1997 . 1 'FOB,,t�._.: .u:; ._: . ..'PY © �� EiiiilOIi' .\I C ut / l/ ✓✓ «� ;. Jf,, ' / F' oh ®S �` . ,i ,;, >: („, ‘ , L- , 1 a . , 1 N s� Dot o is� O i � pue V I ! s TOWN OF QUEENSBURY BUILDING DEPARTMENT !; PZ);` 4a F Based on our limited examination, �� L tY1,' `'� compliance with our comments shall t)lication not be construed as indicating the plans and specifications are in full JUN 2 ILI compliance with the code. l ;`� %? c J ffi''a. u i m +U ' n� t pp Zoning Administrator �, hs'' N 1 i..>y� za o TOWN OF QUEENSBURY ``��LoArA a