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97-411 BUILDING PERMIT VALUE $ 14000TOWN OF QUE.ENSBURY No 97''4 r-= ' , TAX: MAP- NO'. 127..-8-13 WARREN COUNTY, NEW.YORK 30q, — -- 1-7 PERMISSION is hereby granted to - MALLANEY. JOHN OWNER of property located at 35 INDIANA AVE. 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 in compliance with the Town of Oueensbury Building and Zoning Ordinance. 1. OWNER'S Address is 11: INDIANA AVE. QUEENSBURY : NY,...: 12804 2. CONTRACTOR or BUILDERS Name •.;: ;MALLA�EY :...JOHN 3. CONTRACTOR or BUILDERS Addres 4. ARCHITECT'S Name .:; NEW: YORK. BOARD,...._,a- rw� 5.-A CHITECrS Address OFx:.F IRE.:,: UNDERWRITERS.... 6. TYPE of Construction-(Please indicate by X) MOBILE:. HOME )Wood Frame ( I Masonry ( )Steel . ( 1 7. PLANS and Specifications _ w_980.:N§,Q., FT' MOBILE,-HOME AS,. PER...PLOT.'.::P-LAN.,.:SPEC:IFICATION : :: B. Proposed Use . '4 MOBI l OMB :.- D.eei ileLeldi.dl,,',skti.�k.sama+fia a.9�e:iAw'�• $ PERMIT FEE PAID -THIS PERMIT EXPIRES 19 • (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the town of Oueensbury before the expiration date.) k :19 , ,_. _ a De.ceinber: 97 � � Dated at the Town of Oueensbury this fDay of ' ` 19 SIGNED BY for the Town of Oueensbury fluff ding and Zoning Inspector Application for SEPTIC DISPOSAL PERMIT Town of Queensbury Permit No. 7.1/1 Dept. of Community Development Building &Codes Office 742 Bay Road. Fee Paid $ Queensbury, NY 12804 Location of property for installation: s1�//A/7,•9 4C' 7 /11,o, 014/I27—: /3 Property Owner's Name: fl h;n Yv1W11w tic y Property Owner's Mailing Address: 36 -z7id/AAA 6/6 Installer's Name: 1 Y\v\ v`kvm1Avvc.y Phone # 79 6 9YO . Number of bedrooms (if residential): .S - ==Total daily flow: ' '5 7 (residential - compute @ 150 gal./bdrm.) , Topography: 'flat, rolling, steep slope % of slope Soil Nature: Viand, 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: /unicipal, well; other If domestic water supply is a WELL, water supply from any septic absorption is feet. PROPOSED SYSTEM Septic tank: /07121 gallon(minimum size: 1,000 gal.) Tile field: each trench 5'd feet / Total system length: 41 feet Seepage pit(s): number of / size each: ft. by ft. • Size of stone to be used: # c / depth or thickness feet . HOLDING TANK SYSTEM: (if required) Number of tanks: Size of each: . gallons r 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 respect,to this application and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Signature of responsible person: ",77 Date: int • 1011111 OWN OF Q V ENSJ3 U1Z Y REVIEWED BY: , FEE PAID: $ PERMIT NO. APPLICATION FOR PERMIT t- 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: • ohn (�, 'M \1yin P.O. Address: .3 .174://; /19 / IL Phone N/umber6S/079,9 9 Property Location �c//A/IA /4/6 Tax Map NoAr7/ s7 / �3 NAME OF APPLICANT: .se& 7114 //ef-Al£� Address of Applicant: 5v74/ 6eisA All applicants spaces on this application MUST be completed an / 1997 signature of the applicant MUST appear on the reverse side of this apnlica4.0rii. PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES: MOBILE HOME INFORMATION �TO 1ft APPROXIMATE VALUE OF HOME: $ /1/02/2) , New Home Yes No" ZONING INFORMATION: Replacement Home Yes40, Size of Property: gU ft x /Cid ft Size of mobile home / ftx/oft Existing Buildings: �n�� Singlewide V Doublewide Proposed building-distance from property line: No, of rooms (exclude baths) S Front Yard ft Rear Yard ft. No. bedrooms Side Yards /o ft and /4 ft. No. of bathrooms Occupancy Informat • Primary dwelling: Yes No Fireplace /JO Woodstove Accessory Bui l di ng(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 * * * * * * * * * * * * 1- Foundation-Footing size/3 " x eov, -- t Proposed date of placement: Wall material '�� -/$- y7 Wall thickness " height Water .Supply: Well Municipal Ir.." ' Total depth below grade • ft. Septic permit required? •>/ ,. Grade to home floor level ft. FURTHER INFORMATION REQUESTED ON THE REVERSE SIDE OF THIS SHEET • NOTICE TOWN OF ''�",jI�.��``���� d�a�: ANCHORING OF MOBILE HOME U F 1 4`� Ti FRAME IS REQUIRED PER REVIEWED BY ` MANUFACTURERS SPECIFICATIONS DATE r NAME OF INSTALLER/MOBILE HOME DEALER: Zr/A) /%A//Ai✓ey ADDRESS/PHONE NUMBER j5 A-" ' 'E QdPet,,aaA9/ lo� �y 170 STATE OF NEW YORK DIVISION OF HOUSING AND COMMUNITY RENEWAL INSIGNIA OF APPROVAL OF THE STATE BUILDING CODE 1. Insignia serial number V 1 M 0 9-j`�? 2. Name of Manufacturer A I` Z 6QAPt CD/eta 3. Plan Approval Number t /JD ° • AJ 7/A i 1_f 4. Model. or Component Designation 5. Date of Manufacture � / c� All the above information is to be found on a plate or sticker which should be affixed to the Mobile Home. Complete above with that 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 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 rk shall be complied with, whether specified or not, and that such work is aut o i ed by t e o r. Signature Owner, o ner' s agent, arch-F eet, contractor SPECIAL CONDITIONS OF PERMIT: By Code Enforcement Officer . f3 a MMa?3Jtec. M Z`Vit9OFITIA t FINAL INSPECTION REPORT I ` MOBILE / MODULAR Town of Queensbury Building& Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: DEPART? 6 5NSP: DATE INSPECTION REQUEST RECEIVED: NAME: i V\ LOCATION: N) 2/4AiA C� DATE: l PERMIT# 1 7 �e � J MOBILE HOME MODULAR HOME • FOOTINGS FOUNDATION _ BACKFILL_ FRAMING N/A . YES NO 1. foundation support, pier spacing per manuf. — — — 2. anchoring per manuf. .... .. — _ 3. water line shut off — f '�sewer line support ©4 eet — —d✓✓ — 5. heating crossover (dble• `de) off g d. — — �1dryer vented outside skirting ventilai l — 8. hot water relief v.lve pi ring ou ide — — — 9. deck, porches, ste' rai 10. furnace/hot water operat' g — — 11. garage fire proofing — — — 12. door closers — — 13. plumbing fixture — — — 14. foundation insulation (if ppl.) — — — 15. smoke detectors — 16. final electrical — — 17. variance required _ — — 18. data plate okay — — — 19. mobile HUD seal okay — — — Model # Serial# Manufacturer Date of Manufacture OKAY TO ISSUE C/O YES NO Comments: 4� - . WV160S J COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC. 9._,Main Office 176 Doe Run Road-Manheim,PA 17545 MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL �f(i Panel Board No Cert. N2 64946, Cut-in Card No l/ Owner D&/RI 1f M L A-A! - � -Gl� Location T1.1/ �?/ /�l/ .62- !„y! Installation Consisting of\/0°.t rn� �' �l AICY1 Installed By 5-110 6 Lic.No. The conditions following govemed 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 in sns at any time, and if its rules are violated,the Company shall have the right to rev e this e,�it. e. Date 72,15-4? INSPECTOR e MA-L...-M C U A .A C. IllI -- /1/11 ''FINAL INSPECTION REPORT��� MOBILE / MODULAR Town of Queensbury Building & Code Enforcement �� / 742 Bay Road / ,� p i�. / Queensbury, NY 12804 T. Ltd hl --_c-i%% (518) 761-8256 ` `r,. • e i✓ ARRIVE: DEPART: .. O INSP:�14J „." - - DATE INSPECTION REQUEST RECEIVED: NAME: I/ - , :4-, - LOCATIOfV �37 �tn�i�i` -'�J�k DATE: PERMIT.# ,a r MOBILE HOME MODULAR HOME FOOTINGS FOUNDATION _ BACKFILL_ FRAMING N/A YES f NO 1. foundation support, pier spacing / per manuf. — ,,,/// 2. anchoring per manuf. / 3. water line shut off — — —/ 4. sewer line suppo. c 4 feet � ' ��—/// 5. heating crossover •blewi'•) off 1 rd. — V 6. dryer vented outside .. — — 7. skirting ventilated — — 8. hot water relief valve eiping outside — / — 9. deck, porches, steps railing — % _ 10. furnace/hot water ••-rating / 11. garage fire proo g , — — 12. door closers — — 13. plumbing fix e V — 14. foundation ' .ulation (if appl.) 15. smoke deter p rs /G,q••_ 16. final electrical 1..7 / •�••(•• 6— VV — 17. variance required _ 18. data plate okay —19. mobile HUD seal okay — N7 — Model # 14 k Serial# Ot O O l t t 3 . Manufacturer t TZ_�1=1 Date of Manufacturer C' i /7 /89 O TO ISSUE C/O YES NO •� ,tl r n.. A i QvPI Comments: ►♦ T� l `'' /U691'4- V"fr6 b 6 V re G Il 6-mo '0 iN -reitt- aguatui., bc70,4 kjil D i e2. u‘kusr uk,0 i 1> o 5 K 12T NCB TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name J L` 14 7 Location . c cl /.k 4._ Date // �Dsj`lS Permit # 471/ SOIL TYPE: Sand-Loam-Clay- Results if Pe olation Test- (if appl cable) Rate-Minute/Inch TYPE OF 'YSTEM: ABSORPTIO FIEL1: Total Length Length of each trench Depth of ten. es Size of sto - SEEPAGE Ejr . Number- Size- ft. x ft. Stone size PIPING: Size Type Bldg. to Tank Tank to Dist. Box Dist. Box to Fie, d/Pit Openings Sealed? Yes No Partial LOCATION/SEPARATIINS: Foundation to Tank feet Foundation to Absorption feet Separation of Pits feet Conforms as per Plot Plan Yes No LOCATION OF SYSTEM ON PROPERTY: (circle one) Front - Rear - Left Side - Right Side Middle Front - Middle Rear COMMENTS: ��� �ryiv. Unler m61ile Aor,e 4 4.-4 of SYSTEM USE APPROVED: NO Arrived: 3'1/0 Departed: Building Inspe for TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name Location 3c Date Dr / - Permit # 974/ SOIL TYPE. San Loam-Clay- Results of Percolation Test- (if applicable) Rate-Minute/Inch TYPE OF SYSTEPI: ABSORPTION FIELD: Totnl -ngtIY /_b _ Length of each trench I .I Depth of trenches ) Size of stone ii12---11111111 SEEPAGE PITS: Number Size - ( ft. x ft. Stone size - PIPING: Size Type Bldg. to Tank o+lor 67 /.4.)574-64-6-7- Tank to Dist. Box -" 1r'b 9-D Dist. Box to Field/P' . i4 Openings Sealed? 'e No Partial LOCATION/SEPARATION• : Foundation to Tank , feet Foundation to Abso ption /' feet Separation of Pits eet Conforms as per Plot Plan es No LOCATION OF SYSTE ON PROPERTY: . one) Front Rear - Left Side - Right Side .. e Front - Middle Rear COMMENTS: q �l c-f—AcFrLG�` ` O1, Fo k 14c- K i4 c i SYSTEM USE APPROVED: YES O Arrived: Departed: 2 .3 0 Building Inspector GENERAL,INSPECTION REPORT ( 518 ) 761-8256 Town of Queensbury Dept.of Community Development Date inspection request received: Building&Code Enforcement 742 :ay Road Queensbury,NY 12804 Arrive `' 'r0 .m Depa ' 'p5 ati Inspector's r NAME: 0 pNt� ALL.\ F• PERMIT# — LOCATION: 35 113D 1 Pt k1 N FlJF DATE : ll' —76—.99 TYPE OF STRUCTURE: Mb()1 L lAbe..— RECHECK � N/A YES'NO COMMENTS v1 otings/Piers Rv 00Fl � ~-1 II Monolithic Pour Form / v<cinforcement in Place Z,,. a ,/ The contractor is responsible fo providing protection from fre ring for 48 hours following the p accmept of the concrete. Materials for this purpose on site Foundation/Wallpour Reinforcement in Place Foundation/Dampproofin Backfill Appra •I Plumbing Under Slab Plumbing Vent/Vents n Place Rough Plumbing Heating Rough-In Insulation Foundation Wa is Interior R- Foundation W.lls Exterior R- Floors R- Walls R- Ceiling R- Duct work piping in unheate spaces R- Proper 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 Firestopping FINAL INSPECTION iizeieP Gio Y MOBILE / MODULAR Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 • • (518) 761-8258 ARRIVE: DEPART:/OiO INSP:mliaV DATE INSPECTION REQUEST RECEIVED: • NAME: I.fkLL4'4/61 LOCATION: �9 ,q 6Z/S'1( /04 DATE: Z .0 PERMIT# MOBILE HOME MODULAR HOME FOOTINGS _ FOUNDATION _ BACKFILL_ FRAMING N/A YES NO 1. foundation support, pier spacing ' per manuf - —2. anchoring per man. . —3. water line shut,off — —4. sewer line support5. heating crossover (dble,,.de) off grd. — — — 6. dryer vented outside . — — — 7.• skirting ventilated — — — 8. hot water relief ve piping outside — — 9. deck, porchesrsteps, railing — — — 10. furnace/hot water operating — —11. garage fire proofing — — — 12. door closers — —13. plumbing fixture — —14. foundation insulation (if appl.) — — — 15. smoke detectors _ _16. final electrical — —17. variance required _ — — 18. data plate okay — — — 19. mobile HUD seal okay Model #• R O j0$ n%g Serial # +� Manufacturer fQr j Z-Cr2A-F1— • Date of Manufacturer gj/7/g7 OKAY TO ISSUE C/O YES NO Comments: ✓ To_ Cam%l K. J p C l Cp'iJ • i / i • ' • I . . c.7/1 1 ..',, , - . : :7 , . ,. . . . _. . , , , r'10 , ' [ . 1 ' • 9:21 --..... , . . r . • . • , ' '. ' l>. . 1 • , > . (A .1)1' 1 - - ' • \--,-- , , . .. ........Z • --74.000 citM ONIalli \ . - , ,-In,i-;,r,.-90 11\AO•L , .. - , , . (-4-. .(10+,, , -:-.1..,. . . . „--c.....) . Lest. to' hOt ! . tag\\ W• I. ap f ® W ¢ 114 'icy k o'�sde..• t "A. COILLi cc W 3 ..s . Q, Cl) • _� , F'e' Li- W V) b r � 0 Cn W �+, Z i. ', 0 `-Z \, , E D I alailikaaaft allAilk bank et, 1:C .. ts N cp7 * 1 issiommti t I have •. . - a `` ,.,_„ ,____„ . :._, ,, , , ,=_. „, , . ,........,. �1' ', 1 C., �ik *forth on the d;4g. "! t ,77 i , ,_...,,__,,_,, , ,_, _. _ 1. . .... ( -�' SIGNATURE .___. - . i JUL 1 1997 i NV ` r-ova ' -,...............1.....-..,...---*--,.......,,,.....,--A S '' j 1\60r) ,,, in _A4,_____ it4; r ri Th.--:-.-.A 3 A m 1 ,. �7 t _ _ . IZ ® P, '\ 3 tJji . 1 f 1 .1.-' '' ��> O