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1986-339 CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date Deet+Tni)Pr 9 19 Ri This is to certify that wo requeste to be done as shown by Permit No. 86-339 has been completed. MOBILE HOME DWELLING This structure may be occupied as a �I, CENT��T "'rE i * T,ATE T7/1! PSP 1—�' ATTTTJrTE^ Location /// EDGAR AND NIETA. EGGLESTON, JR. Owner By Order Town Board TOWN OF QUEENSBURY Building & Zoning Inspector BUILDING PERMIT TOWN OF QUEENSBURY 86-339 No. WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Edgar and Nieta Eggleston OWNER of property located at Central/Vermont/New Hampshire Ayes. Street, Road or Ave. txi in the Town of Queensbury,To Construct or place a Mobile Home Dwelling w 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 32 Mountainview Lane H Glens Falls, New York rt t.1 oa oq 2. CONTRACTOR or BUI LDER'S Name H fD m Saratoga Housing �* 0 0 3. CONTRACTOR or BUILDER'S Address Saratoga Springs,NY 4. ARCHITECT'S Name 0 rt ri W H 5. ARCHITECT'S Address 4 ri 0 rt 6. TYPE of Construction—(Please indicate by X) 0 ( )Wood Frame ( ) Masonry ( )Steel ( 1 W En 't7 7. PLANS and Specifications No. 28'x56' per plot plan, application submitted including sewage co system. 8. Proposed Use CO MobileHome Dwelling $5.00 C/0 Paid o $ 25.00 PERMIT FEE PAID—THIS PERMIT EXPIRES January 1 19 87 N. H (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the CD town of Queensbury before the expiration date.) - 0 0 Dated at the Town of Queensbury this 23rd Day of June _ 19 86 'D t7 SIGNED BY a4 4 !✓ to for the Town of Queensbury H Building and Zoning Inspec O4 • TO BE COMPLETED BY BLDG. DEPT. - own o/ Queeniur1 Application No. ,TOWN OF QUEE i�S1 Ur?Y Permit Issued • 19 BUILDING and ZONING DEPARTMENT Permit •Expires 19 E C - 11' ;, Bay.and Haviland Road, R.D. 1 Box 98 Zoning Designation Queensbury, New York 12801 variance No, JwUN 16 j86 tl = /A o - �- 6 Site Plan Review No. APPLICATION FOR Approved by: AI M. - P.M. I !$1 1�;P111` 1 111181 i8 MOBILE HOME Covg. • at EUILDING AND_ ZONING PERMIT , - . *. * * * * * * * * * * * * * * * * * * * * * .* * * * * * * * * * * * * * * *::.* A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. ANSWER ALL OF THE FOLLOWING. The undersigned hereby applies for a Building Permit to do the following work which will be done in accordance with the description, plans and specifications submitted, and such special conditions as may be indicated on the Permit. The owner of this property is: f P.O. Address 3 f ,1 ,,.i i4.;�.f i9 i(=.uJ /40 Ot 41C Tn 0( A/ II 0S—c. % Tel. ?? 2 .33 Property Location:weiird;1 „a)c'. / ( e tirizi4l_ 411r: //i.J&,) *Alto - e: ,&'r::Tax Map No./d.6/ / 6 street rumbe'r or building ldt number See ecp o v Subdivision name (if applicable) Deed „,6 (,,iP THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS: • P i i r(/`hc,;7y b J2r ,�� H'7 )ire) Lai G sic)�' %�v Iii !U 4 (ego I 7 .2.3s 3 Name P.O. Address ' Tel. No. Name of -installerrrc" c t51 d+E`� Address , �, AL I) Tel. •STIO- " 0! Name of plumber . t:EA./ 4Ma T . J Address p•4vl� l_ / Tel Name of mason fL ( `$ ,44(. e,zLe,h,)1 Address Zc gS 4-ezue Tel. . ...,./ nic MOBILE HOME INFORMATION: * ZONING INFORMATION: New Home Placement * A PLOT PLAN MUST BE PREPARED AND SUBMITTED, -* drawn reasonably to scale and attached hereto, Replacing existing Home * showing clearly and distinctly all buildings, Size of. new Home _n ft X ,S, f_t • * whether existing .or proposed and indicate all - * set-back dimensions from property lines. Give Single wide • Double wide 11 * street and number or lot number and indicate No. of rooms(excluding baths) (0 * whether interior or corner lot. Show location * of water supply and location and configuration No. of bedrooms `5 * of septic disposal area. * . No. of bathrooms • * COMPLETE INFORMATION REQUIRED BELOW. • Fireplace? L./Wood stove? * Size of property 19) ft X LO® ft. Foundation style and size: * Existing buildings) Size ft X • ft. • . Piers- No.of /(,, Size- ft x ft. * ���� Existing buildings) Use Depth below grade ft. 4 I * Proposed building, distance from property line FOUNDATION - F7ooting size ".X * - _l� .* Front yard ft Rear yard 9 Z _ ft Wall material aTL _i , * Side yards 4 ft and 90 ft Wall thickness " Height cif ft. d' 1 If on corner, setback from side street ft * OCCUPANCY INFORMATION Sr1 Total depth below grade k( ' ft. * Grade to Home floor level ft. * PRIMARY BUILDING - * * * * * * * * * * * * * * * * * * * * * One family dwelling * Two family dwelling Proposed date of placement 7 /;?// A( * Multiple dwelling / Number of units * _�Permanent occupancy Aprox.• value of Home $ ;',„-aj;, * Transient occupancy Water supply - Well Municipal f * Business *' Industrial Septic Permit required? 'Amen * Other • I * If addition, what will use be? * FURTHER INFORMATION REQUESTED • * ACCESSORY BUILDING- ON THE REVERSE SIDE OF THIS SHEET .* • Detached garage/one car/ two car/ car * Attached garage/one car/ two car/_ car * • Private storage building - * Other ' Form MHP 5/86 and-vl • • APPLICATION FOR MOBILE HOME PERMIT, . (CONTINUED) State of New York Division of Housing and Community Renewal • . INSIGNIA OF APPROVAL OF THE STATE BUILDING CODE • 1 . INSIGNIA SERIAL NUMBER 4;_ie C _ • 2 . NAME OF MANUFACTURER I Hf /n il..) • • 3 . PLAN APPROVAL NUMBER • • 4 . MODEL OR COMPONENT DESIGNATION 6 7 • 5 . MANUFACTURER 'S SERIAL NUMBER • 6 . DATE OF MANUFACTURE "7j,. • • • AZ-1.. 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 Q Warren AFFIDAVI T . 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 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. - f ; Signature Owner, owners agent arcni,tect,contra'ctor • • * * * * * * •* * * * * * * *. * * * * * * * * * * •*-.* * * * * * * * * * * * * * * * * * * * * SPECIAL CONDITIONS• 0.F THE PERMIT: • • • • • • • • • • • By sown o/ Queenitury APPLICATION FOR SEPTIC DISPOSAL PERMIT BUILDING and ZONING DEPARTMENT Bay and Havitand Road, R.D. 1 Box 98 ! Oueensbury, New York 12801 DATE / /6'l/PC LOCATION OF PROPERTY FOR INSTALLATION / OWNER'S NAME ( I)�,,,�.. ./-i /v/f~="Il-) ADDRESS a f_d,U 7;/As NV /2,1 o! T E L=7 -3 P.Z T INSTALLER' S NAME (0 (A) ,/n ;)&- TEL Number of bedrooms (residential only) Total daily flow(compute @ 150 gal per bedroom) 1�) Topography: Flat - Rolling - Steep slope - (circle one) % of slope Soil nature: Saner Loam - Clay - Other Depth ft. Ground water -At what depth? ft. Bed-rock or impervious material - At what depth? ft.. Percolation test - Not required - Required - -Rate min-inch. Domestic water supply - Municipal - Well - Other ;,� Separation. - Watersupply(if well) from Septic absorption ft. Proposed System: Septic tank /CVO gal. ( Minimun size, 1000 gal. ) Tile Field - Each trench 6-6 ft. Total system legnth v- J ft. Seepage pit(s) Number of . Size each ft X ft Size of stone to be used #,,-, ,r " Depth or thickness 14 ft. IMPORTANT! '. On a separate piece of paper, submit a diagram of the proposed system with all dimensions shown; including distance from any structure , distance from property lines and from ANY DOMESTIC WATER SUPPLY or -shore-line of lake, stream,pond or wet-lands. Include all dimensions of the system, itself . * * * * * * * * * * * * * * * * *_ * * * * * * * * * * * * * * * * * * * * I .have read the regulations on the reverse side of this sheet and agree to abide by these and aZZ requirements of The Town of Queensbury Sanitary Sewage Disposal Ordinance. Signature ofres onsibleperson =;.' .,41 ,-, !%�, '.2 ! g P 1,./-�c�. Date A ‘ 05/86 and/vl • Section II Septic System Inspections: A. All application! for septic system installation, alteration or repair, as required by the Town of Queensbury Sanitary Sewage Ordinance, shall be • submitted to the Buildina Department at least 24 hours before start of construction and shall include a plot plan showing: 1) the proposed location of the system 2) location and distance to lot lines 3) location and distance to structures 4) location and distance to any water supply 5) size and dimensions of all tanks, distribution boxes, tile fields and/or drywells B. No system shall be covered before inspection and ' approval by the Building Inspector. Failure to comply with this requirement may result in the uncovering of the system by the ,installer and a fine of up to $250.00. • • C. An approved copy of the plot plan-shall be available on the construction site. Failure to produce said plot plan at time of inspection may result in an immediate work stoppage. • D. Should unforeseen problems during construction • prevent proper installation, alteration or repair of an approved system, a new proposal must be submitted to the Oueensbury Building ' Department before further construction. awn of Queenilury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 1-rh4 I hst• f°'- c l` Aio6tc6- I10 G— BUILDING INSPECTOR' S REPORT NAME i7 LOCATION /,l.Ii, ,f e Date / "Z /�/ tto Permit No. , G --33 j' - * * * * * * * * * * ,* * * ✓ = APPROVED - YES / NO Footing/Pier Forms Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext. Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile !I \ Concrete Floors Plbg. Fixtures Gar. Fireproofing Door Closers Smoke Detectors Chimney /J INSULATION: Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey l CALL i it CA1Z t h- Next scheduled inspection (call when ready) Remarks- J 4/i !Al rill Building Insp tor 6/86 and-vl coke" 7/ K5/494 •ueen9burce BUILDING and ZONING.DEPA,RTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 heed ante.. 1 P►. cii, SEPTIC DISPOSAL SYSTEM INSPECTION NAME Edgg4• E53 /e11O4 LOCATION Ceh .4/ /14/¢• f6)--ve DATE 7//6/SG PERMIT NO. 33 7 SOIL TYPE - Sand Loam - Clay - Percolation Test Required? YES -0 Percolation rate - Min/Inch TYPE of SYSTEM: Absorption field, total length / 7/ Length of each trench Depth of trenches 2 " -L Size of gravel ' 3 SEEPAGE PITS4Number of) • Size- Gravel PIPING: Size Type Bldg. to tank " Tank to dist. box Dist. box to field/...� re Openings sealed? l NO Partial LOCATION/SEPARATIONS: Foundation to tank /0 ft - Foundation to absorption Ze?ft+ Absorption to lot line 40 ft:t- . Separation of pits ft. LOCATION OF SYSTEM ON PROPERTY(c'rcle one) Front - e ta - 'Left side - Righiside - COMMENTS: II \� 'obi IQ. 116nic \ h I SYSTEM USE APPROVED 400 NO - building fnsp tor 01/86 and vl .own of Queeniurcy BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME r-G6LLS'-A1 LOCATION )'/ fir G.A./ _ 4-. Date ?/31 / S-C Permit No. 86 - 339 = APPROVED - YES / NO Footing/r - Forms Foundation Water.roofing 4111111P &'( ing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext. Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg. Fixtures Gar.. Fireproofing \\,)\/\\::\\ Door Closers Smoke Detectors Chimney INSULATION: Foundation Floors Walls Ceiling 17 FINAL ELECTRICAL INSPECTION Final Building Survey Next scheduled Inspection(call when ready) Remarks- - 4/q143/LX;2) Building Inspector 6/86 and-vl _Down of Queenit ur/ BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME O CC ro it 5 WV ClIAARA-e— LOCAT I ON �iL�MUN1— C'�►�,vL�2- /Ubw( ps r41-- Date 7/iY/ Permit No Alp -339 * * * * * * * * * * * * * * * * * * * * * * * = APPROVED - YES,/ NO !/Footing/Pier FormsIo6(LG1'k'M _ F% Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext. Porches Finished Floors Interior Trim Stairs & Rai ings Cellar Drain ' e Concrete Floors Plbg. Fixtures ,✓ Gar.. Fireproofing I Door Closers Smoke Detectors / NSAT INSULATION: Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION Final Building Survey Next scheduled Inspection(call when ready) Remarks- - � ©Tf A/c ) rf;n 1 (6'es �{ t, 6b_c-ouJ czci-1-04_ mee_b_.-3_ 2_ a.,44A C6/1-111 Building Inspect,6r 6/86 and-vl / IHIjs , Cutlet, Ire. Aracircitosci Rt. 50 RR8 Box 1 Saratoga Springs, N.Y. 12866 (518) 587-6701 September 18, 1986 To whom it may concern, In regards to the proper setting up of a home owned by Mr. Ed Eggleston. This home was set up according to the specifications set forth by Champion Home Builders . This home meets or exceeds those standards . If you have any further questions or concerns, please feel free to contact me at 583-1870. I will be happy to answer any questions you may have. Respectfully, if4116/70- Guyla M. Pearce Service Manager . . . . , . -. --.:. . . 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