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1987-159 t V CER.T`ITWATE 012 OCCUPANCY LTI'AI`�TC - TOWN OF QUEENSBURY WARREN COUNTY. NEW YORK Date 19 _ This is to certify that work requested to be done as shown by Permit No. $7-159 has been completed. This structure m{t ay be occupied as a Mobile Home Dwelling Location l © Indiana Avenue Patrick. and Shirley Brean Owner By Order Town Board orowN OF QUEENSSURY Building & Zoning lnspactar BUILDING PERMIT 4 TOWN OF QUEENSBURY No. 87-159 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Patrick and Shirle Bre in MCI ru rt Indiana Ave * Street, Road or Ave. OWNER of property located at }' n Mobile Home Dwelling in the Town of Queenshury, To Construct or place a 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. cn r• H F2C0MTFn:1ACT0 VYNEgddressis P . © . BOX 130 Glens Falls , New York �c to m w R or BUILDER 'S Name r4. ARCHITIECVS NTRACTOR or $UI LDER S Address H 0 W W Name y„ C m 5. ARCHITECT'S Address S. TYPE of Construction — (Please indicate by X) { ) Wood Frame I 1 Mmonry { I Steel { 1 7. PLANS and SpaerfioatiOns 1987 Poloron 28 ' x4O ' Doublewide Mobile Home Y• N4 Mfg . Serial No . 18865 per plot and application . ~ Will use a ' stin se tic s stem 8, Proposed Use ro Mobile Home Dwelling $5 . 00 C/0 $ 25 . 00 PERMIT FEE PAID - THIS PERMIT EXPIRES November l 7987 {if a longer period is required an application for an extension must be made to the Building and Zoning inspector of the town of Queensbury before the expiration date_) Dated at the Town of Queensbury this 16th Day of � �j AApril 19 87 n S!Ca N ED BY e r ?Pj for the Town of Queensbury Building and Zoning Inspector 01"0 13E COMPLETED 13Y l31 L,C: ULP'P . / Application No. usVn e7 is[�er7sr urr�t Permit Issued - BUILDING and ZONING DEPARTMENT Permit Expires Bay and Nariland Road, R.D. 1 Box go 'Zoning Designation {� iI� { ; Dueensnury, New York 12801 Variance NO* �uM�{ L pp Site Plan Review No . � APR iJO7 APPLICATION FOR Approved by : MOBILE HOME 9BUILDING CODE DEPT. FU I LD I NG AND ZONING PERMIT L �16 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 submitted, and such special conditions as may be indicated on the P+eruli.t ,The owner of this property is : P. Q. Address a - _ -� 1 . '�'4 -r Property LocationojGF,)G-=E nm — 7 1� ' °�! I1"iap Street t .umber or building beat number Subdivision name ( if applicable) TUS PERSON RESPONSTELLE FOR SUPERVISION OF WORK AS REGARDS iil.rri.DING coDES IS . c, - Ir Name P . Q. Address T - `ruI _ No . Name of Address Tel , Name of Name of Plumber Address Tel . Installer Address ,.rc_.}+ __ lJ s FQ mason 2 el AASORTLE HOME INFORMATION : ZONING 1N 0R1 AT1ON ` New Rome Placement (_ tF� (] " A PLOT PLAN MU:;Fi, liC PREPARED AND SUBMITTED , — 6 drawn reasonably to scule and attached hereto , Replacing existing- Home * showing clearly tti ,d distinctly all buildings , * whether existin+3 r 1 c. ar+.lJUSed and indicate all .: ize of : Iew I-iome�^ft ]eft * ,E scat-back d.i.men � :i ons from property lines . Givc Single wide Double wide street and numb, •r ur 1 at number and indicate _ - -- whether interior. for corner lot , Show loeatiOLL Now of roorns ( excluding baths ) Of water supply z111d luc,ation and configuration No . of bedrooms _3 " of septic dislx. :�l aru,* . Now of bathrooms ,z') * COMPLETE INF0RmA,r:i ON ItJ :QU I RE:D BELOW * fireplace?Wood stove? s . A " Size of property �/�-y7 t t x /� f t . " Existing buildir„l ( s ) ize ft x T_'�undation style and size : * ./ �-� Piers- No . of Size- , nft x�,r lift , + + - '4 ;-P te _..'� � F:xi st ink bui 1.1 i � ,. { E ss 1 r-i:att �•+a'tl��[2 Cat 't'�{.�n r , � -� -- Depth below grade .4Z jt €t . " Pro osed buildings , O _LuLance from property lines FOCINDATTON - Footing slzea+' XZZ Front yard f t Rear yard wall material L0'e'_�_,mn L * Side yards ft and f t Wall thickness ' Height.._.. eft . + If on corner , sttt� ick from side street * t Total depth below grade / / � ft . * OCCUPANCY INFORMATION Grade to Horne: floor lever _ � ft . + PRrKARY BUILDING - to I.-''" .s family dWk4lling Two family dwuiliny Proposed date of placement / * Multiple dwelliny / Number of units Aprox . Value of Home $ Q2= 2 &Ze5z L * c Permanent or:c ul�ancy * _�`I"ran�ient cc€ c+lxaxrlcy Water supply - Well Municipal ✓ Business * Industrial Septic Permit required? L M4A t t ht-r - � $ � � If addition , what will use kx!? _ FURTHER INFORM ISiTION REQUESTED ACCESSORY BU 'LI.I]i3Jc.;- ON THE REVERSE SIDE OF THIS SHEET . * ,:Peta .hed gax'.,gc: /one car/ two ca car * Attached garagc:/one car/ two car/ car * Private: storncle building ' �Ottlrar * Form Mh , 5 / 86 and - vl APPLICATION FOR. MOBILE HOME PERMIT , ( CONTINUE ❑ ) State of New York Division of Housing and Community Ronewal INSIGNIA OF APPROVAL OF THE � BUILDING CODE I . INSIGNIA SERIAL NUMBER_ { - �-T•-_� i � q � 2 . NAME OF MANUFACTURER 3 . PLAN APPROVAL NUMBER � ~ ��3 976 4 . MODEL s I GNAT ION 5 , MANUFACTURER ' S SERIAL NUMBER_ 2 6 . DATE OF MANUFACTURE . F All the above information is to be found on a plato cr stzcrker which should be affixed to the Mobile Home . Complete above with that information. A Town of Queensbury T1 ► -1r _ County of Warren A F F I D Y A T STATE OF NEW YORK 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 Statesnent 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 turn. proposed stork Shall be COW-Plied with, wh >ther specified or not , and that such work is authorized by the owner . Signature - Owner or F s F_;`-ret`a cnirect, contractor : w w * • w w w w tr w w w ■ * w * w w �► w * w w * w w • x k w * a sF ,s w >ti w * w w w w * * • SPECIAL CONDITIONS OF THE PERMIT : By THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY to 41 STATE STREET, ALBANY . NEW YORK 12207 Date January 180 1988 Application No. on fide 00 9190 f 8T A i i fiJ 4 7 61 TFIIS CERTIFIES THAT a/ only the eleetrical equipment as descrlbed below and introduced by the applicant named ors the above application number in the pre"sises of Patrick Brean Indian Ave . Box 131 West Glens Falls , NY mobile home in tine following location; El Basement EN lst Ft. ❑ 2nd F'I_ tsu�i dfi Section 127 Bloc& 11 Lot 11 • � was examined on 6--29-87 and jotand to be in compliance xvith the requirements of this Board. FIXTURE RPTACUIS ,SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS 1t4CANDESCE14T FLUORESCENT Yw AMT. K. W. AMT. K. W. AMT. K.W. AMT. K. W. AMT. H. F. DRYERS FURNACE MOTORS FUTURE ApruANcE FEEDERS speaAL REcOPTI TAME ctocKs Iy UNIT HEATERS MULT1-0UTLET ptMMERS sY5111% s AMT. K. W. OR H. P. GAS H. P. AMT. NO. A. W. G. AMT. AMP. AMT, MAPS. TRANS. AMT_ H. P. NO. OF MI AMT. WATTS SE1Rv DISOONRMICT NO. of S E R V I C E AMT AMP. rym" MET"EQ{IN. 1 .e TAM 1 X 3W 3 X 3W 3 0 AW NO. #cc. cOND. c5f A{-.CWCG No. CW H4LEG OF HI LEGC Na. cir NEUTRALS GP A EUTaAL OTHER AMARATM Reconnect Mobile Home. � 3 Patrick & Shirley Brean RD #4 Box 130 Indiana Ave* BRANCH MANAGER West Glens FAlls , NY 12801 Prr This certificate must not be akemd in ony manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentiohe. � — COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. b r BUILDING and ZONING DEPARTMENT Say and Haviland Road, R. D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME LOCATION y e., Date i ,' Permit No ✓ = APPROVED - YES NO Foot ng/Pier Forms Foundation Waterproofing Backfill Framing Roofing iding Masonry Veneer ugh Plumbing lief Valves I4xt . Porches V''k. ' nished Floors terior Trim Stairs & Railings Cellar ]Drain Tile Concrete Floors �lbg . Fixtures Gar _ Fireproofing _ Door Closers Wba y5`moke Detectors Chimney INSULATION : Foundation Floors Walls Ceiling 1 FINAL ELECT CAL INSPECTION A I'VEWAY AP ROYAL_,,,_ _ +� nal Build ng /S e Next scheduled inspection Zcall when read Remarks- OP , � J 70 -ell 41 ,lfv'� Building Inspector '86 and-vl ��cc II _Down o1 Qieeereshury BUILDING and ZONING DEPARTMENT Say and Havitand Road, RX). 1 Box 98 Queensbury, New York 12801 BUILDING INS 'PECTOR ' $ REPORT NAME �� . � LOCATION Date O r Permit No * ** * * * * * r * * APPROVED YES NO .tj,q/Pier Forms Foundation Waterproofing Back£ill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valises Ext . Porches Finished Floors Interior 'prim Stairs & Railings_ — -� r� Cellar Drain Tile_ _ F Concrete Floors - --- Plbg . Fixtures Gar . Fireproofing Door Closers i Smoke Detectors Chimney TNsuiATION : Foundation Floors Walls Ceiling FINAL k;LECTRICAL INSPECTION DRIVEWAY "PROVAI,�. _.. Final Building Survey Next scheduled inspection (call when ready Remarks- " rtJ G -Building Inspe:c or 6/86 and-vl BUILDING and Z(:]N1NG DEPARTMENT 98 � Y`iBay and Haviland Road, RX) 1 Sox �l C]ueensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME± G Y1 i �L"rjx LOCATION /// Date r _ � Permit No . {' -7 / / rf - * * * * * w * * * ✓* tr * t **D YES NO Footing/Pier Forms_ -�4 R Foundation Waterproofing Backf ill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext . Porches :E Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors -`� — Plbg . Fixtures Gar . Fireproofing y Door Closers Smoke Detectors Chimney I N SU I.AT I ON Foundation Floors wall s Ce ding FINAL ELECTRICAL INSPECTION DRIVEWAY AFYR'OVAL Final Building Survey _ Next scheduled inspection (call when ready ) Remarks- SuiI in Inspector 6/86 and-vl BUILDING DEPT, COPY OF APPLICATION FORM 46-CLo NEW YORK BOARD OF FIRE UNDERWRITERS, FILE THIS COPY WITH BUILDINO DEPT. WHEN REQUIRED, 1. 'TEMP, DATE 00, CITY OR f VILLAGE STREET AND NO. OR ROAD AND POLE NO. / ":'' POLE NO. BETWEEN WHAT TWO - CROSSSTREETSlS �i - PREMISES LOCATEOPf ' .L:. H:' �.. � .. r r� i SECTION Z �*" BLOCK BUILDING ,r OCCUPANCYOINNEWS E lY ANO ADDRESS 3 �,r .C:.:..-. . t '"' ,. . Y I `I" ._ C SUPPLIED ev FROM f'fiEIR i 1fr_ , OFFICE IS lLM NKe - NEW Q OLD IriORK F NEri LJ ADDITIONAL ❑ REMOVED L_1 LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED NUMBER OF OUTLETS No. M Fixtures 6 F BRANCH Lose- Lamp Rtcalsbelte MOTORS NEATE RS CIRCUITS OFFICE USE 'bsr Sida Atfach't ONLY EachHA- A.W-d.I Swi* h Fatrwt Bracken Na T"a Na Nu. INSPECTION ONEads t Owt- aMla bate bass Bass- -we Iat Fl. asd Fl, 9td fill :7F 7 F-Is REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: OO NOT USE THIS SPACE. This application is inlended to coww the above listed equipment to be inspected but if at time of mspectipn there is found u dsorize additi M P I rrd Ni mant not a howe listed, Yo ate aud to make the inspsesien and adfust the Fee to cewer the additional equipment, as provided by Own applicant, ^'IMb EI OF ELECTRIC SIGN TOTAL FEEDERS LAMPS WATTS CHARACTER EXPOSED GAS TUBE SIGN OF riORK CONCEALED TPA NSFORMERS OF VA MIORK TO BE MUMBERP ICAPACITYl STARTED COMPLETED SIZE OF SIGN SERVICE OVERHEAD UNDERGROUND ENT£RS MAKER BViLDING OF SIGN INSPECTION REQUESTED ON OR AS NEAR AS POSSIBLE NEW OLD AVOID DELAY BY GIVING FULL AND ACCURATE lNFORMATIDN. ALL SPACES DATE OF MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. PRINT NAPAE AND ADDRESS APPLICATION SIGNATURE OF APPLICANT STREET ADDRESS ?'} . .I... •`/ �'�� .� - / �{ 3�a - �/` ' y rL It TELEPHONE #k '�r �.F ry CITY OR ...� ZIP LICENSE POST OFFICE '... _ t. 0. CODE y,�_ :11.- /r WHEN APPLICABLE ILICABLE 46 EL (RL- 1/8e) A S ARATE APPLICATION UST BE FILED FOR EACH SEPARATE BUILDING i � � t I I r r I I ri f i i t 43 ! ors C& tea_