1987-305 R
CE,R.'TIFICATE OF OCCUPANCY
PANCY"
TOWN OF QUEENSBURY
WARREN COUNTY, NEW PORK
Date 19 _
This is to certify that work requested to be done as shown by Permit No. 87-305
has been completed.
This structure may be occupied as a Mobile Home Dwelling
Location Fe '� w _ __ s Colrcmbia St
Owner Marjorie Johnson
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoning inspector
- BUILDING PERMIT
TOWN OF QUEENSBURY No. 87-305
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Marjorie Johnson
Street. Road or Ave.
OWNER of property located at
Feld Ave . and Columbia S t .
rs
u.
Mobile Home Dwelling o
in the Town of Queensbury, To Construct or place a _ *t
at the above location in accordance to application together with plot plans and other information hereto filed and
m
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
0
F
R•SAddressis 372 Ridge RoadQu.eensbury , NY
RACTOR or BUILDERS Name
same
�J
N
3. CONTRACTOR or BUILDER'S Address w
9
4
same ea
w
4, ARCHITECT'S Name rs
CIA
C5
O
1�
r5ARCHiTECT'S AddressTYPE of Construction — [Please indicate by X)
i ) Wood 'Frame i ) Masonry ( ) Steel i )
7. PLANS and Specifications
66 ' xl4 ' mobile home per plot plan and application
No. including sewage system — 19 Per Var . 1149$7 Fairmont Fantsay Serial Pao . 63217
B. Proposed Use cr
r-
Mobile Home Dwelling
m
x
0
Ig
m
$5w00 C /O Jan . 1 1988
$ 2 00 PERMIT FEE PAID — THIS PERMIT EXPIRES
(11 a longer period is required an application for an extension must be made to the Building and Zoning inspector of the [o
torn of Queensbury before the exPiration lore3 r
i✓
2nd Suns 19 87
Dated at the Town of Queensbury this Day of
,,,,
"--X CL '0 for the Town of Queensbury
SIGNED BY a
Building and Zoning inspector
_ }V Ylit vVi'1• L}i } 1. V Ls1 • a Ya� a. u♦ y
TOWN 07
flood! C/ Qiseenj i"rty Application No. -
Permit Issued 1 `_1 N LJ vl+ Ij
BUILD antl 2DNING DEPARTMENTpermit. Expires �111 18ING
Bay- and Haviland Road, R.D_ 1 Box 98 Zoning Designation MAY 2 0 1987
+Queensbu€y, New Yc;k 12801 Variance No . , J `Jf �
Site Plan Rev ' ew No .
'7 - �r eurLoLN & C+a�,E D�PT
APPLICATION FOR Approved by 7e
MOBILE HOME � L^/ ;' f. ��r�
BUILDING AND ZONING PERMIT '
�► * * * * * * * * * * * * « * * * * * * * a * * .. » * * * * .
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION . ANSWER ALL OF THE FOLLOWING .
The undersigned hereby applies for a Building Permit to do the fallowing wont which will
be done in accordance with the description , plans and specifications submitted , and. such
:.pecial conditions as may be indicated on the .Permit .
--____________ _._ _ ..._ --_ --___-_-_ _w. .___________ __ _____
The owner of this property is : Y 14
/ ./ , '� - �1 � �gy
P . O. Address ":3' t'd9 ! J�40 Tel . . s
property Location : ZXZ . r` 'iP' (LIZ6 .tea .+�i r s 4CC-,� Tax Map
atreet : ;umber or building lot number
Subdivision name (If applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS RfiGARDS 1;iulf.DING CODES IS :
Name P . O. Address ---� Tel . No .
Name of installer Address Tel .
Name of plumber Address T Tel .
Name ofmason Address
MOBILE HOME INFORMATION : * ZONING INEORWktiTION :
New Home Placement
A PLOT PLAN MUST bl_ P)0'PARED AND SUBMI7"TED ,
" drawn reasonably to scale and attached hereto ,
Replacing existing Home ' showing clearly acid distirnctly all buildings ,
-1
whether existinc. i s ur >rcr
Size of new Home � lE, ft X�£t � 'ed and indicate all
* set-back dimen5iuns from
Single wide Double wide n ia
* property and
t
street and tune�r ,.:,r lot number nd indicate
No . of zooms ( excluding baths ) * whether interior- ai corner lot . Show location
* of water supply and .location and configuration
No , of bedrooms * Of septic disljosckl area .
*
No . of bathrooms � * COMPLETE INFORMATION REQUIRED BELOW ,
Fireplace? N Wood stove? X-Ac> * Size of property ft X ft .
Foundation style and size : * Existing building ( ti ) Size ft X £ t .
Piers- No . of��, 8 Size- Ifoft x 1 'o ft . * Existing builciiray ( s ) Use
*
Depth below grade C:) ft .
" Proposed building , distance from property liric.:
FOCINDATION - Foot:Lng size ' X VA ON"
- � Front yard ft Rear yard ft
Wall material ey yk * Sidra yards f t, and ft
wall thickness!" Height to Oc ft . * If on corner , sut .sac:k from side street f t
Total depth below grade C'^Sg-N fta
" OCCUPANLY INFORMATION
Grade to Home floor level -3� a PRIMARY BUILDING -
* * t rr x * * * * * * * * * * * f * * w * One family dwu l 1 3 nq
Two family dwk� lliny
Proposed date of placement / ( / c�1 * Multiple dwelling / Number of units
*
Aprax . Value of Rome $ Permanent occuparicy_C7s o
„ Transient occupancy
Water supply - well Muni cipal ){ Business
+ Industrial
Septic Permit required? * Other _
If addition , what will use be?
f
FURTHER INFORMATION REQUESTED
* AccEssoRx rsulL.DlNca-
ON THE REVERSE SIDE OF THIS SHEET , * Detached gar,.cl r eerie car/ two car/ cur
Attached gar"ge/one car/ two car/ cur-
* Private storage building
Other
I
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 ,`
2 . NAME OF MANUFACTURER
3 . PLAN APPROVAL NUMBER
4 . MODEL OR COMPONENT DESIGNATION y a Z S I / - �-
5 . MANUFACTURER ' S SERIAL NUMBER_ ?
Go DATE OF MANUFACTURE ,/!'�' ���
AZZ the above information is to be found on a pZate car• sticker which
should be affixed to the Mobile Dome . Gomplete abov(--- wi7 .1h tr'tat inforimation.
Town of Queensbury
County of warren A F F I D A V I T STATE OF NEW YORK
I swear that to the Kest 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 d�scribed ,premises .:nd 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 �T !'?
C7wner o ` s avant rci�a Gect, contractor
rr w rt • � r 1r w w * at ,r at * ie x ,t r * w » w ,► w w r► .t * * w w x � * : t ye � t ,ir k ra w w ,r
:SPECIAL CONDITIONS OF THE PERMIT :
By___
r
Yearn 4( aaw4r4j4
APPLICATI+DN FOR SEPTIC DISPOSAL PERN41T
DATE I
LOCATION OF PROPERTY FOR INSTALLATION !/�v d c_ a / �'G d�L �!� CS 494
Owner's Name: !/ 1 I111�...� +�' / d,.^i 1fH .5 � !"! ,r - Telephone:
Address: Ik?} _ f
Installer's Name: Telephone /
1
Number of bedrooms (residential only) _
Total daily flow (compute @ 150 gal per bedroom) �-
Tarpography. circle one: Flat Rolling Steep Slope % of slope
Soil Nature: circle one: Sand Loam Clay Other / Depth: feet
Cmound Water: At what depth? - feet
Bedrock. or Impervious Materials At what depth? i - feet
Percolation tests circle one: not required required / rate min. inch.
Domestic water supply." circle on<��:Municipa Well Other
IF domestic water supply is a WeU&o
Separations Watersupply from Septic absorption feet
PROPOSED SYSTEM: Septic Tank f[, gal. (minimum size: I ,000 gal,)
TILE FIELD: Each Trench c�5 O feet { Total system length L30 0 feet
SEEPAGE PIT(S) : Number of / Size each feet by feet
Size of stone to be used # _ / Depth or Thickness / _ feet
IMPORTANT
...P'lease...LIST NEW EQUIPMENT TO BE INSTALLED
(over)
Section II Septic System Inspections:
A. All applications for septic system installation, alteration or repair, as
required by the Town of Queensbury Sanitary Sewage Ordinance, shall
be submitted to the Building 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.
Co. 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 Queensbury Building Department before further construction.
I have read the regulations above and agree to abide by these and all requirements
of the Town of Queensbury Sanitary Sewage Disposal ()tdinance.
Signature of responsible person: �
Date.
Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832
SETTLED 1763 . HOME OF NATURAL BEAUTY A GOOD- PLACE TO LIVE
//� ,_._,loeurt o� �ueens �terx�
1 / BuiLDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. I Box 98
Queensbury, New York 12801
Y
BUILDING INSPECTOR ' S REPORT
NAME �ps'i7 �rL �}'ze"
LOCATION _ G Za , ,2 (rI�._ �
Date fic�c �f Permit No . � Sr~-
« APPROVED* -* YES* }
Footing/Pier Forms
Foundation
Waterproofing
sackfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief valves
Ext . Porches
Finished Floors
Interior Trim
stairs & Railings
Cellar Sprain Tile
Concrete Floors
Plbg . Fixtures
Gar . Fireproofs-
Door Closers
Smoke Detect s
Chimney
INSULATION .
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION �_...
DRIVEWAY APPROVAL
Final But idlpg Survey
Next sche `u d snaps CIOY► (call whe ready
Remarks-
Building In ctor
6/86 and-vl
r
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
Fn] 41 STATE STREET, ALBANY. NEW YdRK 12207
Date August 31 , 1987 4ppliratiarl ,4"0. an file J 1 ! J' 95I FS7
THIS CERTIFIES THATOF
only the electrical equipment as described below and introduced by the applicant namsad on the above application nismber in thI pivrmisea of
Marjorle Johnson , Feld Asveitaue , Queensbury , New York
in thefollowing location: ❑ Basement ❑ lot Ft. ❑ znd Fl. Outsl.d+e Section11 ] Block 7 let 11
was examined on b/29 f 67 and found to be in compliance with the requirements of thin Board.
FIXTURE [CEPTACLES SWITCHES PIXTURES ]CO
OKING OOKING DECKS I OVENS I DISH WASHERS EXHAUST FANS
OUTLITS INCANDE5CENT FW01MSCENT I 'v"AW I AMT. K. W. AMT. K- W. AMT. K.W. AMT. K. W. AJAT. H. F.
DRYERS FURNACE MOTORS FUTURE AffUANCE PEEOERS SPECIAL RE+C'PT TUIE CLOCKS I NU I UNIT HEATERS AWLTt-oUTUIT DIMMERS
AMT. C W. 0111. H. P. PEAS H. P. AMT, NO. A. W. G. MIT. AMP. AMT. AMPS. TRAMS. AMT. H. F. N STEMS REi AMT. WATTS
O. OF
SERVICE MSCONNECT Ho. OF S E R V I C� MET E
AMT. AMP. TYPE Ir 1 .0 SW 1 IE' 7W 9 ,I 9w 7.e 4W PER 1lGONP. OF CCCo P. Na. CIF H4LEG OF HH# LEG r+4. of NEUTRALS OF!�EiY G.
1 100 C3 1
OTHER APPARATUS:
E_
Marjorie Johnson . �--�
371 Ridge hazed
Gle a.s Fall:6 , New York 12801 �� BRANCH MANAGER
PCr
k4 j
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentiols.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
.�.J'nuin o� �e�eens� etre�I
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.a_ 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYS EM INSPECTICJN
r-
NAME
LC7CAT ION G
LATE % 7"�' PERMIT NO.
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch -
TYPE of SYSTEM: ^�
Absorption field , total length_
Length of each trench
Depth of trenches
size of gravel
SEEPAGE PITS{Number of) _
Size- ft. X
Gravel size -
PIPING : Siz T e
Bldg * to tank VP C _ V D
Tank to dist * box r✓ -
Dist. box to fiel �' (- � !
openings sealed? YES o Partial
LOCATION/SEPARATIONS :
Foundation to tank
Foundation to absorption ^ ft _
Absorption to lot line + �f t.
Separation of pits ft.
LOCATI YSTEM ON PROPERTY (circle one)
Front Rear Left side - Right side -
CCMM S :
SYSTEM USE APPROVE YES
Bui i g Inspector
01/86 and v1
� �� � � � � �
; , �
�� �
{ � � � � �
�.
. � J
� � a -
� i
I
��
� �� °
���
-��� oe�u � � -
� �
� � � �
�S\� � � � q► Q1�
}4
�`
1
�1
I
` �
11�r
k
i
f
i
i
f ,
1
pin
3 ._ .. .
[f IF
F- IF IF qw`s�'� �J
dq
i
f ,
F
i I
I '
1p
;—A- -
icy
%Nj%%j %lj !jo*jF
F- k-11
�ii N T F
17
t
F
I
au