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1987-340 r CEI�t"TIFICATE OF 0C1CN0iJP �.l'�TCY � TOWN OF QUEENSSURY , WARREN COUNTY, NEW YORK r ANA Daacr riu'jy t 2q 1990 n - 7? 4 87-34€l This is to terrify that work requested to be done as shown by Permit No& has been completed, 1 `-�'-al�1 Mobile Home Dwelling Shia structure may be occupied as a Howard Street I.,c+eaariae► 5 Today ' s Modern Mobile Bone Sales Inc By Order Town Board TOV*rN OF QUEEHSBURY {� n ,tar Building d► Zoning Inspect BUILDING PERMIT TOWN OF QUEEN5BURY No. 87-340 � WARREN COUNTY. NEW YORK � 0 TodayB Modern Mobile Home Sales : Inc . ~ r PERMISSION is hereby granted to c' I Howard Street Street, Road or Ave. ~' l OWNER of property located at in the Town of Queensbury, To Construct or place a Mobile Home Dwelling 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 54 Route 9 0 Gansevoorts New York 12831 � w �c m 2. CONTRACTOR or SULLOERIS Name a same m rt v 3. CONTRACTOR or BUILDER'S Address o to x 4. ARCHITECT'S Name n" rn N (b 03 S. ARCHITECT'S AddressIN r I n S. TYPE of Construction — {Please indicate by X} 4 E I 3 Wood Frame { } Masonry { } Steel rY p. crs 7. PLANS and Specifications 1986 Skyline #0653 double wide 48 ' x26 ' per plat and application No. including sewage system . Serial No . 1510-0167-A.BW L a. Proposed Use Mobile Home Dwelling '. 0 $ 5 . 00 C / O r~ $ 25 . 00 PERMIT FEE PAID - THIS PERMIT EXPIRES January 1 19 88 sz (if a longer period is required an application for an extension must be made to the SuiWing and ?Doing inspector of the town of Queensbury before the aXPiration dale") rp June 19 $7 Dated at the Town of Queensbury this 10th Day of m r- for the Town of Queensbury SIGNED BY °"� Building and Zoning Inspe 'LV 13E C" :i7kS*L.I 1'k:.11 L.Y IkLDG . 'To , p / Application No . ILJTiI�i JUN I V 19Q7 � �n O %� Q" evet .ihurly Permit issued 19 BUILDING and ZONING DEPARTMENT Permit Expires l9 'BUIL.DiNG 8e CODE DEFIT Bay and i-laviiand Road. R,D. 1 Box 98 Zoning Designation "t" 'l- 5- a Clueensibury, New York 12801 variance No. -S Gr -,e� Site Plan Review No . �+ / APPLICATION FOR Approved by MOBILE HOLE EI! ILDING AND ZONING PERMIT .► ar » » . * 1* iF a * a .. a► #M # .► iF It * * �! aF * ar ,r ,. :: �► 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 P . O . Address .� IC.L7c-) �'� r✓ rc 7' f 2 Tel . r Property Location : ^� 2 t �] Tax Map No . Iq Street r:umber or building lot number Subdivision name ( if applicable) THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS : Name , P . O , Address Tel . No . Name of installer CJf .✓ / Address Tel . Name of plumber NG-2 Address Tel . Name of mason ve! ✓ C Address Tel . MOBILE HOME INFORMATION : * ZONING INFORMATION : * A pLOT PLAN MUST BE: PREPARED AND SUBMITTED , New Home placement _ drawn reasonably to scale and attached hereto. Replacing existing Home * showing clearly and distinctly all buildings , * whether existing or proposed and indicate all Size of new home IG�ft K '� ft * set-back dimensions from property lines . Give Single wide Double wide X * street and number or lot number and indicate a * whether interior of' corner lot . Show location No . of rooms ( excluding baths ) rt * of water supply and location and configuration No . of bedrooms " of septic disposal area . No , of bathrooms * COMPLETE INFORMATION REQUIRED BELOW . ft x /L'G� ft . Fireplace?Wood stove? nz L7 size of property /rLrG 7ft . Existing building ( s) Size ft X Foundation style and size : �� Size- ygft xcr 301 ft . • Existing building ( Piers- NO - Of * Be th blograd s`Lf / £t_ * proposed building ] stance from property line pscH�� r " X " ,, I r ft FOUNDATION Foatyng size * Front yard TO ft Rear yard /GaG7 Side yards 14& ft and .36 ft Wall material ft if on corner , setback from side street wall thickness Height ft - OCCUPANCY INFORMATION Total depth below grade f t . PRIMARY BUILDING - Grade to Home floor level £t * One family dwelling Two family dwe. 11 ing » Proposed date of placement Multiple dwelling / Number Of units 'Permanent occuP4ncy Aprox . Value Of Home $ Transient Occupancy • water supply - Well Municipal Business c� » Industrial Septic permit recfulred? Other * If addition , what will use be? » FURTHER INFORMATION REQUESTED » ACCESSORY BUILDING car ON THE REVERSE SIDE OF THIS SHEET . *» Attached garage/One car/ two c tached 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 CUBE ti'vc:J � 1 . INSIGNIA SERIAL NUMBER - �6� �{ v� ) 4L, T ;� +ram— z 2 . NAME OF MANUFACTURER 3 . PLAN APPROVAL NUMBER r� 4 . MODEL OR COMPONENT DESIGNATION 5 , MANUFACTURER ' S SER IAL NUMBER b DATE OF MANUFACTURE RZZ the above information 7s to be found on a plate or sticker which should be affixed to the Mobi Ze Home . Complete above with that information. Town of A F F I D A V I T STATE OF NEW YORX ry Warren County off Warren I swear that to the best of my knowledge and belief the statements container) 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, mhe4er specified or not , and that such work is authorized by the owner . Signature _ _ ____ ___LG _" fi__-•�z __ o er I s atle t , arc - ect , contractor SPECIAL CONDITIONS OF THE PERMIT : g�'-------------4_............._- APPLICATION FOR SEPTIC DISPOSAL PERMIT DATE / LOCATION OF PROPERTY FOR INSTALLATION 4(DQJ&9,D NJ J E' Owner's Name: rs��'� 00,j Telephone: 92 X0J 2 . Address: _ Qtl T '7�� U7r /R✓�! C/ CJ (7 �7'' Installer's Name: { '!-0442a.7 rp ,K. Telephone: — ' du� 7 --s Number of bedrooms (residential only) 3 _ Total daily flow (compute @ 150 gal per bedroom) Topography: circle one Flat Rolling Steep Slope °po of slope Soil Nature: circle one: anti Loans Clay Other / Depth: feet Ground Water: At what depth? `" feet Rc"Irock or Impervious Material: At what depth? ""' feet Percolation test: circle one 6otrequireip required / rate min. inch. Domestic water supply: circle on Municipal Well Other IF domestic water supply is a Well: Separation: Watersupply from /Septic absorption feet/ PROPOSED SYSTEM : Septic Tank 0o 0 gal. (minimum size: 1 ,000 gal.) TILE FIELD: Each Trench — feet / Total system length feet SEEPAGE PIT(S) : Number of / Size each 6w feet by _ feet Size of stone to be used # / Depth or Thickness _ �. feet IMPORTANT _O.P7ease.._LIST NEW EQUIPMENT TO BE INSTALLED (over) Section 11 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 to abide by and all requirements of the Town of Queensbury Sewag Disposal c . Signature off/responsible person: Date. CdA Town of Queensbury Building and Code Department Bay at Haviland Road Queensbury, New York 12801 (518) 7922-5832 SETTLED 1763 . . . HOME OF NATURAL BEAUTY . . . A GOOD PLACE TO L1VF TOWN OF QUEENSBURY �0 BUILDING ND CODES DEPARTMENT BAY & HA V LAND ROADS - QUEENSBUR , NEW YO7RK 12801& ° 32 TELEPHONE (5I8) 792-5832 �� 1 � EXJI LDI NG INSPECTOR' S REPORT REQUEST FORy';INSPECTION RECEI ED :2S& AML NAME LOCATION DATE © PE IT # APPROVED YES I NO FOOTINGfPIERS MONOLITHIC POU FORMS__ FOUNDATIONfDAM PROOFT BACKFILL APPRO L ROUGH PLUMBING' FRAMING ELECTRICAL ROUG IN INSULATION: FOUNDATION FLOORS WALLS CEILING A:pFFZNAL INSPECTIOLN CHIMNEY HEIGH ROOFING SIDING EXTERNAL PORC _. STAIRS-CLEARA PLUMBING FIXTINTERIOR TRIMFINISHED FLOO GARAGE FIREPRDOOR CLOSERSMOKE DETEC FINAL ELECTRIC L INSPE TTON FINAL APPROVAL OF CONS UCTION OK. TO ISSUE C/ OR C/C A SIGNED CERT FICATE OF CUPANCY MUST BE OBTAINED FROM THE BUILDI DEPARTMENT BEFORE THESE PREMIS S ARE OCCUPTRDI }� REMARKS: Cr�L.+� c ARRI�7Ef � DEPAR xmslrEcTOR r CO. �fown a/ Queenji " ry BUILDING and ZONING DEPARTMENT Say and Haviland Road, R .D. 1 Box 98 Queensbury. New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME LOCATION DATE Q f PERMIT NO .� -!f ' c ('') SOIL TYPE - Sand - Lcaam - Clay Percolation Test Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM: Absorption field , total length Length of each ench ," __....� Depth of trench Size of gravel SEEPAGE PITS4Numbe of ) Size- ' ft. X Gravel size PIPING : ze Type Bldg . to tank Tank to dirt . box !'! Dist, box to field/ Openings sealed? Y NO Partial LOCATION/SEPARATI Foundation to t ft. Foundation to orptlon £t . Absorption to t line ft. Separation of its ft . LOCATION O STEM ON PROPER 1 cle one ) Front - a Left side - Right side - CCMMENTS . SYSTEM USE APPROVED YE N Buil ing Inspector 01/86 and vl f low" ©/ Queenit"ry BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME r I r LOCATION 4Z44�0�ve_tl Date Gr Permit No . j ✓ = APPROVED - YES NO KFOOMtdatlon ing/Pier Forms Waterproofing Backfill Framing 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 FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL_ Final Building Survey Next scheduled inspection (call when ready) Remarks- Building Tn9156ctor 6/86 and-vl rnn�. � cc esv°od bFox. .°<ro `G W Q I T I o N. eei Rd , Stewart—Rc Kile La P _ e° �s o .� ROBERT s � "' Q o j Q ono r r, GARDEN Rd F little Rd .a o Hov n CJ� F°ram APTS o c La Iko Ra o 9O&fP^ v H 3 v "or F Potter Rd xi t 8 % ^ O C, a 58 9 ^ 0. c c A o ° P' 4 A 66 teen a A W Zi EVERG EEN r Q Cir S �Z a " Z ? 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