1987-334 w
CERTIFICATE OF Q►+ ft4C1J 'ANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
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Date Nov . 16 , 19 87
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This is to certify that work requested to be done as shown by Permit No. 87-334
leas been completed. byl, �Q
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Mobile Aome Dwellin re lacln
hia structure ma�y ib�e/accu e] d older mcb�ileho
L� Luzerne Road D LK.
location
M C} e�. I.id Ile
Owner
By Carder Town Board
TOWN OF QUEEN SSURY
B adding & Zoning insyectar
BUILDING PERMIT
TOWN OF QUEENSBURY No. 97-314
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Michael J . Liddle
OWNER of property located at 10 Luzerne Road Street, Road or Ave.
Mobile Home Dwelling (replacement )
in the Toms of Queensbury, To Construct or place a N
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. C-'
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1. OWNER'S Address is 10 Luzerne Road Queensbury , New York 12801 ro
2. CONTRACTOR or BUILDER'S Name
same
3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT's Name "t
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5. ARCHITECT'S Address
5. TYPE of Construction — (Please indicate by X)
I ) wood Frame 11 Masonry I ) Steel l }
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7_ PLANS and Specifications �-
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141x70r per plot plant specifications and application io
No. using existing septic - Replace old mobile home with 1982 Titan-160 •x
8. Proposed Use Champion Home Builders Co . ro
Serial No . 19-2-160-8424
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Mobile Home Dwelling
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$5 . 00 C /0 Do
$ 25 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES January 1 7g 88
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(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.) per,
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Dated at the Town of Queensbury this 9th Day of June Ig $7
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SIGNED BY � � for the Town of Queensbury 4
Building and Zoning Inspector
TOWN OF OUEENS=- t . r.-
1"C7 BE COMPLETED 13Y AL LKx. A>LPT . � � � � � IN 2
Application No . IJWt J�EJ Eire �f
i _Jown O/ Queenig"ry Permit Issued 19 JUN 2 1987
BUJI-DING and ZONING DEPARTMENT Permit Expires 19
Bay and Haviland road. R.D. 1 Box 98 zoning Designation BUILDING 8c CODE DEFT,
Queensbury, New York 12801 variance No .
Site Plan Review No . !c .,� r Cry
CAI
APPLICATION FOR Approved
MOBILE HOME MR
3 �`
Eli I LD I NC 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 i s : A.. Z s�s1 Q . I rs l
P . Ov Address /f � �- {,.I'. .c cs )e N l7l c�� tr �C �1 Y L �,� Tel . 70� Q �i
Property Location ; SAME ddg A BO ✓� / flax Map No . / /
street i .umber or building lot number
Subdivision name (if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS uUILDING CODES IS :
Name PeO. Address Tel . No .
Name of InstallerTelw
Address P is g� z� Tel .
Name of plumber Address
Name of mason Address Tel *
MOBILE HOME INFORMATION : * ZONING INFOTION :
' A PLOT PLAN MUST BE PREPARED AND SUBMITTED ,
New Home Placement 1yt � drawn reasonably to scale and attached hereto ,
Replacing existing Home I+ * showing clearly and distinctly all buildings ,
Size of new llome. ^ft X_ `1G� ft
» whether existing or proposed and indicate all
set-back dimensions from property lines _ Give
Single wide K Double wide • street and number or lot number and indicate
* whether interior or corner lot . Show location
No . of rooms (excluding baths )
1 of water supply and location and configuration
No . of bedrooms of septic disposal area .
*
No . of bathrooms - --- * COMPLETE INFOR1 ATI ON REQU I RED BE LAW .
Fireplace? JJ 6 Wood sto-ve? rlel �) ' Size of property 114 _f t X 31a f t .
Existing building ( s ) Size_ a ft x a ft .
Foundation style and size :
Piers- No . of jL4 size- 16EC x ,-rim . * Existing buildings ) Use IWO 75K-
*
Depth below grade_ S .L4u t� ' * Proposed building . distance from property line
FOCTNI]ATION - Footing size (�_• X 1 Front yard Jr ft Rear yard /sic 6ft
Wall material Side yards o Rf ft and 60 ft
Wall thickness Height ft . * If on corner : setlsack from side street ft
* OCCUPANcY INFORMATION
Total depth below grade ft -
Grade to .Home floor level £t . PRIMARY BUILDING -
��Dne family dwelling
Two family dwelling
Proposed date of placement / / * Multiple dwelling / Number of units
* Permanent occupancy
Aprox . Value. Of Home $ 15 1 " * Transient occupancy
Water supply - well Municipal..._ * Business
* Industrial
Septic Permit required? Other
* 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
* ether.
*
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
I . INSIGNIA SERIAL NUMBER__. ,_ I (
2 . NAME OF MANUFACTURER f/ 1 �'�1 ' / ' 1c j6-a- z) E 4 S
3 . PLAN APPROVAL NUMBER 1
4 . MODEL OR COMPONENT DESIGNATION / / rrQ A
5 . MANUFACTURER ' S SERIAL NUMBER
6 DATE OF MANUFACTURE
All the above inf6rmaticon is to be found on a plate or sticker which
should be affixed to the Mobile Home . Comp'Zete above with that information*
Town of A F F I D A V I T STATE OF NEW YOK
Warren Ei
ry
County off 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 1:3
authorized by the owner .
Owner, owner ' s agent . arcnitect , contractor
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SPECIAL CONDITIONS OF THE PERMIT :
]� 3o+vn o f Queenjl urcy
r } BUILDING and ZONING DEPARTMENT
Bay and Hauitand Road, R.D. 1 Box 98
Queens orryNew York 12801
JX4010W
�r t 'lS 1 L DI
NG INSPECTOR ' S REPORT
NAME
LOCATION rfj:�)
Date Permit NO
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 s Railings
Cellar Drain Tile
Concrete Floors
Plbq . Fixtures
Gar . Fireproofi 9
boar Closers
Smoke Detector
Chimney
INSULATION :
Foundation
Floors
walls
Ceiling
FINAL ELECT TCAL INSPECTION
DRIVEWAY AP ROV AL
Buildi g, Survey
Next scheduled inspection { coil when ready )
Remarks-
Ir
soil n Inspector
6/8€� and-vl
aWl" of Q"Cenig "e l
BUILDING and ZONING DEPARTMENT
Say and Haviland Road, R. D. 1 Box 98
4� 1 0 L flueensbury, New York 12801
BUILDING INSPECTOR ' S REPORT.
NAME
LOCATION
Date Aa f' /4 Permit No .
✓ = APPROVED - NO
w'Footing/Pier Forms
Foundation
Waterproofing
Backfi. 11
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 Inspector
6,/86 and-vl
Ar
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'- '70
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