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1989-089 f CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY fi WARREN COUNTY, NEW YORK Date c:i This is to certify that work requested to be done as shown by Permit No. 3 9 has been completed. i ry dwx f This structure may be occupied as a Location 1�`'s��U ; va ; i� ox: tr(, ct i Owner 0- I By Order Town Board ! TOWN OF QUEEINSBURy i Director of Bldg. Lac Code Enforcement 1 l 1 ------- BUILDING PERMIT TOWN OF QUEENSBURY No. XX 89 _ 89 . ' WARREN COUNTY, NEW YORK o PERMISSION! is hereby granted to Robert Northaard � OWNER of property located at Division r gat Street, Road or Ave. I I rA in the Town of Queensbury, To Construct or place a — Tnmporary Mobi Horne o 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. t. OWNER'S Address is RD # 4 Box 415 Division St . Queensbury , N . Y . 12804 0 2. CONTRACTOR or BUILDER'S Name Self 3. CONTRACTOR or BUILDER'S Address Same Q tz+ M 5a 4. ARCHITECT'S Name r3 5. ARCHITECT'S Address C7 I--I Ci fi. TYPE of Construction — (Please indicate by X) r-i O 11 Wood Frame t ) Masonry f ) Steel ff3 H 7. PLANS and Specifications '0 W No. 12 ' x 64 ' Mobile home ( temporary ) 1971 Detroiter n Serial Number 2254 , existing septic . T 8, Proposed Use Temporary Mobile Dome C/o inc l . L=J $ PERMIT FEE PAID — THIS PERMIT EXPIRES Q nh r 1 1989 b {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.i x'y- Dated at the Town of Queensbury this 15th Day of March �19 89 J Q Cr1 SIGNED BY K for the Town of Queensbury F-+ B riding and Zo ni ngl d9pector r LTJ O t1j TO IDE COMPLCTED DY nuic . DFPT, TOWN OF QUEENSBURY {{�� �(/�J�/�/ Application Woo RECEIVED 1 � Permit xSi3likl d ] 9 BUILDING wnd ZONING 09PARTt`RENT Pwxmit •Expires�_`10 MAR � 5 1989 Oay and Haviland Road, R40* I Box #10 zoning Doslgnation Qusensbufy, Now Yank 12801 Vari H sit Plano,. . BLDC . $ C©D Vi E DEPT. APPLICAT�ION F R v _/ BII L u AJ� PUI �.DING AND ZONING PERMI ? 1 M to • 1F w M �► M iR 4 i► MY i* iM ik iY �► ♦ • ♦ dR ♦ M w f w w► , tire w r • r M s A rt • • :: • A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. ANSWER ALL OF THE FOLLO►+IING , The undersigned hereby applies for a Building Permit to do the following work which will Le done is& accord:ancu with the description, plans and e,pecificacLone aubsuitted , and such special conditions am away be indicated n the Permit , The owner of this property Is , P . G. hcidreaas �-�rt Tel . '3 ' Property Location : Tax Map 5 aa tra: t or b ilding let nunber S"division name (if applicable) Z`ICL' PERSON 1t£SPONSII3LC FOR SUPERVISION OF 'WORK AS REGARDS BUILDING CODES IS t rtnanc; C3 W 1J N. O. Adclrosa Tel . Woo � � ' M:ame of Installe room Tel , N"Ille of I.lur"►kxmr Addrous Tol . N:al,rw of nlauon Addrous Tel MOBILE HOME INFORMATION • ► ZONING 1NrORMATIOV : Ly 'aakb / New 110140 Placement l.� * PLOrI' PLAtIE.MIUS'�' BE PREPARED AND SUBMITTED, � w drawn reasonably to scale and attached hereto, Replacing existing Home A2WA4It" • shying clearly and dletinCtly all Dµildin+ls , Size of new dome /'2- ft x ft * whether exist 'sou ar proposed and indicate all ' set-back dimensions from property linos . Give* Single w , 1e '` Double wide " street and numbor ur lot numbev and indicaLo No . of roams excluding baths ) S " whether interior or corner lot . Show location * of water supply and location and configuration Now of bedrooms 3 " Of noptic disposal area , Now of bathrooms " * COMPLETE INFORMATION ftDl¢UInED BELOW , pi:2 1"1aQd s ,,,�7—,,..a,...._..� * Size of property ! ;2`Q fit x `ft . Foundation style and size : Sxlnting building ( u) Size lzrft x Ce 1�- ft . Piers- No . of � 'Sizze , t�7f" ft. ' Existing building iu ) Uue _ {iLAj t-1j& Depth below gradeA Geis-ob- ft . " PrOpouad buildinus diut..aneo from property lima FOUNDATION Faoting size & n yt ► a � -1PQ . * Front Yard Beft Roar yard Croft Wall material * Side yarda 2Cr kt and A4CA= ft Wall thickne `" He ' ft . * If on corner, setback .from aide atreet ft i `coral depth be grade �``�. ft. * OCCUPANCY INFORMATION Crada t ome floor level ft . • PRIMARY BUILDING wOo w w w + • w ne w w w w w w r w r w "a • !� one fsamily dwelling Two family dwoll ing Proposed date Of placement /,� wwwwwwwwo* Multiple dwel l Lng / dumber of units * Perm anont Occupancy AprOx . Value of Home S * "" pransient occupancy Water supply - Well MunicipalowwWwowwftww „ Dusiness a � * Industrial Sclztic Permit required? /V Q * [stl-►fsr * if additioos wheat will use be? FURTHER INFORMATION REQUESTED * & 7"4c-M & * ACCESSORY DUILDTNG� ON THE REVERSE SIDE OF THIS SHEET * * Detached garage/one car/* arJ car wc CAttachod garage/one car car Private storago building * OqwpwpwOOother * Form M11 P 5 / 86 md - vl APPI- I CATION FOR MOBILE HOME PERMIT,, ( CONT I NUEDj State of New York Division of Housing and Community Renewal INSIGNIA OF APF'IMAL OF THE . STATE BU I M I NG CODE I . INSIGNIA SERIAL NUMBER__. Z J 2 . NAME OF MANUFACTURER 3 . PLAN APPROVAL NUMBER 4v MODEL OR COMPONENT DESIGNATION ' y 5 . MANUFACTURER ' SaSERIAL NUMBER - G . DATE OF MANUFACTURE 7 Ail the above information is to be found on a plate ov sticker which should be affixed to the Nobi to Home . CaMPZete .above +.pith that informatiorx. rt rt rt rt rt w ,w rt w +r +r # A w Town of Queenub-Ury county of Warren A F F I D A V . I T STATE OF NEW YORK I swear that to the 'bast of my knowledge and belief the statements contained in this application , together with the and specifications ubmitted , are a true and complece state,nant of all proposed work o b d ne on tha as be premises and that: all Provisions of the 8uILC1INC COOL' , THE ZONING O CE, and all orbs laws pertaining to LRe proposed work shali be complied with., who r reified or not, nd that such work is authorized by the owner. owner owners age are sp SPECIAL CONDITIONS OF THE PERMIT: Robert Northgard Jr . _ . . March l5 , l9 $ 9 Tax Map # 147 - 1 - 10 Division St . This Mobile Home will - be placedlon ' thi.s property as a temporary measure to provide housing for the North,gard family during the re - construction of their house that suffered fire damage . The wheels will be left on the unit in that it will be removed from the property within 30 clays following; the issuance of a Certificate of Occupancy for the repaired house'. TOWN OF QUEBNSBUR'Y BUILDING AND CODES DEPARTMENT SAY & HAVILAND ROADS QUEENSBURY, NEW YORK 22804- TELEPHONE (518 ) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST FOR 2NSPECTION RECEIVED NAME r[i �`� f�C'ripl i LOCATION [J DATE c PERMIT # ` ..,APPROVED YES NO FOOTSNG/PIERS MONOL.ITHSC POUR FORMS FOUNDATION/DAMP—PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH—IN �— TNS'ULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTI04T: CHIMNEY HEIGHT ROOFING SIDING } EXTERNAL PORCH' S/STEPS STAIRS—CLEARANCE- & RAILS --- PLUMBING FIM`2.'URES/REL. IG' VALVE_ INTERIOR TRIM/PR.IeDOORS FINISHED PTOORS GARAGE F-F)?FPROOFING DOOR CLI (S) SMOKE DETECTORS r FINAL ; CmRICAL INSPECTION FINAL P720VAL OF CONSTRUCTION dIf A SIG, ED CERTIFICATE OF OCCUPANCY MUST BE OBTA*ED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED!' REMARKS : ? TER_.] ay u/ 1 INSPECTOR. TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT SAY & HA VILAND ROADS QU,EEN.SBURYx NEW YORK 1280g- TELEPHONE (518) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST FOR INSP CTION RECEIVED NAME / �G LOCATION if t2 (_!%'Y7 DATE PERMIT # 9 APPROVED �...-'L �p YES -No FOOTING/PIERS �^ /� P- L� toC 1 MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN INSULATION. FOUNDATION FLOORS WALLS CEILING t,w4FINAL INSPECTION. may CHIMNEY HEIGHT e ROOFING SIDING EXTERNAL PORCHES/ EPS ,STAIRS-CLEARANCE A RAILS _._. PLUMBING FIXTURE, /RELIEF VALVE INTERIOR TRIM/P)fIVACY DOORS FINISHED FLOOR GARAGE FIREPR FIND DOOR CLOSERS SMOKE DETECT RS FINAL ELECTRI L INSPECTION FI L APPROVA OF CONSTRUCTION c /II'r A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARRE/ OCCUPIED!' REMARKS: /I 'o .r..` l '{- 0 IN;P OR YOU ARE HEREBY REQUESTED To INSPECT AND ISSUE CERTIFICATES FOR THE FOLLOWING ELECTRICAL EQUIPMENT TO BE INSTALLED BY THE UNDERSIGNED F �! TEMP N DATE CITY OR VILLA yr '1��Y11A(N�SH�I�P_� ALE COUNTY STREET AND NG.OR -�'"tl•" =� 3 �rT--51 � POLE NUMBER BETWEEN WHAT TWO GROSS STREETS IS PREMISES i.iYGi1EDT SECOON BLOCK LOT 6COU 'IJAM "1„ BUILOINGCK>CUPANCY OWNER'S NAME AI?4g ADD}R�E�SS [7 \ ``'�,, HOME TEL�H NUMBER �f CURRENT SUPPLIED BY E ipy c ' FROM THEIR C s OFFICE WORK TELEPHONE NVM�BIEFy,�. BUILDING IS Imo` ^' J new ❑ OLI.�,.cl WOFM IS NFW ❑ ADDITION DEFECTS REI WED ❑ LIST BELL IN ALL EQUIPMENT WHICH YOU INSTALLED Uxs- NUMBER OF OUTLETS Na of Fixtures & MOTORS HEATERS BRANCH OFFICE USE Lamp Receptacles CIRCUITS ONLY loon Side Attach'l Ceiling well Recap'Is Switch Pendant Brackal Na. Type Each LLP Na_ Esch Na e INSPEGTION OUT- SIDE SUB- RASE MENT ksl FL- FL- FL. REMARKS: LIST OTHER ELECTRICAL DEVICES N[)r SET FORTH ABOVE: THIS APPLICATION IS INTENDED TO COVER THE ASO VE-LISTED EQUIPMENT TO BE INSPECTED. BUMF Al- TIME OF INSPECMON, THERE IS FOUND ADDITIONAL EQUIPMENT NOT ABOVE LISTED, YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE TO COVER THE ADDITIONAL EQUIPMENT, AS PROVIDED BY THE APPLICANT. SYZE OF MAINS FEEDERS ELECTRIC SIGN&I-AMPS TOTAL WATTB CHARACTER OF WON EXPOSED GAS TUBE SIGNITFIAN SPORMERS OF Nq ❑ CONCEALED DATE W1D A TO BE 'sTAn QED ONE COMPLETED SIZE OF SIGN(NVMBERy CgpACfTy SERVICE ENTERS BUILDING MANUFACTURER OF SIGN OVERHEAD ❑ UNDERGROUND DATE INSPEMiON REQUESTED ON(OR AS NEAR AS PDS.SIBLE) MUST ENTER APP UdVM IDEWWW^TIOl M MMBER I ' AVCND DELAYS BY GIVING FULL ACCURATE INFORMATION_ SPACES MUST BE FILLED 10ATION MAY BE RETUFIINIEfi- PRINT NAME AND ADDRESS NAME (CANT DATE F A PLIATIt 'SIRES%T}ADDRE$^,� ' rTE NFCt, CITY OST OFFICE E J, LICENSE NU WH AP CABLE r 4� ❑ 85 John Street ❑ 41 State Street ❑ 594 Delaware Avenue f ❑ 217 Lake Avenue ❑ 202 Arterial Road NEW Y0Rk, NY 10038 ALBANY, NY 12207 BUFFALCY, NY 14202 J ROCHESTEFI, NY 14608 SYRACUSE. NY 13206 THE NEW YORK BOARD OF FIRE UNDERWRITERS DA A 6 1 D) ......... ....... w fz Po W& fzS&PTI ro HOU5& S4;(! TOWN OF QUEENSBURY Bay at Hauiland Road, Oueensbury, NY 12801-9725 — 518-792-5832 July 12, 1989 Robert Northgard Division St. Glens Falls, N .Y. 12801 Dear Sir; Enclosed please find a copy of the Permit Application for your Temporary Mobile Home. You will see the provision for removal of the home within thirty (30) days of the occupancy of your rebuilt home. The Certificate of Occupancy was issued on May 31 , 1989W Be advised that the mobile home must be removed from this property in the very near future. Please notify the Building Department of the expected date. Yours t T Victor Lefebvre Code Enforcement Officer V L/nr enc. CC* David Hatin, Director Bldg. & Code Enforcement "HOME OF NATURAL BEAUTY . . . A GOOD PLACE TO LIVE" SETTLED 1763 TOWN OF Q►UEENSB URY Bay at Hauiland Road, Queensbury, NY 1 2804-9 725-5 1 8-792-5832 March 15 , 1989 TO : Town Board Members FROM : Victor Lefebvre RE : Robert Nosthgard Temporary Rousing I have inspected the mobile home , proposed for use as temporary housing , for the Northgard family . The heating system is operable . The exterior and interior of the home are in good condition . The service connections will be inspected before occupancy _ In my opinion , this home will be acceptable for the purpose proposed ; Temporary Dwelling Res full submitted , � a Victor Lefebvre Code Enforcement Officer VL/cg cc : Steven Burgos , Town Supervisor David flatin , Director Building & Code "HOME OF NATURAL BEAUTY . . . A GOOD PLACE TO LIVE"' SETTLED 1763