1989-530 1
7 �
f = r
CERTITWA'TE CAP O CCU- P A►.NCxJLT
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
I
I
Date Anri 1 12 19 90
• [q
This is to certify that work requested to be done as shown by Permit No. 89- 530
has been completed.
This structure may be occupied as a Mobile Home
i
Location --Lot 9 FoneLst Park
Owner Patricia Clark
i
Hy Order Town} Hoard
TOWTf OF QUEE`NSBURY
Director of Bldg. do Cade Enforcement
BUILDING PERMIT
a
TOWN OF QUEENSBURY
No. 89- 530
WARREN COUNTY, NEW YORK k,
t
PERMISSION is hereby granted to Patricia Clark ±~
OWNER of property located at lot 9 Forest Park VanDeusen Rdstreet, Road or Ave.
in the Town of Queensbury, To Construct or place a Hobi 1 e dwe
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
Same
c:
r-
2. CONTRACTOR or BUI LDE R'S Name
7'C
Saratoga housing
3. CONTRACTOR or BUILDER'S Address
C-r
4. ARCHITECT'S Name
m
5. ARCHITECT'S Address
x
m
Grp
B_ TYPE of Construction — (Please indicate by X)
- !
-o
Wood Frame I } Masonry ( ? Steel
7_ PLANS and Specifications
No_ 14 ' x 56 ' Mobile Home as per plot plan , and application and rn
Specifications . m
8. Proposed Use
z
♦ C"D
MOB1LE HOME a
$ _ 23 _ 00 PERMIT FEE PAID — THIS PERMIT EXPIRES February 1 19 90
Ilf a longer period is required an application for an extension must be made to the Building and Zoning inspector of the w
town of Queensbury before the expiration date.) .0
r
m
Dated at the Town of Oueensbury this 7th Da of July 1$ E39 r
SIGNED BY for the "Town of Queensbury
wilding and n4og Inspector
BE COMPLETI~n DY nLDC . DEnz'.
/awn 01 Q"e*'0j '3Zdr0*e Application No, TOWN OF QUEENSSURY
BUILDING rnd ZONING DEPA"TMENr permit Iscaued I9��� RECEIVED
Clay and Haaviland [load. Nj.D. 1 Box ou permit Exvirea 19
C1uu+trnstauty, NOW York 12601 Zoning Deraignation JUL � $9
Variance No.,
Site Plan fwviuw No .
APPLICATION FOR Approvu & BLDG. & CODE DEPT.
4"'
MOBILE HOME � •�'�'PUILDIN; AND ZONING PERMIT
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION . ANSWER. ALL OF THE FOLLOWING ,
The waderaignod hereby applies for A Funding -prrmit to do the following work which will
in wccardancu with the doscription , Plana and a apa:cifications raub+nitted ,
I�eci:at'carrclitiona_aa'ukry be indicated on the! Permit . ;and such
1'h; -rr..rwr rr r4r�.sr.ti.ryrrr�rrrwr- rr...r..rr. r rrr-ir r.rr w.r r...ri-
owner of this propert
P . b . Addre"sgas
PrO!.crrtY Tul •- !yL
I oc:at ion a
street , .u,a0arrr or bu �idiny lot number Tax Map No * 5;,�
ul�divi ; ion nauur ( i ! applicable)
I'I'ILSON RESPONSIBLE
Poll SUPERVISION OF WORK ASRDS UI
FtEGAR,D, BUILDING CODES IS ;
ti.ua,e f'. O. Ad.areas
t Ike O f 'Pal . No
Installer Addre$a
r .aloe uY pl umkouv Tel .
.Auu Of rIi:auo Addrarnu 7'ui
Address Tel
._
MOBILE HOME INFO1tMAT 0 + ZONING INFOR1*1ATICN": W._.
td4w 11o10C Placement � A PLM PLAN 'MUST Etc PREPARED AND SUBMIdrTED ,
Ftc p 1 a c i ng existing Home drawn reasonably to scale and attached hereto,
showing clearly an" distinctly all Luilding ;x ,
ixe of new Home ft X ," ft whether existing or Proposutd And indicate all
Single w `- 1c Double wide
set-back diruensions from property linos . Give
street and nLunber or lot nt-wa)er and indicate
No . of rooms ( excludoj .a
ding bths ) 7"27� `r whutJh" interior or corner lot . Show loc.at"n
No . of bedrooms =;4 Of WALer supply and location :and configuration
+ of septic dislaas.al area .
No . o f bath rooms [ +
+ C'OMPL.ETC INFORMATION REQUIRED liCL.OW .
rireplace? Ao Wood stove?_ Size of property 1Ft X ft .
Foundation style and sire : " hxisting buildiIITL ) Size ft x ft .+
Piers- No . of Size ft x ft . +
Existing builc3ierg ( :: ) Uaaa:
Depth below grade ft .
'� Proposed buildirra
FOUNDATION � Footing size •• g di::6anc:e aFrout l+ rcrpurty lie.:
Wall material 6Y A" „ Pcont yard ft Rear yard ft
,. Side yards ft anti �f t
wall tilickness _•� Height ft . IY on corner . setlaack from aids acrout ft
Tor- al depth below grade ft . � OCCUPANCY INFORMATION
Grade to Hoare floor level ft. . PFLOTHARY BUILDING
x y • a w * • • w r x r x # w + f One L'umlly dwelling
Proposed date of placement 07 j j + fcUftily dwe; ilinq
n � + ultiplas dwelling / Number of units
A pr o x . V a l uw of Home $ ofiaf, a��a� r erltuanunt Occupancy
/ Transient occupancy
Water supply - well V M"nicipal tiusinuass
„ industrial
SeNytic Permit required?�_ Ottlur
+ if addition, What will usas bv:
FURTHER INFORMATION REQUESTED `
ON THE REVERSE SIDE OF THIS SHEET.* ACCESSORY DUII.DTNGr
Detached garage/one car/ two car/ car
it Attached garage/one Carl two carj'� car
No
'�Private storage building
" Otber
+r
Form M11P S / aG and - vl
APPLICATION FOR MOBILE HOME PERMIT, ( CONTINUED)
State of New York nivLsion of Housing and Community Renewal.
INSIGNIA OF APPtcOVAL OF THE STATE BUILDING CODE
1 . INSIGNIA SERIAL NUMBER
2 . NAME OF MANUFACTURER ��
3 . PLAN APPROVAL NUMBER
4 . MODEL OR COMPONENT DESIGNATION "T ! iG �s�.
5 . MANUFACTURER ' S , SERIAL NUMBER , 427 "T f3
G . DATE OF MANUFACTURE
AZI the above •inf6rmation is to be found on a pZate or atiaker which
ahou Zd be affixed to the Mobi Ze Home . CompUte..above with that infox7natian.
#Town # # # # # # # +!
Coup y f Warren A F F I D A Y . I T STATE OF NEW YORK
County of Warren
I swear that to the bast of my knowledge and belief the statements contained
in this application, together with the plans and specifications aubmLtt+ad , are a true and
complete statelnent of all proposed wont to be done on the described promises and that all
provisiona of the UUILDINC CODE , THE ZONXNC ORDXNANGEr and all other lawn pertaining to
the proposod work sh"ll be complied with, whather spacified or not, and that such work is
authorized by the owner.
signature �L�L.0 VA
_ - -------
Owner, gen arc Itect, contractor
r w • • w R rr • • w w r ,w r u M w w w # , w rr ■ # w w w w w w r ,r w ♦ w +w s r F r w r w ' r
SPECIAL CONDITIONS OF THE PERMIT :
F
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
pUEENSBURY, NEW YORK I2801�
TELEPHONE (528 ) 792-5832
BUILDING INSPECTOR' S REPORT
REQUEST FOR INSPECTION RECEIVED_ ± t6
NAME
LOCATXON f
DATE PERMXT # �3✓
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC PO FORMS
FOUNDATION/D -PROOFING
BACKFILL APPR VAL _
ROUGH PLUMBIN
FRAMING
ELECTRICAL RO H-IN
XNSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
I / FINAL INSPECT N.-
CHIMNEY HEX T
ROOFING
SIDING v
EXTERNAL POR HEST TEPS +
STAIRS-CLEAR4NCE & RAILS
PLUMBXNG FXXJUR S/RELIEF VALVE_ _ Y
INTERIOR TRX� XVACY DOORS
FINISHED F
GARAGE FXREP FXNG
kq -
DOOR CLOSER (
SMOKE DETEC
FINAL ELECTRI A INSPECTION
Ilot
NAL APPROV O CONSTRUCTION
A SIGNED C TIFIC E OF OCCUPANCY MUST BE
OBTAINED F OM THE UXLDING DEPARTMENT BEFORE
THESE PRE ISES ARE CCUPIED!
REMARKS:
INSPECTOR
a
SELECT BUSINESS FORMS (609) 84a-5203
APPLICATION FOR ELECTRICAL INSPECTION
PLEASE BEAR DOWN YOU ARE MAKING (4) COPIES
MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
National Headquarters
900 Haddon Ave., Collingswood, N.J. 08108
APPLICANT"
Date.
City, Town or Township _._ L* y+ ezn ITL�.r�� _County �, r>�r Syr%State
Location/Address 601
Orr
Located in Rural Area - Please Attach Directions) Pole #
Owner cy- ` e= ' k�� 1+4/ Permit #
Occupied As j29C2i fle Q wr .a
Occupant e - Building: New Ofd �]
Work Area in Buildin Floor #, etc. ) :
A for: Wirin Q Service [� or: Readv for Ins ection :
Fee Remitted - $ Cash [] Check M.O. Make Payable To: M.D. I.A.
Number of RougEWiring Ouxfets Elect, Heat 750Switches
Lighting d Amp. Service Surface Unit Dishwasher Range
Receptacles Ater Heater Air Conditioner Dryer Pump
45
Number es 3� Oven Garbage Disposal Wiring and Controls for Burner
Amp. R e tacles Fractional H.P. Vent Fans
Other Equipment: 7,Q
MOTORS H,P, i/2 1/12 1/10 1/E I t/6 1/4 1/3 1/2 3 2 3 5 7kh l0 15 20 25 31 40 50 75 100
Mark Number
of Each Size
Applicant's
Signature License # Permit #
T/A Utility :
Applicant's Address : (NAME C1 FCE L TIONJ
(City) (State) {Zip} Service Request #
Phone -* Electrician :
DATE RECEIVED: DATE INSPECTED:
Correct Location : game as Above C3 or:
Red Notice Label �
Rough Wiring Outlets Surface Unit Oven
Switches Range Garda Disposal
Receptacles Water Heater Dishwasher
Fixtures Air Conditioner ❑ryer
Amp. Service Equipment Burner, Wiring & Controls for Amp. Receptacle
Amp. Service Conductors Pump Vent Fans
MOTORS FI..P, 1/20 1/12 1/30 1/a 1/6 3/4 1 li/i 2 3 5 7J/2 1 10 15 20 25 30 40 50 75 100
Mark Number
of Each Size
Elect. Heat 5a0 751, 1000 1250 1500 175a 2000 225a 2500 2750 3000
MIAo-" �r. s # FCIIII gfHfxiAL,f/IEI � lia7lEf�F DATE ��IE �
0 RW Progress: Inc. � LKD Q _ Contractor
CFT Violation : Work Comp, Q Inc. 0
Q L/A Owner CASH
[] L/A Fee CH K #
Due
0 IPA Municipal MD #
INV #
Date : Applicant
f
. S
AI�ISTER W D F �'�}1
BEDROOM LIVING ROOM
REDROOM
i
2 7n5
3Cf C, .L 'y"S Sq. FIB .� �
c v �" " B2 G
. , '
7*
TOWN
Zoning Administr `pr
r +�
i
r
TOWN OF QUEENSBURY BUILDING DEPT.
PROPER METHOD FOR SUPPORTING A MOBILE HOME
SHOWN FOR USE WITH A SINGLE WIDE MOBILE HOME ONLY
FOR USE WITH A DOUBLE WIDE USE SAME METHOD UNDER EACH SIDE
TRAILER BODY
TRAILER BEAM TRAILER FRAME
WOOD BLOCKING
r
CEMENT BLOCKS
! . .
FINISH GRADE `r
REINFDRCEMENT R4. __ _ 6-6-10 WIRE MESH
REINFORCEMENT ROD AND MESH AS PER CONDITIONS
SLAB TO RUN FULL LENGTH OF THE TRAILER AS SHOWN