2006-770 TOWN OF QUEENSBURY
F
742 Bay Road,Queensbuq,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20060770 Date Issued: Monday, November 10, 2008
This is to certify that work requested to be done as shown by Permit Number P20060770
has been completed.
Location: 466 LUZERNE Rd
Tax Map Number: 523400-308-011-0001-030-000-0000
Owner: CECIL HART
Applicant: DONALD A. HUNT
This structure may be occupied as a:
Mobile Home Out of Park By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the , e
property owner of the responsibility for compliance with Site Plan, (LDJ4
Variance, or other issues and conditions as a result of approvals by the Director of Building& Code Enforcement
Planning Board or Zoning Board of Appeals.
06` TOWN OF QUEENSBURY
*pc0 742 Bay Road,Quccii>lhury,NY 12804-5902 (518)761-8201
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20060770 Application Number: a20060770
Tax Map No: 523400-308-011-0001-030-000-0000
Permission is hereby granted to: DONALD A. HUNT
For property located at: 466 LUZERNE Rd
fi
in the Town of Queensbury, to construct or place
at the above location in accordance with application together with plot plans and o A in 4 rmation hereto filed
and approved and in compliance with the NYS Uniform Building Codes and -r .ury Zoning
Ordinance. i e o onstructi n Value
Owner Addres . DONALD HUNT Mo.' Home Ou •f Par
466 LUZE'1 E Rd
QUEENSB 'Y, NY 12804-0000 Tota Va e
Contractor o : ' der s Name Address k Electrical spection Agency
1
Plans & Specifications
2006-770
1512 sq ft mobile home and new septic system
$95.76 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday, October 25, 2008
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the T Queel.u ;i a •. !ay, October 25, 2006
i.
SIGNED BY ii, `S. for the Town of Queensbury.
Director of Building&Code Enforcement
4 , TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20060770 Application Number. a20060770
Tax Map No: 523400-308-011-0001-030-000-0000
Permission is hereby granted to: DONALD A. HUNT
For property located at: 466 LUZERNE Rd
in the Town of Queensbury,to construct or place
at the above location in accordance with application together with plot plans and other information hereto filed
and approved and in compliance with the NYS Uniform Building Codes and the Queens bury Zoning
Ordinance. Type of Construction Value
Owner Address: DONALD A. HUNT
466 LUZERNE Rd Mobile Home Out of Park
QUEENSBURY, NY 12804-0000 Total Value
Contractor or Builder's Name/ Address Electrical Inspection Agency
Plans &Specifications
2006-770
1512 sq ft mobile home and new septic system
$95.76 PERMIT FEE PAID- THIS PERMIT EXPIRES: Thursday, October 25, 2007
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Towir e nsbu �, W,A6 need .,.October 25, 2006
SIGNED BY "� for the Town of Queensbury.
Director of Building&Code Enforcement
APPLICATION FOR PLACING A MOBILE HOME
OUTSIDE OFA MOBILE HOME COURT:
This application for a Mobile Home Permit shall be accompanied by a plot plan
drawn reasonably to scale showing all dimensions, the size of the lot, the location on
the lot of the Mobile Home, the water supply and sewage system. If the applicant is not the owner of the
premises,then the application must be accompanied by the written acknowledged consent of the owner.
Applicant Information Property Owner Information
Name: C .ECIt_ R--\flRT Name: L-L_ 4, V\
Address: y(e(p LAY? E i E- RC) Address:
J
Phone No: Phone No:
Parcel Information
Property Location: y( Lv7at1/41E RO Tax Map Number: \-- c, „,1
Road,Street,Avenue
Mobile Home Information
Approximate Value of Home: $ %l app New Home: No
Replacement Home: e o Size of Mobile Home: 2-7 ft. by (00 ft.
Singlewide: Doublewide: Year: 2 CCs., Make: CtitMOoo'E.
Model: `(j V 11 OG1-k Serial #
State fully the reasons for this request:
L ls4
Applicant's Signature Date
EaTown of Queensbury• Community Development Office 742 Bait Road, Queensbury, NY 12804
. .
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(a.3' . .3e.
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J91'
..~.................�..~~...''''~'....����.....................
•
AFFIDAVIT
Town of Queensbury State of New York 3
;j County of 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 5
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: CA-64 kiet.,Or
• Owner, Owner's Agent,Architect, Contractor Date4'
FOR TOWN USE ONLY
Report of the investigation of the Zog Administrator and recommendations:
APPROVED: \/
DISAPPROVED:
OTHER RECOMMENDATIONS:
ACTION OF THE TOWN BOAR
APPROVED: V
DISAPPROVED:
OTHER RECOMMENDATIONS:
By Resolution Number: 41,21 2_00hn of the Town Board of the Town of Queensbury,
Warren County, New York.
Dated this day of , 20
Town Clerk, Town of Queensbury
� rev ( � I -3O OFFICE USE ONLY l r
1
TAX MAP NO. PERMIT NO. 06-770 DATE ISSUED:
•
,
•
PERMIT FEE 71----APPROVALS: ZONING TOWN CLERK ;
•
MOBILE HOME -APPLICATION FOR PERMIT:
A building permit must be obtained before placement of mobile home on parcel. No inspections will be made until a
valid building permit has been issued.
Applicant Information Property Owner Information
Name: n.„kid 4. Ii
Pg, ! A✓1 Name: Do.?ct/c( A //61,,-i--
Address:
/61,,Address: 4/ t)6 Lt.LzP,rh & , Address: 1-(;47 e N
Qul.ti n j 1J vn r y , , 124 �t"��y1S rl //J,/ 1 Q f�
J
Phone No. Pd 307 6 1411S. Phone No. fa 3Q 6
Parcel Information /�
Proposed Date of Placement: Property Location: V j /tcZrorr, P /d 6AAetsiivad-�!
Road,Street,Avenue ./
Name of Mobile Home Park: (if applicable) Tax Map Number: 30y, //-/-30
Mobile Home Information Zoning Information
Approximate Value of Home: $ :5-g)60 0 Zoning Classification:
New Home: No Size of Property: _L�00 ft. by 1 QQ ft.
es
Replacement Home: No Existing buildings: "2 4(3 q�� ,ve y)
Size of Mobile Home: '9-7 ft. by 56 ft. Setbacks: front yard 3 0 ft. rear yard n O ft.
side yards I 0 ft.and i n ft.
Singlewide: Doublewide: x'
Number of Rooms: (exclude baths) Accessory Building(s): circle
Number of Bedrooms: y
Number of Bathrooms: , Detached garage: 1-car 2-car car
Circle: Gas Fireplace/Woodstove/Wood Fireplace Attached garage: 1-car 2-car car
Foundation Support: Storage building: Yes No
Type Size & Depth Other:
Piers
Runners Water Supply: well . municipa
Slab Is Septic Permit Required? or No
Continued on back
410 Town of Queensbury • Community Development Office ■ 742 Bay Road, Queensvurj, 1.13(14
r
1
Atr17)
9Name ofInstaller or Mobile Home Dealer: /ClektiSecK--(--vot2_ ti43YleS
Address: i s wur r-106-1 ()Jay Phone: J/e 36 7 /-- 1
6,.,...e.,c,vbv,,...), /0, -.) /
Complete information below found on a'Plate"or"Sticker"which is affixed to the mobile home:
✓ Insignia serial number:
✓ Name of manufacturer: SA l/•1) r'
Ay
✓ Plan Approval Number.
✓ Model or Component Designation: %00 q C?•IP5 6 ag
(New hom only)
✓ Date of Manufacture: 0 Q
r AFFIDAVIT
J
J
r
E Town of Queensbury State of New York
fi County of Warren
I
J
J
I swear that to the best of my knowledge and belief the
statements contained in this application, together with the plans c
and specifications submitted, are a true and complete statement
of all proposed work to be done on the described premises and s
that all provisions of the BUILDING CODE, the ZONING
ORDINANCE, and all other laws pertaining to the proposed work x
5 shall be complied with, whether specified or not, and that such x
e. work is authorized by the owner.
J
w / y
Signature: . -rtcan C'
Owner,Owner's Agent,Arc itect, Contractor
s 8
x a
SPECIAL CONDITIONS OF PERMIT
//
} '/Ait
—
By: /I
ode Enfor nt Officer
Town of Queensbury • Comnzunity Development Dice • 742 Bay Ro , Queensbury, NY 12804
06- 770
APPLICATION FOR PLACING A MOBILE HOME
OUTSIDE OFA MOBILE HOME COURT: OCT 1 8 2006
This application for a Mobile Home Permit shall be accompanied by a plot plan
drawn reasonably to scale showing all dimensions, the size of the lot, the location on ,,
the lot of the Mobile Home, the water supply and sewage system. If the applicant is not the owner of the
premises, then the application must be accompanied by the written acknowledged consent of the owner.
Applicant Information Property Owner Information
YRJName: Doc nail A. Name: ne'lcd6 . A . fltnit
Address: � er Address: 11( d12, ar
ino ,.•
UP tk ry IV /zg.0 0,40.P,n.)--b 6(r - ,r /9. ',y
Phone No:54-307 Gg1K Phone No: S-/S - 07-_ 6 9 /g
Parcel Information
Property Location: Li,�t�"(�ies
LK( Tax Map Number: 302 , 1-i-30
Road,Street,Avenue
Mobile Home Information
Approximate Value of Home: $ .1 ;000 New Home: • No
Replacement Home: 4.40 No Size of Mobile Home: ft. by s-7 ft.
Singlewide: Doublewide: VI Year: 31 G Q C Make: Sky / / n€i
Model: 0 0 T i/z ' Serial #
State fully the reasons for this request: .i kawcG q 6 S _$' i`n Cei
' i /ei A 40-pl e2 ) (ill SS �J f��'� i 1/fir; /9ZII/
r D w r(.(I / ( K(/ /‘4,07 ( ?a,- �f� (If 'r
y
�vNe / � , tra t- fceni, #r. eip ;C 161/1
CO 8 W8 81 d]S 90 04/4
PPg
licant s Signature 13/13-266
)123330 NM01
J,Hf19S' 33f10
ga Town of Queensbury • Community Development Office • 742 Bath Road, Queensbury, NY 12804
' . .
•
AFFIDAVIT
Town of Queensbury State of New York
County of 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 5
work is authorized by the owner.
Signature: aiti a. vo
FOR TOWN USE ONLY
Report of the the Zoning Administrator and recommendations:
APPROVED: ���
DISAPPROV
OTHER RECOMMENDATIONS:
ACTION OF THE TOWN BOARD:
APPROVED:
DISAPPROVED:
OTHER RECOMMENDATIONS:
By Resolution Number: of the Town Board of the Town of Queensbury,
Warren County, New York.
Dated this day of , 20
Town Clerk, Town of Queensbury
0,Town of Queensbury • Community Development Office • 742 Bay ROI7(1, Queensbury, NY 12804
a
- 0111111.,
ep TOWN OF QUEENSBURY
IF VAS 742 Bay Road, Queensbury, NY 12804-5902 518-761-8201
AFFIDAVIT
TOWN OF QUEENSBURY STATE OF NEW YORK
COUNTY OF WARREN
I swear that the following used mobile home that will be transported
into the Town of Queensbury for placement will have the following. A
building permit approved and issued, meet all zoning requirements,
the mobile home's HUD sticker affixed to mobile home and meet
HUD requirements for the Middle Zone. As the person responsible
for the transport and placement of this mobile home, I accept total
responsibility for removal of the mobile home from The Town of
Queensbury, if it does not meet the requirements for placement.
Signature: obia-m,; �(, Date: _Lak:24_
le Home Owner, Owner's Agent, Mobile Home Contractor
Signature: Date:
Town of Queensbury Code Enforcement Officer
"HOME OF NATURAL BEAUTY . . . A GOOD PLACE TO LIVE"
SETTLED 1763
Q..0,,omp.etv,---' " • .-HCl. OL-11
10\0�� E U Aub10
► r - -..'-.-'-.
TAX MAP NO, vW
— PERMI . • "E• YIT FEE_ '
APPROVALS. ZONING
TOWN CLERK_
APP ________________________________
LICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT;
l
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE��T r
PERMIT, ORE ISSUANCE OF A VALID
OWNER: ` = +'
INSTALLER:
ADDRESS:
ADDRESS:
PHONE NOS. E a_ -- 7 . — h `� �
PHONE NOS.
LOCATION OF INSTALLATION: 1 ) r— t
YEAR BUILT X (
BEDROOMSNO.OF COMPUTATION= = j RESI ENC INFORMATION:
I TOTAL DAILY �
FLOW D E
X 150 gallon per bi
1981 -1991 �........................... I
INSTALLED?
GARBAGE GRINDER
bedroom
X 130 gallon per bedroom I
1992 present X 110 gallon per bedroom j - i SPA OR HOT TUB
0INSTALLED?
PARCEL INFORMATION: t...........; '
✓ TOPOGRAPHY: FLAT OLLING
STEEP SLOPE %SLOPE
,/ SOIL NATURE: SAND
LOAM CLAY OTHER
✓ GROUNDWATER: AT WHAT DEPTH?
WHAT DEPTH? __IA
BEDROCK/IMPERVIOUS MATERIAL: AT
✓ DOMESTIC WATER S IPLy: MUNI
CIPALWELL
/
(IF WELL: WATER SUPPLY FROM ANY SEPTIC-SYSTEM ABSORPTION IS
./ PERCOLATION TEST: RATE IS FT. )
COMPLETED BY A LICENSED PROFESSIONAL ENGIN ER OR ARCHITE INCH (TEST TO BE
CT)
PROPOSED SYSTEM FOR NEW CONSTRUCTION: All individual sewage disposal systems must be designed
a licensed professional engineer or architect (unless installed in a Planning Board approved subdivision). Add2by
2
gallons to the size of the septic tank and leach field for each garbage grinder, spa or whirlpool tub. ) 50
/ SEPTIC TANK:
1o_GALLON (MIN. SIZE IS 1,000 GAL.) TILE FIELD: EACH TRENCH T
✓ TOTAL SYSTEM LENGTH: _
FT. SEEPAGE PIT(S): HOW MANY?
✓ SIZE OF EACH FT. X FT.
/ SIZE OF STONE TO BE USED: #_________/DEPTH OR THICKNESS___L__FT.
/ BED SYSTEM SIZE: X
✓ ALTERNATIVE SYSTEM:
LENGTH AND/OR SIZE
✓ HOLDING TANK SYSTEM: (If required) NO. OF TANKS:
/SIZE OF EACH
/ GALLONS./TOTAL CAPACITY
—�_GAL.
NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL W
APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDEDED BY A TOWN •••
I
•
For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Queensbury, any
permit or approval granted which is based upon or is granted in reliance upon any material misrepresentation or
failure to make a material fact or circumstance known by or on behalf of an applicant, shall be void.
I have read the regulations with respect to this application and
agree to abide by these and all requirements of the Town of QUESTIONS? CALL 761-8256 OR EMAIL
Queensbury Sanitary Sewage Disposal Ordinance. codes®pueensbury net
`�c VISIT OUR WEBSITE FOR MORE INFORMATION
•,`J , — l j G www.queensburv.net
Signature of •erson Responsible Date
A,,-7.1. Town of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804
f. 06--770
OFFICE USE ONLY ,
TAX MAP NO. PERMIT NO. PERMIT FEE ;
APPROVALS: ZONING TOWN CLERK ' ; �rT 8 206
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT:
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID
PERMIT. j�
OWNER: 0, 4 � K tn. INSTALLER: MA/ f5 Mfgrl Lic
kirP i tip'ICs"
ADDRESS: j:/4(l /44.2.0 r he-- ki a..V•C 114ill. / ADDRESS: 1 6...,en e-✓ i C(,Z/1 (,SI ak
PHONE NO 1, i
_, _ PHONE NOS. I.� 3 V
LOCATION OF INSTALLATION; I, 2 e. . "1:/i it _ -4 /!MEW
NOOFMS
RESIDENCE INFORMATION:
YEAR BUILT X i COMPUTATION= = TOTAL DAILY FLOW
BEDROO.
1i 1980 or older I
X! , 150 GARBAGE GRINDER
! gallon per bedroom = INSTALLED?
1981 -19911 I
X 130 gallon per bedroom =
1.
1992-present .343Iiy'v SPA OR HOT TUB
i�1 110 gallon per bedroom I = 33C INSTALLED?
PARCEL INFORMATION: ��J1�
✓ TOPOGRAPHY: FLAT ROLLING Y) STEEP SLOPE %SLOPE
✓ SOIL NATURE: SAND )10 LOAM Y OTHER
✓ GROUNDWATER: AT WHAT DEPTH? NA BEDROCK/IMPERVIOUS MATERIAL: AT
WHAT DEPTH? +�
✓ DOMESTIC WATER SUPLY: MUNICIPAL /ti WELL
(IF WELL: WATER SUPPLY FROM ANY SEPTIC-SYSTEM ABSORPTION IS FT. )
✓ PERCOLATION TEST: RATE IS D— -. PER MIINUTE PER INCH (TEST TO BE
COMPLETED BY A LICENSED PROFESSIONAL ENGINEER OR ARCHITECT)
PROPOSED SYSTEM FOR NEW CONSTRUCTION: All individual sewage disposal systems must be designed by
a licensed professional engineer or architect (unless installed in a Planning Board approved subdivision). Add 250
gallons to the size of the septic tank and leach field for each garbage grinder, spa or whirlpool tub.
v. SEPTIC TANK: SAL • IN. SIZE IS 1,000 GAL.) TILE FIELD: EACH TREN �Z
� 0 t CH- FT.
✓ TOTAL SYSTEM LENGTH: 44* FT. SEEPAGE PIT(S): HOW MANY?
✓ SIZE OF EACH FT. X FT.
✓ SIZE OF STONE TO BE USED: # 2- /DEPTH OR THICKNESS 1 FT.
✓ BED SYSTEM SIZE: X
✓ ALTERNATIVE SYSTEM: LENGTH AND/OR SIZE
✓ HOLDING TANK SYSTEM:(If required, I r OF ' S: /SIZE OF EACH
✓ GALLONS./TOTAL CAPACITY: 'L.
NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN
li APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED.
I;
For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Queensbury, any
permit or approval granted which is based upon or is granted in reliance upon any material misrepresentation or
failure to make a material fact or circumstance known by or on behalf of an applicant, shall be void.
I have read the regulations with respect to this application and
agree to abide by these and all requirements of the Town of QUESTIONS ? CALL 761-8256 OR EMAIL
Queensbury Sanitary Sewage Disposal Ordinance. codes Qqueensburv.net
VISIT OUR WEBSITE FOR MORE INFORMATION
www.queensburv.net
,Aelee,c_al...e.'" . .40,-.,-_. , V A,
Ignature of Person - - ponsible I.te
Y
,4rY w. ; Town of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804
06- -7720 ,
allk Fire Marshal's Office
7own of Queensbury• 742 Bay Road • Queensbury, New ` ,1,Ik •1281)4
•
Michael J. Palmer. Fire Marshal•Gary Stillruan, Deputy Fire Marshal u t NOV O 008
APPLICATION FOR FUEL BURNING APPLIANCE & CHIMNEYS
Application is hereby made to the Building &Codes Office for the issuance of a Building & Use Permit
pursuant to the New York State Fire Prevention & Building Code. The applicant or owner agrees to comply
with all applicable laws, ordinances,regulations, and all conditions that are part of these requirements and
also will allow all inspectors to enter premises to perform required inspections.
IMPORTANT NOTE TO APPLICANT: ROUGH-IN AND FINAL INSPECTIONS ARE REQUIRED.
OWNER: `S2��%� INSTALLER/BUILDER:
ADDRESS: A) (o(4, z,`, ADDRESS:
PHONE NOS. S i 7 /a ki53 PHONE NOS.
LOCATION OF PROPERTY: SUBDIVISION NAME:
LOCATION OF PROPOSED CONSTRUCTION AND/OR INSTALLATION:
CONTACT PERSON FOR BUILDING&CODES COMPLIANCE: PHONE:
si FUEL BURNING APPLIANCE WOOD COAL PELLET GAS OIL
INFORMATION
STOVE
FIREPLACE INSERT
FIREPLACE,FACTORY BUILT* t/
FIREPLACE,MASONRY
FURNACE(GARAGE ONLY)
*IF FACTORY BUILT,PLEASE PROVIDE: MANUFACTURER NAME: C ru A et i. MODEL NO.
LISTED BY: NUMBER: QUESTIONS?
CALL 761-8205 or 761-8206
CHIMNEY INFORMATION BLOCK BRICK STONE OR EMAIL:
firemarshal@queensbury.net
MASONRY** CHECK ONE ✓ VISIT OUR WEBSITE
TILE STEEL SIZE IN FOR MORE INFORMATION
INCHES www.queensbury.net
FLUE CHECK ONE ✓
DOUBLE CHIMNEY
TRIPLE WALL INSULATED DIRECT VENT
WALL LINER
CHIMNEY MATERIAL CHECK ONE ✓
**IF NON-MASONRY,PLEASE PROVIDE: MANUFACTURER NAME: MODEL NO.
ADDITIONAL NOTE: CONSTRUCTION/INSTALLATION MUST CONFORM TO NYS FIRE PREVENTION&BUILDING CODE AND/OR
MANUFACTURERS REQUIREMENTS. CONSULT AVAILABLE TOWN OF QUEENSBURY HANDOUTS REGARDING REQUIRED
INSPECTIONS.
FINAL INSPECTION REPORT
MOBILE / MODULAR
Town of Queensbury
Building & Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256
e ) DEPART: [NSP:
ARRIVE:l ,.�1� +�
DATE INSPECTION REQUEST REC IV D: k t —\p -)?
NAME:
LOCATION: • • E�
DATE: — — 1 � PERMIT#
MOBILE HOME MODULAR HOME
FO(YTINGS FOUNDATION BACKFILL FRAMING
N/A YES NO
1. foundation support, pier spacing
per manuf. —
—
2. anchoring per manuf. — �
3. water line shut off _/�f
4. sewer line support @ 4 feet ,//
5. heating crossover (dblewide) off grd. — —
6. dryer vented outside
. 7. skirting ventilated
8. hot water relief valve piping outside
9. deck, porches, steps, railing _ ✓� —
10. furnace/hot water operating f
11. garage fire proofing • , —
12. door closers _
13. plumbing fixture
14. foundation insulation (if appi.) — -
--i* 15. smoke detectors
16. final electrical — —
17. variance required —
18. data plate okay _ ,19. mobile HUD seal okay
Model # Serial #
Manufacturer
Date of Manufacturer
OKAY TO ISSUE C/O YES NO
Comments:(CoPt5 F
FINAL INSPECTION REPORT
MOBILE / MODULAR
Town of Queensbury
Building & Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256
ARRIVE:( 145-DEPART:tU-�.,-. [NSP:
DATE INSPECTION REQUEST RECEIV
NAME: r i�1 cr
LOCATION: 9'(c(c 1 )
DATE: 1 1_ —(0 —OC6 PERMIT# CYO-7M
MOBILE HOME MODULAR HOME
FOOTINGS _ FOUNDATION BACKFILL_ FRAMING
N/A YES NO
1. foundation support, pier spacing
per manuf.
2. anchoring per manuf.
3. water line shut off _ _
4. sewer line support a 4 feet _ —
5. heating crossover (dblewide) off grd.
6. dryer vented outside ... _ ✓ /
7. skirting ventilated A
8. hot water relief valve piping outside
9. deck, porches, steps, railin f S'T 60AQAi)1Rltl f
10. furnace/hot water operating ot:pT V
11. garage fire proofing
12. door closers -
13. plumbing fixture .... ..0
14. foundation insulation (if appi.)
15. smoke detectors ..�C�tC� _ _ _
16. final electrical
17. variance required
18. data plate okay _ ✓
19. mobile HUD seal okay .... �
Model # 6 `7C7A-i Serial #________
Manufacturer
Date of Manufacturer 9 -2,7 -oz)
OKAY TO ISSUE C/O YES NO
Comments: U wREZA— F l R.EPcAC.F___
q4(
Septic Inspection Report
0/0S'
Office No. (518) 761-8256 Date Ins o uestreceived:
Queensbury Building &Code Enforcement Arrive: `Y"am/ m part: am/pm
742 Bay Rd., Queensbury, NY 12804 Inspecto Initials:
NAME: 6414f I //i"`-'2 PERMIT NO.: 0
LOCATION: J(i6' L L"Z - 12- INSPECT ON:
RECHECK:
Comments and/or diagram
Soil Type: Sand/ Loam/ Clay
Type of Water: Municipal/ Well Water
Waterline separation distance _ft.
Well separation distance ft. _
Other wells: ft. �i 'i (_
Absorption Field: Total length ft. Irtt
Length of each trench ft.
Depth of trenches ft.
Size of Stone
Seepage Pits: Number
Size: x
Stone Size:
Piping SiTi;`; TY Q
Building to tank 4-I(3 i�� ( '6
Tank to Distribution Box
Distribution Box to Field/ Pit
Opening Sealed: Y/ N/ Partial
End Cap
Inlet/Outlet Pipes&Baffles �.Y— N
Location/ Separations
Foundation to tank ___ ft.
Foundation to absorption ft.
Separation of Pits _...____ .ft.
Conforms as per Plot Plan Y N
Engineer Report and As-Built Y .__ N
Location of System on Property:
Front Rear Left Side Right Side
Middle Front Middle Rear
S -m U - tat s
Approved
i Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
Last revised 021006
Last revised 1/6/05
Ijea/K-e_s.c7167
Foundation Inspection Report
Office No. (518)761-8256 Date Inspection ret i -d:
Queensbury Building&Code Enforcement Arrive:"").:_•'1,5-./ (pm r P epart: 7. . u r fp
742 Bay Rd., Queensbury,NY 12804 Inspector's Initi
NAME: ' IT#: ?7-9
D�^
LOCATION: Ab Ze 7 ASPECT ON: - —
TYPE OF STRUCTURE:
Comments
Y _ N N/A / c1 3/02C J LVC-11 f "T
Footings
Piers
onolithic Slab t
'. cement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on site.
Foundation/Wallpour
Reinforcement in Place
Footing Dowels or Keyway in place
Foundation Dampproofing
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building &Codes Forms\Building&Codes\Inspection Forms\Foundation Inspecction Report.doc
Last printed 12/20/2005 9:24:00 AM
e- /0 7tZsbAA7
Foundation Inspection Report
Office No. (518)761-8256 Date Ins ction request received:
Queensbury Building&Code Enforcement Arrive: ,lO am/AODepart: am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspect° s initials: VY�
NAME: PERMIT#:
LOCATION: 116 UZ .e. INSPECT ON: .
TYPE OF STRUCTURE:
Comments
Y N /A COM I C t I 6—) I 11‘
ootings
Piers ? 7- 2. -4S-3
\\, Monolithic Slab
Reinforcement in Place V1.-e-e-osT./0t,J
The contractor is responsible for
providing protection from freezing /f kcej-r`O -t-, ,.S 6 /0
for 48 hours following the placement
of the concrete.
Materials for this purpose on site.
Foundation/Wallpour
Reinforcement in Place CIA F '2 k# s *)'
Footing Dowels or Keyway in place S IA)/26
Foundation Dampproofmg
Foundation Waterproofing
Footing Drain Daylight or Sump
C��� � �ecH6c%
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
Lands N/F Noel D. LaBonte, II
1470/110
Lands N/F Colby LaBelle
1285/166
00
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1-7
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(DEED: 100 FT.)
1
LL Z (DEED T`ITALS 200 FT.) U-1 Z
Ng of
MINIMUM BUILDING SETBACK'
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AM
Lands of Hart `f PROPOSED ABSORPTION
FIELD (2P".F- OF
Area: 38,645.9 Sq. Ft. ± I I ` ABSORPTION
TRENCH)
�—— PARCEL EXCEPTED IN 3463/15
m
(0.887 Acre±) �� j I
\ 0 0 -O
(F. Conklin to W. & L. Hart, 1970)
Known as ( �,
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"466 Luzerne Road"�
o
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Map No. 308.11-1-30
COLLAPSED _
GARAGE & LEAN-TO.
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(TO BE REMOVED) —; —V^ --a O
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EXISTING NEWLY -PLACED --t Z
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1000 GAL. PRECAST
CONCRETE SEPTIC TANK ion tt Z
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Lands N/F Garrie EN.
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EXISTING
-POURED
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675/905
` (PROPOSED 3 BEDRO. 8 REMAINING PORTION y`
HOUSE)
_ -
OF FRAME STRUCTURE, N
TO BE UTILIZED AS A yA
"WORKSHOP"
i
M
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WAIN
y
2ND PARCEL IN 3463/15,w
-1ST PARCEL IN 3463/15- —
1 ¢
_
I I
MINIMUM BUILDING SETBACK
—
00
2 0 (DEED: 100 FT.)
J�
99. 8S
Al- 70 °- 27' 40'- 4)
««< To West Mountain Road
DEED_ REFERENCE:
Donald A. Hunt
To
Cecil Hart
D: 1/11/2008
R: 1/15/2008 3463/15
ZONING INFORMATION:
Parcel fall within "Suburban Residential" Zone
(SR -1A)
Minimum lot area: 1 Acre
Minimum lot width: 150 feet
Minimum front setback: 30 feet
Minimum side setback: 10 feet: min. sum of
both sides: 30 feet
Minimum rear setback: 20 feet
Luzern e
�co
co
a.
O
Z a
(DEED TOTALS 200 FT.)
CURB y, I '
'
STOP
II IV 70 2,5 = 40 "-1,P
1) Existing site grade is essentially flat.
2) Site grading around proposed structure(s)
shall provide for positive storm water
runoff away from said structures.
3) Installation of individual sewage disposal
system and connection to existing Town
of Queensbury water system shall be in
accordance with existing Town standards.
POLE
NYP 57
POLE
NM 86
/00.//1
(DEED: 100 FT.)
Lands N/F Colby LaBelle
1432/194
UPPER r gnu.....••. HV s
1.4141,//�,r^'', Fq�� o/
'j,OH TREES
RIE
tE_�IendonRidge c�r'�APRIL � �s
Cl
The
BELLEw u . � WAR LA y
Glen. \�9�. 1 JS '� L WAY
CI IA to oow
LUZERNE MABEL-,,, !
.-,.-.._. .....TEA
Mount Hermon \ 6t tRCotE
Cemetery
v
Her d �DR�
I $quark I,-,
�/tticgo�, CT
AmbeLShire pD
_.i.__ _..-..
-PITCH �R -4 --- �
t4fY ?�
RIDGE c T^
OR Northwest
Village
moa i
O� �Q West uountain
BOJ \ Ski Area
�T I
00
de 1p (DEED:
�oJ /d0
DHW
-70-
:)HW 70
Oakwood ;o a
1 a
"nG QUE&V ORD m$ �.,z LA
Victoria yDENEVA DR t
.'I—-- ---- $
Grant
�$herman
III a1 °9 �N is
yo Acres ,
sbury i Qo JJ yUPPER SNE
Homestead CR
1. ELAINURST DR (Pqvillage it Pr S
1
2.AOR(A10ACK8TIPVT) Mobile D�
' 3. ALPINE AV (PVT) $ -
I 4. WINDSONG Da mvn Park ii 5 �
r^ a CENTRAL
SANDERS ,V
c � 1
Is61,
Teattles
.
pKpD MDRtBNGSID C'PAULSWAY�^
.—,/I DA FOR CT "-�\ f Lt1NSBpI
FO^'tytLLS AD N QMPNYOEt'';!
G8,...r
ILS D Hudson
YtNGBtND s ` Pat tit"'"'� Hudson Poin � /
piration as3 Nature Preserve; "'
- -- ---
'Park
LOCATION MAP
(Not to scale)
To VanDusen Road »»>
��T I
, i FAI �
N
West n C
End
Park LU
WGtens
Squad—
s t
' p0A
d �
0'
(Foreshortened) - o
OF A SURVEY OF LANDS OF
Cecil Hart
SITUATED IN
Town of Queensbury , Warren Co. , N -Y.
Scale: V = 30' August 11, 2008
SURVEY & MAP BY
CHARLES T. NACY
LICENSED LAND SURVEYOR
/ 32 JOHN STREET
QUEENSBURY, NY 12804
Only copies made from the original of this Unauthorized alteration or addition to a survey
survey map which are marked with an map bearing a licensed land surveyor's seal is
original of the land surveyor's embossed a violation of Section 7209, subdivision 2, of the
seal and bearing the surveyor's original New York State Education Law.
signature in red ink shall be considered
valid and true copies.
DR !
2G./