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2014-462 ` _ TOWN OF QUEENSBURY roya742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development - Building Sc Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20140462 Date Issued: Friday, October 31, 2014 This is to certify that work requested to be done as shown by Permit Number P20140462 has been completed. Location: 200 LUZERNE Rd Tax Map Number 523400-309-009-0002-001-000-0000 Owner: HOMESTEAD VILLAGE L P Applicant: JAMES DUPREY This structure may be occupied as a: Mobile Home In Park By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the property 7 1) 4 owner of the responsibility for compliance with Site Plan,Variance, or �Y' J other issues and conditions as a result of approvals by the Planning Board Director of Building& Code Enforcement or Zoning Board of Appeals. TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20140462 Application Number. A20140462 Tax Map No: 523400-309-009-0002-001-000-0000 Permission is hereby granted to: JAMES DUPREY For property located at: 200 LUZERNE Rd in the Town of Queensbury,to construct or place at the above location m 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 Queensbury Zoning Ordinance. Type of Construction Value Owner Address: HOMESTEAD VILLAGE L P Mobile Home In Park $10.000.00 4294 ROUTE 5 Total Value $10,000.00 CALEDONIA,NY 14423 Contractor or Builder's Name /Address Electrical Inspection Agency Plans&Specifications 2014-462 Lot 17 Windsong Drive Mobile Home 14' x 60' Model 3920, Serial # CHB-07-93-005C, Champion Home Builders 5017093; moving from Gilcrest Hill Rd, Hartford,NY $100.80 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday, September 26,2015 (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 Town o uee bury; � t to l t ber 26 2014 SGJ i�. . 4 SIGNFf)BY for the Town of Queensbury. Director of Building&Code Enforcement Office Use Only MOBILE HOME APPLICATION-- I ys! Ii 'n , . ) `� _Received \�� 1 DATE: I Ithi r� Tax Map ID �I N TAX MAP ID ,3Og.rq' cP 4 1 I\Al\ SEP Pirmm�tMd. U I C7' c/&.4 Permit Fee Imo Ire QC,EtCSBURY PROPERTY LOCATION: I TnWN O" � r NAME OF MOBILE HOME PARK: PROPOSED DATE OF/PyL�A�CEEMLENT:� •� / APPLICANT UL2M 1-,,J, (/�l{�.. In'e((/��/,./_ / OWNER �I ! r5 /��-y//��,,( ADDRESS aI'e iJ t Ilye, �/�J1I` L 7 ADDRESS (1361] i Cc /1`" `- lan $36-5—A91051 X'(J'S /1� QUJNc I” 4✓an A PHONE —.' 1O ! PHONE CV a?0310 - �tS2sli �NAME OF INSTALLER OR MOBILE HOME DEALER SCuct (5u Aur Y l✓ 42../6737 ADDRESS: Cl-2- h\- -1 ,A5t7 Q'; IGrr� 'Tri t (1 rbc V A c f kf6, N1 \ 2 k .�-k , P PHONE CC l� l ts— t it, , CONTACT PERSON FOR BUILDING&CODES COMPLIANCE PHONE: COMPLETE INFORMATION BELOW FOUND ON A"PLATE"OR"STICKER"WHICH IS AFFIXED TO THE MOBILE HOME Insignia serial number C t\% -p 7-q- - U r)S L Name of Manufacturer P a .• (" Place Approval Number Model or Component Designation (New home only) Date of Manufacture: {R t 3 MOBILE HOME INFORMATION ZONING INFORMATION Approximate Value of Home $Si OCO Zoning New Home or Replacement Size of property ft.by ft. Size of Mobile Home 4_q_ft.by 60 ft. Existing buildings Singlewide or Doublewide Accessory buildings Number of rooms(exclude bath) Storage buildings Number of Bedrooms 2, Detached Garage _1 _2 3 - Number of Bathrooms Z Attached Garage ' _1 2 _ 3 Gas Fireplace;Wbodstove or Wood Fireplace Setbacks Front yard: ft. Rear yard: ft. Side yard: ft. Foundation Support Size Depth Water Supply Well: Piers _ _ Municipal: Runners _ Slab Septic Permit Required? _Yes _No 1 Town of Queensbury Building&Codes Mobile Home Application July 2014 Procedure for placing and occupying a mobile home or modular home: i 1. Application is submitted and review: 2 copies of plot plan and layout must accompany application along with septic application (if needed) and fee. 2. Permit is issued— Permit card is placed on property 3. Footing forms are inspected before pouring concrete: Home is placed on foundation or piers 4. Arrange for electrical inspection —see "Certified Electrical form" on Town website 5. Septic Inspection, if needed 6. Anal electrical Inspection 7. Stairs & platform covering door width and door swing with handrails on both sides of platform and stairs are required for all exterior doors. 8. Final inspection by Building & Codes Department 9. All mobile/manufactured housing must be anchored to the ground upon which they are site per manufacturer requirements. 10. Installer Warranty seal must be provided at the time of Certificate of Occupancy 11. If anchoring is not possible due to-weather conditions or any other item, a Temporary Certificate of Occupancy will be issued; Fee -$10; Deposit$100.00 (refunded when all items are complete) DECLARATION: 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 completed with,whether specified or not, and that such work is authorized by the owner. Installer Warranty will be provided at time of Certificate of Occupancy. Print Name: GJ" Date: c74 C /7 er, Agent, ContrLihkor Signature: Date: Special Conditions of Permit By: Code Enforcement Officer 2 Town of QueensburyMobile&Codes Home Application July 2014 • . Town of Queensbury Building & Codes • Office Use-Only MOBILE HOME APPLICATION - '`f P-- =Receiv"ed:'� \ '�J 2 Map11V n\C �7 25 PermitNo.: I CI-; 1 ICcaa A permit must be obtained before placement of mobile home on parmtxt t No inspections will be made until a valid building permit hasbeen issued., 'Pefn it Fee: $ Applicant T 7 Vi_` `i Property Owner 46/ ,Aho PS Address C 1 vJ t wtb5o t C QQ-.Address y-305 SI, El J- t /ecJcatti41 N P/1/1/42.7 Phone Ce51-311e9 Phone 55S--A016-6/5 e.)01, ,vy Contact Person for Building&Code Compliance: 'kr rT- LAcseue_ Wine: 363-62 1( Name of Installer or Proposed Date of Placement / Mobile Home Dealer .' ,„ Name of Mobile Home Park /Lvy1ec/PAd P/%te Address tt5Z7 _iaTEq ) ilsn- wsoo y Property Location /7k4lc/fn /74, Phone -9,3-1 z-brax Map ID 309, ? a2 / Complete information below found on a"Plate"or"Sticker"which is affixed to the mobile home: • Insignia serial number: • Name of Manufacturer: • Place Approval Number: • Model or Component Designation: (New home only) • Date of Manufacture: Mobile Home Information Zoning Information Approximate Value of Home $ Zoning New Home or Replacement Size of property - ft x ft. Size of Mobile Home ft. by ft. Existing Building(s) Singlewide or Doublewide Accessory Bldgs. Number of Rooms(exclude bath) Storage Building(s) Number of Bedrooms Detached Garage _1 car _2 car _3 car Number of Bathrooms Attached Garage _1 car _ 2 car _3 car Gas Fireplace _ Setbacks Front Yard: &O feet WoodstoveRear Yard: /S feet Wood Fireplace Side Yard: /0 feet Foundation Support Size Depth Water Supply Well L / Piers Municipal I _ .Mone. 7J Ad Runners Septic Permit Required? Slab NO Town of Queensbury Building&Codes Mobile Home Permit 518-761-8256 Procedure for placing and occupying a mobile home or modular home: 1. Application is submitted and reviewed: 2 copies of plot plan and layout must accompany application, along with septic application (if needed)and fee 2. Permit is issued-Permit card is placed on property 3. Footing forms are inspected before pouring concrete: Home is placed on foundation or piers 4. Arrange for electrical inspection-see"Certified Electrical Form"on the Town's website 5. Septic Inspection,if needed 6. Final Electrical Inspection 7. Stairs and platform covering door width and door swing with handrails on both sides of platform and stairs are required for all exterior doors 8. Final Inspection by Building&Codes Department 9. All mobile/manufactured housing must be anchored to the ground upon which they are sited per manufacturer requirements 10. Installer Warranty seal must be provided at the time of Certificate of Occupancy 1 11. If anchoring is not possible due to weather conditions or any other item, a Temporary Certificate of Occupancy will be issued: Fee- $10.00; Deposit-$100.00(refunded when all items are complete) ✓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 completed with, whether specified or not, and that such work is authorized by the owner. Installer Warranty will be provided at/timee ofnCertificate of Occupancy. Print Name: V - �C.M 6`e{, Signature: \(41V A l'UMQS Ow er,Owner's A ent,Contractor g Date: I— ZS 201 Special Conditions of Permit: By: Code Enforcement Officer Town of Queensbury Building&Codes Mobile Home Permit 518-761-8256 fl 9-8 q hnsbury Building & Code Enforcement— Manufactured I Modular inal Inspection Office No. (518) 761-8256 Arrive: %__. rr a•,rt: �j '_,_� am/pm Date Inspection request received: Inspector's Initis, S.: NAME: -� PERMIT/ �Ci" e-te,a. LOCATION: 0 W L>r DATE: /D�3 Hy y Manufactured Home Modular Home Footings_ Foundation_ Backfill_ Framing_ S CJ 3 /&O 7 Comments: Yes NO N/A Foundation support,pier spacing, J// Per manufacturer Anchoring per manufacturer 2'from ends Water line shut off ✓V Sewer line support 4 feet / V Heating Crossover[doublewide)off grd. Dryer vented outside I Skirting ventilated 1 sq.tt per 1.500 sq.ft. Hot water relief valve piping outside Deck,porches,steps,railing Furnace/hot water operating / Garage Fire proofing // Fire Door/Door closers / Plumbing Fixture/3'Vent through roof(Modular] 7✓// Foundation insulation[d applicable] JJ/ Smoke/Carbon Monoxide Detectors/Interconnected V \ Viralecui f � , Variance required J` Data Plate okay / Manufactured HUD seal okay Warranty Seal after January 1,2006 V VC- Installers Warranty Seal / .... i 18"x 24"access or 22'x 30'attic access . i Vapor retarder under home 6 mil poly or other 911 Street number Okay to issue C/C or C/O[Temp./Penn.] Model# Serial# Manufacturer Date of Manufacturer LAPam Whitirg120101Bufding Codes FonnsWtanufactured Nodular Final Inspection 03 0410.doc LDS /- 3 Queensbury Building & Code Enforcement — Manufactured / Modular Final Inspection 149 Office No. (518)761-8256 Arrive: >aD a _I 1pm Date Inspection request received: Inspector's Initials: ._'� NAME ________41e0/4#42,1aPERMIT - y - A LOCATION: I ' / wUDATE fib —a4--/4) Manufactured Home Modular Home Footings_ Foundation_ Backfill_ Framing_ Comments: Yes No _N/A_ Foundation support, pier spacing, / Per manufacturer J) Anchoring per manufacturer 2'from ends ✓ V/ Water line shut off V Sewer line support @ 4 feet Heating Crossover[doublewide}off grd. Dryer vented outsideji Skirting ventilated 1 sq.ft.per 1.500 sq.ft. / Hot water relief valve piping outside /✓/ Deck,porches,steps,railing J/ Fumace/hot water operating Garage Fire proofing I\ KN ICL— Fire Door/Door closers f/ v? n.T N \ Plumbing Fixture/3'Vent through roof[Modular] 7/ / r1 { ' FRN latic Foundation insulation[if applicable] ,v// / ' F- t D N),5, Smoke/Carbon Monoxide Detectors I Interconnected Y — \v ,R LC p <GS� Final Electrical Variance required r-"cSN .e- \--CASs-\t___ tom\1,1/4..\(:) Data Plate okayNN. \'� Manufactured HUD seal okay — t>O ` p% \1 -t-� Warranty Seal after January 1,2006 g��`EG J e\�\ c N Installers Warranty Seal `` \\ 18"x 24'access or 22"x 30'attic access / lv O \A E.�� Vapor retarder under home 6 mil poly or other J — ,. � \ L 911 Street number w ��['�JEA"��- �Yr� Okay to issue C!C or GO[Tamp.!Penn.] t �T� —Y — CAtIBD k: �1 0 D Model# Serial# ` �� —ti ^1 Manufacturer — b.cc? ‘ --Vi7_. _rki5 Date of Manufacturer — L1Pam Whiting120101Buldmg Codes Fomis\Manufactured_Modular Final Inspection 03 04 10.doc \=oo —V-770 Inspection Report Office No. (518) 761-8256 Date Inspectionquest .. Queensbury Building&Code Enforcement Arrive: r e15 a ea Alcenilej 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: RP NAME: r1pQ 61 CI-'!CN1F 91lE Ao .\tu 1/MIT#: LOCATION: u3\t tti5n &, t . INSPECT ON: \D— 7-11{ TYPE OF STRUCTURE: �}{ Comments Y N N/A otings 9� iers Zyn# yg' i� Monolithic Slab Reinforcement 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 Inspection Report.doc Last printed 12/18/2013 2:44:00 PM day 311 Queensbury Building & Code Enforcement— Manufactured / Modular 'nal Inspection Office No.(518)761-8256 Arrive: \t) _! - vCpm s-rt h:`„Olio Date Inspection request received: Inspector's I NAME: Ottr a4 PERMIT /cp'I Li0 11CC t3 i�t�f Q t- n 4/J DATE: it-a a-'� LOCATION: a� rIJ � �- Plea Manufactured Home Modular Home Footings_ Foundation_ Backfill_ Framing Comments: Yes No NIA_ Foundation support,pier spacing, Per manufacturer Anchoring per manufacturer 2'from ends Water line shut off Sewer line support @ 4 feet Heating Crossover fdoubtewide)off grd. Dryer vented outside Skirting ventilated 1 sq.ft.per 1.500 sq.ft. Hot water relief valve piping outside Deck,porches,steps,railing Fumace/hot water operating Garage Fire proofing Fire Door/Door closers Plumbing Fixture/3'Vent through roof[Modular] Foundation insulation[d applicable) Smoke I Carbon Monoxide Detectors I Interconnected Final Electrical Variance required Data Plate okay Manufactured HUD seal okay Warranty Seal after January 1,2006 Installers Warranty Seal 18'x 24'arrnss or 22'x 30'attic access Vapor retarder under home 6 ml poly or other ��C. 911 Street nut / � �p D .I�F Okay to' V �j� J 0 tj Model# jFIZZ> Serial#6,146-13-1A -ba . �Calt"? -1 Manufacturer G\\(1I, Cs tJ \-kcME Pr3\ Date of Manufacturer _(2125 L-1Pam Whiting20101Bulding Codes Forms\Manufactured_Modular Final Inspection 03 0410.doc ilA \\V 0 /YX� ti !4 - H F ,'fP _ �� CI 7 ---N , ill ri -50'f/ir "I Xi -3L# ' ::1L ga4.. Dig l — to 17" 4tisim< Jr >444440,,,,ii- 47 2r Y , ----- zzt - >1 in s -Y '**y d ✓ '' . — k ii° it,. 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