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2005-484
TOWN OF QUEENSBURY YJf 4 L '`x 742 Bay Road, Queensbury,NY 12804-5904 (518)761-8201 Community Development-Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20050484-28989 Date Issued: Wednesday, August 22, 2018 This is to certify that work requested to be done as shown by Permit Number P20050484-28989 has been completed. Tax Map Number: 296.14-1-7 Location: 78 MONTRAY RD Owner: Paradise Park Queensbury LLC Applicant: Grayson Properties This structure may be occupied as a: Manufactured Home 1120 s.f. Lot 5 By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the ; property owner of the responsibility for compliance with Site Plan, 411 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. Application for Permit— Mobile Home Town of Queensbury, 742 Bay Road Oueensbury, NY 12804 (518) 761-8256 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 Office Use Name: L J}I (r1 I SOl'J 41'. File Permit NoQO `t gZ • Address: t O di C AE sq N :5 YA Fee Paid L4 a, ,(:),C).) e.e h ? ) l c 1J J f�e 1)l , i Reviewed By: / /o/Er Phone No. li9� h 6 V ,,� ?i e- c.� L� e-, .3 e 'Parcel Information P ad y li rit anon �- 3 o�� 6 ' Proposed Date of Placement: Name: J 11 rN 1 i_I U5 Property Location: TY PIN\€iNA m R& Address: Trek!r:i 6'r,0-4-A[nn[my Road,Street,Avenue BUILDING AND CODE tom j Name of Mobile Home Park:1-6 © .L 6-- v _ ppi —_ afa 1'cable) __ CO L J-- c�,eeN S r Phone No.. - _ p -_._._.___ =.� Tax Ma Number: / -. _-.--- _ - - - . _ :.Mobile Home Information-. --_ -_- __ .- _.. -Zoning Information- - _ _ ---.-- -Approximate-Value of Home: $ -- Zoning Classification: New Home: Yes No Size of Property: ft.by ft. Replacement Home: Yes No Aj O Existing buildings: Size of Mobile Home: )�ft. by �� ft. . f Setbacks: front yard I cc* ft_; rear yard /b ft. Singlewide Doublewide: Side yards `3 C ft.and 3 0 ft. Number of Rooms: (exclude baths) Number of Bedrooms: v Accessory Building(s): circle Number of Bathrooms: i— Detached garage: 1 car; 2 car, car circle: Gras Fireplace/Woodstove/Wood Fireplace Attached garage: 1 car; 2 car, car Storage building: Yes No Foundation Support: Other: TYPE ST7F&DEPTH Water Supply: well orCmunicipal Piers x SlabRmin ers x Is Septic Permit Required? Yeses r No Further information requested on the reverse side of this sheet • Name of Installer or Mobile Home Dealer: Address: Phone No_ Complete information below found on a"plate"or"sticker"which is affixed to the mobile home. 1. Insignia serial number: ... _ - .....___-__---- 2. Name of manufacturer: 3. Plan Approval Number: -F# 4. Model or Component Designation: (New Home ONLY) 5_ - Date of Manufacture: / �/�tv5o AFFID-AVIT - - - _ — - _ ::.: Town of Qaeensbury __- 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 work is authorized by the owner. Signature: d--7-ifee? i'wner,owner's agent,architect,contractor Special Conditions of Permit By: Form: 11/1911999sh Code Enforcement Officer - FINAL INSPECTION REPORT MOBILE: / MODULAR - Town of Queensbury Building &Code Enforcement 742 Bay Road Queensbury, NY 12804 / ‘7 (518) 761-8256 / ,7 a ri". ARRIVE: y,./12)DEPART: DATE INSPECTION REQUEST RECEIVED: ///' ' NAME-' 6PCCVS--, A4"(\ Wz4fLOCATION: 1,1—) flctT DATE: a---`3-0(49 PERMIT 00-g—Lt MOBILE HOME MODULAR.HOME : FOOTINGS FOUNDATION BACKFILL FRAMING: NJA YES • NO !.cf 1. foundation support, pier spacing per manuf. 2. anchoring per manuf. 3_ water line shut off 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 • 19. furnace/hot water operating 11. garage fire proofing 12. door clOsers 13. plumbing fixture 14. foundation insulation (if appl.) 15. smoke detectors . 16. final electrical 13. variance required 18. data plate okay • 19. mobile HUD seal okay Model# Serial # Manufacturer Date of Manufacturer / • • OKAY TO ISSUE C/O . 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