RC-000749-2017 (2) NOTICE FILE
COPY
CRAFT PAPER INSULATION
MUST BE COVERED BY
WVN�eil 11 PS
NON-COMBUSTIBLE BARRIER
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NOTICE
FOAM INSULATION MUST BE
COVERED BY A 15 MINUTE
THERMAL BARRIER
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NOTICE
ANCHORING OF MOBILE HOME
FRAME IS REQUIRED PER r D E C [E 0 d [_
MANUFACTURERS SPECIFICATIONS
DEC 0 5 2017
TOWN OF QUEENSIBURY
BUILDING&CODES
BUILDING
OWF QUEENSBURY
BUILDINOG DEPARTMENT
Bas6d on our limited examination,compliance
with:our comments shal, not be construed as
indicating the plans ana specifications are in
full ;compliance with the Building Codes of
New; York State.
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TOWN OF QU 308.14-1-52 RC-000749-2017
BUILDING & 0 O
Forest Park MHP
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Reviewed B
L 2 Timber Lane
Date: New Mand. Home 16' x 76'
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RC-000749-2017 '- , T ` � y -Forest Park MHP 2 Timber LaneNew Manuf. Home 16' x 76'
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MODEL 122-L-26007
3 BEDROOM,2 BATH
NOMINAL SIZE:16'X W
Tt7'I'AL AREA:1153 SQ.I;'T FOR REVIEW ONLY
122-L-26007 LI ERATURE
G1171'.70'BOX PLAN �» I
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INSTALL NO. 264ui STATE OF NEW YORK
�C -000--t Lk4V- j n
DEPARTMENT OF STATE
.61 ONE COMMERCE PLAZA
B�Fy 99 WASHINGTON AVENUE
ALBANY,NY 12231
INSTALLER'S WARRANTY SEAL
THIS SEAL REMAINS THE PROPERTY OF THE DEPARTMENT OF STATE
Di NEW MANUFACTURED(HUD CODE) ❑ RELOCATED MANUFACTURED(HUD CODE)
A. Manufacturer's name:, (.6 Q ►-)1
B. HUD label number. fa •?'? Serial number:; 0044
C. Retailer's name: " /321,„A rztf
D. Retailer's address: j
E. Retailer's certification#: Telephone#:
F. Installer's name: 4,4 ram- („Okfre5
G. Installer's address: it i/Ame j c�..SArso*je_P r ++rSF t. -`!! ': /•i) '�'`
H. Installer's certification#: 1 '' 4'1?'9! Telephone#: 7i 41 s 5
I. Date installed: Municipality issuing building permit: (=--t' ;
!'ter. (City, Ibwn,Allege)
J. Customer name and physical address (911)where home is installed: ; =-'?. '`/ aE
fr3 At) C. . '��rS �►'' ,NewYork,
By attaching this SEAL to this manufactured home,the undersigned Installer of this manufactured home warrants as follows:
1. That the installation of this manufactured home meets the standards of the New York State Uniform Fire Prevention and Building
Code.
2. That the Installer is certified as an installer by the New York State Department of State.
The foregoing warranties are in addition to and not in derogation of all other rights and privileges which the consumer may have under any
other law or instrument.The foregoing warranties are in addition to,and not in limitation of or substitution for,any and all other warran-
ties,express or implied,given or made by the Installer,whether contractually or by operation of law.
Printed Name of Person Signing Seal:
Signature of Installer or 7 f f
Limited Installer: .� ... . r�. .--� � ' _
If you have a problem with your home,you should first contact your installer or retailer.If the problem is not resolved by the Installer or
Retailer you can contact the Department of State at(518)474-4073.
DOS-1680(Rev.03/09)
Yellow Copy—Department of State White Copy—Retain for Your Records Goldenrod Copy—Permitting Agency Seal-Affix to Home