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2009-401 TOWN OF QUEENSBUR.Y 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20090401 Application Number. A20090401 Tax Map No: 523400-3 09-009-0002-001-000-0000 Permission is hereby granted to: HOMESTEAD VILLAGE L P For property located at: 200 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 Queensbury Zoning Ordinance. Type of Construction Value Owner Address: HOMESTEAD VILLAGE L P Mobile Home In Park 4294 ROUTE 5 CALEDONIA,NY 14423 Total value Contractor or Builders Name I Address Electrical Inspection Agency Plans &Specifications 2009-401 46 Windsong- William Younes - 1022 sq ft mobile home in park $36.32 PERMIT FEE PAID- THIS PERMIT EXPIRES: Saturday, September 04,2010 (If a longer period is required,an application for an extension mustbe made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the Town of Quee uryt, r a eptember 04, 2009 SIGNED BY �., r r for the Town of Queensbury. Director of Building&Code Enforcement www r rOFFICE USE ONLY rr_ra_rrrarrr. rrrr "Rf' a n. my" `• t,` `. TAX MAP NO. PERMIT No '' DATE ISSUED: f PERMIT FEE_^y! APPROVALS: ZONING TOWN CLERK f frsrrrara araaar rrrw..r rraaarrr ar rrrraar r..wrrrra rrarrara f t'`iv:,' � .... .:^.ate. . MOBILE HOME - APPLICATION FOR PERMIT: A building permit must be obtained before placement of mobile home on parcel. No inspections will be made until a valid building permit has been issued. Applicant Information Property Owner Information Name: Od.[IiAA JOIAME_�, Name: T i-r T s 1 443 01,4A(dGC 6_iVT Address: 1102� W H 17'LS /3 "-14 1�57,CrC3 Address: t-oa-7 ED &44b AN j1 v o y Al V 14 41 y Phone No. 7 yy ' D Q-X msl)—3PY Phone No. AI Parcel Information Proposed Date of Placement: Property Location Road, Street,Avenue Name of Mobile Home Park: dome :57'0-6 �jt L1.44 appiicabie) Tax Map Number: —( ..........................................................................................................................................--------.......................__.._......................................................................................................................_.................... ...... Mobile Home Information Zoning gInformation Zoning Classification: c:S I Approximate Value of Home:$IVY 9 I New Home: ❑Yes No Size of Property: T a ft. by )D-1> ft. laZz �' Replacement Home: Yes ❑No Existing buildings: Size of Mobile Home: 14 ft. by r/3 ft. € Setbacks: front yard ft. rear yard / ft. side yards ft. and 4' t. Singlewide: Doublewide: Number of Rooms: (exclude baths) Accessory Building(s): Number of Bedrooms: 3 Number of Bathrooms: i Detached garage:❑1-car ❑2-car ❑ car ❑Gas Fireplace❑Woodstove-0mood Fireplace Attached garage: ❑1-car ❑2-car ❑ car Foundation Support: Storage building: , Yes ❑No Type Size & Depth Other: Piers Water Supply: ❑Well Municipal Runners Slab Is Septic Permit Required? ❑Yes [ No .................................................................................................................................................................................................._....................................................................................................................................................: Continued on page 2 Town of Queensbury • Community Developnwnt Office • 742 Bail Road, Queenst nvy, :q t t_au4 a� Name of Installer or Mobile Home Dealer:_Ca MA 5 1 Z uC1\11 ru 6 Address: JAAJ 1 11-9&j/ �d - °7�G54&42 Phone: Complete information below found on a"Plate"or"Sticker"which is affixed to the mobile home: ✓ Insignia serial number:_ IqT A 1 l s o T� 4 i F? 19 321 ✓ Name of manufacturer: Fa 2 ES ��� ►� — �F1D L L� �AZ� ✓ Plan Approval Number: ✓ Model or Component Designation: ✓ 19 0� n�No! nip; Date of Manufacture: 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 work is authorized by the o Signature: Owner, Owner's A ent, Arch t, Contractor ----------------- SPECIAL CONDITIONS OF PERMIT By: Code Enforcement Officer Town of Queeiishury • Coninnonly Development Office - I42 Bay Road, Qzieensbui-y, STY 12&04 ti Lp t}V] ` ,��hSr P-ID h*T (41 c I ar CO CO 9-D POW r 1 1 ^ \07, Ile Y /.. - i e'er 4:"•�k^"1 GG�'Lf'�,,._�.h"WS 1! ia�2 ' r • `•-,-4 ,'-i- .. ... .. - iii jPy�v� i t� o �r �n i a� a�o r f f 1 t .Cl, ..�►) r� 2j '� r) C) Z) ZT 71 ab co s s 9 r y z 9 9l l 9 .s 9 91 L1 89 b oil �ii cn{ �� � � � � IL ZC �C ),� .5"Ct ���. (t $C. S(�; o-�Y�� ►�r"?3 °`c �; 8�S Cs �.s s s' �' �s � rs�•�s Glr •�, �'th ``�. s � \t 1 4\? \ \d t z s a lit d 2[ �� _._. _. I . _ S� 'r ,�dj��s yr yx a yg k 'JUA-M I t;- X Kti I Lf-- FINAL INSPECTION REPORT MOBILE- / MOOULAR Town of OueerrbUry Suiting &Code Enforcement 742 Bay Road Quoensbury, NY 12804 (518) 761-8256 ARRIVE: pq b DUPART-M- INS DATE INSPECTION REQUEST RECEI'V- NAME: LUC-)F— LOCATION: AUR- LOW-V-E B Pc A DATE: PERMIT-f 0(� MOBILE HOME FoonNM— FUUMATM — BACKFML— FRAMM N/A YES NO I- foundation support, pier spacing per manuf. ........................ 2. anchoring per manuf ............... 3. water line shut off ................... 4. sewer line support @ 4 feet ....... S. heating crossover(dblewide) off grd. 6. dryer vented outside x................... 7. skirting ventilated .................... 8. hot water relief valve piping outside 9. deck, porches, steps. railing ..... 10. fbrnaceAxA water operating ........ I I. garage fire proofing .................. 12- door closers ........................... 13. plumbing fixture ...................... 14. foundation insulation (if appl.)...... 15. smoke detectors ....................... 16. final electrical ........................ 17- variance required ..................... 18- data plate okay ....................... 19. mobile HUD seal okay.............. Model # serial#16�rm Manufacturer utrRyk Date of Manufacturer OKAY TO� _�,/YES NO conuDents. 6 FINAL INSPECTION REPORT MOBILE / MOOULAR Town of Queensbury BuikWQ &Code Enforcement 742 Say Road QUeW W-128Q4 (518) 761-8256 ARRIVE: " DEPART- INS DATE INSPECTION REQUEST RECEIVVb NAME: LOCATION: 116 ai�'� DATE: # MOBILE HOME MODULAR HOME FOOTINGS FOUNDATION RACKFILL FRAMU40 N/A YES NO 1. foundation support, Per spacing per manuf. ........................ 2. anchoring per manuf ............... V/ 3. water line shut off ................... V 4- sewer line support @ 4 feet ....... S. heating crossover(dblewide) off grd. 6. dryer vented outside x................... 7. skirting ventilated .................... 8. hot water relief valve piping outside 9. dock, porches, steps, railing ........ 10. furnaceAwt water operating ........ 11. garage fire proofing .................. 12. door closers ........................... 13. plumbing fixture ...................... 14. foundation insulation (if appl.)...... 15. smoke detectors 1-1.................... 16. final electrical ........................ 17. variance required ..................... 18. data plate okay ....................... 19. mobile HUD seat okay .............. Model# Serial# Manufacturer Date of Manufacturer 7 OKAY TO ISSUE CIO YES INO Comments: FINAL INSPECTION REPORT MOBILE / MODULAR ' Town of Queensbi" Bulling &Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 76141256 ARRIVE.W' jDEPART: 1Uk:: INSP: L DATE INSPECTION REQUEST RECB �' G NAME: —k LOCATION.—" DATE: PERMIT# Cj —t 0 MOBILE HOME MODULAR HOME FOOTINGS_ FOUNDATION _ BACKMIL_ 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 .......S. heating crossover(dblewide) off gird. 6. dryer vented outside ..:................... _ 7. skirting ventilated .................... — — 8. hot water relief valve piping outside — — 9. deck, porches, steps, railing ........ - 10. fiunace/hot water operating ........ fff 11. garage fire proofing .................. — f 12. door closers ........................... _ — 13. plumbing fixture ...................... — 14. foundation insulation (if appl.)...... 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 GO YES NO Comments: