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009040-2018 12242018INSPECTION WORKSHEET (009040-2018) Town of Queensbury - Building and Codes - Fire Marshal 742 Bay Road - (518) 761-8256 Building (518) 761-8206 Fire Marshal Case Number:RC-0804-2018Case Module:Permit Inspection Date:Thu Dec 27, 2018Inspection Status:Passed Inspector:John O'BrienInspection Type:Building Inspector Visit Job Address:63 ILLINOIS AVEParcel Number:309.9-1-30 Queensbury, NY 12804 Contact TypeCompany NameName Primary OwnerDKC Holding Inc. Checklist ItemPassedComments Building Inspector NotesYES12/27/18 As per my Building Inspector Visit of the manufacturer home at Clute Enterprises the home is compliant for installation at 63 Illinois Ave. CMH Manufacturing, INC. DATE OF MANUFACTURE : 11/07/17 SER. #: CWP036982TN MOD. #: 36TRU1462Ah18 O'Brien, John (Inspector) Dec 27, 2018Page (1)