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2004-026 ry TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902. (518) 761-8201 Community Development- Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY .. .Permit Number:. P20040026- Date Issued: Wednesday, April 06, 2005 This-is.to certify that work requested to be done as shown by Permit Number P20040026 has been completed. Tax Map Number: 523400-309=009-0002-001-000-0000 Location: 200 LUZERNE Rd Owner: HOMESTEAD VILLAGE L P Applicant: CYNDIE RUGGIERO This structure maybe occupied as a: By Order of Town Board Mobile Home In Park TOWN OF QUEENSBURY ^ 4�{ Director of Building&4fode Enforcement I_ TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20040026 Application Number: A20040026 Tax Map No: 523400-309-009-0002-001-000-0000 Permission is hereby granted to: RI TCTCTTF,Rn• For property located at: 200 WZERNE Rd in the Town of Queensbury,to constrict 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. _' i' kl' ;;'Type of Construction Value Owner Address: HOMESTEAD VILLAGE 'LIP 4294 ROUTE 5 Mobile Home In Park $5,000.00 CALEDONIA;NY 14423 Total Value $5,000.00 Contractor or Builder's Name Address ' 3 {, Electrical Inspection Agency I ! Plans&Specifications 2004-026 12 WINDSONG DRIVE 980 SQ FT MOBILE HOME (1983 MOBILE HOME) $33.80 PERMIT FEE PAID -THIS PERMIT EXPIRES: Friday, January 28, 2005 f (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.) 1. 4 1' Dated at the To7 eensb d VY d Way; 4October. 06, 2004 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement Application for Permit- Mobile Home Town of Queensbury, 742 Bay Road, Queensbury, 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: �V File Permit No. RECEIVED: Address: uj//,C�j Fee Paid 33J2 2004 Reviewed Ey: .................................................... TOVV!q OF UUt—:F ffS-B—URY Phone No. BUILDING AND CODE Property Owner Information Parcel Information Proposed Date of Placement: Name: 4 S! G/r/664 3�==- Property Location: ............. Address:. Road,slll�venue Name of Mobile Home Park: (if applicable) Phone No. Tax Map Number aDd/o� --a Mobile Home Information Zoning Information Approximate Value of Home: $ /Zoning Classification: New Home: Yes 11� Size Of Property: _ft.by ft. Replacement Home: LYes-" No Existing buildings: Size of Mobile Home., ft. by-7(2 ft. Setbacks: front yard fL; rear yard ft. Singlewide: Doublewide: Side yards ft.and ft. Number of Rooms: (exclude baths) Number of Bedrooms: Accessory Building(s): circle Number of Bathrooms: Detached garage- I car; 2 car, _car circle: Gas Fireplace/Woodstove/Wood Fireplace Attached garage: I car-, 2 car, _car Storage building: Yes No Foundation Support: Other: TYPE SIZE&DEPTH Water Supply. well or municipal Piers x Runners x Is Septic Permit Required? Yes or No Slab x Further information requested on the reverse side o this sheet E00- !f 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. ('7 f���j?!-g 2. Name of manufacturer J _ 11D / 3. Plan Approval Number: 4. Model or Component Designation: (New Home ONLY q 5. 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 owner. Signature: —�- owner,owner's agent,architect,contractor Special Conditions of Permit By. Fonn: 11/19/1999sh Code Enforcement Officer 09/22/2004 20:29 5748253050 HOLLY PARK PAGE 01/01 e' HOLLY PARK 9123/04 To: Homestead Village Attn: Bob From: Ho119 Park Division,Indiana Building Systems,LLC 51700 Lovejoy Drive Middlebury,IN 46540 Dear Bob, Although we did not build the unit you have in question,it is our practice that all 2x6 14'homes are builtwith a 30#roof load,middle zone construction. The standard 2x4 homes are built to south zone 20#roof load. If you have any questions,please feel free to call me @ 1-900-204-6559. Martha senderaon Sales Manager Nil �a . > ,� iec �j�,/2✓�Qfi dC� r JS //J Sly ftJ Uk HOLLY PARK DIVISION,TNDIANA BUILDING SYSTEMS,I.I.C. 51700 LOVEJOY DRIVE-MIDDLEBURY,IN 46540-TEL 574-825-3700 -FAX 574-825-3050 WWW HOLLY--PARK.CON C L INSPECTION REPORT WMI BILE / MODULAR Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: DEPART: �� I ' DATE INSPECTION REQUEST REECEIVE �-//3 NAME eRuG�« �►��Jl '.�.,/� LOCATION:.JJ�� DATE: PERMIT N a(fif' MOBILE HOME MODULAR HOME FOOTINGS FOUNDATION BACIFILL FRAMING N/A YES NO 1. foundation support, pier spacing / per manuf. ........................ — ✓ — 2. anchoring per manuf. ............... — 3. waterline 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 ........ - 10. 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 ....................... — — 17. variance required ..................... — 18. data plate okay ....................... 19. mobile HUD seal okay .............. Model # Serial# Manufacturer Date of Manufacturer OKAY TO ISSUE C/O YES NO Comments: r FINAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury �y�M Building & Code Enforcement dd 742 Bay Road Queensbury, NY 12804,� (518) 761-8256 ARRIVE: 212,'- DEPART: INSP: � DATE INSPECTION REQUEST RECEIVED: NAME: �LOCATIONPNc,L 4) 4)1 16 SO- A q DATE: ,3I! °Za� PERMIT#� M0131LE HOkE MODULAR HOME FOOTINGS FOUNDATION BACKFILL FRAMING N/A YES NO 1. foundation support, pier spacing per manuf. ........................ — — — 2. anchoring per manuf. ............... — — —Iwater line shut off ................... . _ 4. sewer line support Q 4 feet ....... 5. heating crossover (dblewide) off grd. — _ — 6. dryer vented outside ...................... 7.. skirting ventilated .................... —_ 8. hot water relief valve piping outside — — — 9. deck, poaches, steps, railing ........ 10. 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 ........................ — — — 17. variance required ..................... — — — 18. data plate okay ....................... —_ 19. mobile HUD seal okay .............. Model # Serial# Manufacturer Date of Manufacturer OKAY TO ISSOE C/O YES NO Comments: �lv:- FINAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 G �518) 761-8256 ARRIVE:zP3 DEPART: INSP.0k DATE INSPECTION REQUEST RECEIVED: NAME: ,yi it {t/fly LOCATION: DATE: /2- L c`l PERMIT# — 1CIN MOBILE HORSE MODULAR HOME FOOTINGS FOUNDATION BACKFII.L 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 (D 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 ........ 10. fumace/hot water operating ........ 11. 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# Manufacturer Date of Manufacturer OKAY TO ISSUE C/O YES NO Comments: } FINAL INSPECTION EIPORT MOBILE / MOOL ILAR 3 ffJ� Town of Queensbury Building & Code Enforcement �� I 742 Bay Road Queensbury, NY 12804 t, (518) 761-8256 PIN ARRIVE: DEPART: I INSP: ° DATE INSPECTION REQUEST RECEIVED: �I NAME: LOCATION: DATE: MOBILE HOME MODULAR HOME o �- DO�Qp FOOTINGS FOUNDATION BACKFILL 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 ®4 feet ....... 5. heating crossover (dblewide) off grd. — — 6. dryer vented outside ...................... — 7.. skirting ventilated .................... —_ S. hot water relief valve piping outside — — — 9. deck, porches, steps, railing ........ _ 10. himace/hot water operating ........ _ 11. 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# Manufacturer Date of Manufacturer OKAY TO ISSUE C/O YES NO Comments: � 6 FINIAL INSPECTION REPORT MOBILE / MOOULAR Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY .12804 1 (518) 761-8256 ARRIVE: ` i DEPART: INSP: DATE INSPECTION REQUEST RECEIVED: NAME: fJ rU LOCATION: DATE: (! PERMIT# MOBILE HOME MODULAR HOME FOOTINGS FOUNDATION BACIFILL 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 ®4 feet ....... _ _ _ 5. heating crossover (dblewide) off grd. — _ 6. dryer vented outside ...................... I/ 7.. skirting ventilated .................... — 8. hot water relief valve piping outside — 9. deck, porches, steps, railing ........ — — 10. fiumace/hot water operating ........ —11. 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# Manufacturer Date of Manufacturer OKAY TO ISSUE C/O YES NO Comments: ��� A FINAL it isPECTI®N RrzPORT MOBILE / MODULAR Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: DEPART:-7 �nr IN DATE INSPECTION REQUEST RECEIVED- NAME: (' LOCATION; La ")Sanc, DATE: -q PERMIT# _0 a MOBILE HOMS MODULAR HOME FOOTINGS FOUNDATION BACI¢TLL 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 ®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 .,3c — — 10. 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 ....ti` 3:�.�%P�z — 17. variance required ..................... 18. data plate okay ....................... —_ 19. mobile HUD seal okay .............. Model # Serial# Manufacturer Date of Manufacturer OKAY TO ISSUE C/O YES NO Comments: Y FINAL INS ECTI®N REPORT MOBILE / MODULAR Town of Queensbury Building & Code Enforcement 742 Bay Road f Queensbury, NY 12804 (518) 761-8256 ARRIVE: DEPART: INSP: DATE INSPECTION REQUEST RECEIVED: NAME: LOCATION: DATE: ` PERMIT# li MOBILE HOME MODULAR HOME FOOTINGS FOUNDATION BAC144ILL FRAMING N/A YES NO 1. foundation support, pier spacing per manuf. ................. — — 2. anchoring per manuf. ............... _ 3. water line shut off ................... . _ f 4. sewer line support a 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 �g ........ —40. deck,ftirnaceN t water opera� " ........ 11. garage fire proo g ...........:...... 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 # l// Serial # Manufacturer .A �r Date of Manufacturer J�e /� ' �� 7(/ OKAY TO ISSUE C/O YES NO Commeg�s/vim V/,, e 4i Gr FILIAL INSPECTION REPORT MOBILE / MOOULAR Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE:`J'' - DEPART: INSP: DATE INSPECTION REQUEST RECEIVED: NAME: cf C'J E LOCATION: L.a Z. ,y,t V'G�� r DATE: PERMIT// 0Ifo MOBILE HOME MODULAR HOME FOOTINGS — FOUNDATION _ BACKFILL FRAMING N/A YES NO 1. foundation support, pier spacing oe per manuf. .................. _ — 2. anchoring per manuf. ............... 3. water line shut,off ................... 4. sewer line support ®4 feet ....... _ 5. heating crossover (dblewide) off grd. le." 6. dryer vented outside ...................... 7. skirting ventilated ..... . .. 8. hot water relief valve piping outside — 9. deck, porches, steps, railing ........ 10. 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 ............... — 17. variance required ..................... _ — 18. data plate okay ....................... _ 19. mobile HUD seal okay .............. Model # Serial # Manufacturer Date of Manufacturer OKAY TO ISSUE C/O YES ---'NO Comments: r EEC lls SCa�'l /A G�Ilej !�r Cd AJ 42 /.s> t e on RE EIS E® 2 JAN S 2004 7 TOWN OF QUEENSBURY S" BUILDING AND CODE Aced s. •Vic!rU v-'�'� i ��-ram 0.5/11/2013- 00:12 FAX l 001 REOOI D DA TE ::� .: INVE OR IM 19C91 /03 . CUSTOMER INFORMATION i LAST*tA.lytE rmTNAME. HOME HONE WORK PHONE Ruggiero Cyndie (SIS) 668-5816 COMMU IT iNAME STREET ADDRESS 8c LOT LOT N_ COMMUNI'rY P NEK Homestead V"iffage LOt#12 i Y2 s Carp CIiCr 9l'ATE ZIP COUNT 1A5T OF.SLRIAL �}ueembu F=804 Warner SOME INFORMATION STk"IL5 AMDER llM'C WHO'S fNVENTOttY SA S a NTER Vt�TE MODEL I9 Salt! Used . A.G..L I-Sales 1, Used YEAR MANU1+ACri,iRE t SERIES MOUELI# —COMPLETE SERIAL 19$3 Huffy Paris 7 — _ t 01HP10288 SINGLE OURI.El1' IP E WID'Ctd ENGT BED uAXH COLOR FLOORED WITH Single I14 70 L..J r S/4r Yerfow lv/A• �OM SHIP.DATE PItliYidWS OWNER ifA'Cl:'COOK OVER. Brack\Strait 09/19/03 NI:t!'iioME AS144NG PRICE FOOTEASMAO A�MT PARK PACKAGE USED HOME SELLING:PRICE viz z29.0a ( $d.00. a.00 $0.00 RECEIVED JA►v 2 6 2004 TOWN OF QUEENSBURY BUILDING AND CODE S oq- S-1 \-.., �;�Y-' tee \�N) ^_ 5I. \�.4 � t _ �{" ` S� I " _ e n � � ECE .--7-�-f- .- �' ' V�� �� S�� •S..off } I JtlAl 004 'OWN OF Qjj, BUILDING ANEENSBUD DRY LC CD E +fir+S � � v rs � ':✓ >�r � --Z` 1 )? 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