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2004-192 TOWN' OF QUEENSBURY 742 Bay R6ad,Queensbury,NY 12804-5902 (518)761-8201. Community Development -Building &-Codes (518) 761-8256 CERTIFICATE O F OCCUPANCY Permit Number: P20040192 Date Issued: Thursday; March 26, 2015 This is to certify that work requested to be done as shown by Permit Number p20040192 has been completed. Location: . 78.MONTRAY Rd Tax Map Number: 523400-296-01.4-0001-007-000-0000 .Owner: GRAYSON PROPERTIES LLC Applicant: GRAYSON PROPERTIES. This structure may be occupied as a: Mobile Home In Park 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,Variance, or other issues and conditions as a result of approvals by the Planning Board Director of Building&code Enforcement or Zoning Board of Appeals. TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20040192 Application Number: A20040192 Tax Map No: 523400-296-014-0001-007-000-0000 Permission is hereby granted to: . GRAYSC)N PRC)PF,RTTF,S T,T,C; For property located at: 78 MONTRAY 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: GRAYSON PROPERTIES LLC 1004 CHESTNUT St Mobile Home In Park $16,000.00 Total Value $16,000.00 MECHANICVILLE, NY 12118 Contractor or Builder's Name /Address Electrical Inspection Agency Plans&Specifications 2004-192 LOT 19 MONTRAY ROAD 980 SQ FT 1995 MOBILE HOME $33.80 PERMIT FEE PAID-THIS PERMIT EXPIRES: Sunday,April24, 2005 (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.) Dated at the T wn o uee a rday,April 24, 2004 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement Application for Permit— Mobile Home Town of Queensbwy, 742 BayRoac4 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 In ��-,, Office Use Name: GC- -, S OA2 o s� e S V l File Permit No. 9 Address: 7? M °NAB A Zd --�� )q Fee Paid , v 1 Reviewed By: Phone No. 5) Parcel In ormationL Property�Ownon f Name: p S o / Proposed Date of Placement: r o r e. / I- Property Location: ,� e Address: 0 7 C k -S!1 1�to 4 S Road,street,Avenue CA 4I✓d C fJe'1/ N //ap, Name of Mobile Home Park: 19,n DAM-,.e c PP .Phone No. TaxMap.Number:' 94-4-1 -t=4� 1Llobile.Home Information ._..-- _----_ Zoning.Irformation Approximate Value of Homer s J 6 Zoning CIassification: A F R 20 04 New Home: Yes 1 Size of Property: ft.by 4o N M G,+„r iSBURY Replacement Home: Ye Not j 61�I0 t�,vD CODE /( Existing buildings: Size of Mobile Home: ft. by d ft. Setbacks: front yard fb; 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: 1 car; 2 car, car circle: Gas Fireplace/Woodstove/Wood Fireplace Attached garage: 1 car; 2 car, car Storage building: Yes No Foundation Support: Other: TYPE SIZE&DEPTH Water Supply: well or municipal Piers s Runners x Is Septic Permit Required? Yes or No Slab s Further information requested on the-reverse side of this sheet R> 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. s - 2. Name of manufacturer. � � ei a od 5 sy-i gS. 3. Plan Approval Number: 4. Model or Component Designation: (New Home ONL19 _ 5_ Date of Manufa —AFT-11YA in- cture: - - - - _.-.. Town of Queenry: —State ofNew 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. Siglature: er,owner's agent,architect,contractor Special Conditions of Permit By Form: 1 111 911 999sh Code Enforcement Officer Wel. ury Building & Code Enforcement— Manufactured / Modular Final Inspection Office No.(518)761-8256 Arrive: Z Z, a am p Date Inspection request received: Inspector's Initials: q NAME: PERMIT LA , 1 LOCATION: -(R tAo KSTR'L 11 RD 19 DATE: C�J ^ �c�IQ Manufactured Home Modular Home Footings__ Foundation_ Backfill_ Framing- -' Comments: Yes No WA Foundation support,pier spacing, Per manufacturer Anchoring per manufacturer 2'from ends Water line shut off Sewer line support @ 4 feet Heating Crossover[doublewide)off grd. Dryer vented outside Skirting ventilated 1 sa.ft.aer 1,500 sq.ft. Hot water relief valve piping outside Deck,porches,steps,railing Fumace/hot water operating Garage Fire proofing Fire Door/Door closers Plumbing Fixture/3°Vent through roof[Modular] Foundation insulation[if applicable] Smoke/Carbon Monoxide Detectors/Interconnected Final Electrical Variance required Data Plate okay Manufactured HUD seal okay Warranty Seal after January 1,2006 Installers Warranty Sealj 18"x 24"access or 22"x 30'attic access / Vapor retarder under home 6 mil poly or other v �j 911 Street number Okay to issue C/C or C/O[Temp./Perm.] Model# Serial# Manufacturer Date of Manufacturer LAPam Whiting12010113uilding Codes FormsXManufadur+ed Modular Final Inspecfior_03 04 10.doc FILIAL INGPECTION REPORT _ MOBILE / MODULAR Town of Queensbury Lp�o�'� Building & Code Enforcement Z -2181 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: DEPART: t59 INS✓ e DATE INSPECTION REQUEST RECEIVE NAME: G,V� C I`} LOCATION: k-bT I�A "l]QTBR ( R� DATE: Z —I —�(D PERMIT# 1'-f)L-I MORALE HOME MODULAR HOME 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 .................... _ 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: vTEtA6 O cJ Z—S`BCD Q1W C C+AR.ET o FINAL INSPECTION REPORT MOBILE- / MODULAR Town of Queensbury Building &Code Enforcement 742:Bay Road Queensbury,. NY .12804 (518) 761-8256 ARRIVE r�DEPART: v INS DATE INSPECTION REQUEST RECEI D- NAME: C LOCATION: DATE: _ -��j� PERMIT VzqGb 1( MOBILE HOME MODULAR.HOME FOOTINGS FOUNDATION BACKFILL FRAMING' NIA. 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. beating crossover(dblewide) off grd. _/- 6. dryer vented outside .............. 7. skirting ventilated .................... 8. hot water relief valve piping outside 9. deck, porches, steps, railing ........ — 10. fiunace/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# Manufacturer p Date of Manufacturer V OKAY TO ISSUEC/O YES; NO Comments: F��►J �E`�� LA-i'J�„� bTEP�j To 7-vAm u-E-1p�-- FINAL,INSPECTION REPORT MOBILE / MODULAR Town of Qtieensbury Building &Code Enforcement 742 Bay Road Queensbury, NY 12804, (518) 761-8256 ARRIVE: DEPART: S . DATE INSPECTION REQUEST RECEIVED: NAME: ap LOCATION: �41_9 MombL�PA }� DATE: ��(_J r S PERMIT# f MOBILE HOME MODULAR HOME 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 .................... — 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 HiJD seal okay .............. — — Model# Serial# Manufacturer Date of Manufacturer OKAY TO ISSUE C/O YES NO Comments: FT �. FILIAL INSPECTION REPORT MOBILE / MOOULAR Town of Queensbury Building & Code Enforcement \y�fJlltV f.1Q11f�t- 742.Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE:%` DEPART: IV; IN r DATE INSPECTION REQUEST RECEIVED: NAME:`` `f LOCATION: !� DATE: DM Aha-LPERMIT.# J95 MOBILE HOME MODBJLAR HOME 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 .x................... — — 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 # r: '1 '' N17 Manufacturer L Era? Date of ManufacturerLn OKAY TO ISSUE C/O YES V NO Comments: Q L , o ��rnL.rr� n1 PLr3nLPLPL J LPLrr3n��nLnLrL3rr3 pd"E.' ��n��n�n��n�n� co 5 BY THIS CERTIFICATE OF COMPLIANCE THE S 5 E NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 - � 5 5 BUREAU OF ELECTRICITY 5 5 40 FULTON STREET - NEW YORK,- NY 10038 5 5 5 CERTIFIES THAT 5 Upon the application of upon premises owned by 5 DOUBLE ILL ELECTRICAL INC. GARRISON PROPERTIES 46 TWIN CHANNELS RD. 78 MONTRAY ROAD 5 5 QUEENSBURY, NY 12804-7230, QUEENBURY, NY 12804 5 S 5 5 Located at 19 MONTRAY ROAD'QUEENBURY, NY 12804 c5 5 5 A lication Number: 2019867 = - _ 201-9867 - 5 pp Certificate Number: CS 5 Section: Block: Lot: Building Permit: BDC: A239 5 5 5 5 Described as a Residential occupancy, wherein the premises electrical system consisting of 5 5 electrical,devices and wiring, described below, located in/on the premises at: 5 Outside, 5 5 5 5 A visual.inspection of the premises electrical system, limited to electrical devices and wiring to'the extent detailed 5 herein; was conducted in accordance with the requirements of the applicable code and/or standard 5 promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5 5 authority having jurisdiction, and found to be in compliance therewith on the 24th Day of August,2004. 5 5 Name QTY Rate Ratine Circuit Type 5 5 Service 5 5 1 Phase 3 W Service Rating 100 Amperes 5 SService Disconnect: 1 100 cb 5 5 Meters: I f5� 5 5 5 5 S 5 -se6l 5 - 5 5 5 S 1 of 1 5 5 5 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 . 5 o L��n�nLr�LrL��n�nLl�LrLrER-PO r�nLl��n�Lr�Lrr�LrLI��L��L L3 LrLnLPLPLPL'1L 0,910-0 L-��9PLnLI�L�L��n�Lr� o _ 4 0 a l r/9 S a AJ _ A WN ,F .7.c,'ENS BURY BUILDING AND CODE I I Z SRi iRY Rim (NG DEPARTMENT Based on our limited examination, Com lian with our comments shall *rued-as-indicatinjg-bP plans a specifications are in full m lie qq with the Building Codes f New Y rk State. i - D i M � I Pr01102 t, Q y M1 }Y ,•i9:11. •i;y Tti (�Qy Al , V JI- L 10 'r H. F;•. VEF A PR 2004 10UVtN1 t�y i4 t•;" t` r-':fig'�•. � '- .� � Y'�`�4��