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2004-253 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20040253 Application Number: A20040253 Tax Map No: 523400-308-019-0001-041-000-0000 Permission is hereby granted to: R MSSA DITROSS For property located at: 27 PINELLO 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: ELISSADUROSS PO BOX 673 Mobile Home Out of Park $28,000.00 GLENS FALLS, NY 12801 Total Value $28,000.00 Contractor or Builder's Name/Address Electrical Inspection Agency GLENS FALLS MOBILE HOME INC. 39 SARATOGA RD GANSEVOORT_ NY Plans&Specifications 2004-253 980 SQ FT 2004 MOBILE HOME Parcel needs Town Board approval for placement of a mobile home outside of a mobile home park. May 17, 2004 Town Board meeting date for review and consideration. $33.80 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday, May 28, 2005 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at a Tow f Q s ,May 28, 2004 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement Application for Permit— Mobile Home Town of Queensbury, 742 Bay Road Queensbury, NY 12804 (518) 761-8256 A building permit must be obtained before placement of mobile home on parcel. No inspections will be made until a valid building permit has been issued. Applicant Information Office Use Name: - 1�55 d �� ��S S File Permit No. Address: B 6 Fee Paid 3- �1e�s�alls Reviewed By: Phone No. 51 - 7 & --__ Property Owner Information Parcel Information ! 'S S d Proposed Date of Placement: Name: �/) � L(, 1�d s$ Address: !" ' ' 'J K 4 73 Property Location: oZ 7 1"/ h e-110 lecl, O u eeiisLirX o4 Street,Avenue fia 1 Is, /V Y /Z 9�0 Name of Mobile Home Park: applicable) Phone No. 5-a- 7ct 3 -V 6&.1/ Tax Map Number: _ . Mobile Home Information ...__.._ :. Zoning-Information Approximate Value of Home: Zoning CIassification: New Home: Ye No Size of Property: ibC) ft.by ZO Oft. Replacement Home: � No � Existing buildings: N X 70 )&Io b l le Size of Mobile Home: ft. by '�d ft. Setbacks: front yard 75 ft.; rear yard ft. Singlewide: Doublewide: Side yards ft.and /�' ft. I Number of Rooms: (exclude baths) 5 Number of Bedrooms: Z Accessory Building(s): circle Number of Bathrooms: Detached garage: 1 car; 2 car, car circle: Gas Fireplace/Woodstove I Wood Fireplace Attached garage: I car; 2 car, car Storage building: a No Foundation Support: Other: TYPE SIZE&DEPIH Water Supply: well or muni " Piers x Runners x Is Septic Permit Required? Yes or No Slab x Further information requested on the reverse side of this sheet W Name of Installer or Mobile Home Dealer. "ns �lSd ��� �o�2S ;Y►�, Address: 130Y S e V00 r Phone No. 51 �`��- 2901 Complete information below found on a"plate"or"sticker"which is affixed to the mobile home. 1. Insignia serial number. -_-.. -.._..._.._ . 2. Name of manufacturer. Sk y.f)N 4Z7- 3.' Plan Approval Number: 4. Model or Component Designation: (New Home ONLY) 5_ Date of Manufa _.. AFFID-AVI..T.- . Town of -- -S 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 BUELDING 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. c signature: ,(/ _ J4�� owner,owner's agent,architect,contractor Special Conditions of Permit By Form: 11l1911999sh Code Enforcement Officer' FINAL. III SPECTION REPORT MOBILE / MOOLIL AR Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE:/ 11 DEPART: INSP: Qp-- DATE INSPECTION REQUEST RECEIVED:/J NAME: - oros-z' LOCATION: DATE: /`Z /3� PERMIT# (� 2 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, pot•ches, steps, railing ........ — — — 10. f imace/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: c JJA£ �� FINAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: .� DEPART: j INSP: �' r DATE INSPECTION REQUEST RECEIVE r—/ NAME: C— t 6 I )V LOCATION: 2 ne 1(b J\o1 DATE: — PERMIT N _ Zi MOBILE HOME MODULAR HOME FOOTINGS FOUNDATION BACICFILL 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 — T7 9. deck, potches, 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 Y Serial# C — Manufacturer 1 v^��c� Date of Manufacturer OKAY TO ISSUE CIO YES NO Comments: lo ' b d Atoms-t�Cl l� t -ulU I I i` INAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury Building &Code Enforcement 742 Bay Road Queensbury, NY 12804 Il (518) 761-8256 u ARRIVE: DEPART D:.��'INS DATE INSPECTION REQUEST RECEIVED: r-- NAME: LOCATION: DATE: Ce _ S —0 4PERMIT# 0-J6 3 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, pouches, steps, railing ........ 10. furnace/hot water operating ........ 11. garage fire proofing .................. 12. door closers ........................... - 13. plumbing fixture ............... .... 14, foundation insulation (if app - 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! 1 /)O YES NO Comments: I v '�C'��� I 'v�YV FINAL INSPECTION REP RT MOBILE: / MOOL ILAq. Town of Queensbury Building &Code Enforcement 742.Bay Road Queensbury,.NY. 12804 (518) V-82% ARRIVE: DEPART: .IN DATE INSPECTION REQUEST RECEIVED.. NAME: !� \ LOCATION: DATE: Lo ! ` O-S PERMIT#'OL) MOBILE HOME MODULAR,HOME FOOTINGS� FOUNDATION _ .BACKFML— FRAMING N/A _ YES NO I. foundation support, pier spacing per,manuf. .......... 2. anchoring per manuf. ............... _� ~ 3. water line shut off ................... 4. sewer line support 0 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. f u-nace/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 — 1.9. mobile HUD seal.okay ..........,... — — — Model # Serial# Manufacturer Date of Manufacturer OKAY TO ISSUECIO YES: NO' Comments: � C- � �v�� `FINAL INSPECTION REPORT c9MI OSILE'./ MOOLILAR Town of Queensbury Building & Cade Enforcement. 742.Bay Road Queensbury, NY 12804 (518) 761-8256 rjARRIVE: DEPART: INSP: DATE INSPECTION REQUEST RECEIVED: NAME: LOCATION: 2� DATE: PERMIT# MOBILE HOME MODULAR HOME. FOOTINGS _ FOUNDATION BACKFML_ 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 .......S. 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 ..................... — — I& data plate okay ........................ ~_ — 19. mobile.HUD seat okay .............. — Model 1f Serial 1/ Manufacturer f I)ate of Manufacturer OKAY TO ISSUE CIO YES' . NO Comments: . v DUROSS ,- f 0,�,y. J� 1� 71 - -------- 0U M T,� `�rr�' C r' �:_ -,''�`��iiRY BUILDING & CODE EPT. 09 r*1s91017, REVIEWED BY 'lb R DATE TOWN OF QUEENSBURY BUILDING DEPARTMENT Based on odr lim' ination mac' 8 comppliance with ur comments s a not be constru d as indicating the plans and s 'fications are in full compliance with the Building Codes of New York St te. HOUSF �p y y 9 a ✓ 8 , ss ii i^ �+qs DEPT. �i�,_. •. �n DATE 60Y I f i 3 , i 0 i yid l 1 Leo Jve s K 1 t 70' E i.5 s� 1�. To Zito C Ml STOCK #314 Skyline 3203CTB Approx. 902 sq. ft. Glens Falls Mobile & Modular Homes, Inc. 1304 Route 9 Gansevoort, NY 12,831 www.gfmliomes.com (518) 798-2801 (Fax) 798-2803 -- - - ------ Iwnt rrA SrvUrt•�♦ j........ M'� A/�1 v •'- - -•I- ���III � / a" ,.Orr rArr n. ' r,An�,pnAt rrrnl.Opt vrI: I LIVING ROOM C I �. BEDROOM MASTER �` I I. T'•IO" 1 /' No.L nn _ 1 KITCIIENIDINING tq' 9" BEDROOM ud _ I m 10.®. \\ i 9-4- Ito. 9 I m 1 . A �...�:_ _ �--__. ' ..___r--•-�-I � --- �I ate�-. nr r.(It r arnrr 203CT131H14 3HEDROOM-CATHEDRAL THRU-OUT (902 SQ.FT.) BED M --✓ No.2 10 ^ - DEDR00M T•10" — No.2 9'4•. UPI UCUC(Nr OPTION 2NO UATI�.