2004-759 TOWN OF QUEENSBURY
742 Bay Road,Queensburq,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20040759 Date Issued: Thursday, May 19, 2005
This is to certify that work requested to be done as shown by Permit Number P20040759
has been completed.
Tax Map Number: 523400-309-009-0002-001-000-0000
Location: 200 LUZERNE Rd (55 wINDSUNG DRIVE)
Owner: HOMESTEAD VILLAGE L P
Applicant: ANGELIA GENIER
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 Director of Building&code Enforcement
Planning Board 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: P20040759 Application Number. A20040759
Tax Map No: 523400-309-009-0002-001-000-0000
Pennission is hereby granted to: ANGELTA GENTE,R
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
4294 ROUTE 5 Mobile Home In Park $28,000.00
Total Value $28,000.00
CALEDONIA,NY 14423
Contractor or Builders Name/Address Electrical Inspection Agency
Plans &Specifications
2004-759 ANGELIA GENIER 55 WINDSONG DRIVE
14'X 70'MOBILE HOME
$33.80 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday, October 19,2005
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Tor- eensb , Tuesday, October 19,2004
( a
SIGNED BY . �'+ 9 for the Town of Queensbury.
Director of Building& de orcement
RECEIVED
Application for Permit— Mobile Home S E p 2 4 2004
Town of Queensbwy, 742 Bay Roue Queensbury, IVY 12804 (518) 761-8256
TOWN OF QUEENSBURY
BUILDING AND CODE
A building permit must be obtained before placement of mobile home on parcel. No insp ons a maile
until a valid building permit has been issued.
Applicant Information
// � Office Use
Name: /� (�P GZ. ���%r File Permit N�? �1 7S
Address: h1�
Fee Paid
C; _e6lia�i�- JL1 726 Reviewed B
_ Y• _
Phone No. __..._.__
Property Owner Information Parcel Information
Name: " Proposed Date of Placement: , CrrP r S�s c
.� �
Property Location:
Address: Road.Suee! ,A e '/ Q
Name of Mobile Home Park:4>L* Lz�r&Ik
(i applicable) _: -
_ .
-Thond No. Tax-Map-Number: j. .._.._ /
Mobile Home Information :Zoning Informevion
.:
Approximate Value of Home:$
Zoning Classification: it L
New Home: Yes No
Size of Property: ft.by IV6 ft_
Replacement Home: es No
Existing buildings: 5ke�4
Size of Mobile Home: _ft. by Z6 ft.
Setbacks: front yard ft.; rear yard ft.
Singlewide: _ Doublewide: Side yards _10 &and ft.
Number of Rooms: (exclude baths) 5
Number of Bedrooms: 2 _ Accessory Building(s): circle
Number of Bathrooms: J
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 x
Runners x Is Septic Permit Required? Yes or No
Slab x
•�i�Cr
Further information requested on the reverse side of this sheet
VD
Name of Installer or Mobile Home Dealer. 'A) A
Address:
' 3
Phone No.
l� lS
Complete information below found on a"plate"or"sticker"which is affixed to the mobile home.
/`-I-�� Iu l�n600 CPS
l f
1. Insignia serial number.
2. Name of manufacturer.
3. Plan Approval Number:
I
4. Model or Component Designation:
(New Home OM I)
Date of Manufacture: C74 6
_. AW DAVIT. .
Town of ee --
._.. ._._ .. -- -.. .. ..: .. .. —State of-New=Yoii� . .
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.
t
Signature:
owner, s agent,architect,contractor
i
Special Conditions of Permit
Form: 11/19/1999sh Code Enforcement Officer
FINAL INSPECTION REPORT
MOBILE / MODULAR
Town of Queensbury
Building & Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256
ARRIVE: DEPART:�w INS
DATE INSPECTION REQUEST RECEI ED
NAME: >�L Q E�0
LOCATION: SK �I��(>(>..�c�L.)C7
DATE: �J� — `Ck PERMIT# Z-ICA--TS9
MOBILE HOME MODULAR HOME
FOOTINGS _ FOUNDATION _ BACKFILL_ FRAMING
N/A YES NO
1. foundation support, pier spacing
per manuf. ........................ _ -
2. anchoring per manuf. ............... _ 7 _
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 Cl NO
Comments:
FINAL INSPECTION REPORT
MOBILE / MODULAR
Town of Queensbury
Building & Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256
ARRIVE:.DEPART: JINI
DATE INSPE[C�TION REQUEST /RECEI
NAME: g-T L'.Q
LOCATION: J U� i /\(,�'j
DATE: PERMIT#
MOBILE HOME MODULAR HOME
FOOTINGS FOUNDATION BACKFILL FRAMING
N/A YES NO
I. foundation support, pier spacing
per manuf. ........................ — — —
2. anchoring per manuf. ...............
— — —
3. water line shu off ................... .shut
,off
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. 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 # . Serial#
Manufacturer
Date of Manufacturer
O
OKAY TO ISSUE C/O YES NO
Comments:
Y
FINAL INSPECTION AlfiPrJrR-r
MOBILE / MODULAR
Town of Queensbury
Building & Code Enforcement
742 Bay Road
Queensbury, IVY 12804
(518) 761-8256
ARRIVE: DEPART: INSP:
DATE INSPECTION REQUEST RECEIVE
NAME:
LOCATION:
DATE: l PERMIT#
MOBILE HOME MODULAR HOME
FOOTINGS — FOUNDATION — BACMLL_ 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
Da of Manufacturer
OKAY TO ISSUE C/O YES NO
1`Zo �fl of
Comments:&' 1�)E r\�3 g E�
FINAL INSPECTION REPORT
MOBILE / MODULAR
Town of Queensbury
Building & Code Enforcement
742 Bay Road
Queensbury, NY 12804 .
(518) 761-8256
ARRIVE: DEPART INSP:
DATE INSPECTION REQUEST RECEIVE �5 U
NAME: e-
-(C
LOCATION:
DATE: G 5 C� PERMIT# ()q "7
MOBILE HOME MODULAR HOME
FOOTINGS FOUNDATION BACKF LL 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. 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 # Serial#
Manufacturer
Date of Manufacturer
OKAY TO ISSUE C/O YES NO
comments:.—. '(-(rJ o
rrNAL INSPECTION REPORT
MOBILE / MODULAR
Town of Queensbury
Building & Code Enforcement ,
742 Bay Road
Queensbury, NY 12804
(518) 761-8256
ARRIVE: DEPART: IN P `-
r
DATE INSPECTION REQUEST RECEIVED
NAME:
LOCATION:
DATE: V RMIT#
M0131LIE HONZ MODULAR Ho
FOOTINGS FOUNDATION BACIFILL ING
N/A ES NO
1. foundation support, pier spacing
per manuf. ........................ _ r _
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. f imace/hot water operating ......: _ — —
11. garage fire proofing
12. door closers .......................... -
13. plumbing fixture ................ ....
14, foundation insulation (if a ...... — —
15. smoke detectors .............. .......
16. final electrical .............. ........ — _ —
17. variance required ........ ........ — —
18. data plate okay ........... .......... _
19. mobile HUD seal okay ............
Model # Serial#
Manufacturer
Date of Manufacture
OKAY TO SUE C/O YES NO
Comments:
r
_El511AL INSPECTION REPORT
J
MOBILE / (MODULAR
Town of Queensbury
Building & Code Enforcement
742 Bay Road 9:t5JO
Queensbury, NY 12804(518) 761-8256
ARRIVE: DEPART: IDATE INSPECTION REQUEST RECEN
NAME:
LOCATION:
DATE: Id��O r PERMIT#
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 —
9oiches, steps ing ........ — —
1 furnac /hot wale eratm ........
.op
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
-
CD r1v6r-v--
Comments: V05
Flllll:'AL`i90I�ECTIOIV REPORT
MOBILE / MODULAR .
Town of Queensbury
Building & Code Enforcement
742_Bay Road
Queensbury, NY 12804
(518) 761-8256
ARRIVE: DEPART: INS
DATE INSPECTION REQUEST RECEIVE
NAME: ��� E ��
LOCATION: 55 t� i h�t� n pa V E
DATE: - PERMIT.#
MOBILE HOME �_ MODULAR HOME
900
FOdrINGS ` FOUNDATION _ BACKFILL_ FRAMINL'i_
N/A YES NO
1. foundation support, pier spacing
per manuf. ........................ — v'
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. d ; porches, steps ra'lin .... -►a ^—�
1 . furnace of water ratin 10)... —
11. garage fire proofing ..................
12. door closers ........................... — —
13. plumbing fixture ...................... — —
14. foundation insulation (if pl.)....
15. smoke detectors .........� .� �i`
16. final electrical ... ... .t� � lo�G —
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:
v
OIL
FINAL INSPECTION REPORT
MOBILE / MOOLILAR
Town of Queensbury
Building & Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256
ARRIVE: DEPARTZ`1[ INSP:
DATE INSPECTION REQUEST RECEEIVED:
NAME: A N C�CrJ
LOCATION: V
W�)DDATE: —� PERMIT#
MOBILE HOME MODULAR HOME
do°y 1
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:
FINAL INSPECTION REPORT
MOBILE / MODULAR
Town of Queensbury
Building & Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256
ARRIVE: DEPART: INSP:
DATE INSPECTION REQUEST RECEIVED:
NAME:
LOCATION:
DATE: PERMIT #
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 HUD seal okay ..............
Model # Serial #
Manufacturer
Date of Manufacturer
OKAY TO ISSUE C/O YES NO
Comments: / �� "30 C c% c/ Le/
"/,j �i/t� @� /6a l eeC*.—
en - L�LI�G� �� !y//41/Ga1�f G'i.4;rzTJ `.-c7i6
Gi X l 77cl3t�S <+3 1�G'1��� Wei Cb'dd�c-�dJlwL
Residential Final Inspection
Office No. (518) 761-8256 Date Inspection req s ceiv d:
Queensbury Building&Code Enforcement Arrive: a epart: a m
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials.
NAME: — P F TMIT#: 7 UO�A` 7
LOCATION: ATE: 10 —��--O7 A
TYPE OF STRUCTURE:
Comments
Y N N/A
Chimney Ht./"B"Vent/Direct Vent Location
Fresh Air Intake ADJGtiDRr D �L. �RCl�A7�..
3 inch Plumb Vent through roof
Roof Complete
Guard 30 in.or more @ stairs,decks,patios
Guard at stairwell at 34 in. or more
Guard at deck,porches 36 in. or more ��
Exterior Finish Complete
Interior/Exterior Railings 34 in.to 38 in. - Q
Platform at all exterior doors WA
Interior Handrails stairs 2 or more risers TlZC) ��- O �� �
Grade awayfrom foundation 6 in. with 10 ft.
Handrail Termination at Newell Post or Wall
8 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18"above Arade `� M✓C�
Gas Furnace shut-off within MR. or within line o site
Oil Furnace shut-off at entrance to furnace area
Furnace/Hot Water Heater operating CA
�
Low water shut-off boiler
Relief Valve(s)installed
Interior privacy/trim/doors/main entrance 36 in.
Bathroom/Kitchen watertight �� G
Safety glazing
Window in stairwells safety glazing evzc)
Interior Smoke Detectors:
Every level: / Every Bedroom: N
Outside every bedroom area: �� C}
Inter Connected: / Batter backup: - � �/` R LCC�
Bathroom Fans,if no windowv
Carbon Monoxide detector
Plumbing fixtures 1
Foundation insulation olp
Floor truss,draft stopping finished basement 1,000 sf
Enter ency egress below grade
Basement stairs closed rise>4 inches
hour fire door/door closer G
ara e fireproofingU,
Duct work Sealed properly
Attic access 30 in.x 24 in.x 30 in.(ht.)In accessible area
Crawl Spaces 18"x 24"access, 1 s .ft.-150 s . ft.vents
Building No./Address visible from road
Final Electrical
Site Plan /Variance required
Final Survey Plot Plan
As Built Septic System/Sewer Dept.Inspection Sticker
Flood Plain Certification, if required
Okay to issue C/C(Cert. Of Compliance)
Okay to issue Temporary C/O(Cert. Of Occupanc )
Okay to issue Permanent C/O(Cert. Of Occupancy)
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SEP 2 4 2004
TOWN OF OUEENSBURY
BUILDING AND CODE
NOTICE TUIN p,, MF o , l �� :hT��� ►
`���/# 1� Based on od
A{]O OF MOBU HOME T9s'i'zi7 Q;.f witl oui C- ln".1ents shall
FRAME IS REQUIRED PER r 4 � :'�'jst uetj Fis inbcating the
Q Mans ,�r,a s cil :.�i.4 are in full
RANUFAMRERS SPECIFICATIONS / y e
.e."i 4i'±�Sil�.n.�w
F11 F -C-opy
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NOTICE NOFICE
KRAFT PAPER INSULATION MUST BF FOAM INSULATION MUST BE COVERM
rOVERED BY NON-COMPI-IFTI-D' BY A 15 MINUTE THERMAL BARB!