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2003-366 TOWN OF QUEENSBURY. 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 1 Community Development-Building&Codes (518)761-8256 l]. 1 OCCUP NCC�RTICERTIFICATETEOF Permit Number: P20030366 Date Issued: ,Monday, December 19,2005 This is to certify that work requested to be done as shown by Permit Number P20030366 has.been.completed._.: .r Tax Map Number: 523400-309-009-0002.001-000-0000 Location: 48 WIN(DSONG DRIVE Owner: HOMESTEAD VILLAGE L P Applicant: TERRY LEJEUNESSE 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'Ether 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: P20030366 Application Number: A20030366 Tax Map No: 523400-309-009-0002-001-000-0000 Permission is hereby granted to: HOMF,STF,AD VILLACrF, L P For property located at: 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 ROUTES Mobile Home In Park $3,000.00 Total Value $3,000.00 CALEDONIA,NY 14423 Contractor or Builder's Name/Address Electrical Inspection.Agency COMMONWEALTH ELECTRICAL A PO BOX 706 HAGI JR.NY Plans&Specifications 2003-366 LOT 48 WINDSONG DRIVE 14' X 70' 1985 MOBILE HOME AS PER APPLICATION $35,00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,June 10,2004 (I£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 t the n o u nsb esday,June 10,2003 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement c . VI Application for Permit— Mobile Home Town of Quee;i bury, 742 Bay Road Queensbury, AT 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: Al e- _ File Permit No. 3Co - - T Address: Fee Paid &. . Q- `r Reviewe Phone No. / - - RECEIVED Property Owner Information Parce11nf0rmati0d UN 0 2 2003 Proposed Date of Placement: AWN OF QUEENSBURY Name: ort „�� f,/t�LG BUIU G AND CODE t Property Location: Address: Rlo° ') r Avenue < < Name of Mobile Home Park: 4"ne c,1 e ej L/I r4 IL (if applicable) `�1. Phone No. Tax Map Number: Mobile Home Information Zoning Information Approximate Value of Home: :'T Zoning Classification: New Home: Yes Size of Property: ��ft.by ZY0 ft. Replacement Home: No Existing buildings: Size of Mobile Home: ��ft. by '7f2 ft. Setbacks: from yard�_ ft. ; rear yard ;Z9 ft. - Singlewide: _ Doublewide: Side yards 2& ft.and !D ft. Number of Rooms: (exclude baths), $� Number of Bedrooms: �5 Accessory Building(s): circle Number of Bathrooms:_I 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 munici Piers x Sluanbners x Is-Septic Permit Required? Yes"-or No Further information requested on the reverse side of this sheet ,r Name of Installer or Mobile Home Dealer. 01 tQ Address: � G L C Phone No. ���,old 3 Complete information below found on a"plate"or"sticker"which is affixed to the mobile home. ` r 1. Insignia serial number- 2. Name of manufacturer: 3. Plan Approval Number: 4. Model or Component Designation: (New Home ONLY) 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. ��JCc Si e: x owner,owner's agent,architect,contractor Special Conditions of Permit By- Form: 11/19/2999sh Code Enforcement Officer TOWN OF QUEENSBURY ' 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community-Development-Building&Codes (518) 761-8256 Ins.pection"s per Permit Permit# F20034366 Inspection Date Inspection Type Approved/Denied Comments Permit Type Person Responsible 6/2/2003 12:00:OOAM ' Miscellaneous Mobile Hoene In Park JOEL CLUGSTONE Approved .2003-366 1985 Liberty-48 Windsong,Dr VERIFY DATA PLATE. OK 1/14/2004 12:00:00AM Final Inspection Mobile Home In Park JOEL CLUGSTONE Denied MOBILE HOME OCCUPIED AT THIS TIME BOB TO CALL FOR-INSP. 7/19/2004 12:00:OOAM ; Final Inspection Mobile Home In Park JOEL CLUGSTONE Denied 2003-366 Lot.48 Windsong Dr. Mobile home A.C/O has not been issued for this home. Contact this office immediately for Final Inspection. 7/22/2004 12:00:OOAM, Final Inspection• Mobile Home In Park JOEL CLUGSTONE Denied 2003-366 48 Windsong Not ready 9/29/2004 12:00:00AM' Final Inspection Mobile Hoene In'PArk DAVID HATIN Denied 2003-366 Need Data Plate - P1NAL �N�PECTION REPORT - _ - Town -at ca rnsbury Builadih4a SL Coia4a* �nfcwogor 4ant Quern buryF, NY -12804 • I3A'TE INSPECTION. REQLJF.ST-FaF_CE -NAME: DATE: — PERMPr #{- - MOSIIoE HOME - Mi�lDLTLAR HOME I?K�Nv7M'I".f1�rTCsS- F+C3��X3-NI'�ATIClN BA.C'KTFIL.L. FRAMING 1 f6undatio>ra supp►cart, pier spacitjnLg pertmea nuf_. ........................ �'_ anchoring per nranuf- -_---------- 3_ water line shutoff ------------------- - 4_ sewer line support <91� 4 feet _- S. hefting crossover �dblewida) off grd_ 6_ dryer vented outside ---------------------- 7. - sicirting .ventilated =------------ -------- -a- liot water relief valve piping outside 9_ deck; pot ches, steps, railing -------- - 1t3__ fi rnace/hot water aperxating 11_ garage fire proofinM- ---- ------------- " 12_ door closers ---_ -----. .--_------ 13_ plumbic x�g fixture ___ .._.... __.___.._ - 14. foxvmdation ilmsulaticrn IS- smoke detectors -----------................ -16. fins.l electrical .................. " 1?. variance required- _-_._.___ -... AL S.. cJaata plate okay ____.... ----- . 19. mobile FLUB .seal' okay ----- -------- �ic�del # - - - - - Seriaal-#• - Bate of Manufacturer -QKAY TU ISSUE CIfJ� YES _-_' IBC?• . FAN®AL_ �EOJ��PE�TeC»'O� RED®RT M'®/"��"����._1E= / �fib►���....A.� Tc�►uvn of Gtu�nsbury . E3uilding SL C:oC!@ Entorcerrment 742 Bay Road Ctueansbury, NY 12804- (S1 8) 76 1-82SB ARRIVE: DEPART: INS _ DATE INSPECTI©N REQUEST RECEIVED NAM E: LQCATioN: t---'A FS SAC FOCJrI`INGS F©�32�€DATION BACKFILL FRAMING IV/A YES NtJ 1_ foundation support, pier spacing per rnanu.f ------------------- ----- 2_ anchorixlg per manuf_ --------- - ----- 3_ water lirie shut off -- ------------- ---- 4_ sewer line support CW 4 feet S_ heating off grd. :]Y 6_ dryer vented outside __ ___ ________ _________ ?. skirting ventilated - - ---------- -------- 8_ hot water relief valve piping outside 9_ deck, porches, steps, railing --- --- -- ILO- Furnacell-iot water operating ------- - 11_ garage fire proofing ____ _ ___ __________ 12_ door closers ___-_ __ _________ ____ _____ 13_ plxm birxg fixture ----- - - ---------- ----- 14_ foundation insulation (if appl_�____ __ 15_ smoke ,clfatectors ----------- -- ----- ----- l6_ final electrical ________________________ 1'7_ variance x-equired __ _______ _____ _______ 18_ +data plate okay ___------ --------- --- 19_ mobile HL3ZD seal okay ---------- - -- - A _ 1 V-A—[C> Bate of Manufacturer —Z�� — Z� f Q►KA"Y 'TC3 ISSLTF �If 'Sc'ES NCB Comments: -r4:)Wn of C)ua� ury E3uilcfir-to SL Ccx:lqa E:"nft>ro4am4ant E3aLy Flaztcl Que nsbury, NY 1 :2804 (518) -761-8:256- DATE YZIE<:MJIBS']r RECEIV 1*-Z,AJNAIF-: IPIF-Yzmll-r # perrxxaxxuf.. ........... . ............ axlc--]klc)-rirlg pt--I- rnEm-uf-- --------------- line shut off ------------------- - 4_ sewer ILI-Txf-- support 4 feet - ------ heating off prcl. 6. clx-yE--r- vented c)-litsiaf-- ______________________ 7. slcirtirig --roimtilxLt9--a ------- ----------- --- S. licl't VV.-Lt4--r- relief valve piping outside 9. deck, rycArolita-S. steps, IrlLitirlo - -- ----- furxxa4--t--Ahc)t vvEatt--r CP-e-T-zLti_rk9 -------- jgzLrage- fir-t-- pvc>clpfilao -------- ---------- olc3st--rs ---------------- - ---------- . ... ............. ...... 14. foundation ixts"laticoia (if *LPPI-)------ ---------------------- - JL 16- fin�al - ----------- ------------ r,17. vaxiium-c-,v-- required .............. . ...... L Is. data plate o'luty ....................... 19. nacibiloo- El-LJIE> se-al okay - - ------- ---- Mc,del V A 4-E ml I Fa e-tx 11 re I r Date of Maiatifiacture-m- 4 IF 000- -rc>wn <A C2u4ansuury Building 8L Ccba4a E-=nlc>roiern4Bnt - 742 E3c-ty FlcoeLcf C)uoonsbiury, N")r 12804 (SI S) 761-02,56 jef LOCATION Af :-3 YES k4c) support, IRILle-3r spacing per ruLa-imir- ------------------------ rnaxwuf. ............... Novetu-'r lixli-- ShAlt,<--Off ................... . 4. sc--,wc--r -line s-qpp<>x-t (W-4 feet ....... 6- clryo--x- -ve--ritea outside- ------------------ --- - 7- - SICiXtir3Lg ,-.-*--Xltilatea -----:--------------- 8- hot water relief pipbao outside 9- deck, pc3,irc--Ixo---s, steps, inailbao -------- 110. fxrrtm4--e-A[x-c),t 'VAe&Ltg--r cyp*--vafilmg ... ..... Al. SnrgLZ-e, fire prcmmofijmS .................. 12- cicwc>r clas*--rs --------------------------- 23- plumbing fi--CtLlrf-- ---------------------- 14- F4o-x3xxclatic>rx ixxsxA&xticma (iF 4,ELrvjpl-)------ IS- sximc)-k-4-- detectors ------------------------ 16- fix2lLl electrical ------------------------ 17- variance required -------------- -- ----- is. data PleLtt-- <>kgLy ........................ 19. vac ibilt-- FYLJI> seal okay .............. sf--rilftl At Mesxufacturer l3oftw of Majaufaratuxt--r CDOIK..Oklr -r4c> ISSU-13 <-',/Ca 4L- AOr 00, 11=�1!l,It ie�it_ ■N'��'R E C T l a1�N R E P�i�T Town of Quensbury 4 Builciinjg 8R. CodQ I^nfcnaeiment 742. May Fic►oxd Qum tansbur , N'Y 12804 (Sl 8) 761-8256 • ARRIVE: DEPART: "'"-r► IN _ BATE INSPECTI©N REQUEST RECEIV D- NAM E: -C� L.<DCATION: " 4-->I7 DATE: `� — � � PERMIT # 7 z�r��- ►f�_ 14Y[®�HLE �i0A31E !b�©ID�JLd#�! HQMIE FC)+C]i"I'INGS FCJIJNL?ATION BACK.FILL PR.ANiING NIA. Y�,S NCB 1- fouridatioxi support, pier spacing per xxzanuf_ ----_----- - -------_ 2_ anch®ring per manuf- ------------ - - - -'`�- 3- water line shut off --------- ------- - -- 4. sewer line support (n� 4 feet ___-___ S_ heating crossover (dbiewide� ©ff grd_ 6_ dryer vented outside -.-.:----- --------- - - - -- 7- skirting ventilated -- - --------- -- - - ---- -- S_ hot water relief valve pipirig outsicle 9_ deck, porches, steps, railing - ---- -- - _ 1 C}_ furnace/hot water operating - ------- I I- garage fire proofing ---------- -- - - -- - - 12- door cic3sex-s - - - ------ -------- 13. pp1tirxxbirig fixture, . . L'`I: �-7 ,.�►t 14- foundation. irxsulation (if appl-). ..... 1S_ sxxxolce detectors --------- - ---------- - -- 16- fiscal electrical ........... . . . . ......... 17_ variance regxxired .. . .......... ..... . ... 18_ data plate. okay ......._. . ._ ......... 19- okay ------- - -- - --- ' Allanufacturer Date of Madraufacturer ' ke, OKAY TO ISSUE C/O YES I�C3 Co*rments: _ Town of CQuesnsbury E3uildin4g Fx Code Enforc4a .�erxt J , 742 Bay Road ffl Qu*--+ensbury, -IVY 12804 (518) 7 1-8256 DATE INSPECTIOI*i REQUEST RECENED DATE: M�]f�IZQE 3�©PSE M�DULI�R BIOME. l^�C7MC:�'TI1"�TGS FoiTP3DATI+JN BAG'`KF-ZLL FRAMING 1_ fc�uridatiori support, pier spacing - _ per is ilir- ------------------------ 2. anchoring par irianuf_ -------- ------- 3_ water line shut,csff ................... . 4� sewer 1i.ne support �,'? 4 fret `}�� 5. heating crossover �dblr�wide) off grd_ 6_ dryer vented outside ------------------ ---- =_7_ skirting ventilated ------------_-------- - 8_ hot water relief valve piping outside - -- - - 9. deck, porches, steps, railing -------- ,10_ fimnm ace/hot water c peratinS -------- 11_ garage fire prc*ofing -------- ---------- 12. dcaor closers ---------------------------- -- 13_ plumnbing fix-ftire ---------------------- �✓ 14, foundation insulation 4CW appl_)------ +� 15- smoke detectors =-------_ ------------ JL6- fix l electrical -----_---- --_--._-.--- IL7. variances required -------------- - ------ 18_ data plate C),k&Ly ----------- ------------ -19- mobile HIJI O seal okay -- ------------ Modes # � Serial # i�a�aufacturer Date of Manufacturer ©KAY T© ISSUE CIO YES NO 'G1►rr�rnnlits:--'---� �`� �c_�- ►-mac � 44, ff%A§4=NMlL-E= OOF l%O%CM=M"L-AM6.F% -rc)wn of C2#uog nsboury IE3u!lcflno 8L C:c)04a .'Enfarc4qmcatnt 742 Rmy Ftcmcf Clue nsbury, NY 12804 761-0256 DATE INSPECTION REQUE.S`I' RECEIVED= LA Tq/JAL "VIES pact VruxlLxxr. ........................ 2. ax-ic--Iic>ring pt--3r rriasruf- ----------- ---- ------------ ------- - 4_ sewer Brie support <W 4 Bff-et ------- c),ff Swa- - 6- clr-yf--r vented c)lxxtsiclf-- --�--------------------- &Icix-tilia -.roantilftbea -----:------------ --- lac)t water -relief valve piping outside 9- C1404--k, pouches,. StA--PS, I-ftililX&- -------- vvjatt--r cypt--l-ARktilas -------- proofing ------------------ 12_ door olc>st--r& ............... ..........._ plurTill'imis fixture. ...................... 14,. ftmridmtic>xx irtsxxtati4noxx (if ftppl.)------ Is- SnMA34ct-- ..........I------------- 16- final electrical ............. ........... 17- -vaxiajmoe ire4qxxix-c�4a --------------------- IS.. data plate o4cgLy ----------- ------------ 19_ MaCibilt-- 1-11311> St--al <31"Y __ _ ___________ -YES NCJ J%nC782LLE / r*AOlO®L.JL_AR Town of CQueensbury E3ullding 8L Code Enforcement 742- Bay Road Queensbury, NY 12804 (518) 761-8256 Zoe Z�.A'TE INSPECTIf�73V REQLT�.""�T ,Fr�G.i✓CEI,'ti/✓I,�r.L7/: ���i L.C►CATIC�N� �� �? 14rli+�lr�Z3t.E Hi�+li�lE M+C7►�r'�3'Z.AR Ht]►143�t» FD�rZNGS F+C?LJrNI�►A.'I'I+C�N $ACKFII_L FZ2AMZNG NlA _ YES NO 1_ foundations support, pier spacing per m.-uauf- ------------------ --- --- 2_ ancla©ring per rl anuf_ ---- ----------- 3. water Brie strut off ..-------- ------- - - - 4_ sewer line support @ 4 feet _ -_____ _ 5_ heating crossover (dbiewide) off grd_ 6- dryer vented outside -- ---- ----- ----------- 7_ skirtirxg ventilated ___ _ - ------ ---- --- 8_ hot water relief valve piping outsicle 9_ deck, porches, steps, railing __-- __- _ 10_ furnacellicA water operating ----- --- I1_ garage fire prczofing - -- ----------- -- -- 12_ doc>r closers ---- --- - ------------ -- ----- 13_ plumbing fixture -------- --------- --- -- 14. foundation insulation (if-appl.)__ __-_ 15. smoke detectors ______ _ __ ______________ 16_ (anal electrical -------------- - ------- -- 17_ variance required ----- ---------------- IL 8. data plate okay ____________ -------- --- 19_ rnsobile H1rTI7 seal okay _ _ ____________ Mod1 # - Serial # ',' Maa�.ufacturer mate of Manufacturer t7KAY TO ISSUE t� +C] YES ;''��NQ a JF=E"AMIL` QF%BIMPECT�04�� REPORT - _ _ ffkn cmlE sLsE / Torn c:)f C�"eo nsbury E3LjilafinSj 8& CDcxJe3k IEnforcamatnt �-^+�, 742 motet �yRlt��rraa i�ry /� t�LjoonSbL.1- J, R Y 7 "1204 (SIB) 761-8256 or Of OF 4 DATE I NSPECTI©N REQUEST RECEIVED: �Q�A��S.,E �-lI�ME �®►�EJI..AR. II-�034�E ];=hC]N[,rTINrt�rS FCt'i..TNDA'I"I+C7N B.A.t-'7ES� F'RAi�+'IZNG NIA YES Nc ) 1. fcaursdati.c►n support, pier spacing - per *"a"ixf ------------------------ 2. anchoring par rnmaxif- --------- ---- -- 3_ water line sliut,off ------- ----------- - - 4_ sewer lire support feet ------- 5. heating crossa)ver off grci_ b_ dryer vented outside ---------------------- 7_ slcirtirig ventilated -------------------- e 8_ hot water rlief valve piping outside 9_ deck, pot-ches, steps, railing -------- 1 O_ furnacelhot water operating -------- 11_ garage fire prcaofing __________________ 12. dc}cw closers --------- ------------------ 13- plumbiurlg fixture ...................... 14, fccumdatican insulati<3,xx (if appl-)------ Is- smc0cc detect<>rs ....................... 16- final electrical ------------------------ 17- variance requirerd --_------------------- 18_. data plate C) c"y ----------- ------------ 19- xXaobile HUD seal ci"y -------------- Model # - Serial Ov Manufacturer Date of Manufacturer C3�AY `I'Q ISSUE CfC7t YES _ NQ• -" Comments: - - s -rc)wn of (::kuEmgn*-,t3ury Ouilclirto Bt C<>04a 1-=nfc3prc am4ant 742 -E3 ay Ft-oetcl - Clue nst>ury, -NY 12804 (SIS) 761-82S6 YZIEQ)AJIF-Sr IV 9 IWAA, ly-IRS perKnAL"Alr. ....... ................. rmarillf. ............... 3. water line sl3ut,off ----------------- 4. sewer lixxv-- sxxpp<>x-t (Zo 4 F04--t - ------- S. Uc--atirxg crossover off &-rcl-- - 6. C13ryc--Ir vc--ntcxl C>Axtsiclf-- ---------------------- slcir-tir3Ljg--%rfaixtilLELted -------------------- IEXC>t -.IVELtf--X- relief 'V.ELI-.rf-- piping outside deck, p-cmrc--Hf--S, steps, railing -------- 10- fLxrrm6#--/H<A wato--x- cxpv-,x-zttiim4g -------- fiirc-- prc>cAixiM -------;- ------ ---- 12_ door olclst--rs -------------- - ---- -------- 13- plumbing fbMirt-- ---------------------- 14, fc:)-xmmchLti<>rx irxsxAntk>xx (if gapIpl-)o------ 15. 833MC)ACC-' Cl#--te4--tCWS ----------- ----------- 16- firml electrical ..................... ... 17- variance requdx-c�41 ----------- ----- ----- is- clnta plate,- okay ....................... 19. xxx4o;bile-- I-IIJI:> seal <3,k.%y -------------- - P4 C)- Vk ......... t--� -rc">wn of Quenat:>ury Ouilclinig St C::cKl4B [-=nfc>rcam- nt 742 Oexy Flcmtcl Clues nsbury, We 12804 4z DATE INSPECTI©N REQUEST RECENEI3- QR '60000, PIC--3r rxutjmxxF- ------- ---- ____-_-_ --- 2_ anchoring per - --------------- 3- -.,VfLtf--r lixxf-- sutit,c),fy -- ----------------- - 4_ sewer .line support (ZD 4 feet ---- --- CAY gra- 6. clx-yc--I- vested CnitsicIta- -------------------- slcix-tirls .-w-0--ritilatowd - -:-------------- hot waterrelief valve pipizzg outside 9. clec--Ic, pcxrc--Hf--S, rAk--ps, railing -------- fLxrxizL6#--Axc3ot wnU--x- cvp*-,x-*Ltirig ------- - jgELir.--Lgc-- fix7,t-- prcx:Aixxg -------- ----- - ---- 1:2- door closers -------------- ----- -------- 13. plxxrx-xlbizig fbctuxt. ...................... 14. f6uxicLatic>rx ixiisulixticmm (if appl-)------ Is- &mm<3kc-- <If--te<--tc3,rs . ....................... 16. fixml electrical ----- ------------------- 17. 'VaGrjajaCe V<--4tliT-e4d ............... . ..... Is. ClAt'a PLatd-- okay ------------------------ 19- okay-mobile �3CTD seal -- ------------ Manufacturer ]Date of Manufacturer OF -rc3wn of Cluoq nst3iury SIL C;cxJ49 E-nfiorc-.4arnoent 742 Omy Flcmxcl C:)uc--onsk>ury, We 12804 (518) 761-8256 DATE INSPECTION REQUEST RECENED: _ J-4 1_ Foundation support, pier spacing per %011 oef rn"Et"IXF- ------------------------ 2. vLrxc--Iac>x-irxg per rriaxi-uf- --------------- ------------------- - 6. clr-ye-i- ------------------- O.Rix-tixxg ventilated :-------------- Hc)t water reliefvalvepiping outside 9. deck, p4c>rc--bjt--s, steps, fUrrmm--t--Aaot water garage Hvf-- pycx:Ai"o -------- - --- - ----- 12. door <AC�sf--rs ------------ --------------- pi"riall'irlg ftxtLxr.�. ...................... 14. FicotmacIaLticoxx insxalatioxx Cif ELplpl.)o------ 15. smacAc4edetectors ---.____-.---- ......... . 16_ final e-le,4--trical ............. ........... 17. -.rvwiamce required ......... ............. 18.- data plate C>"y ----------------------- 19. xxxc3fAlt-- HLJD seal t3keLy -------------- Date C3f aeo—I IF■ifVA.L_ FlEPOFtT W%O§O E3 2 L-E / i i O®U L_A Ft Town of Clueerzsbury Building S& Code Enforcement 742 Bay Road Cluoonst3ury, NdY 12804 AI2RIVl-:7: DM -ART: INSF: DATE INSPECTION ME LTEST RECEIVED: . 1l3�ia��Y..E H®M3E M�D�JLAIIi I-IQMIE FOCrrII�TGS FOUNDATIt3N BACKFILL FRAMING N/A YES NC► 1. foundation support, pies spacaixig ;per rruaumuf. .... ....... ..... ........ anclxori.iig per rria ixxF- -- - ----------- - 3. water line slxut cAf . ............. ..... 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- furnacethot water operating -___---- 11_ garage fire proodlrfg -------- -- ---- --- - 12_ door closers --- - -- ------- -------------- 13. plumbing fixture -- - -- ------------ --- -- 14- foundation insulation (if appl.)--_ _. - 1 S. snzolce dete c-tors ... .......... .. ........ 16. final electrical .. ..................... . 17. requ.irecl ........... .......... 18. data plate okay ---- -------- -------- - -- 19. mobile �1TJ:Z> seal okay -- ------------ Model ft Serial # AJlanufacturer Date of A/Yanufacturer OKAY TO ISSUE C/Q YES NO �....•�' � /'� �� ` tom.. r RECEIVED JUN 0 2 2003 TOWN OF QUEENSBURY 1 � -Fill COPY NOTICE ANCHORING OF,MOOILE HOME f TO' 'I'I � . ,�' , ` FRAME IS REQUIRED PER ' • MANUFACTURERS SPECIFICATIONS BUILDING tpT. 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