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2003-642 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20030642 Application Number: A20030642 Tax Map No: 523400-296-014-0001"007-000-0000 Permission is hereby granted to: GRAYSON PROPF,RTIF,S I,I,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 Dome In Park $7,000.00 Total Value $7,000.00 MECHANICVILLE,NY 12118 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications 2003-642 Lot 16 Montray Heights Mobile Home Park 910 SQ FT MOBILE HOME AS PER PLOT PLAN SPECIFICATIONS $35.00 PERMIT FEE PAID-THIS PERMIT EXPIRES:. Saturday,August 14,2004 (If a longer period is required,an application for a ension must be made to the code Enforcement Officer of the Town of Queensbury before e e irati at 00 Dated at the own o b h day,August 14,2003 171) SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement Application for Permit-- Mobile Home Town of Queensbw y, 742 Bay Roag Queensbury, NY 12804 (518) 761-8256. A building permit must be obtained before placement of mobile home on parcel. No inspections will be made until a valid building permit has been issued. Applicant Information M 'Office Use Name:-.q,�S��/ i'4/. 1 �-S' ��, File Permit No. Address: . Fee Paid Al,T l Reviewed By: Phone No. zg�� 6�7 �z Parcellnformation � Property Owner Information '(�.%Ito� C Proposed Date of Placement: -(50:j c3 Name: r c� Property Location: mor tz � Address: I C�! C� -,� {- - Rosa,Stn k Avemue } Name of Mobile Home Park:: / 1c -r L40 r (V applicable) 7 Phone No. Tax Map Number: / ' Mobile home Information - Zoning Information_._ Approximate Value of Homer$ 0 Zoning Classification: New Home: Yes Size of Property: by V ft. ti Replacement Home: Yes No Existing buildings: Size of Mobile Home: (Pig-- ft. by I ft. Setbacks: front yard��5� ft.- real-yard 02 ft. Singlewide: _ Doublewide: Side yards ;C Y ft.and_ 7 Q ft. Number of Rooms: {exclude bath's} ,._7.. Number of Bedrooms: Accessary Buildin s circle Number of Bathrooms: Detached garage: 1 car, 2 car, car circle: Gas Fireplace/Woodstove/Wood Fireplace Attached garage: 1 car, 2 car A-L-,uaee- Storage building: Yes Foundation Support: other: TYPE SIZE&DEPTH Water Supply: well or municipal Piers °� �3d x Runners x Slab x is Septic Permit Required? Yes or � - .Further information requested on the reverse side of this sheet. Name of Installer or Mobile Home Dealer. 4-4 AW Address: V/ Phone No. S,� ( — Complete information below found on a"plate"or"sticker"which is affixed to the mobile home. I. Insignia serial number. 2. Name of manufacturer. Rome-`' Te. mb,`,`f e Molner 3. Plan Approval Number: , 4. Model or Componeirt Designation: (New Horne ONLY) 5. Date of Manufacture: AFFIDAVIT w 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: owne ,owner s agent .,contractor Special Conditions of Permit BY Form: 11119/1999sh Code Enforcement Officer it CM1MIL-10 F CMK=LmiL-AqALR Town c)f CQue�ensbury Ouiiciino 8L C ac i+B Enforcem4ant 742 I3my• F:tc>acJ ttu+cc-:nsbury, '1'dY •12804 (5 18) 76 1-8256 - BATE INSPECTION RECQLT:EST RECEIVED: - - LC7CATION� Zee DATE IT # 1 �IIIII.1sm tl� l �H]r I�® il FC3L7►IZrT�S FC3Ii.TNT3t'�TYC�I`d BAf:`]KFILL FRAMING N/A `YES: NO 1_ f313.ndation suppc rt, pier spacixag i p[17C irnanuf_ ........... ........... .. �. aII.C1aC1I 1Ia per ri12i m i f. -----_- -- -- 3_ watear Pine -shut,off _ ------------------- - 4_ - S_ heating crossover (dbiewide� off grd_ 6_ dryer vested outside ---- ---,----------- ---- 7_ • slrirti_ng -veutilateed ------`-- ------------ 8_ hot water- relief valve piping outside 9. deck, pot-ches, steps, railing -------- s 10- f xrnace/h4cA water orating -------- 11_ garage fare grcaofing -------- ---------- _ 12_ der closers --------- ----- ----------- 13_ ptu nbing future. ....................... 14, fou.ndaticna itisxilaa.ti4mv (if appl_)------ 15. srxxc:)ke detectors ....................... 16_ fixail electrical ......................... 1'7_ varixx nce required ............... . ...... IS- data plane okay ....................... 19- ---------- ---- - - Mlanufacturer- . Bate of h/Yanufacturer - _ - t3KAY T© ISSUE C/C3 _��''�'ES .- N©• -. QViI�B�Lt - r MCMEM"LA4i- -rc)iwn" of QuE ensbury Buiidinco .6k Code Enfor4-gBme3nt 742 Bay Road Quo nsbu ry, "Y 12804 AK.I�:1'�7E: Z7EF'AI2T: � INSP. DATE, IN,SF'L.GTICtN I2.EQX.JE:.ST R�CLIV�.I�: aK���a..� H©r�oaL - astc�r�►�u�...�.aa Hv�st� . FOOrI`II�TGS FC7►LJNDATION $ACKFIL.L FRAIirIING 1_ fc�unciatic3n support,' pier spacing per rrianuf -- --------------- 2_ anchoring per iriariuf_ - ---------- - - --- 3_ water line shut off -------------- ----- 4_ sewer Brie support <W 4 feet _____- - S_ 1a sting crossover dblewide) off g-xd_ 6_ dryer ventted outside- --ti------------------- 7_ skirting ventilated --- ------------------ 8_ hot water relief valve piping outside 9_ porches, steps, railing -------- 1Q_ furnacelhot water operating ___ _____ Z2_ garage fire prCK3fing ------- - -- -------- 12_ door closers - --- ---- -- - ------------- --- 13_ plunnbirw fixture --------- - ------- --- -- -14_ fc>undaticia insulation (if appl_)------ Is- smoke detectcsrs 16_ fiimnl +electx .G�! _ 3'7_ variance: required .. - .............. 18_ data plate, okay __________ _ ___ _________ 19_ nmcobile 141j:i3 sell okay _____ _________ i Serial # Manufacturer UOL Date of manufacturer �� ____._ # €3KA�Y TO ISST-JE C/<D . YES. 1fJ Comments: L/�I f f 'L_ ��_+�►CL'�' G��-I.� - - - - - IFZ3lMAA16LL— M"9W5=M=-IrICM" N%ONCMEBIL-M .0-41 Town of Clu4eanst)ury Ouilclino SL C::cKJ4B E=-nfc>rciam49nt 74!2 E3aky Flc3etcl ---------- Cauie nsUury, NY 12804 ARRIVE: DEPART C" SP. DATE INSPECTION REQ'tTEST RECEIVED: LOCATION: 1 per (SI 8) 761-8256 JA rqAMlp-. ------------- rriaxilar. .................. ...... maxillf. ........ ....... 3- VVELt#--r line slxxlt,<:off ------------ ------- - .4- sf--vvt--x- line sxxpT>cxrt (ED 4 feat - ------ 6- dryer vented outside ----------------------- 7- - --.IcirtijaH -.roaxxtillabewd :--------- ------ 8- hot water pipumo outside 9- deck, j>cwtx--Ix*--s, steps, railirig --------- vvato--ir cypt--irELtilmo -------- proofing ---------- --- - ------ 12. dkD-cxz- closers --------------------------- 13. pliamalbibao fix-tvwc-- ---------------------- 14, fio=adnticw-1 E&PPI.)...... 15- sximcwlct-- detectors ....................... 16- final c--U--ctric--nl ........................ 17- vaxiamu--e required . ............ . .. ..... IS- data pleLto-- okay ............... ........ 19- mobile FIAJI> seal 6kay -------- ------ 7-r PC 4c> 16 44M 37 if a CDOIC-A"N' -r-4ck s NC?- _r t — P e, .-i/ i t - • t vi 46 30 1 1�[�.DI r ` E�'T: } EVIEWED BY — - 4 A.t- in � Teel s n �,�T Iire=it¢ entssha11. m Oill as �n the --�--- naie cc�nstcfi�al�an.S are Wit Codes _ vs.. s��+ding carzip!iance = ti of ye��Ya