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2001-200 TOWN OF QUEENSBURY 742 BayRoadQueensbury,NY 12804-5902 518 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20010200 V Date Issued: Wednesday, May 09, 2001 T This is to certify-that work requested to be done as shown by Permit Number _ P20010200 has been completed. Tax Map Number: 523400-309-005-0001-001-000-0000 Location: 158 LUZERNE Rd Owner: D&G MANAGEMENT LLC Applicant: NICHOLAS JACOBS This structure may be occupied as a: By Order of Town Board Mobile Home In Park TOWN OF QUEENSBURY Director of Building&Code Enforcement TOWN OF QUEENSBURY 742 Bay Road,Queensbury,N1 12804-5902 (518)761-8201 Community Development- Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20010200 Application Number: A20010200 Tax Map No: 523400-093-000-0002-009-000-0000 Permission is hereby granted to: TODAY'S MODERN HOMES For property located at: 158 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: D&G MANAGEMENT LLC Mobile Home In Park 41,000.00 PO BOX 224 Total Value 41,000.00 GLENS FALLS,NY 12801 Contractor or Builder's Name/ Address Electrical Inspection Agency Plans &Specifications 2001-200 TODAY'S MODERN HOMES LOT 32 SUGARBUSH RD. 1,664 SQ FT MOBILE HOME AS PER APPLICATION $74.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Wednesday,April 30,2003 (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 ; a uee y; � ..---• s ril 30,2001 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement Application for Permit— Mobile Home Town of Queensbury, 742 Bay Roach Queensbury, IVY 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: GUa ti.`c 4Verioll 110'4 .f 4.1° File Permit Nock f r01-0O Addressy 604--e 9Fee Paid �`� � av 674Y1).56/0-027; /v / /z0J/ Reviewed By: Phone No. L0 --/6 a( . APR 2 5 2001 Property Owner Information Parcel Information WN OF QUE NSBURY Proposed Date of Placement: 5- LDING AND CODE Name: //k2-ymitn./P,5 ` �^ Property Location: I/3 z So ot bur Address: /�V /U o1,Q, 6 aw Road,St�t,Avenue 62/fry l?vr r //It( /agog . Name of Mobile Home Park: A)0rWt S (if applicable) Phone No. /Z— 593 0Tax Map Number: 9 3 / c / 9 Mobile Home Information Zoning Information Approximate Value of Home: $ � 1 Zoning Classification:. New Home: No J 456 (11 U�" Size of Property: 52- ft.by//V ft. Replacement Home: - No �, Existing buildings: Size of Mobile Home: ;61ft. by ft. Setbacks: front yard ( ft. ; rear yard 6 ft. Singlewide: Doublewide: Side yards ,/0 ft.and 7(4, ft. Number of Rooms: (exclui baths) .1 Number of Bedrooms: c7 Accessory Building(s): circle Number of Bathrooms: A 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: A& plea Pi(' Other: TYPE I SWF&DEPTH Water Supply:. well or municipal Piers Runners x Slab x Is Septic Permit Required? Yes• or No Further information requested on the reverse side of this sheet 1110. Name of Installer or Mobile Home Dealer: ms^ _ Address: S y iZ 't , Aft/ /93/ 1 Phone No. `R--2%-/o 0 i_ Complete information below found on a"plate"or"sticker"which is affixed to the mobile home. 1. Insignia serial number: .S VA) O 736 -L/iS 2. Name of manufacturer. Ski/ 3. Plan Approval Number: 6; 3 4. Model or Component Designation: ij¶K2 0 - G 7 (New Home O1VLI9 5. Date of Manufacture: 9/V/ 0 — -- - -- A F-F I D A V_I:T--— — 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 a ent,architect,contractor Special Conditions of Permit By: Form: 11/19/1999sh Code Enforcement Officer FINAL INSPECTION PIZIPI i MOBILE / MODULAR Town of Queensbury Building &Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-82 ARRIVE: DEPART ! (V INSP: DATE INSPECTION REQUEST RECEIVED: r � 1 NAME: (f-e- `)441A LOCATION: .1'2 �u-c nt(2 DATE: 5 c` 0 1. PERMIT# C)t` 2-eft) L J MOBILE HOME MODULAR HOME FOOTINGS _ FOUNDATION _ BACKFILL_ FRAMING N/A YES NO 1. foundation sus••. pie spacing per manuf. .. ._ / — 2. anchoring per .id. ..•• — ✓� 3. water line shut,off — —V/ — 4. sewer line support 0 4 fee — ✓✓ _ 5. heating crossover (de ewi•;) off grd. — 6. dryer vented outside . — — 7.• skirting ventilated ... — — 8. hot water relief valve pi 'i g outside — _ 9. deck, porches, steps, rai g — — ,10. furnace/hot water opera;1: / — — 11. garage fire proofing •,/_/ _ / 12. door closers 1/ , / 13. plumbing fixture _/ /// — 14, foundation insulation (if appl.).. ... V 1./ — 15. smoke detectorsy .... /v� _ 16. final electrical 5-.. .1 .0.....•. 17. variance required _ — — 18. data plate okay — _/ — (4 19. mobile HUD seal okay — t/ — Model # . _ ' Serial#o V)0-09 ' -LA-„i Manufacturer �•1-1,L1'tie" Date of Manufacturer ` re OKAY TO ISSUE C/O YES NO Comments: E IEIEMP �r�L�PrJ EMPL rEPrJ c_PLPEr_PrJ ESOPE_�E.PrP LUMPED LIPPED �riO 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 5 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 S CERTIFIES THAT 5 Upon the application of upon premises owned by 5 5 5 5 NICHOLAS JACOBS NICHOLAS JACOBS S P.O. BOX 242 32 SUGARBUSH RD 5 SGLEN FALLS,NY QUEENSBURY, NY 12804 1 5 Located at 32 SUGARBUSH RD QUEENSBURY, NY 12804 S 5 S 5 Application Number: 1014808 Certificate Number: 1014808 5 5 SSection: Block: Lot: Building Permit: BDC: A239 5 gDescribed as a Residential occupancy,wherein the premises electrical system consisting of 5 electrical devices and wiring, described below, located in/on the premises at: 5 Outside, __5 _____ ___--=-- . _ ____ -_-- . __ , _- _- _ _.. _ __ __r- - - - - --- -- : - -. --- -- - % - was inspected in accordance with the National Electrical Code and the detail of the installation,as set forth below, was found to be in compliance therewith on the 4th Day of 05/07/2001 S Name QTY Rate Rating Circuit Type 5 5 5 5 5 5S 5 5 5 5 5 5 5 5 5 5 5 5 5 __ 5 = ( seal _' 5 S % ;. . _ 5 5 1 of 1 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. S 5 5 an PLo.Pr_P_rop P:PompLIEE_M��IEMPLOP PLOMEP01l1 Te y,►;, GY Q 1EEW BURY B1r WtNG DEPI RTMEE T ,,i 1 r C n7sCeld on our limited examination, y_11 `<. : ''. compliance with our comments shall not be construed as indicating the ° ;10 4— Gt1 pins and specifications are in full � ��� ED TO �A ` OF n. . 4, compliance with the code. BUILDING qAy.....3 *EPT NOTICE APR 2 6 2001 • f ANCHORING OF MOBILE HOME TOWN OF O UEENSBURY REVIEWED BY CI, FRAME IS REQUIRED PER - B9.iaLD1 . 1-aD DUDE DATE MANUFACTURERS SPECIFICATIONS 1 ■�■■■■■1 -- --- ❑— L— mom mom la, r UTILITY =d Emma ,Tr_m DINING • "� OPT. pP _ <o ■■■ •OPT. 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