2001-425 RY
TOWN OF QUEENSBU
Road,Queensbury, 12804-5902 (518) 761-8201
��� 742Bay Q ury,
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20010425 Date Issued: Friday, June 29, 2001
This is to certify that work requested to be done as shown by Permit Number P20010425
has been completed.
Tax Map Number: 523400-309-009-0002-001-000-0000
Location: . LUZERNE Rd
Owner: HOMESTEAD VILLAGE L P
Applicant: ROBIN BAKER.
This structure may be occupied as a:
By Order of Town Board
Mobile Home In Park • TOWN OF QUEENSBURY
n/
Director of Building&Code Enforcement
40�� TOWN OF QUEENSBURY
Fos 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20010425 " Application Number: A20010425
•
Tax Map No: 523400-309-009-0002-001-000-000
Permission is hereby granted to: HOMESTEAD VILLAGE 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 Mobile Home In Park 30,000.00
4294 ROUTE 5 Total Value 30,000.00
CALEDONIA,NY 14423
Contractor or Builder's Name/ Address Electrical Inspection Agency
Plans &Specifications
2000-425 ROBIN BAKER LOT 85 HOMESTEAD VILLAGE
24' X 44' MOBILE HOME AS PER PLOT PLAN SPECIFICATIONS
$66.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Sunday,June 22,2003
(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 th To f Q nq ury• une 22,2001
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
r/ i°;ECEIVE10
Application for Permit— Mobile Home JUN 18 2001
Town of Queensbury, 742 Bay Road Queensbury, NY 12804 (518 20, 21 QUEENSBUP
BUILDING AND CODE'
A building permit must be obtained before placement of mobile home on parcel. No inspections v�n��e `made
until a valid building permit has been issued.
Applicant Information
Office Use
Name: ® Q IA) k FA_ 4.1° File Permit No. 01 4
Gi Q
Address: O AO fdq Fee Paid
_k, t( Reviewed By: i'
Phone No. ,..51 /93/
Property Owner Information Parcel Information
Proposed Date of Placement: 'LOP— 0 e
Name: WO em IP, ci,„ e^
y)-9� d- c od p- Property Location: �v Road,Street,
Avenue
Address: D• i Sheet,
CA1A-ODNitsiN� / L f"/y j Name of Mobile Home Park: W frcT&1ll)
(if applicable)
Phone No. //
- --- �-(l® 2-)40 't'//--
J a5) Tax Map Number: 9 3 / II • I-
Mobile Home Information Zoning Information
Approximate Value of Home: $ 30, 0 e ,ass
Zoning Classification:
New Home: Yes No /
Size of Property: ft.by RV ft.
Replacement Home: 60 No
Existing buildings: f/UNo__
Size of Mobile Home: .2)-( ft. by Y./ft- 3l7
Setbacks: front yard ft. ; rear yard ft.
Singlewide: Doublewide: Side yards ft.and ft.
Number of Rooms: (exclude baths)
Number of Bedrooms: Accessory Building(s): circle
Number of Bathrooms: �.
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 ST7F&DEPTH Water Supply: eIl or municipal
Piers )(514- C Pr x Odlo vg0 1t194-, (�
Runners x Slab Is Septic Permit Required? Yes or No
x
Further information requested on the reverse side of this sheet I
Name.of Installer or Mobile Home Dealer: P0) `�wS Qd 04—
o
Address: I d- "r M®S 0 U (1(L0 vf, N 1 5-
Phone No. Z k`J l -3
Complete information below found on a"plate"or"sticker"which is affixed to the mobile home.
1. Insignia serial number: 5O G} — 3 Y v
2. Name of manufacturer: 6.6.6A GJ V 0 ID
3. Plan Approval Number:
4. Model or Component Designation:
(New Home ONLY)
5_ Date of Manufacture: JOf 9/
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.
Signature:
owne ,owner's ent,architect,contractor
Special Conditions of Permit
By:
Form: 11/19/1999sh Code Enforcement Officer
FINAL INSPECTION REPORT
• MOBILE / MODULAR 6'\
Town of Queensbury c
Building & Code Enforcement 7 .- a)
742 Bay Road
Queensbury, NY 12804
(518) 761-8256 0 ,,7 y��
ARRIVE: DEPART I Lv�INS ^\N
DATE INSPECTION REQUEST RECEIVED:
NAME: CDh<V,C g-
LOCATION: 3Th ANN.....6-4A-(-,likkN, /
DATE: 6 l PERMIT II Q\-1z�
J
MOBILE HOME MODULAR HOME
FOOTINGS _ FOUNDAT1ONN BACKFILL_ FRAMING
\ N/A., YES NO
1. foundation support, pier sp ing
per manuf. — — —
2. anchoring per manuf. —I_
— —
3. water line shut _. / —
4. sewer line support @ feet — —! —
5. heating crossover (dble 'de) off grd. — _6. dryer vented outside . — — —
7. skirting ventilated — — —
8. hot water relief valve pip' outside — — —
9. deck, porches, steps, railin — — —
10. furnace/hot water operating — — —
11. garage fire proofing r — — —
12. door closers — — —
13. plumbing fixture 1 — — -
14. foundation insulation (if appl.) —
15. smoke detectors — i --
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: 6.01.c.,:_cr j 6 0 .
FINAL INSPECTION REPORT
MOBILE / MODULAR
Town of Queensbury
Building & Code Enforcement D_gil)
742 Bay Road
Queensbury, NY 12804
(518) 761-8256 L/
ARRIVE: DEPART
DATE INS TION REQUEST RECEIVED:
NAME: % ith
LOCATION:• _ •i 1Ih() V t`
DATE: i' -1?-fir-,4 r1� PERMIT X())-
MO -IILE HOME MODULAR HOME
FOOTINGS _ FOUNDATION BACKFILL_ FRAMING
N/A , YES NO
1. foundation support, pier . _ • g
per manuf. _ .
2. anchoring per manuf. ....3. water line shut off ... —I/
4. sewer line support @ 4 fee, —
5. heating crossover (dblewidw off grd. -
6. dryer vented ou..ide
7. skirting ventilated ... —
8. hot water relief valve piping outside
9. deck, porches, steps, railing — /
10. furnace/hot water operating ✓
11. proofing fire ►`
garage
12. door closers t�/ —
—
13. plumbing fixture —/ — —
14. foundation insulation (if a.. .) ✓ —
15. smoke detectors j —
16. final electrical N;/ -7/ —
— —17. variance required
18. data plate okay — /-
19. mobile HUD seal okay — — —
Model # p Serial #
•
Manufacturer B R.(/1®0
Date of Manufacturer
OKAY TO ISSUE C/O YES NO
Comments:
FINAL INSPECTION REPORT
MOBILE 0 MODULAR. .
Town of Queensbury pmA
Building & Code Enforcement l`
742 Bay Road t �
Queensbury, NY 12804 G/ ,� �
(518) 761-8256 / S
. ARRIVE: DEPART: 6-)11jINSP:
DATE INSPECTION REQUEST RECEIVED:
NAME: Vo,n /Y
LOCATION:
ATE: <\c ld ay PERMI'IVE) )
MO:;ILE HOME 1 MODU Oflltl `�
FOOTINGS _ FOUNDATION _ BA
N/A YES NO
1. foundation support, pier spacing
per manuf.
2. anchoring per manuf.
3. water line shut off ...
4. sewer line support @ • feet ... ...
5. heating crossover (dble `de) o grd.
6. dryer vented outside
7. skirting ventilated _
8. hot water relief valve i i.••= outside
9. deck, porches, steps, railing
10. fumace/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 # b ,5p FI�SSerial # t L 15
Manufacturer Leg 1 '
Date of Manufacturer 17_0 177
OKAY TO ISSUE C/O YES /NO
Comments: \R. -27
��n��
G�l K 1"' 672Q/
1 o 5 P. —
R7� 177 � . . PAST Ft-126-v( Do G o f
Cut2fl Lti,
FINAL INSPECTION REPORT
MOBILE / MODULAR
Town of Queensbury
Building & Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256,E 6.. ` `/
ARRIVE: DEPAR1 INSP: c-'P V/
DATE INSPECTION REQUEST RECEIVED:�1
, Pi NAME: k A
LOCATION: a 5- : 7l e LW
DATE: P C map PERMIT#r) _ A:72-
MOBILE HOME MODULAR HOME
FOOTINGS FOUNDATION _ BACKFILL_ FRAMING
N/A : YES NO
1. foundation support, pier spacing ,
per manuf. _ _ _
2. anchoring nuf. _ — _
•
3. water line ut o
4. sewer line s port @ 4 feet -
5. heating cross ver (dblewide) off grd. _
6. dryer vented o tside ; _ _ _
7. skirting ventila _
8. hot water relief v ve pipin l outside _ _
9. deck, porches, step rail' g
10. furnace/hot water o at' g _ _
11. garage fire proofing . . _ _ _
12. door closers _ _ _
13. plumbing fixtur _ _ —
14. foundation insulation (if app _
15. smoke detectors _ _
16. final electrical _ _
17. variance required _
18. data plate okay _
19. mobile HUD seal okay
Model # 3 q A b Serial # f ft t-1°7-72-A
Manufacturer .f1-1 1 -QbU
Irate of Manufacturer 6 lry lei '
OKAY TO ISSUE C/O. YES ZN
G `C l eo u_)p0 J
Comments:
i_01-
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1,7 y eaf,1"W 0 0
pi(Y0 sb99 - 3`to 11-6
• .:Q06
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111.7 COPY
GENE*
jUN i 8 2001
TOWN OF QUEENSB1JR_Y
)-11
TOWN Of:QUEE1 RY JILDiNG DE ARTMENT
Based on cur I!Tilted examinatic ,
cornptiancwii our comments hall
hot be con tru d as indicating t lb'
I C Lp-rmle-a4) pe 'fications are in ft
complianq )the code.
NOTICE
ANCHORI G OF MOBILE HOME
FRAM IS REQUIRED PER
MANUFACTURERS SPECIFICATIOINS
TOWN OF QUE NSBURY y63
BUILDING & tir;
REVIEWED BY 4_41
ik\
DATE • MOM 7
,
•
• RECEIVED
JUN 1 8 2001
TOWN OF QUEENSBUR"
BUILDING AND CODE
cDaCI
•
a
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