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2002-900 j TOWN OF QUEENSBuRy F LE 742 Bay Road,Queensbury,NY 12804.5902 (518)761.8201 Community Development-Building&Codes (518) 761.8256 CER T r IFKal M F OCCUPANCY Permit Number., P20020900 Date Issued. Wednesday, December 11, 2002 This is to certify that work requested to be done as shown by Permit Number P20020900 has been completed, Tax Map Number. 523400-308-008-0002.022-000-0000 Location: 35 LEO St Owner. DOLORES RODRIGUEZ Applicant: MAA.URICE COMBS This structure may be occupied as a: By Order of Town Board Mobile Home Out of Park TOWN OF QUEENSBURY Director of BiRding&Code E me TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20020900 Application Number: A20020900 Tax Map No: 523400-308-008-0002-022-000-0000 Permission is hereby granted to: MAT TRICE For property located at: 35 LEO St 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. T"e of Construction Value Owner Address: DOLORES RODRIGUEZ Mobile Home Out of Park 35 LEO St QUEENSBURY,NY 12804 Total Value Contractor or Builder's Name/Address Electrical Inspection Agency MAT JR1CF COMBS 42 WARRFN LN OTJEFNSBTJRY-NY 12804 Plans&Specifications 2002-900 Installation of a mobile home to replace older model per plot plan and specification, $30.44 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday, October 31,2003 (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 To October 31,2002 SIGNED BY '71 for the Town of Queensbury. ' Director of Building&V—Code En orcement 2 TOWN OF_QUE-ENSBURY 742 Bay Road, Queensbury, NY 12804-5902 518-761-8201 A P P L, I C A T 1 0 N F 0 R A MOBILE HOME OUTSIDE OF A MOBILE HOME COURT Mail or Bring This Application To: BUILDING & ZONING DEPARTMENT RECEIVED- Queensbury Town Office Building Bay at Haviland Roads 0('T 2 5 2002 Queensbury, New York 12804 TOWN OF QUEENSBURY BUILDING AND CODE This application for a Mobile Home Permit shall be accompanied by a plot Ian drawn reasonably to scale showing all dimensions, the size of- the lot, the location on the lot of the Mobile Home, the water supply and sewage system- the applicant is not the owner in fee of the premises. then the_ application must ,be accompanied by the written acknowledgpd consent of the owner- 1. O © r-es- u e NAME OF, APPLICANT ADDRESS 35- d 2. LOCATION OF MOBILE HOME PREMISES BY SIREET.OR ROAD, ETC. UIVI: NEAREST CROSS STREET 3. /0 3— NAME OF OWNER OF LAND e- OWN ERS—ADDRESS 4. State fully the reasons for this request t1 42 01 (Use extra sheets if necessary 5. Description of mobile home: Year Model Make Serial Dimensions MICA-----ANT'S SIGNATURE --------- Address E D Application for Permit— Mobile Home Town of Queensbury, 742 Bay Road, Queensbury, NY 12804 (518) 761-@P- T6 a A building permit must be obtained before placement of mobile home on parcel. No. ade Q until a valid building permit has been issued. MaRMLAIN 14pplicant Information Office Use Name: /(W,0,tW File Permit No. Address: Fee Paid6,4q (z? C, eo Reviewed .................... ..... Phone hone No Property Owner Information Parcel Information Z,0, /4- Proposed Date of Placement: B,AR Name: OZ Property Location: 35 La-0 IS+- Address: Road,Street,Avenue Name of Mobile Home Park: ly /�"I Phone No. (if applicable) 30f, OOV—C� Tax Map Number: Mobile Home Information Zoning Information Approximate Value of Home:S Zoning Classification: New Home: Yes No Size of Property: ft.by 2,001 -Replacement Home: (Y7 NO Existing buildings: Size of Mobile Home: ft. by ft. Setbacks: front yard 7 2— ft_; rear yard & Singlewide: Doublewide: Side yards :71, ft.and ft. Number of Rooms: (exclude baths) Number of Bedrooms: Accessory Building(s): circle Number of Bathrooms: Detached garage: I car; 2 car, _car circle: Gas Fireplace Woodstove Wood Fireplace Attached a . e* I car; 2 car, —'car Z��tTcge building No Foundation Support: '0 TYPE SEE&D= Piers x Water Supply: well or in ci a Runners I-LWd-C6r,,L X Is Septic Permit Required? Yes or No Slab x Further information requested on the reverse side of this sheet Name of Installer or Mobile Home Dealer: '.Addiess' Phone No. Complete information below found on a"plate"or"sticker"which is affixed to the mobile home. I. 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_ Signature: A4�141 owner,owner's ageniVwcr �contrictoi Special Conditions of Permit By- Form: 11/19/1999sh Code Enforcement Officer r` Porch, Deck, Dock, or Boathouse Permit Application Town of Queensbury—Dept of Community Development,742 Bay Road,Queensbury,NY (518)761-8256 A permit must be obtained before beginning construction, No Permit File No. inspection will be made until applicant has received a valid Fee Paid $ building permit. All applicants' spaces on this application must be Reviewed By: completed and must appear on the application form. Applicant: R,&f-1, LA e- Owner: D01 0 reS ee..,V-10 UCH Address: 36 )-E0 -'STPE-E 70 Address: -:S 5 L-Eo +- Phone# Phone#(5fA) _ LQ!9— Email Address: Email Address: Person Responsible for Supervig—ion-o-TW ark as Regards to Building Codes: Name Address: Phone Property Location: Lot Number: House Number Subdivision Name: Tax Map Number: --z 6 V Estimated Market Value of Construction: $ L1 Porch eck (0 Dock u Boathouse L3 Other work(describe Size of structure to be built 7-Yto(, square feat -)( Y 5 1 R� Submit along with this application: 1. Two plot plans drawn to scale,preferably using a survey map. Indicate proposed structure showing setback dimensions from all property lines. Show location of water supply and location and configuration of septic disposal area. 2. Two sets of structural drawings. Indicate size of posts or studs, floor joists, decking or flooring material to be used. Show how the porch or deck will be fastened to the building. If a roof will be constructed, indicate the size of posts or studs,roof rafter spacing and span. Indicate type of roof. sloped, flat, shed, or other. Indicate the type of material being used for the roof. Declaration: please sign below after you have carefully read the statement: To the best of my knowledge 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 noted,and that such work is authorized by the owner. Date: Applicant's signature: L:\SucHemingway\Building.Pennit.FORMS\Porch.Poreb.Permitdoc 8/13/02 revised per DH IF=jr4jjAACkkL_ §"SS3=M4=-JrRC:P" REPO_ XM"N- N%ncmmn§L-E=- r4ncmc=IL.JL-Ac*,vm 400,001�6 -rc>wn� of (:;Iuc3 nsk:3ury Building SR. C:;cK:ic3, Rnfoorcepmant "742 E3ay F:tc:patcf - Clue�nst3ury, NY 12804 (518) 761-8256 DATE INSPECTION REQUEST RECEIVED: LOCATICIN: —`' 'Yl F3 S 1*.14c> 1. foundation support, pier perrnalixif. ............... 21- . ............... 3- NAratsar line Strut off 4- sf--vvt--r Iiiae- suppo @ 4 t ------- CIryt--Z- 'vc-pXxte�6 C31itsicle- -------- --- -- ----- skirting ventilatedje_ - ---- - ------- -- :------- -- ----- S. lic)t water rtalit--F piping outside 9. clf--ck, perches, steps, railing --- ----- fUrrjLact--/IhLcA vvELtt--r operating --- ----- -------- -------- -- -- - --------------------- --- fi-wtury. . ......... ....... . .... 14- fOujudaticyja insulation (if -`XjPFPI-)---- - cic--te,,r-tc:),rs - -3� - - -'6 -000, 1 2-:,: ef i electrical ..... . ------- ir kq t ---keo0ol, variance required -.. .................. I$. -data plate okay ....... ...... . ......... ISO- C:)I--ay -------------- Model # Date of Manufacturer � Manufacturer CA COMMONWEALTH ELECTRICAL INSPECTION SERVICE, INC. Main Office 176 Doe Run Road # Manheim, PA 17545 MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL No, l_�li. 11f1t�1f��'1f No, Pennit /r/rtrlf«ffarr/fffrfNlif/trRININNf��+'t � Cut-in Cain* ftlttttlrrR#It#Iff�lliflltfRittfr+f OWne�#a#1##/lffflM #f�#RMfM#tff f rRfl it ! til Nf fRfMNlrff rrr#Rtfrfrf#f4frHlfl/N//f//tttflltfftfn told frif tiff ttffflrr#1R/tltNlt t 1 An" Location1#10M #1 Mfj#1Ni fill MMI#1#1#Ii #t#Iit!#tiRl#1MIIMltI#!R#trlff##MflfrflffltNl#iii11M#.Mttltfir#rfftffllf#tfillNlfflf 1!#iMttailllMf1f11 Installation Consisting of#f#I t + It I MI 1##MI#IIIIf 1# X4411100eto f frff f i rMu#i t1 flftf III t ffi off MI"Ifffff#I###Rtit#IR#RRIHi Ito I108#rf#If#I MIMIf111i1tffMffiM#M#MIIII#t###Ifee11####111IfI#ffdoI#tf1/#mIIf1#M#1#tIIIaM1fM1MRMfrrrfftarf#rfltff/rlfffmt#I #ifMMI#Iftf Mf#MH Ilea I#f#f#r#MIfl IfMi MM if I I f f i r R to ff#Nrff 1 of I It I I It I ad Ito#III II I Ise#lot i It IofIIdoIf II to 61lead I11111#11#4 I1#41/104to II i1#ffflffatt M#M#ff Rf#liffttR it M of t `v� oto.s Installed !#Ilttf###If�f1##IM #RItMNM##fllllf ff#fi#1fM#M 11911#1#1R1111MMI MM#ttf11 is Not i111#ffiif,Mlff###ti1lllllt#,1##MMIM/#MIMfi The conditions following governed the issuance of this certificate, and any certificate previously issued ik cancelled; This certificate only covers the electrical equipment and installation conditions as of date, [upon the introduction of additional equipment or alterations, application shall be promptly made for inspection. Inspectors of this Company shall have the privilege of makin in pections at any time, and if its rules are violated, the Company shall have the right t re ke thi ' iUcat 0 Of Date,,/,, 1tt#t /!##�If#Ifliriiirr#ffriM#Iiff 1#If rR INSPECTOR #i11 IIfIMI/tffI off I/f lfttllf#/14##Mf fif trf lfllMRfffflrrtff lfflrrfffl Marnhar N VP A I A R I PlNiA.L_ 1NSPtECT�ON RSf�ORT if%A08lLE- / fn^C=:pcML jL-AR- Town' of Clueensbury _ Building 8& Co4J9 Enforcc3mc3nt 742 Bay Road = Clut3 nsbury, NY 12804 (51 8) _761-8256. ARC VE: T3EP'ART: INSF': '- �►Az-�. 70 LC7CATIG7N: �" '� + MK7I�SILE �iJ►IAR+tE � 1mrErR1I�'[.IL.,A►.I�t. H<!ME FOCYZ INGS FOLJNI�AT`ION BACKFIL.L FRAMING N/A YES NO 1_ foundation support, pier spacing per manu£ ------------------ ------ 2_ anclic3ring per iziztauf_ ------------ --- 3_ water line sliut off ------------------- 4_ sewer line support (W 4 feet ------- 5_ •heatirig crossover �dblewide3 off grd_ 6_ dryer vented outside -- ---- ------------- - 7_ skirting veritilated - ------- ----------- 8_ h€ot water r lief valve aping outside 9_ deck, perch steps railing .. ...... 1(1_ furnace/lzot ter Aerating -------- 11_ garage fire pr g ----- ---------- --- 12_ door cicisers _ -- -------------------- 13_ plurribing fix re - --- - --------------- 14_ foundation ulati (if appl_). ____- Is- srnolce de tors __ - -- ----------- -- 16- fin e c al l ' al ___... .._ ............ 17- variaric rv--4udred ........ ..... . ..... is- data Ala `6"y .............}........ ".. 19_ n-iobile HTJZ> scat c+kay' -------------- r Ttlod+�1 # Serial # Manufacturer � "' "'"Ld o o I�atc. crf Manxafaclau-er oec ©I�AY TC� ISSUE CIE] YES -. NQ rz 1��7C�- Offwe Use .GENERAL INSPECTION REPORT Inspector: Town of Queensbury Ready at time., Dept. of Communio Development Request received. Meet: Building& Code Enforcement At time: 742 Bay Road 511� , Queensbury, NY 12804 ARRIVE D amlpm: EPAR am/pm Notes: (518) 761-8256 Inspector's Initials r�q aeA- NAME: PERMIT# LOCATION: 40 Cj INSPECT ON(date): /0/7/*0-o-(,,,— TYPE OF STRUCTURE: RECHECK N/A YES.. O COMMENTS ing Y ot oli s icrs--- 7— ion th fcPour Form. Reinforcement in Place The contractor is responsible for providing protection from freezing for 48 hours following the placement of the concrete. Materials for this purpose on site 'Foundation[Wallpour Reinforcement in Place Foundation/Dampproofing­ Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Place Rough Plumbing_ Heating Rough-In Insulation Foundation Walls Interior R- Foundation Walls Exterior R- Floors R- Walls R- ceiling R- Duct work or piping mi . unheated spaces R- Proper Vent,Attic Vent Framing__ Jack Studs/Headers Bracing[Bridgmig— Joist Hangers Jack Posts/Main Beam. Air Infiltration Barrier- --- . --- .1 - Fire Separation 1,2,3,hour Penetration Sealed Fire Wall 2,3,4,hour Firestopping L:\SueHemit)gway'Building,Codes.Inspection.FORMS\GFNERAL INSPECTION REPORT-doc i f r, z 00 4J 0 U 4- Q� w w N z 1x W W z +i 0) C 'r W 1» �• >1 a) � � I" C 1 S. co l � 4J N �' C C 1% 0) d) u V � V 'r r- 4r. r• 0 0 t-L `a 0� U C:E IV 1 0 41. LL 4" C. W W C4 � 1 0 1 P-C S. , 4j z V) 0 �J)j � VI W 0E , 'r N 0 U m W a. 0 P 4 C z s- 0 +J -0 � M Q'0 0 rt (0 (D E � � °p d � 0 or-Z 4»v � W V C: J r` 0` �+ S. V) 0 -Pi�,r• M C O P 0„ iW 0 or" LL Ul 1 0 C +J N Z 4- 0 (01'- h 0.0.r �. .4 x c c )m �,� � � q C � W u � wasp � 11 v ,It 0 r•I M U c 0 0. 0 C.V L I� t � V) IL .0 W 0 0 c uVr C -P 0 (aI4J4= 0 r, S. 44 � �w q 00 0 � 0p 00v0Ili WILvttC � h C�' 4- u>. 4J41H 0 � 'r" OV) CCCM0000 W ' CA W O+r(A N(L N 0 x 11% 0 0 0 OD: M M 0 0 )e, U) aW 0 4-W U) to 4J 0 M M P ,N P byt 0) 4J a O L Z 00 I 4J C M Id t� ttS H r• P r" 0 IX 4s .0 Q1 ' '��'"° `i3 J S- 0 U 4-) Q) ro Q1 rJ C W00)4 4QL0) CHCfi.Y +JC C C (0 4-Ot S- C *0 W E U 4J H 04- GLOCA. NWN0L '0C41Q) U0JQCU,rOV Q rd 0 it 0 d)-r- > M4) d)'wW 'r Mr+ m 'rQO000) 00UL 'rQ � 0) z J a V) tY� j (zV)00V) ILm -- Clt' ,4LLLLV)uJ,-,LLZU `'� t� �12 lF=N"AAh6.L- l"VSPEC�TiOi'�� REPORT B%ACZDIE3§L-M l%nC=:PEM"L-AMhILFM -Fawn of C:ku4e nsk3ury Ouilclino 4& CCc>Oqa E=-nfar(--fBwr"f3nt '742 Oety F=tc)o;acl- CaueHdnst3ury, N")r 12804 (518) 761-8256 Y2 ]EXA-rIE INSPECTION REQUEST RECEIVED: BATE: -I oc> 7-6 to D IL pier spat--mg perrria-mif- --- -------- ---- . ..... ... 2 per xruumAxf --------------- 3_ vvatfa-v liyit-- slxtlt off ------- -------- --- 4- st--vvt--r lilaf-- support (W 4 feet --- -- - gvcl- --- --------------- 7- skirting -vt--TxtilsLt#--6 ---- -------------- 'S- liuit -.?vat*--x- relief valy ipirxg outside 4 1 1;)- pc)P:rc--nc-.3, S.-tl%algf- fir-t-- pr ------ ----- - -- - - ---- ----------- --- ---- --- plxjjml:Axlg fixture ----------- ---- ------ 14- fcnmadatiuxx i sWaticml (if ELPPI-)- -- -- I IA--- srxxc>jkc-- dAEAt--ctcws --------- ---- - --- ---- 16- fliwatl fAcAotrio-Ml -.____--_-.- --- ------__- 1'7- variance rc:4qxiired -------------------- - IS- data plate. okay ---------------- -------- --- ----------- INA4:3di-I & 0��- 009-7- `serial # Manufacturer L OKAY -IF YESrC) I[SSXJ Mob Office Use -GENERAL WSPECTION REPORT Inspector: Town ofQueensbury Ready at time.. Dept. of Community Development Request received. Meet: Building& Code Enforcement At time:7���� 742 Bay Road Queensbury, NY 12804 ARRIVE am/pm: DEPART am/pm Notes, (518) 761-8256 Inspector's Initials NAME: —R?LVlq PERMIT 4 -qCO LOCAT104le— q 6 vam ilAeki �A —O�SPECT ON(date): 16)hwlk TYPE OF STRUCTURE: RECHECK N/A YES NO COMMENTS Footings/Piers Monolithic Pour Form Reinforcement in Place The contractor is responsible for 9 Lae providing protection from freezing for 48 hours following the placement --7 of the concrete. Materials for this purpose on site 'Foundation/Wallpour Reinforcement in Place Foundatioa/Dampproofing_ Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Place Rough Plumbing Heating Rough-In Insulation Foundation Walls Interior R- Foundation Walls Exterior R- Floors R- Walls R- Ceiling R- Duct work o' piping mi . unheated spaces R- Proper Vent,Attic Vent Framing Jack Studs/Headers Bracing/Bridgmig— Joist Hangers Jack Posts/Main Beam Air Infiltration.Bairier Fire Separation 1,2,3,hour Penetration Sealed Fire Wall 2,3,4 hour Firestoppin L:\SueHemiiigway\Building.Codes.hisl)cction.FORMS\GENBRAL INSPECTION REPORT.doe (0a TO��4 OF O111L 4JLD dUiLDI G DEF 1RTlt�E,�IT n TOWN OF QU��� __ __�.__�----_____... ��� ur ifir fl mo lion, compliance with our comme shall BUILDI EPT not to constru d as indite the a so - ittcations are.' full REVIEWED cumptlanc h ttt'e code. DATE �D T c. i 1 C'V�S Av 7Zr t VI P& +' RECIVED 4 OCT 2. 2002 TOWN OF QUEENSBURY f�"'' �ti. • BU{LD1NG AND CODEw.. 4 CTICE ANCHO G OF MOBILE HOME --- - FRAME 1S REQUIRED PER MA oi �TtS SPECIFICATIONS Wall Panel Flashing Decking As Specified With 114" Spacing Min' QPen Sp Railing Post r. l Deck Joist 16'o.c. 2 et�an9 pv , 4x4 Post To Footing �C- 2x 12 Headers Joist Hanger Nailer Same As. Joist 1�