2001-751 01111K -
.40014.4. TOWN OF QUEENSBURY
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742 B R a ueensb NY 12804-5902 518 761-8201
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Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20010751 Date Issued: Friday, November 02, 2001
This is to certify that work requested to be done as shown by Permit Number P20010751
has been completed.
Tax Map Number: 523400-309-009-0002-001-000-0000
Location: LUZERNE Rd (LOT 9 ALPINE AVENUE)
Owner: HOMESTEAD VILLAGE L P
Applicant: CRYSTAL HESS
This structure may be occupied as a:
By Order of Town Board
Mobile Home In Park TOWN OF QUEENSBURY
(1"- av,P ,/
Director of Building&Code Enforcement
��� TOWN OF QUEENSBURY
s 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
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Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20010751 Application Number: A20010751
Tax Map No: 523400-309-009-0002-001-000-0000
Permission is hereby granted to: CRYSTAL HESS
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
SHO MOBILE HOME BROKERS
USED MOBILE HOMES
3048 ROUTE 50
587-6704
SARATOGA SPRINGS.NY
Plans &Specifications
2001-751 CRYSTAL HESS
14' X 70' MOBILE HOME AS PER PLOT PLAN SPECIFICATION
Lot 91 Alpine Avenue,Homestead Village Mobile Home Park
$33.80 PERMIT FEE PAID - THIS PERMIT EXPIRES: Friday, October 11,2002
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the ex siration date.)
Dated at,the Toju4nsb, ►, • . !. sday, October 11,2001
SIGNED BY Y ' \ for the Town of Queensbury.
Director of Building&Code Enforcement
Application for Permit— Mobile Home
Town of Queensbury, 742 Bay Roact Queensbury, NY 12804 (518) riC 761-82 �C '
permit must beobtainedbeforeplacement of mobile home onparcel. No inspections will be m'd
Eri
A building us p la
until a valid building permit has been issued. OCT 0 2Q0'
Applicant Information TOWN OF
.Office Use BUILDING��p SOD R�
Name: 6-" a 74 L e S 5 File Permit No.r-- ��f " 76 E
8.9
Address: Pd, 06( '/S Fee Paid .3
_1 kQ-a �(6 l)-FQ/ Reviewed By:
Phone No. 7 e 'd 5 O 47
, , . .
Property Owner Inform on Parcel Information
Name: 6 1d, Proposed Date of Placement: 9/ :Vok-e, ,,j e / �-�/
mohs rc, el,er,, Property Location: d/(L(3,2 L ih e'44
Address: l�cic��C�e . RAv ue
Name of Mobile Home Park: 5kde- i#/i
t_____
(if applicable)
Phone No. : ,•� "l_j�01-6—' 6/3 d 2 1' Tax Map Number: / /
L ' c0e rr)' ks
Mobile Home Information Zoning Information
31)
Approximate Value of Home:$ 000 ` 3`
1 J Zoning Classification:
New Home: Yes) No
Size of Property: J ft.by)d(J ft.
Replacement Home: Yes
Existing buildings:
Size of Mobile Home: /47 ft. by 70 ft.
Setb_a_c_k_s: front—yard ft. ; rear yard aft.
Singlewide: / Doublewide: —-Side'yards 3 0 ft.and 0 _ft_ i
Number of Rooms: (exclude baths) 5
Number of Bedrooms: 3 Accessory Buil ' g(s): circle h`a.
Number of Bathrooms: ,p `
Je--% Detached gaga : 1 ; car, car
circle: Gas lace/ ve/Woo eplace Attached e: car; 2 car, car
St a building: Yes o
Foundation Support: er: -
a,,--,,,,,o,' TYPE SIZE&DEPTH Water Supply. well or municipal Cro&sik Zak
Runners vk l x
G1 /4.— x Is Septic Permit Required? es5):r ) No
'2 7`7(-- s S 71s Rae-LW/SP) 6
Further information requested on the reverse side of this sheet 11,
Name of Installer or Mobile Home Dealer. JAL, v —/ 4 c
Address: oZ / I y p Lc- Q c _ ! al p
,7)-2J
Phone No. 510 ! 3 6 5
A-2(. 20-O(i'
Complete information below found on a"plate"or"sticker"which is affixed to the mobile home.
1. Insignia serial number ', 4 f
2. Name of manufacturer. • 7�("z!'f a✓-7 cf 5
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:
owner,owner's agent,architect,contractor
Special Conditions of Permit
By
Form: 11/19/1999sh Code Enforcement Officer
FINAL INSPECTION REPORT
MOBILE / MODULAR r1"
Town of Queensbury ,,,,,/
Le-
Building & Code Enforcement
742 Bay Road �01
Queensbury, NY 12804 , ' '-
(518) 761-8256 Q,it"'
I
ARRIVE: DEPART:,�i'` INSP:3 2
DATE INSPECTION REQUEST RECEIVED: P/ / GU
NAME: d i A 1✓.1
LOCATIO r. :Tl..-,40 b--e //
DATE: I/ 2 ,202.) / PERMIT#dot 1-d)57
AZ MINI
MOBILE HOME MODULAR HOME
FOOTINGS _ FOUNDATION _ BACKFILL_ FRAMING'_
N/A . YES NO
1. foundation support, pier spa ing
per manuf. — —
2. anchoring per manuf. .. _ /3. water line shut off _ V___.4. sewer line support @ 4 f- V
5. heating crossover (dblewi..- off grd. 7/ —
-
6. dryer vented outside ..4....7. skirting ventilated __ /_
8. hot water relief valve pip' , outside 7 _
9. deck, porches, steps, r:• ing _ _
10. furnace/hot water..o -rating
11. garage fire proofing _,( _
12. door closers _
13. plumbing fixture _ V —
14. foundation insulation (if appl. _ V 15. smoke detectors�/
16. final electrical NIP I b. ! d I _ j
17. variance required _ —
18. data plate okay _19. mobile HUD seal okay _
Model # 2(erQ3 U :erial #f 12 7✓ 5r C)
Manufacturer - rwu
Date of Manufacturer /01Z4�O
OKAY TO ISSUE C/O YES NO
Comments:
OP�rJ�r�c_PLIOOPLOrPLPEEPLIrJMr�r�r�rJMP LEM PEPLI PEJ�rJ [MP r_PEPLIEPE_PEPr�rJ �E.PL t El
5 5
BY THIS CERTIFICATE OF COMPLIANCE THE
NEW YORK BOARD OF FIRE UNDERWRITERS 5
5 5
5 BUREAU OF ELECTRICITY 5
5 40 FULTON STREET - NEW YORK, NY 10038
5 CERTIFIES THAT h.
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Upon the application of upon premises owned by )
5 e5
CRYSTAL HESS CRYSTAL HESS
5 91 ALPINE AVE QUEENSBURY,NY 12804 GLENS FALLS, NY 12801
CX 3415
5 c5
5 Located at 91 ALPINE AVE QUEENSBURY;NY 12804 — - - - --__ - - -- -- 5
5 S
5 Application Number: 1024876 Certificate Number: 1024876 5
5
Section: Block: Lot: Building Permit: BDC: A239
5 5
Described as a Residential occupancy,wherein the premises electrical system consisting of 5
electrical devices and wiring,described below, located in/on the premises at: C5,
5 single house trailor,Outside, C�
5 5e
was inspected in accordance with the National Electrical Code and the detail of the installation,as set forth below,was 5
found to be in compliance therewith on the 30th Day of October,2001.
Name QTY Rate Rating Circuit Type
Service Crj,
1 Phase 3W Service Rating 100 Amperes EU
Service Disconnect: 1 100 cb 5
5 Meters: 1 5
5 5
5 5
5
5
5
5 5
5
5
5 5
seal 5
l of 1
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.
5 5
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