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2001-858
Il ,�� iiitw TOWN OF QUEENSBURY 742 Bay Road, Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20010858 Date Issued: Wednesday, January 09, 2002 This is to certify that work requested to be done as shown by Permit Number P20010858 has been completed. Tax Map Number: 523400-309-005-0001-001-000-0000 Location: 158 LUZERNE Rd Owner: D&G MANAGEMENT LLC Applicant: HERM N SEXTON This structure may be occupied as a: By Order of Town Board Mobile Home In Park TOWN OF QUEENSBURY (DJ 4 .f \ Director of Building&Code Enforcement � ` TOWN OF QUEENSBURY f�/ 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20010858 Application Number: A20010858 Tax Map No: 523400-309-005-0001-001-000-0000 Permission is hereby granted to: HERMAN SEXTON 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 3,500.00 PO BOX 224 Total Value 3,500.00 GLENS FALLS,NY 12801 Contractor or Builder's Name/ Address Electrical Inspection Agency Plans &Specifications 2001-858 HERMAN SEXTON 44 PINE CONE DRIVE 1985 MOBILE HOME 14 X 70 AS PER APPLICATION $60.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Tuesday,November 26;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 expiration date.) Dated at the own Qu slOry; i 1 `. —November 26,2001 SIGNED BY V \ for the Town of Queensbury. Director of Building&Code Enforcement Application for Permit— Mobile Home Town of Queensbury, 742 Bay Roan 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 Office Use Name: ;- (3 fLF(,A File Permit No.p )O )----EL52 Address: \flt© Fee Paid 5• oO Reviewed By: Phone No. — 3 ( I • EIVE® Property Owner Information Parcel Information NOV 1 S 2001 Proposed Date of Placement: TOWN OF QUEENSBURY Name: (nr S KoQ ti— Aft(� BUILDING AND CODE Property Location: c'q rJ S Co f Address: Road,Street,Avenue Name of Mobile Home Park: 70v2- - i,,,,,,,p c (if applicable) //,, l Phone No. �� 'f q'Z S8 3 Tax Map Number3O / ds / ) J Mobile Home Information Zoning Information Approximate Value of Home: S 3 5-Do Zoning Classification: ligla4— New Home: Yes (° Size of Property: ft.by _ ft. Replacement Home: Yes No , Existing buildings: �Siz ofMobile Home: t LE ft. by 70 ft. Setbacks: front yard ft. ; rear yard ft. Singlewide: Doublewide: Side yards ft.and ft. Number of Rooms: (exclude baths) q Number of Bedrooms: 'Z Accessory Building(s): circle Number of Bathrooms: v 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 SIZE&DEPTH Water Supply: well or municipal Piers x Runners 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: Address: Phone No. Complete information below found on a"plate"or"sticker"which is affixed to the mobile home. 1. Insignia serial number: a)1L7 /9 7 ' y/) 2. Name of manufacturer: fif\Qe,lam '' 3. Plan Approval Number: 4. Model or Component Designation: (New Home ONLY 5. Date of Manufacture: `�?l?,/erAFFIDAVITl 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 Fnforcement Officer FINAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury /10 Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: VD'. DEPART: Obi, IN • G 6 DATE INSPECTION REQUEST RECEIVE, NAME: F) Rn LOCATION: 11 DATE: _ J V. PERMIT # /-10_ 2_5g MOBILE HOME !A (RLL DULAI( HOME FOOTINGS 1/OUNDATION _ FRAMING N/A . YES NO 1. foundation support, ier spac. g per manuf. _ 2. anchoring per manufl 3. water line shut off 4. sewer line support @ 4 feet/ ,/ _. 5. heating crossover (db ewi S off grd. 6. dryer vented outsi — _ 7. skirting ventilated 8. hot water relief valve piping outside _ ,1 9. deck porches teps, ailing ter o r' 10. furnace of wa pe tin g 11. garage fire proofing �!/ — 12. door closers J — 13. plumbing fixture 14. foundation insulation (if a 1.) _ f 15. smoke detectors 16. final electrical / 17. variance required •< 18. data plate okay 19. mobile HUD seal okay Model # ;% r Serial # Qi o 1c Manufacturer M v�r® • \ y Date of Manufacturer VD -tY OKAY TO ISSUE CIO YES /NO • Comments: Ltdopia,% =V_� D b i-vt- )r c, COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.7 Main Office 176 Doe Run Road-Manheim,PA 17545 � MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL Cr Permit No. Cert. hi 0 73544 Cut-in Card No. Owner ec rD Location LP/ / F Ale- afl Ale- Die• • cozzo Installation Consisting of....1400 r Le- l7 C 3 e72- e°C '/l/da71a„ a Installed By J ��� Lic.No. The conditions following governed the issuance of this certificate,and any certificate previously issued is 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 making i ctions at any time, and if its rules are /violated,the Company shall have the right to ev ke th ,p at�j Date. I- 'I'2 INSPECTOR '_�j(//� AO Member N.F.P.A..1.A.E.I. FINAL INSPECTION REPORT • MOBILE / MODULAR Town of Queensbury /�%J Building & Code Enforcement • U� ,4 ) 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: DEPART: I INSP:3 DATE INSPECTION REQUEST RECEIVED: NAME: 6\(-< P JY), 2,. ! v fF. LOCATION: 4/1 L/LlAS—, i DATE: I _D PERMIT#`� I c MOBILE HOME MODULAR HOME FOOTINGS _ FOUNDATION _ BACKFILL FRAMING N/A YES NO 1. foundation support, pier spacing Per manuf. _ _ • 2. anchoring per manuf. _ 3. water line shut off 4. sewer line support 0 4 feet 5. heating cros ver (d. ewi': off grd. 6. dryer vented outsi. 7. skirting ventilated _ 8. hot water relief valve pip g outside 9. deck, porches, steps, raili 10. furnace/hot water operatin! 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 # 9 Lis C,9 ( 5 Serial # L 1A C- l47 i Manufacturer V �\`l� A C �5 Date of Manufacturer I(2 11 10/ OKAY \ r` YES NO Comments: y�r�'!'4-44.. V & ( v 1 � ` ^ n iC • ) 9 • (no ► e c "r :)_,e„ , .5e . ., ...,.., RE„E., %-• vEo_d- .,._ 2001 Tow,,), - • kr,• 1---------LY . n 3.AQ-.3 i P ' , 4=‘.----- . r---- 4-': NOTICE AN -:ORING1F-MOBILE HOME FR ME IS REQUIRED-PER— • _.,..., :' MANUF'CTURERS SPECIFICATIONS • Li- o A FILE C7( , --- 1 . k-----7. 'OF QUEENSBURY BUILDING DEPARTMENT • BUIL - 0 DE t SDERTer - Based on our limited examination, . I4-1'}+\‘-153LVVNia: QUE NSBURY , M-4 .j . rdpianceuith our comments shall not be construed as indicating the ---- --)-P -,JAVIEWED P g.:-..r.—.Z.-- —m—,compliance ,„ 4 - plans-and-specificatims are Mull ‘ DATE /I/ i 0-00 (I i with the coile. 4 ''.I-- -r----------- --...„........„...,.... i1 II 11 } . _ .. .. . . 1. _. .. I.. • • , 1..,... . _ III III . .., _ . . .. . . .. ilimiim•illiom al ii ____ . . • .• .. . . . . . ..,,, .• •. .•. . .• .,,g•• . . . . . .,. (71- W .• q..,. . . . •• 0-- I ' -- . • .. \ c..44 , • • "rt. '" • I • . ••. ..... • ! _.-1 ,.., ),'''... • . . I . 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