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2000-304 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 _ Community Development-Building&Codes (518)761-8256 CERTIFICATE OF :OCCUPANCY CIO Number: 0000304 Ct0 Date: Tuesday, August 22, 2000 Application Number:,1000304. Permit Number: 1000304 This is to certify that work requested to be done as shown by Permit Number 2000304 has been completed. 3r This structure maybe occupied as a -`Mobi-le -Home Tax Map Number: 523400-093-000-0002-01'1-001-0000 Location: LUZERNE Rd Owner: HOMESTEAD VILLAGE L.P. Joyce Sherman Lot 151 By Order of Town Board TOWN OF QUEENSBURY Director of Building&Code Enforcement BUILDING PERMIT Town of Queensbury, 742 Bay Road, Queensbury,NY 12804 County of Warren (518)761-8256 VALUE $ 36000 Building Permit No. 2000304 TAx MAP NO. 93 . -2-11 . 1 GLENS FALLS MOBILE HOME Permission is hereby granted to Owner of property located at LOT 151 HOMESTEAD VILLAGE in the Town of Queensbury,to construct or place a MOBILE HOME at the above location in accordance to 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. Owner's Address: 39 SARATOGA ROAD .GANSEVOORT, NY 12831 Contractor or Builder's Name: GLENS FALLS MOBILE HOME INC. Contractor or Builder's Address: 39 SARATOGA RD GANSEVOORT, NY 12831 Electrical Inspection Agency: NEW YORK BOARD NEW YORK BOARD OF FIRE UNDERWRITERS Type of Construction: MOBILE HOME Plans and Specifications: 1056 SSQ FT MOBILE HOME AS. PER PLOT PLAN SPECIFICATIONS Proposed Use: MOBILE HOME 35. . .May 17 2002 $ PERMIT FEE PAID—THIS PERMIT ENPIRES (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.) - - 17 May 2000 Dated at the Town of Queensbury this -' - Day of SIGNED BY "I W,— umfzln, for the Town of Queensbury Code Enforcement Officer Application for Permit— Mobile Home Town of Queensbury, 742 Bay Roam Queensbriry, .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 v} Office Ise Name , /,�/$ / � File Permit No 4Cj 3 (3 � _ � �� �,9 p,cEa/4� Fee Paid Address: , nSec �© ( • l � I Reviewed By: REC ,..,. -m Phone No o? a3 SAY 11 2000 OA � Parcel lnfarrnatior�Q WN OF GU�ErvS�,, Property Owner Information _ t�IL®ING AN®Cool Proposed.`Date of Placement: �y Name: c Property Location: d4 O-T— �3 ! Address: R street,Avenue Name of Mobile Home Park: C.f aPPlicable) Phone No. Tax Map Number: / �2_ / J1 Mobile Home Information /0 Zoninglnformation Approximate Value of Home:$ �"� Zoning Classification: New Home: Yes No Size of Property ft.by ft. Replacement Home: Yes No Existing buildings: Size of Mobile Home: dq ft. by q_ft. Setbacks: front yard IL, rear yard ft: Singlewide: Doublewide: Side yards ft.and ft. Number of Rooms:(exclud baths) Number of Bedrooms: Accessory Building(s): circle Number of Bathrooms: Detached garage: 1 car, 2 car, car circle: Gas Fireplace or Woodstove Attached garage: 1 car; 2 car, car Storage building: Yes No Foundation Support: Other. TYPE A SIZE FF Water Supply. circle Piers Runners Slab well ; municipal Further'information requested on the reverse side of this sheet Name of Installer or Mobile Home Dealer: /OR�tS /�St1 �6 t�e S Address: r9- Phone No. State of New York Division of Housing&Community Renewal Insignia of Approval of the State Building Code Complete information below found on a"plate'or"sticker"wl%ich should be affixed to the mobile home. 1. Insignia serial number �3X 2. Name,of manufacturer: o�t ae r i— 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 j 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: 11/18/1999sh Code Enf &cement Officer I f ' Efut G ,nn nn , ,i G np ' EEC 1 INIMI), INC, l SEW 10111( Eleclricalend Fire Inspeclion•Enforcing&Consulling SeNica M McLeao Road,Codand,NY 130 , E x DATE, CERTIFICATE NO. IR liobili i Ada # . AS APPROVED FOR. OWNER. w ' ,� � ,fit 131 ..., IDES, MAP feeder odi , t A J ,Ir t 4 f r t , f . , This certificate a lies ool to tha Ifical wifiq and goipmaol lisled above oo the Doted date, w ally i n is uisoal iospaclioo,leis certificate steal he valid for a p l�l ELECTRICIAN. Joseph " � �' "��� � " " y ��. ar m a e d hoold tha cloctr�cal�stam ba altered io aoy way klodiog,M rat t , united the i o of a iliooal claclrioal a of moot this certificate sha komo void �, t nifi to applias ly to the occ�paocy osa and owoershlp as iodicated h2rem, ADDRESS; ��_ j" 1 , H co aoc oc o�+ioal of Iha co a iodicalad above the aflilicale s "N"r�j , , m p Y P p p tY " immedialc y become uoid,if foc soy caasoo It aflk to hacomas lmlid doe to the abn m0io 1.4 conditions a reins cctioo h haw Yock Atiaotic�lolaod loc,is dacassa''(�{{�,to ualidatc the ioslal alion, Y ^L� I " ��;f P Y s AI-F r-=f11%AAA%LL_ I"EBB=ECTIG7N R>EPOFRT Town- caf Ouscnsbury Building Ek Cods -Enfcarcern8nt 742 Spy Road C)uo nsbury, NY 12804 (5l 8) 761-8256 AI2RiVE - L7EF'ART; DATE INSPECTION REQUEST RECEIVED= NAME: ` LOCATIC?l�i� � � - - � •� A+i�l�l[I..� 1�4ME AS4l�,?LTL.A:� l�It5��1�lL FOOrTZNGS FOB TNI� BACI�FILL FRAR/f I1�FG- 1_ foundation suppo . pier spec" - permanuf_ .. . - ...__....._ ... 2_ a-vl<—r-las per inane ------------ _ 3_ water lisle shut off --- ----- -------- /v 4-_ sewer lixze support feet --_- ._. / 5. laeatixsg crcpsscaver (dole 6_ dryer vexited Cxutsidt--" ..-a-- ------------ 7_ skiFtirng ventilated - ------- -_ - -- 8. l-iot relief valve. pipin c>utside 9_ deck, pcarches, Steps, railing f urT ace/hot water operating 1 l_ gara.gc. fir,(-- prcxafirlg --------- ----- 12_ door cicisers _... ..__ . ................. 13_ plurribixig fixture ----- ---- ------ ------ 14_ Rnm da.ticm insulation (if a.ppl_). .. .. 15- srlauR6 de.tectc►rs --------------------- 16_ final electrical ------ -------- -------- 17- variance required ------------------ - 18. data plate calcay ...:. . ... .. ............ "r 19_ mobile HiJD seal c3kay ___�_-_—__--__-_- N.1c ld l M.maufac turer I3atc. c7f manufacturer � C7►KAY TO YES. E..orru�ents- - TOWN OF QUEEN§BURY TOWN OF QUEENSBURY Bilit.LiNG DEPARTMENT 81,11LDING & Based on our limited examination, Er compliancewith our comments shall — REVIEWED BY not be construed as indicating the plans and specifrca#ions are in full DATE f compliance Mh the coc)e. C7 ? � NOTICE CIV ELJ ANCHORING OF MOBILE HOME MAY 11 2000 FRAME 1S REQUIRED PER t: W.v OF:QUEENSSURY UEACTURERS SPECIFICATIONS BDII__DINQ ANp_ FILE COPY GLENS FALLS M &M HOMES,tNt 39 SARATOGA RD GANSEVaaRT, NY 12831 c (BIB)798.2801 M •, 'G.WG � �G G?YL �� � A Y Q S wx NI 71 •�s�z� AN `1Haoll�SNd9 . ` Q�dJald�d5 6E c �'`" '�N1`53WOH W'8 W S11��SN31J'