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2000-303 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518)761.8256 CERTIFICATE OF OCCUPANCY Permit Number: 2000303 Date Issued: Friday,September 15, 2000 This is to certify that work requested to be done as shown by Permit Number 2000303 has been completed, N10�,SLE HOME Tax Map Number: 523400-093-000-0002-011.001-0000 Location: LUZERNE Rd Owner: HOMESTEAD VILLAGE L.P. By Order of Town Board TOWN OF QUEENSBURY Director of Building&Code Enforcement Application 1for Permit- Mobile Home - � Town of Queensbury, 742 Bay Road, Queensbury, NY 12804 (518) 761-8256 A building permit must be obtained before placement of mobile home.do•'parcel. No inspections will be made until a valid building permit has`been issued. ,.; Applicant Information (( i `Office Use Name: 8 bile, File Permit No.��k��!�� Address: � Ff� Jagg, P_ Fee Paid 3 Reviewed By: ! .............----__.........-------_.....-- Phone No. �.����b �7� t • - •- RECEIVED e> 4, Property Owner Information i Parcel lr formation MAY 11 7000 � � Proposed Date of Placement: OF{ UE[=p4SBU.9y Name: ____ -,,,_,.�..,, U It�9G,�.rtl� CU,C3 Property Location:� o C [-- Address: s Avenue Name of Mobile Home Park: 0 IAI Cifapplicable) / Phone No. Tax Map Number. t I / �t• r .Mobile Home Information / Zoninglnformalion Approximate Value of Home:$ Zoning Classification:�J[4 �L���--, L�`tit New Home: Yes 6 Size of Property: ft.by ft. Replacement Home: Yes No Existing buildings: Size of Mobile Home: -2—�ft. by Wft. Setbacks: front yard ft.; rear yard ft. Singlewide: Doublewide: Side yards $_and ft. Number of Rooms: (exclude baths) J— Number of Bedrooms: .3 Accessory Building(s): circle Number of Bathrooms: Detached garage: 1 tar; 2 car, car circle: Gas Fireplace or Woodstove Attached garage: 1 car; 2 car, car Storage building: Yes No Foundation Support: Other: TYPE _ FPTTI Piers Water Supply. circle Runners Slab well; municipal Further information requested on the reverse side of this sheet (( Name of Installer or Mobile Home Dealer: 1g N tS M 0 1 Address: S0 OiC .S.�C b ! � - a 3 t Phone No. _ �� !.9(� �?.t6 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"•which should b&affixed to the, mobile home. 1. Insignia serial number: -( 2_ Name of manufacturer: / ► ice' O ` 3. Plan Approval Number : 4. Model or Component Designation: (New.Home ONLY) 5. Date of Manufacture: AFFIDAVIT � Town of Queensbiny 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 suchwork is ` authorized by the owner. Signature: owner,owner's agent,architect,contractor Special Conditions of Permit By. Form_ 11/18/1999sh Code Enforcement Officer 1 Member AF,P.A,&IAEI ATLANTIC , IN, INCI o NR 10K Ekctn,of Cutt tcate • Eleclrical and Fire Impactiool-En(orcing I Consolling SeNico 991 Mclean Road;Mud,NY fi304 ���I Y 22959 DATE: CERT FICATE NO.' 1CIA F, Ilobile , OWNER: �' AS APPROVED FOR: .� W4167I ADDRESS: NAP folip �,fir,,e- f�eder q�I�M , , 1 JU • #1 1,4 1`I 1 t G W p 1 1 11 1 ,f 1 This mllllc to app ies only to the olcctrid Oiq and o�uipmout listed 3W ou the noted date. WO is explm d of lmplW op this visual luspdioul Is certificate shall be ua itl for a p loi ELECTRICIAN; O415h, t , . {' o rtr u datolShouldthealootcicaisstcu�bcaltcrotlivau wa iuciutliu ,but �.��� y y y 9 ,`"�yI}y, Pat, �}py��s��, pdl,; �}� �`"��l+'vy�'�� " o h �u d ' of atltlitioual oicctcicai o ulpmoot this certificate sha become void 1,11,1 f, fit l, flio ,t 1 leaf phos only to tho occupancy usa sod owo�r#as l did d horoiol ADDRESS. , , Nltte,� I au u osc, oc aucy or owucrship of the pcoperty iud ul d above the certificates' t � 1 1 i t 1 1 1 i to ccome uoi ,If for auy cossou this c�rtiticatc hccomcs lmH due to the above m do coufllous,a NcW York Atlaut c iula d,In.is u � AI-F 11 1 IF=A"ASLL- R%A4=MBL-l=- loor -l%AC=311=LJK-AoMLFq - -Irc)wn- of C)ueo nabury Eauilclino Ek C:,cxliB Enforcement 742 E3c,-xy F:tc:>c-tcl C Cluoienat.>ury, NNO' 12804 '(518) 761-8256 =Z0 I aw-cz Ro I- ccmui&�ti ]a -STIPP.-o-rt. pier -spacing perrKlmalar- ------------------ ------ pf-3 rrutrIXIT- --------------- su Ir\ 4. r-t Ca" 4 fit ....... :5- off grcl. 6- dryer -Vrqajate'a L-C --------- ---- -- - - -- N/r slcirtnm�g -Volalt ------------ --------- lhc)pt waterwaterpiping <311tsich-- as- St 10. furn�aot--Ahvot water r x�a.ting ........ --- -------- �*---------- fi-.7ctxlry- - - - - -- ------ -- ---- 14. isisiiIat6ar (if �appl-)'�� ... . 'T slxxc>ke-- cle-ta< tcurs ------- ------- electrical -------------------- ---- 17_ -Var-jallot_- required -- ------------------- Pil.-,Ltf-- cdc-ay ---------- - ------------- --------- ----- # LVlannfacturer ]>atc-- of 1V4ajmxxfac:ture-r -rawn cif Qu4a nsbuiry Building 8L Chia -Enforcement 742 Bay Road : = G'.Iu+ansbury, WY 12804 (518) _761-8256 ARRIVE: L3EPART-_`�— ` INSP! I�A'2-E IN'SPE?CTI4N REQLTI�ST R�CEIVE.L'>: - - LOCATION- YJel � . 2ai®lE��L� Yi��1bSEY- F4 CXrJT,FGS FC3XJr4I3ATI4C>1'4 BAC`KFILL FRA�1rfING - ;% - - N/A YES �,,,,r-Nt:J► 1_ fotanda.tion su r`t,. pier spacing per rnanuf. --- --- ---------------- �_ - 3. water line shut off ------------------ 4. sewer stapport Cam? 4 feet -----•- 5_ heating crossover (c11.$slewide) .ofF grd= _� 6_ dryer vented outside" -_._..____ ---- ?_ skirting ventilated ... `- _______ _______ - �f 8_ hot water relief valve piping outside 9. deck, porchE;s, steps, ralirlg .. .... +✓ 10. fiarnace/U4at I.vae tr oe pratin-N=g .... 1 1_ garage fire proofing --- - -_�� -� 12_ door cicisers -- - -- -------- ---- .-�--- �/ 13- pltznibirig fixture _ _ _ _ _ ________�1 _.. 14. foundation insuia.ticm a. (if appl 15_ sxnolce Clg_tec:tors -_ ........... _. .. 16. final electrical _-_- -_--- . -- _• - 17_ variance required -------__ �. - .-- - 18- data plate olcaY ---_--- -- - ---------- i 19. rnoblle HiJiDk seal CACay -.---_._--.. 3 Model # f Seraal N. -7--74- I1�aa�tafacturer� ���� �- I3atc.. of Niaraufacttarer ©SAY TO IS UIE C/C3 -YES. �"�► vt..it_.i� t�C s - �. . lids®03 011.1E / !'A!O I=- l..M!_A42tL FM - -Town- 61 Cause nsbury Building 8c C `aacs nfcwc�amsnt 742- 18c1y Rcoad Quee�rtsbury,_ ,N")r -=1280.4 - (518)- 76 1-8258 j ARRIVE: DEPART:"' INSP= - --�'" DATE INSFEGTION REQUEST I2EGEIVED_ -- F'LRMIT- # 'G M��EY.E H�1lE FC3C.XI'ING s FC:?L,7NI�A�'I BACKFIL.L FI2..AIi�iING N/A YES' - 1 F _ foundaticin su rt, iesr pa+ci" pPQ ....... . .... .... - 3_ water lime_51iut c3ff ------ - - -.-- --- - 4. sewer line sugprt- 5_ heating crc3ssovei- (dblewid � cr1F-grd. 6- di-Yei veratd outsides --'=---- --_--------- 7- -- - -------- -------- s- hAat water relief valve pipin outside 9. deck., porches, steps, railirxg ---.--- 1Q_ fjxrjaace/hot water ciperatirig ------- 11_ garage fire proofing ----_------- --- - - i2_ doc3x- closers _--- - -_ ---- - -- -- - - -- --- 13_ plua�rzbing fixture ......... .. . .. . .... .... 14_ foundation irisulaticin- -Of appl 15. srraolte detectors __ _--- .__ __--- ---. 1.tS- final electrical ------------------- ._ 1`?, variance rec}ui-rc;d --- --------------- . is- data -plate olcaY - -- -------------- --- --- ` 19- mc3biie HUI� seal c�Icay ------- ---- Mc3de1 # Seri l ## E M facturer Date of ariufactur+ r' i OKAY. TC3 ISSUE G/O YES NO �L- A R FIa � 0 . �F TOWN 0F,QUE BUILDING REVIEWED 81 DATE, 17, A*'CEIVED MAY TOWN OF QUI EN BURY BUILDING AND CODE . MOBILE��E -• FRAME iS REQ�IIRE MANUFAGTl1RERS SPECIFICATIONS s j yq' Min A. rrr-r-rr•-Frr-rr� . . = rr—_err rr rn - Y : rrr -rr 'v rrr=X:7 rr x 8 m r- -i'ri rr N -rrn—fir I ODhy z- N s' .i'axu'MC.•.+..:...Rw:w .5' ':. .�..�.. '�,, a' '.,•.>'r+..:wa.: .. .J..,.,. ..en. r..+