1999-221 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
June 18 99
Date 19
This is to certify that work requested to be done as shown by Permit No. 99221
has been completed.
MOBILE HOME
• This structure may be occupied as a
LOT 37 HOMESTEAD VILLAGE
Location •
Owner CUBBERLY, ' DOLORES
TAX MAP NO. 93 . -2-11 . 1 By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. do Code Enforcement
:BUILDING PERMIT
TOWN OF . QUEENSBURY .99221
VALUE- $. 22000... . ...';. . . .. . No.
TAX MAP NO. 93 . -2-11 . 1 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to CUBBERLY, DOLORES
OWNER of property located at LOT 37 HOMESTEAD VILLAGE Street, Road or Ave.
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 Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
LOT 37 HOMESTEAD VILLAGE
QUEENSBURY, NY 12804
2. CONTRACTOR or BUILDERS Name
SHO MOBILE HOME BROKERS
3. CONTRACTOR or BUILDERS Address
USED MOBILE HOMES. 3048 ROUTE 50
SARATOGA SPRINGS, NY 12866
4. ARCHITECTS Name •
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
MOBILE HOME
( I Wood Frame ( )Masonry ( )Steel ( I
7. PLANS end Specifications
No.
8. Proposed Use
MOBILE HOME
May 12 2001
$ 41 PERMIT FEE PAID —THIS PERMIT EXPIRES 19
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.)
12 May 1999
Dated at the Town of Queensbury this Day of 19
SIGNED BY for the Town of Queensbury
Building and Zoning Inspector
r1-61-\tAt
f . • TOWN OF Q(J1.;1_NSI3 (_IIZY
REVIEWED BY: IL,/
OD
FEE PAID:
PERMIT NO.
APPLICATION FOR PERMIT •
MOBILE HOME OR MODULAR
A BUILDING PERMIT MUST BE Oil I A I NED BEFORE PLACEM[N r or MOBILE HOME.
NO INSPECTIONS WILL BE MADE UNT I I. A VALID BUILDING I'EIUrI I T HAS BEEN ISSUED.
The owner of this property is: -Qm -�. ,- /e1c4po3
P.O. Address: a9 Y 0)— ( Pism(1 f ('hone Number it,- 2 - "6 in.)
Property Location k ¶) JjDr .&P\J1i4_qc-c.4.. Tax Map No. 9 /.
NAME OF APPLICANT: * YeS c_L2 .,. Pam)( _"
Address of Applicant: 3 j,) YSj' (cl ,� S i7
All applicants _spaces on this application MUST be completed and Lhe
signature of the applicant MUST appear on the reverse side of this applicati
on.
EIVED
PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES:
MAY 0 7 1999
TOWN OF QUEENSBURY
/06 BUILDING AND CODE
MOBILE (TOME_ INFORMATION AI'I'IZUXIMAIE VALUE OF (TOME: $ /
New Home Yes Ion ZONING INFORMATION:
Replacement Home Yes No Size of Property: �cft x 00 ft
C� n
Size of mobile home J1 fix 1111 Existing Buildings: 'YID-A,-
' .Singlewide )( Doublewide - —'
Proposed building-disLance from property line:
No. of rooms (exclude baths) Front Yard 0 ft Rear Yard 2.../ ft.
Side Yards 947 ft and aLi ft.
No. bedrooms
Occupancy Informat
No. of bathrooms y ic
Primary dwelling Yes No
Fireplace -----Woodstove Accessory Building(s) :
Detached garage (one car /two car car)
Foundation style and size: Attached garage (one car /two car car)
A-2' Storage building
Piers-No. of Jsizeui x ft -Other
Depth below grade ` ft * * * * * * * * * A * * * * * * *
Foundation-Footing size )' " x '2,'." Proposed date of placement: S/
Wall materia` _415 7
Wall thickness " Height " Water Supply: -Wel1 Ounicipai-
Total depth below grade ft. Septic permit required?
Grade to home floor level ft.
FURTHER INFORMATION REQUESTED ON TIIE REVERSE SIDE OF THIS SHEET
dyNA1.11: or INSTALLER/MOB iI.I: NOME IlI:Al.I:It: 573-5T7 —(07
nIlI1R1:SS/I'IlOtlf NIR1lll:ltSty -
e-)Y (24--
S IA I I. Or NEW YOIIK DIVISION OF Illltlti I rU, AND COIIrIUN I I Y UI (II tlA1. `-
I NS I GII IA (IF AI'r'ROVA1. (IF THE SI A I E I111 I I.I)I NG CODE
1 . insignia serial number ��� } �� ✓� -Iv
2. Name of Manufacturer :. ,.. . .
3. flan Approval Number A! T i�' .�-
4. Model or Component Des IllnaI. Ion
5. Da Le of Manufacture -L� 9 ''9. 7.s -
All the alcove Information Is to be found on at Irlalc or sticker whIch
should be affixed Lo the Mobile Nome . Complete above wIIh IhaI. Information.
•
Torun of gneensbur•y Stale of New York
County of Warren
AI'I'II)AVII •
I swear I.haI. to the hesI. or my knowledge and bet lef the sl.atemenl.s con LaIlied
in LIiIs ai►1►I IcaLlorr, tocle[lier• wl I It I he 1►lans and slier. i f Ica [ I slll►ml Ll.ed ,
are a trim and comb 1 e Le s La Lemen t. o f it I I 1►rol►osc!tl took to I►ct done on I he
described I►remIses and ha I. a I I Irrovlslons oI the ItliII Ill N CODE , the /ON1tll;
01(1)I11AIICF , and all other !MIS Ircr•Litlnlntl to the I►rnl►oWd work shitll l►t' t'onil►IIeil
wll.lt, whether spec Ifled or not , and ha I. such work I ; auINor Izetl Ivthe owner.
S I clan Lure _ C ' - —
(h•mr.r• , o►•►n 'r s agent, architect ,
contractor /
SI'ECIAI_ CONDITIONS or I'I:RMII':
•
Hy
- ---
emtle (Tutor% .nleii 1. Ol f f rer
DECLARATION: Please sign below oiler you have carefully read the slnleinenl.
'I'u the best ol. my knowledge the statements contained in this application, together with the plans
• and specifications submitted, arc a true and complete statement ol. all proposed work to be done on
the described premises and that all Lnovisions of the Ituild!_I.P _c_t►dc, the l.crniill'_Oidina c_e and all
oilier laws pertaining to the proposed work shall he complied with, whether 5lrc•eilicd or noted, and
that such work is authorized by the owner. I'm Ihcr, it is understood That I/we shall submit prior to
Certificate of Occupancy or C'crlilicate of Compliance haunt; issued, an AS IIUII;I' PI..O'I' PLAN by
a licensed surveyor; drawn to scale, showing actual location of project on premises.
Signature: _ _
(owner, owner's agent, archilect, contractor)
MemberfJ.F.P.A.&I.A. Electrical Ce/ tificate
•
ATLANTIC - INLAND, -INC. - NEW Y®RK
Electrical and Fire Inspection-Enforcing&Consulting Service
997 McLean Road,Cortland;NY 13045 DATE: 07/07/ 999 CERTIFICATE NO.: C- 229504
4
OWNER: Dolores Ca�Sbf�i^` AS APPROVED FOR:
Homestead Village Lutt37 Mobile Home:
ADDRESS:C!ueensbury, NY
laiDfluip feeder o ilyXXXX
92,d
k=. /
..
,,,. .. This certificate applies only to the electrical wiring and equipment listed above on the noted date.
' warranty is expressed or implied on this visual inspection.This certificate shall be valid for a period
ELECTRICIAN: Joseph Del ski- _, _: 3'', one year from the above noted date.Should the electrical system be altered in any way including,but
Rd. ,',, limited to the introduction of additional electrical equipment this certificate shall become void.
S` Parkhurst-`��. �'�"I >, , , addition,this certificate applies only to the occupancy use and ownership as indicated herein.I
ADDRESS: ri"ASisE'�,t?o to t \ (�•_TEI3 1 ' � _ change in the use, occupancy or ownership of the property indicated above the certificate st
ram_ t��' ` Immediately become void.If for any reason this certificate becomes invalid due to the above mentior
/� �c nd'lions,a •re-inspection by New York •Atlantic-Inland, •Inc.is •necessary to validate •the installation.
f\,...,^,
AI-27
tri
FINAL INSPECTION REPORT
MOBILE / MODULAR
Town of Queensbury
Building & Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256
ARRIVE: DEPART. , INSP:cQ1r
DATE INSPECTION REQUEST RECEIVED: 4' / 7 11
i
NAME: / rrw� re •- r
LOCATION: "J , 1nv , , I' > ' e, //C
DATE: ice'- I ERMIT# ("l j. : f
MOBILE HOME MODULAR HOME
FOOTINGS FOUNDATION _ :A LL_ FRAMING
N/A , YES NO
1.`'foundation support,pier s cing
per manuf. — —
2. anchoring per manuf. — — —
3. water line shut off — —
4. sewer line support ® feet
5. heating crossover (d ewide) off grd. — — —
6. dryer vented outsid — — —.
7. skirting ventilated — —
8. hot water relief va a piping outside — —/ —
e: deck, porches, steps, railing _ / —
furnace/hot water operating — —
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 # Serial #
Manufacturer
Date of Manufacturer
OKAY TO ISSUE C/O YES NO
Comments: ALA ( iz RAT l O-S
Pg61)totb tD� P
FINAL INSPECTION I tElr;Poa rr�
MOBILE / MODULAR
Town of Queensbury a/-* (
Building & Code Enforcement ,S4 e wk.,
742 Bay Road be e.-C.-
Queensbury, NY 12804
•
(518) 761-8256
ARRIVE: DEPART:1 INSP:
DATE INSPECTION REQUEST RECEIVED: / /4 I
NAME: �d 1 U J`eS LA._ b€-(
LOCATION: d---ar 37 LJ M JC to ke-'-fiA41}
DATE: 6,11- L 3 PERMIT# 49-- dca J
MODIILE HOME MODULAR HOME
FOOTINGS _ FOUNDATION _ BACKFILL_ FRAMING
N/A YES NO
1. foundation support, pie spac'\g
per manuf. , — —
2. anchoring per imanuf. V
—
! 3. water line shut,off\ iv
4. sewer line support 6., feet 1 —5. heating crossover (dbl 'de) o grd.
6. dryer vented outside — —
7.• skirting ventilated — �—
8. hot water relief valve iping outside /'
9. deck, potches, steps, ling — — �/
10. furnace/hot water oper ting —
11. garage fire proofing / — —
12. door closers V —
13. plumbing fixture / .T —
14, foundation insulation (f appl.) —
15. smoke detectors ... .,/.. . _
16. final electrical C?.1....f.1.1.. L` —
17. variance required
18. data plate okay — f —
19. mobile HUD seal okay — ✓ —
Model # 3F P-9( r 79. Serial# A F% o t8 3 4
Manufacturer ASTRC)
Date of Manufacturer � 17-4' C?5-
OKAY TO ISSUETCTO YES ' v'' NO
Comments: Co‘,,,,,PL6-`r- R Mc..._ F EkR, fog c-A
-,04jI FokiU. Ge- i ' 6 Tr'if —
:
•
0 4 cDkc>il- r t y c
cc, die l(I
FINAL INSPECTION REPORT
MOBILE / MODULAR
Town of Queensbury
Building &Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256
ARRIVE: DEPART:6 INSP:
DATE INSPECTION REQUEST RECEIVED:
NAME:
LOCATION: s vyik ! / `��'
Qtec
DATE: !9 PERMIT#
MOBILE HOME MODULAR HOME
FOOTINGS FOUNDATION _ BACKFILL FRAMING
N/A . YES NO
1. foundation support, pier spacing
per uf. — — —
2. anchoring per manuf. —— —
3. water line hut off
4. sewer line upport (i, 4 f••t
5. heating cros•over i blewi.e) off grd.
6. dryer vented •utsibe
7. skirting ventil.ted _
8. hot water relie valve pip g outside
9. deck, porches, s ps, rai g
10. furnace/hot wate lopera mg — — —
11. garage fire proo h g
12. door closers
13. plumbing fixture
14. foundation insul.tion (if appl.)
15. smoke detectors
16. final electrical ., _ y-
17. variance required
18. data plate okay _
19. mobile HUD seal okay
Model # E11 `3 Serial # O(8$
Manufacturer AS l`�O
Date of Manufacturer Ck '26 1
OKAY TO ISSUE CIO YES /NO
Comments: \C 1`"i bl Nan...Q___
cc - ,I
- OK
r3
/ •
RECEIVED
_--------A � ----- - MAY 0 7 1999----
_ TOWN OF QUEENSBURY
_ -- BUILDING&ND GOOF
_ _ _ _ _ Ing
TOWN N OF QUEENSBURY BUILDING DEPARTMEP
- - ----Based-on-our limited-examination,
cA compliance with our comments shall
-----..- . -- _._-- --_---------------_---- !y not-be construed as indicating the
plans and specifications are in full
— -- compliance with the code.
TOWN OF QUEENSBURY •
BUILDING & G : D T. NOTICE
BY ANCHORING OF MOBILE HOME
REVIEWED !.. _ FRAME IS REQUIRED PER
DATE•- J- _. �._ MANUFACTURERS SPECIFICATIONS
/ H .
2v L.P-�► =. k 15 L?fttZ-‘C�e. 4. - 1..di -4
/ - - .
-aa . . .
RECEIVE _
MAY 0 7 1999 . -
2�_ - TOWN OF EENSBURY _-- -
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