1999-634 Certificate of Occupancy
Town of Queensbury
Warren County, New York
, . Date January 12 , 2000
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99634
This is to certify that work requested to be done as shown by Permit No.
has been completed.
This structure may be occupied as a MOBILE HOME
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Location LOT 23 HOMESTEAD VILLAGE
Owner
TAX MAP NO 93 . -2-11 1 By Order Town Board
TOrW1: acQUEENSB Y
Director of Building& Code Enforcement
-.1403ti6b114..9=a11110VSSIMso
BUILDING PERMIT
Town of Queensbury, 742 Bay Road, Queensbury,NY 12804
County of Warren (518) 761-8256
VALUE $ 21000 Building Permit No. 99634
TAX MAP NO. 93 . -2-11 . 1
Pernussion is hereby granted to ROYALLMINNS, JOHN
Owner of property located at LOT 23 HOMESTEAD VILLAGE
in the Town of MOBILE HOME
Queensbury,to construct or place a
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:
FLEMING, CONNIE LOT 23 HOMESTEAD VILLAGE
QUEENSBURY, NY 12804
Contractor or Builder's Name:
GLENS FALLS MOBILE HOME INC.
Contractor or Builder's Address:
39 SARATOGA RD
GANSEVOORT, NY 12831
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Electrical Inspection Agency:
NEW YORK BOARD
NEW YORK BOARD OF FIRE UNDERWRITERS
Type of Construction:
MOBILE HOME
Plans and Specifications:
17 X 70 SQ FT MOBILE HOME AS PER PLOT PLAN SPECIFICATIONS
Proposed Use:
MOBILE HOME
35 October 8 . 2001
$ PERMIT FEE PAID—THIS PERMIT EXPIRES
(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.)
8 October 1999
Dated at the To of Queensb N,./triv^k
this Day of
SIGNED BY�j� for the Town of Queensbury
• Code Enforcement Officer
V .„ V
OCT011999
t rJ OWN OF QU131ZNS'13UtzY Tom Fc r-EN
-SUP DING'��� CODE�E(1F1Y
+,4
REVIEWED BY:
F MID: $ � O�
[ E
NO.
3 L/
PERMITPERMIT � l 9 -�,
APPLICATION FOR PERMIT
MOBILE HOME OR MODULAR
A BUILDING PERMIT MUST BE OBTAINED BEFORE PLACEMENT OF MOBILE HOME.
NO INSPECTIONS WILL BE MADE (1NTII. A VALID BUILDING PERMIT HAS BEEN ISSUED.
c
The owner of this properly is: e47/(16--,
P.O. Address: L a Pho
1 ne Number `)qz2.-(-61 0
PE ?E
ty :2._:
Tax Map No. / /
NF A : I
ant: LVT` _F-0-
koN-Nok.1 i 1Y\; ny‘_s
All applicants spaces on this applicat(on MUST be completed and
signature of the applicant MUST appear on the reverse side of this application.
PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES:
MOBILE HOME INFORMATION
APPROXIMATE VALUE OF HOME: $ a f •e0-
New Home Yes 41110ZONING INFORMATION:
Replacement Home es No
Size of Property: ft x ft
Size of mobile home 4 ft4 ft
Existing Buildings:
' Singlewide \Doublewide ' '
No. of rooms (exclude baths) Proposed building-distance from property line:
Front Yard ft rlr Yard ft,
No. bedrooms Side Yards ft and ft.
Occupancy Information:
No. of bathrooms l
Primary dwelling: Yes No
Fireplace ^ Woodstove ' Accessory Building(s) :
Foundation style and size: Detached garage • one car /two car car)
Attached garage one car_/two car car)
Piers-No. of Size ft x ft
Storage building
Other
Depth bet ow grade_ ft
n * * * * * * * * * 4, 14 A. * * * *
Foundation-Footing size u x'
Wall malaria Proposed date of placement:
Wall thickness " Height " Water Supply: Well Municipal
Total depth below grade ft. ; Septic permit required? Ajt
Grade to home floon level ft.
FURTHER INFORMATION REQUESTED ON THE REVERSE SIDE OF THIS SHEET
NAME OF INSTALLER/MOBILE HOME DEALER: _XILUd._. -6.624-- `
ADDRESS/PHONE NUMBER ? �i'� r1 S
STATE OF NEW YORK DIVISION OF HOUSING ANI) COMMUNITY RENEWAL
INSIGNIA OF APPROVAL OF THE STATE BUILDING /CODE �/
1 . Insignia serial number Pq� Ob -f 2 ( 2 +/�—V) l�--)0,1--''
2. Name of Manufacturer
3. P1 an Approval Number W-6 ' i4 I. S-3
4. Model or Componen I Designation
5. Dale of Manufacture "� .1 -9
All the above information is to be found on a pia Le or sticker which
should be affixed to the Mob Ile Home. CompieLe above with that in forma Li on.
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Town of Queensbury State of New York
County of Warren
AFFIDAVIT
I swear that to the best of my knowledge and hellef the sta Lenten Is contained
in Lb is appl ication , I:ogether• wl th the plans and specifications submi lied,
are it true and compl e le s La lenient of all proposed work to by, done on the
described premises and that all prov Is bus of the BUILDING CODE, the ZONING
ORDINANCE , and all other laws pertaining to the proposed work slut II )he contp1led
wll.h, whether specified or not , and that such work Is au horized b1 11(. finer.
Si go17a NT* � P •
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Owner, owner' s agent, ar ri LedL,
con Lrac for
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SPECIAL CONDITIONS OF PERMIT:
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By
Code I'nforccment Officer
DECLARATION: Please sign below of er you have carefully read the statement.
To the best of my knowledge 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 will), whether specified or noted, and
that such work is authorized by the owner. Further, it is understood that 1/we shall submit prior to a
Certilicate of Occupancy or Certificate of Compliance being issued, an AS BUILT PLOT PLAN by
a licensed surveyor; drawn to scale, showing actual location of project on premises.
Signature:
.(owner, owner's agent, architect, contractor)
J_� J_s_l' gl'AtQ b..l' d_l'.ml>!_l' � Am e_l'J_� J_•.l' �_l' �_l'J�_lJ_� Ao.t1 e_l'J_A_l'.),,o,l'.Ao_n' ,_l � J_�_l'J_� J_�_l'J_��olvvi. J_..lJtr.A. �11,._l �_l'J_�_lJ_.Tel �_lJ_�,l'JL...,,_::I_C''4
_(, rY
K; THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE IIA
i St�78�09e7 BUREAU OF ELECTRICITY
' I- 111 WASHINGTON AVE., SUITE 704, ALBANY, NY 12210 1
i Date NOV MBE.R 22,1999 Applic, •'o, No. n; 4 6120999/99 H 457238 5
OAP
i THIS CERTIFIES THAT — ih
P only the electrical equipment as described below and introduce, by the a ica t named on the above application number is in the premises of it
=G rY
JOHN ROYAL2_1. INNS, HOMESTEAD VILLAGE LOT 23, QUERTISBURY, NY ;
in the following location; El Basement ❑ 1st Fl. ❑ 2nd Fl. OUT Section Block Lot 23 ih•
was examined on lVOVZiI 'R .199 and found to be in compliance with the National Electrical Code. A
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1 FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS r
:r OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. I;
-' DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS Y
11 AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. IMI H.P. NO.OFSYSTErFEET AMT. WATTS IY
:CI IA
II PV;
ih
j' SERVICE DISCONNECT _ NO.OF S E R _ . V - I C__ E p
i, METER F NO.O CC COND. A.W.G. A.W.G. A.W.G. I}
--:1AMT. AMP. TYPE EQUIP. 1 0 2W 3 0 3W 3 0 4W p 0 OF CC.COND. NO.OF HI-LEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL ,}-
. ry,
• OTHER APPARATUS:
lb 1 SET 2 PRASE FROM DISCONNECT TO-1 1&, MOBILE' HONE-1
:1it
, r;
,;
'),
1.•"",) r
r,_
• RANDY 0. HITCHCOCK' �',6t,' °a,�;-. • L K� !r
t 3537 CO PT 20 1,--4 a • +r V. p
SA�r:Rm NY 12865 ,-.L':�s
�� e �` iI GENERAL MANAGER PVi
{, ti / q� , 9
4' 4 ?-
:-.0 •-,. .,., i' - I- Per ri
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ix: This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
'4 476Y.7r 1.YY-Y Y•WiVr..YY.Y YiY Y%Y;foil YiY YWilY.Y 47r.;74ii;,lie Y�Y Y%Y Y•YY.Y 47r;YVaiiY Y•YY.Y Y�Wr.YiY 4Y Y YY Y Y•Y Y.YYiY YiY Y07r,47r.5.76YiY Y•Y 41-1YiYY•YY•Wiil 451 S
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
FINA
L INSPECTION REPORT P m •
MOBILE / MODULAR
Town of Queensbury
Building & Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256
ARRIVE: DEPART./ INSP:
DATE INSPECTION REQUEST RECEIVED:
NAME: F -e/`C r \c
LOCATION: 4` U
Dy
DATE: digan. - i. 1 PERMIT# J__
MOBILE HOME MODULAR HOME
FOOTINGS FOUNDATION _ BACKFILL_ FRAMING
N/A YES NO
1. foundation support, pier spacing
Per manuf. — — —
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2. anchoring per manuf. — —
3. water line shut off — —4. sewer line support @ 4 fej — — —
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5 heating crossover (dble 'fle) off grd. — —
6. dryer vented outsi•e
..
Q.. skirting ventilated — — —
8. hot water relief valves •iping ou 'de — — —
9. deck, porches, step-, rai r • — —10. furnace/hot water perating11. garage fire proo g — — —
12. door closers — —13. plumbing fixtur — — —
14. foundation ins ation (if appl.) — — —
15. smoke detec •rs — —16. final elect ' al — —17. variance r-•uired _ —18. data plate okay — — —
19. mobile H D seal okay — — —
Model # • Serial #
Manufacturer
Date of Manufacturer
OKAY TO ISSUE C/O YES NO
Comments: CP‘.. U l D 0 S �-i f
FINAL INSPECTION REPORT.
MOBILE / MODULAR
Town of Queensbury
Building & Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256 f
4 r/
ARRIVE: DEPART: -' INSP:�.1�`/
DATE INSPECTION REQUEST RECEIVED:
� 1
NAME: f 164i \
LOCATION: L T 23
DATE: 1 lO PERMIT II 'v
MOBILE HOME MODULAR HOME
FOOTINGS FOUNDATION _ BACKFILL_ FRAMING_
N/A . YES NO
1. foundation support, pier spacing
Pe
r manuf. — — —
2. anchoring per manuf. — — —
3. water line shut off —4. sewer line support @ 4 feet .... .. — —
5 heating crossover (dblewid- off • d.
dryer vented outside ..:....
7. skirting ventilated -
8. hot water relief Valve pip' g outsid: — — —
9. deck, porches, steps r.' ' — — —
10. furnace/hot water operatinl — —11. garage fire proofing -
12. door closers — —13. plumbing fixture — — —
14. foundation insulation (if a $1.) — — —
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: DRyo2y Pds N 10 .
�X( .
\LY_ () --- (Xyh
FINAL INSPECTION REPORT
MOBILE / MODULAR
Town of Queensbury
eve()
Building & Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256•
ARRIVE: DEPART/
DATE INSPECTION REQUEST RECEIVED:
NAME: o y�
LOCATION: � ��` ( �
DATE: — � PERMIT# 9)?-63
MOBILE HOME MODULAR HOME
FOOTINGS FOUNDATION _ BACKFILL_ FRAMING
N/A . YES NO
1. foundation support, pier sp•cing r —
per manuf. —
2. anchoring per manuf. .... —3. water line shut off 4. sewer line support 4 f••t J =
5. heating crossover (dblewi s e) off 1rd. —
6. dryer vented outsi o e ..:.. v
7. skirting ventilated — — —
8. hot water relief valve pi.; g outside — _J —
9. deck, porches, steps, rai ing —
10. furnace/hot water operat g / v 11. garage fire proofing -
12. door closers —
13. plumbing fixture /14. foundation insulation (i appl.) -/
15. smoke detectors 16. final electrical — —
17. variance required — — —
18. data plate okay — —
19. mobile HUD seal okay —
Model # 1 77-/C I'd Serial#'drf 19` 00/A)
q0- z
Manufacturer A3-fgo
Date of Manufacturer _0( 11 I
OKAY TO ISSUE C/O YES �NO
Comments: flvR/wi Vatrsr U v I
FINAL INSPECTION REPORT U"1
MOBILE / MODULAR
Town of Queensbury
Building & Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256
tit)
ARRIVE: DEPART:: % INSP: lam"
DATE INSPECTION REQUEST RECEIVED:
(-. 1
NAME: DtjIL 1 /4W 6 ' �+
LOCATION: Lei 2-3 M� Yf*o 4 .
DATE: /0 S f PERMIT#
MOBILE HOME MODULAR HOME
FOOTINGS FOUNDATION _ BACKFILL FRAMING-
_ \N/A . YES NO
1.
1. foundation support, pier spacing
per manuf. -
2. anchoring per manuf.3. water line shut off —4. sewer line support @ 4 feet . — — —
5. heating crossover (dblewide) o grd. — —6. dryer vented outside7. skirting ventilated — — —
8. hot water relief valve piping ou ide -
9. deck, porches, steps, railing ... .... — —10. 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 # K.. 741( Serial # 4f)q', Dd7%
Manufacturer A6-(0
Date of Manufacturer 11 3
OKAY TO ISSUE C/O YES NO KComments:g/et�- �.2rr�a2T ,•!/
FINAL INSPECTION REPORT iy)
MOBILE / MODULAR
Town of Queensbury
Building & Code Enforcement . C.31.-:-V
742 Bay Road
Queensbury, NY 12804 \` ` Ul3
(518) 761-8256 W�
ARRIVE: DEPART; NSP:
DATE INSPECTION REQUEST RECEIVED:
NAME: C\�fL,,(\No\i P.c‘eNi\-1 , c
l ,
LOCATION: ,h---( 33 \--\(7n\c/5 v i' )'
DATE: I _� PERMIT.#C- ,...__Lca_i-
e
MOBILE HuME MODULAR HOME
FOOTINGS FOUNDATION _ BACKFILL_ FRAMING
N/A . YES NO
1. foundation support, pier spacing
per manuf. — _____ —
2. anchoring per manuf.j — — —
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3. water line shut off .\ — — —
4. sewer line support r@ 4 feet .... .. — —
5. heating crossover (dble 'de) o ' grd — — —
6. dryer vented outside ..ti... ...... .... ... _ — .
7. skirting ventilated ...• — — —
8. hot water relief valve piping outside — —9. deck, porches, steps, railing — — —
10. furnace/hot water operating — — —
11. garage fire proofing — — —
12. door closers — — —
13. plumbing fixture _. — —
14. foundation insulation (if appl.) — — —
15. smoke detectors G — �_
16. final electrical ..:l.1i. v k.. —
17. variance required ..1.1�� — —
� f
18. data plate okay — — —
19. mobile HUD seal okay — — —
Model # Serial #
Manufacturer
Date of Manufacturer •
OKAY TO ISSUE C/O YES NO
Comments: .
r�
c)c\-_-G "p L.
RECEIVED
OCT01 1999
LA 23 5f
7- ` \• T'1V N OF QUEENSBUPY
B111LD9N�a P,PlC�l�+�rlr.
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NOW
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ANCHORING OF MO 1LE HOME
FRAME IS REQUI ED PER
MANUFACTURERS SPECIFICATIONS
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<---, 4<______--_,
. FD . F._, C...4• 0,.._.: py
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TOWN 0 U; EN2Pt i:? ;i D (, pp_iaEv,. "�:..� i>�.3 r�f,t:f� SYMq
ii. on our iirn tod examination,
�P�!
at:,
compliance with our comments shall
not he construed as indicating the
p t-,:is a;o specifications are in full
-.) .f.'• .c-17 . 3 1 <yip
v _ . 1,U LD NG 6.1 qk.P
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-- --NI ( 1\ I . . REVIEWED BY '_ ..
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DATE . d ____ef--- _.____....___
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Mr -71
j_!_LLLLLLL'_ • LIVING THIRD ' SECOND
L L L DINING.I_
MASTER --1 Lta-a`x s. •a•L ROOM BEDROOM BEDROOM
BEDROOM _• L L I_t rm+, , 13•9'x 1z-0O• e•-3 x s-s IT-Er x 12-10
L�L_L_L�
laaxla-r LL® LL_---- LLLLLL, --- —
t�- cry ;
l_L L.I L i.! • STANDARD THROUGHOUT
:11all L.p[ LLt;66i
1tELr $ :r
3BR, 1BA NT147007
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OCT 01 1999
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Tc iA!N OF QUEcr13B@JRY