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1999-644 .. . . • .... . . , .. . .,., .. .. . . . , „...,,.:. Certificate Of Occupancy ,. . . ,. . Town of Queensbury Warren County, New York r • Date May 31, 2000 L ' } oq , 996A4 . This is to certify that work requested to be done as shown by Permit No. has been completed. L, This structure may be occupied as a MOBILE HOME Location 6 3 OHIO AVE. _ .._... Owner - —DtT.-Tetiatia a. ,L-ii.\-41-4,.' TAX MAP NO. 127 . -5-4 By Order Town Board TOWN OF QIJEENSBURY ,,,------, .-Difeete o''zi4ii d LZ., Enforcement . . BUILDING PERMIT VALUE $ 5000 TOWN OF QUEENSBURY No. 99644 TAX MAP NO. 127 . -5-4 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to MITCHELL, LINDA OWNER of property located at OHIO AVE. . Street.Road or Ave. in the Town of Oueensbury,To Construct or plaoe 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 Oueensbury Building and Zoning Ordinance. t. OWNER'S Address is OHIO AVE. QUEENSBURY, NY 12804 2. CONTRACTOR or BUILDERS Nome LAMPLIGHTER HOME 3. 2Rftsjfl rBBUILDFAXA793-7522 RFUUT EDWARD, NY 12828 4. ARCHITECT'S Name ATLANTIC INLAND 6. /AI yEgbAdgres GREENWICH, NY 12834 6. TYPE of Construction—(Please indicate by X) _ MOBILE .HOME 1 I Wood Frame ( I Masonry ( )Steel ( ) 7. PLANS and Specifications 840 fp FT MOBILE. HOME ( 1974) AS PER PLOT PLAN SPECIFICATION 8. Proposed Use MOBILE HOME 48 November 19 2001 $ 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 Oueensbury before the expiration date.l 19 . : November 1999 Dated at the Town of Queensbury this Day_of 19 SIGNED BY 1"i�t�'�^ for the Town of Queensbury Building and Zoning Inspector • i l '' b t , RECEIVED elk' OCT 1 2 1999 • TOWN OF Q(JEt N ' .513 UIZ 1' TOM O,-a, =N `v'FlY IiiN C�J.IE af�3ia,�'MU COD r REVIEWED BY: FEE PAID: ., - PERMIT NO. , /APPLICATION Foil PERMIT MOBILE HOME OR MODULAR A BUILDING PERMIT MAST BE OBTAINED BEFORE PLACEMENT OF MOBILE HOME. NO INSPECT IONS WILL BE MADE IINTII. A VALID BUILDING PERMIT HAS BEEN ISSUED. The owner of this property Is: L d e.ed V1 bi-- -',tl gd V-e+ L�-c�h€ ti 54-tLL i \ ili4rtow P.O. Address: i4v,ktd.Z �j Phone Number -7g3--�, q7 Property Loca Lionb / ` 79'' 2.5-7 t 60 c 0 \ye In. u e. q by Tax Map I ..2/_ __ NAME OF APPLICANT: 1, h cl A l'',L-cyii 0 L L Address of /Ippl !cant: 9 6 A.-L. D I tick- ' e., cp Li e,.. . In < L.27 All applicants spaces on this application MUST be completed and the 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 ,•, j 3) AI I'IIOX I MA I E VALUE OF HOME: $ vb- O /D6 New Home Yes 4111014 kXJA ZONING INFORMATION: Replacement Home Yes No , � P _ Size of Properly: (P 0ft x /0 O ft ,o� ft Size of mobile home xC7fL � xlsLing Buildings: i'l)d � � SInglewIde A � Doublewlde 6� No. of rooms (exclude baths) U Proposed building-distance from property line: Front Yard ft Rear Yard ft. No. bedrooms Side Yards ft and ft. No. of ua Lhroouts� Occupancy In forma Li " � Primary dwelling: Yes Ho Fireplace41 Woodsiove /v Accessory Building(s) : Detached garage one car /two carcar)Foundation style and size: _ Attached garage (one car_/Iwo car car)t —'Storage building Piers-No. of (_S1ze li ft x • ,fi Other 1i n 6\65 Depth below grade _f t t * * * * * * * * * 4, 14 14 * * * * * Foundation-Footing size" x ID." Wall materia': Proposed date of placement: Wall thickness " Height " Water Supply: Well Municipal. Total depth below grade ft. Septic permit required? _ Grade to home floor. level ft. FURTHER INFORMATION REQUESTED ON TIIE REVERSE SIDE OF THIS SHEET .� A ' -cq-cyc- LO , L L 3� i �47-L 1}tv r 1 c - DitAL4 r 1/�. hC • NAME OF INSTALLER/MOBILE HOME DEALER: ., ADDRESS/PHONE NUMBER v,, , L r-s s 6 , ?a-V0 STATE OF NEW YORK DIVISION OF HOUSING AND COMMUNITY RENEWAL INSIGNIA OF APPROVAL OF THE STATE BUILDING CODE 1 . Insignia serial number Gj U 2. Name of Manufacturer 1e, r t _e` --- ( /Ue,, -rcDpi, 3. Plan Approval Number tiJ 4. Model or Component Designation fn (, Q-6 R. Date of Manufacture 1 All the above information is to he found on a plate or slicker which should be affixed to the Mobile Home. Complete above will, that information. • Town of (lueensbury State of New York ' County of Warren AFFIDAVIT 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 he compl led wI t.1i,; whether specified or not, and l:hat: such work Is authorized by the owner. Signature O7G41Le,10 Owner, owner' s agent, architect, contractor , SPECIAL_ CONDITIONS Of PERMIT: By Code Eri1orcemenl: Officer DECLARATION: Please sign below after you have carefirlly read the stalement. 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 clone 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 noted, and that such work is authorized by the owner. Further, it is understood that I/we shall submit prior to a Certificate 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: ma41e'-e-+' (owner, owner's agent, architect, contractor) • Application for SEPTIC DISPOSAL PERMIT Town of Queensbury qi' Dept. of Community Development � Permit No. �?" �If' Building &Codes Office AEC L. \f' 742 Bay Road Fee Paid $ Queensbury, NY 12804 OCT 1 2 1999 JU�'i'l C;=O°SAC�3BUt�Y ---- J �' Il- -3 ICU`.:)01�� ' Location of property for installatio {�-�j- () e Q h v _ i ,nnr►e - '.. Ied eel- Property Owner's Name: .i�;L� t i a , /� '( � f to in , Cle-ed, LL , h, ryiF'� Property Owner's Mailing Address: q 6 AL P, n1 0} tie Q �^ y � Installer's Name: r) 1') Ill 1IAr:1( 2) Phone # J 11^ &j • . Number of bedrooms (if residential): Total daily flow: cl' C © G-q,\1 6 ,) (residential -compute @ 150 gal./bdrm.) Topography: y flat, rolling, steep slope % of slope V • Soil Nature: x sand, __loam, clay, _ other /depth: bQ (J0.1,3 Ground water: at what depth? (ti feet / Bedrock or Impervious Material: at wl;at depth? feet Percolation test: not required, required [rate min. per inch Domestic water supply: X municipal, well, other If domestic water supply is a WELL, water supply from any septic absorption is feet. PROPOSED SYSTEM Septic tank: 1)00p gallon (minimum size: 1,000 gal.) Tile field: each tench 0 U feet / Total system length: I 'd feet Seepage pit(s): number of / size each: . ft. by ft. Size of stone to be used: # / depth or thickness feet • • HOLDING TANK SYSTEM: (if required) ,/l//q' Number of tanks: ' Size of each: gallons • Alarm system and associated electrical work to be inspected by a certified For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Queensbury, any permit or approval granted which is based upon or is granted is reliance upon any material misrepresentation or failure to make a material fact or circumstance known by or on bebAlf of an applicant, shall be void. I have read the regulations with respect to this application and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. Signature of responsible person: i /f,,_/I/��j/ Date: 76//.7/9.9/ its F / � 71;g,% o (;) )x /O �r7wo-// ,SLR fei+- h»sL ,4e r �i•� • J_•_l'J_•_l'• !eell''.AQ'_ J!l'J_•_l !l'P, J,?_l'.$Ak!') •l AkPAl' •il WIA htl'Al;l._l'J!cl J!_l' • 'Ai):'AID. J_•_l...M.i. •_l J_•l' Ql'J_•_l' t:5.11A!J_•_l' •_l'V.V.": .1 Ak:J;� •i' • 9_ WI i THE NEW YORK BOARD OF FIRE UNDERWRITERS . 'kGF" is • 08"253 BUREAU OF ELECTRICITY. r wi I- 111 WASHINGTON AVE., SUITE 704, ALBANY; NY 12210 �} MARCH I J,20 i0 464411! 0/00 H •L.)£ie`T.1.7 ,} S(1 Date Application No. on file ly! i THIS CERTIFIES THAT _ +• ' z•zt only the electrical equipment as described below and introduced by the applicant named on the above appii ation u e is in the premises of 1i iY LINDA MITCHELL, 6:3 OHIO AVE. , OUNEN813UHY, NY ', in the following location; El Basement El 1st FL El 2nd FL OUT Section Block Lot ij MARCH 02 2000 :X; 'Ai was examined on r and found to be in compliance with the National Electrical Code.. �, rF !C4 g! • FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS P} =C OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. y' 11K' IA =<' DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS '�' BELL S Iy , AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. Call H.P. NO.OFSYSTEf FEET AMT. WArS 'Y . :1. '.: - SERVICE DISCONNECT NO.OF -- - - --. § Ek:___. .•- R V I C -E - - ,N; =t' AL -' AMT. AMP. TYPE EQUIP. NO.OF HI-LEG A.W.G. NO.OF NEUTRALS A.W.G. ,>7 OF NEUTRAL --` OTHER APPARATUS: • 1N t, Ir • ,r 6 rY • 1' Ay A' IA C' q! ' 'r •I d LINDA t�I:°T,CHE LL .1.`-‘‘).. I,.7 'S• ;Y -41 63 OHIO AVE. a ; i WI QU Pi'N88U11Y, NY, 1.280� . F .tr+ c� r' F•-: GENERAL MANAGER k • •.. _. ar c h�, ►- e - -i' fi Per ' • 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. r '/,Y•YYik,7•Y 47,,Y•Y Y•Y Y46 4-6 Y•Y Y•-Y 74,Y Y•Y 7•Y Y•Y Y�Y Y•Y Y•Y YoYY•Y YiY Y•Y Y•Y Y•Y;•4Y 4YY•Y Y•Y YiYYbY Yea.711Y YiY Y•Y 4'6 Y•Y Y•Y.'4Y;i:6 Y•Y 4, Y�Y YV Y•Y 4Y Y•Y;Vil ffibil' rnov Eno RI ICI f1INr f1FPARTMFNT_ THIS COPY OF CERTIFICATE NIIIST NOT RE Al TERM-) IN ANV MANNER FINAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: DEPART) INSP: DATE INSPECTTION REQUEST RECEIVED: NAME: Cl k LOCATION: C) O C. � DATE: ( gb PERMIT.# I L` 9 1 MOBILE HOME MODULAR HOME FOOTINGS _ FOUNDATION :7�CKFILL_ FRAMING_ \\ N/A . YES NO 1. foundation support, pier sp.cing per manuf. — — — 2. anchoring per manuf. — — — 3. water line shut off — —4. sewer line sups•rt @ 4 fee — — — 5. heating crossover •blewid-) o' grd. — — pckyirtger vented outside —sin ventilated — — '0 hot water relief valve pip' g outside — —9. deck, porches, steps, rail' g — — — 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 I .— — — 19. mobile HUD seal okay — — — Model # Serial# Manufacturer Date of Manufacturer OKAY TO ISSUE C/O YES NO Comments: epev j.oo S l �' FINAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury ) )(VW Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 . ARRIVE: DEPART://° INSP: " 126/ DATE INSPECTION REQUEST RECEIVED: r\ O\ \ 1 NAME: 1 LOCATION: L6-5 O)\;() DATE: PERMIT al-AO q � J MOBILE HOME MODULAR HOME FOOTINGS FOUNDA •N BACKFILL_ FRAMING N/A YES NO 1. foundation support, pi,r spacin per niauuf. 2. anchoring per manuf. 3. water line sht,off _ 4. sewer line suppLa 4 _ 5. heating crossover (dble •-) off grd. 6. dryer vented outside ..4 7. skirting ventilated 8. hot water relief valve pipin l outside — / 9. deck, porches, steps, railin t 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 # \ C�? Serial # 65/8 Manufacturer AaP-19d0 6 Date of Manufacturer ?) tqlqii OKAY TO ISSUE CIO YES /NO Comments: INAL INSPECTION REPORT MOBILE 0 MODULAR Town of Queensbury Building & Code Enforcement • 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: DEPART INSP:C DATE INSPECTION REQUEST RECEIVED: �� ' NAME: . . n \ C "\_Q LOCATION: l_J) � DATE: — J'+ _. OO PERMIT# I. l .0 49 MOBILE HOME MODULAR HOME FOOTINGS _ FOUNDATION _ ?AQIFLL _ FRAMING N/A , YES NO 1. foundation support, pier spaci g per manuf. 2. anchoring per manuf. _ _ — • 3. water line shut off 4. sewer line support @ 4 feet I 5. heating crossover (dblewide) 3ff d. 6. dryer vented outside 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/ 1.) _ 15. smoke detectors _ — 16. final electrical 17. variance required — 18. data plate okay 19. mobile HUD seal oka • Model # Serial # • Manufacturer Date of Manufacturer OKAY TO ISSUE C/O YES /NO Comments: A C�RTI F(Cif-T-G o ti AA.,7 A)6 66 U Tit 1 pcc s Cyr f Fvu <__ hv sP . FINAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: DEPAR'I':I, INSP: DATE INSPECTION REQUEST'g RECEIVED: / NAME: H 64 IAA. `I--.& .6--GL LOCATION: DATE: _ d 446 PERMIT# CALA. """ MO"4LE 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 @ 4 feet — — — 5. heating crossover (dblewide) off y.d. — — — 6. dryer vented outside - 7. skirting ventilated — — 8. hot water relieflalve piping ou •ide — —9. deck, porches, - 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 # Serial # Manufacturer Date of Manufacturer OKAY TO ISSUE C/O YES /NO Comments: [.Y6-- Gig . �o� j O UA)o PP° AL-- p/662S u5% '#19-t 6 4-5e Cc•R. 'W GENERAL INSPECTION REPORT ( 518 ) 761-8256 Town of Qucensbury Dept.of Community Development ' Date inspection request received: Building& Code Enforcement It 742 Bay Road Queensbury,NY 12804 Arrive am/pm Depart/ ` at m Inspector's Initials•q � NAME:Lot (1(\',C& PERMIT# O. — l `c LOCATION: Lc7 3 �` DATE : . 'Ci! - t% TYPE OF STRUCTURE: ,( 7-j! RECHECK N/A YE NO COMMENTS F ings/Piersi 3nJ �� I Monolithic Pour Form i 1 � }-� J�f� // Reinforcement in Place /[/� / GL The contractor is responsible for providing protection from freezing for 48 hours following the plac of the concrete. Materials for this purpose on site Foundation/Wallpour Reinforcement in Place Foundation/Dampp eo.fl Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Plac Rough Plumbing Heating Rough-In Insulation Foundation Walls Interior - Foundation Walls Exterior R- Floors R- Walls R- Ceiling R- Duct work or piping in unheated spaces R- Proper Vent, Attic Vent • Framing Jack Studs/Headers Bracing/Bridging Joist Hangers Jack Posts/Main Beam _ Air Infiltration Barrier Fire Separation 1, 2, 3, hour Penetration Sealed Fire Wall 2, 3, 4 hour Firestopping cy_ GENERAL INSPECTION REPORT Ui0 ( 518 ) 761-8256 �� Town of Queensbury Dept.of Community Development Date inspection request received: Building& Code Enforcement 742 Bay Road Quecnsbury,NY 12804 Arrive am/pm Departs/ am/ Inspector's Initials r �, NAME: ,L� ct,16c� �`� \"\ �Q PERMIT# lS� ��AA LOCATION: 7 U , , DATE : 3- , ``, D\ TYPE OF STRUCTURE: k- n-\(\_ _ -- RECHECK N/A YES NO COMMENTS otings/Piers 1 t I Monolithic Pour Form Reinforcement in Place G1/OU6_ reeff- ra 0�� ���M 5 The contractor is responsible for providing protection from freezing for 48 hours following the placement of the concrete. Materials for this purpose on sit Foundation/Wallpour l�vuj� �d '/ �� le Reinforcement in Place Foundation/Dampprool i ng Backfill Approval Plumbing Under Slab Plumbing VenUVents in PI cc Rough Plumbing Heating Rough-In i Insulation Foundation Walls Interior R- Foundation Walls E.itcrior R- Floors R- Walls R- Ceiling R- Duct work or pipi g in unheated space R- Proper Vent, Attic V nt Framing Jack Studs/Head rs Braci ng/Bridgi n Joist Hangers_ • Jack Posts/W'n Beam Air Infiltration Barrier Fire Separation I, 2, 3, hour Penetration Sealed . Fire Wall 2, 3,4 hour Fi restoppi ng TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name L ram'C)cl 1`4t Location F1'‘.)F . Date 1 .—Z?flPermi t # cl(1-6 H''-1 SOIL TYP . and-. sam-Clay- Results of Percolation Test- (if applicable) R. Minute/Inch TYPE OF SYSTEM: ABSORPTION FIELD: • .1 Length 12_ 1 Length of each tre; 7.6 , 1,4,-)i 1j Depth of trenches Size of stone AMIIIMMMtA, SEEPAGE PITS: Num'ier- Size - _T . x ft. Stone size - PIPING: Size Type Bldg. to Tank 1-� '' cAA � Tank to Dist. Box • 2-1" p\K_ Dist. Box to 'Field Pit " p‘x Openings Sealed? es' No Partial LOCATION/SEPARATION' : Foundation to Tank f feet Foundation to Absorption ' _1i ; feet Separation of Pits ;feet Conforms as per Plot Plan (Yes) No LOCATION OF SYSTEM ON PROPERTY: (g;p_one) iRear of Right Side Front - Middle Rear COMMENTS: SYSTEM USE APPRO E6 ! ` YES NO Arrived- ' Depar // Building IfisPector r" /f ; Efdi6d GENERAL INSPECTION REPORT ( 518 ) 761-8256 Town of Queensbury Dept.of Community Development Date inspection request received: Building& Code Enforcement 742 Bay Road Queensbury,NY 12804 Arrive a am/pm DeparF`' a� m Inspector's Ini j NAME:�'S n ]l�\l ` Sk2_e_.\\ PERMIT# ( ^ `t LOCATION: �`�, DATE : — TYPE OF STRU TURE: RECHECK ( r N/A YES NO COMMENTS ootings/Piers 1 I I I Monolithic Pour Form \) . -- 39:J—D CAA A fZ 6`t Reinforcement in Place ; iC � The contractor is responsible for i K' � � Z- providing protection fr* freezing' I Z )� Q for 48 hours followi thi place ent —1 J��g - of the concrete. Materials for this purpose olt site Foundation/Wallpour Reinforcement in Place Foundation/Dampproofing_ Backlit! Approval Plumbing Under Slab Plumbing Vent/Vents in Place Rough Plumbing Heating Rough-In Insulation Foundation Walls Interio R- Foundation Walls Extcri r R- Floors Walls R- Ceiling R- Duct work or piping in unheated spaces R- Proper Vent, Attic Vent Framing Jack Studs/Headers Bracing/Bridging Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier _ Fire Separation 1, 2, 3, hour Penetration Scaled Fire Wall 2, 3,4 hour Firestopping GENERAL INSPECTION REPORT ( 518 ) 761-8256 Town of Queensbury Dept.of Community Development ' Date inspection request received: Building& Code Enforcement 742 Bay Road Queensbury,NY 12804 ArrivaLipan ----Depart nspector's Initia NAME. !N G'- /vl/ PERMIT# —.6 LOCAT ON: DATE : 3 9 TYPE OF STRUCTURE: RECHECK / 2- L j COMMENTS ' N/A YES ,NO Footings/Piers [J� Monolithic Pour Form Reinforcement in Place The contractor is responsible or - providing protection from fre zing for 48 hours ollowing the pl•cement of the concret Materials for this ,urpose on sit Foundation/Wallpo C----CjVB C-- C E� OC �= Reinforcement in Plac "�- Foundation/Dampproofing_ �..(� Backfill Approval �� Plumbing Under Slab t` I � � \Z6 4 Plumbing Vent/Vents in Place 1� "1 ti3 Rough Plumbing Heating Rough-In Insulation Foundation Walls Interior R- Foundation Walls Exterio R- _ Floors - Walls - Ceiling R- Duct work or piping in unheated spaces - Proper Vent, Attic Vent Framing Jack Studs/Headers Bracing/Bridging Joist Hangers Jack Posts/Main Beam _ Air Infiltration Barrier Fire Separation I, 2, 3, hour Penetration Sealed Fire Wall 2, 3,4 hour Fi restoppi ng FINAL INSPECTION REPORT MOBILE / MODULAR n Town of Queensbury y P Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 -7 013 Cp9 7 S (518) 761-8256 ARRIVE: DEPART: 1. < INSP: DATE INSPECTION REQUEST RECEIVED: r NAME: j--N -C\a (N. LOCATION- I (Q 11) DATE: -9)/. PERMIT it MO 'ILE HOME MODULAR HOMU< C7 FOOTINGS FOUNDATION _ BACKFILL_ FRAMING -\N/A . YES NO 1. foundation support, pier spacin: \ per manuf. — — 2. anchoring per manuf. ..t l _ 3. water line shut off — — 4. sewer line support ®4 feet - 5. heating crossover (dblewide) o grd. — — — 6. dryer vented outside - 7. skirting ventilated — — — 8. hot water relief valve piping ou .ide — —9. deck, porches, steps, railing ..... .. — — — 10. fumace/hot water operating — —11. garage fire proofing — —12. door closers — --13. plumbing fixture — — — 14. foundation insulation (if appl.) — — — 15. smoke detectors — —16. final electrical17. variance required — —18. data plate okay — — 19. mobile HUD seal okay — — — Model # tAitOC, 36 Serial it 63*18 Manufacturer LPL A-6 (i0e&-)fORT) Date of Manufacturer t["3 4 OKAY TO ISSUE C/O YES NO Comments: ) ip_e,& P (:kL° q 1999 Novi g ,(0421 eve--- k ToW Of' QUE. Non FILE COPY BUILDING' �� RY AND CODE /(, i lb�� i3` 10 O �1 I I li id Il 9 i5 fp ODP d br- I f ‘ 2.pov'' — FGicE 0 /n § PI4 1off Ce ()hi A id tt 0 -w... _41 ____06 • a . 0 ( 2,/ .. ,(.I? ( _a , _ cf...___ ____cr_ . .., 0. .,_......„ i 11 0 ›- . .,- • 1( b l (:-') )25 a 8 w ® _W w j --P,2_ �• , —R -3EA — ----° 1 '-h. 'N_) ..,-._.\ ‘'.c: X, �, � t � I /' oL -----►L.boP ®)r,�S lqX .r§9 ' Th._ • I y - have seen or observed, or believe I saw evidence of, N �__ _ all objects such as houses, wells, trees, fences, etc., Lf , = n on this document. I also represent that I have Ts_D LU Z o� inafly measured the distances set forth on the di c LCS-...i W O �a►� • e ® zCC LAJ apt, fir a �— SIGNATURE tp co w NN.F2 oQd [ � �--ca s . T-77.--y = w 4