97-051 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBU.RY
WARREN COUNTY, NEW YORK
February 26 99
Date 19
role
97051
This is to certify that work requested to be done as shown by Permit No.
, has been completed,
14 FT. BY 70 FT. SINGLE WIDE, MOBILE H. ME
This structure may be occupied as a
LOT 168 HOMESTEAD VILLAGE
Location
FARR, JEAN
Owner
TAX MAP NO. 9 3 . —2—11 . 1 By Order Town Board
-TOWN OF QUEE SBURY
Director of Bldg. & Code Enforcement
BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY No 97091
TAX MAP NO. 93. -2-11. 1 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to FARR, JEAN
OWNER of property located at LOT 168 LUZERNE RD. Street,Road or Ave.
in the Town of Queensbury,To Construct or place a 14 FT. BY 70 FT. SINGT,F WIDE MOBILE HOM
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.
dATER'S Address is
OF MOBILE HOME LOT 168 LUZERNE ROAD HOMESTEAD VILLAGE MH
QUEENSBURY, NEW YORK 12804
2. CONTRACTOR or BUILDER'S Name
GLENS FALLS MOBILE HOMES , INC.
339 CSARAACTOR TOGA or
BUILDE ROAD R'S Address
ANSEVOORT, NY
4. ARCHITECT'S Name
NEW YORK BOARD
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
MOBILE HOME
( 1 Wood Frame ( 1 Masonry ( I Steel ( )
7. PLANS and Specifications
14 FT. BY 70 FT. SINGLE-WIDE MOBILE HOME (REPLACEMENT HOME ) AS
FER PLOT PLAN AND SPECIFICATIONS
8. Proposed Use
14 FT. BY 70 FT. SINGLE WIDE MOBILE HOME
35 March 3 1999
$ PERMIT FEE PAID —THIS PERMIT EXPIRES
(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.)
Dated at the Town of Queensbury this 3 Day of March 19 97
SIGNED BY for the Town of Queensbury
Building and Zoning In or
r
• , FEB 241997
�4 .[ O WN OF Q UEI�NS I3 0,,itY4 u . :._::.::. p'."
REVIEWED BY:
FEE PAID: $ \73
PERMIT NO. q — ® 57
APPLICATION FOR PERMIT
MOBILE HOME OR MODULAR
A BUILDING PERMIT MUST BE OBTAINED BEFORE PLACEMENT OF MOBILE HOME,
NO INSPECTIONS WILL BE MADE UNTIL A VALID BUILDING PERMIT HAS BEEN ISSUED.
nt
The owner of this property is: Vid4-61-ffi.ej (1,4,112.1,4"Ir*
P.O. Address: "A. + Phone Number
Property Location Tax Map No. / /
NAME OF APPLICANT: Cp _!4KAJA.K
Address of Applicant: -f( 5 ! ,t.&2_. : 4 '
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--
APPROXIMATE VALUE OF HOME: $ J/
New Home Yes m
ZONING INFORMATION:
Replacement. Home, Ye No
Size of Property: ft x ft
Size of mobile home ) ftx.70ft
Existing Buildings:
Singlewide ✓ Doublewide 1 •_
No. of rooms (exclude baths) 5Proposed bu'i�din!-di.t nc;,. from property line:
Front Yard ft RA r Yard ft.
No. bedrooms -j Side Yards ��� s
ft a ft.
11,
/?� Occupancy I, fo atiin:
No, of bathrooms
Primary dwe ling: es 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 —"
Oilier
Depth below grade ft
* * * * * * * * * * * A. * 44, * * *
Foundation-Footing size " x ."
Proposed date of placement:
Wall material
Wall thickness " Height " Water Supply: Well 'Municipal
Total depth below grade ft. ' 'Septic perntit required? PO
Grade to home floor, level ft.
FURTHER INFORMATION REQUESTED ON THE REVERSE SIDE OF THIS SHEET
• NAME OF INSTALLER/MOBILE HOME DEALER: — .r14104?
ADDRESS/PHONE NUMBER .
STATE OF NEW YORK DIVISION OF HOUSING AND COMMUNITY RENEWAL
INSIGNIA OF APPR�OF TII E STATE BUILDING CODE
• 1. Insignia serial number <S'ItG) 54)6 "hi
2. Name of Manufacturer ,`4Ar; ��Cy//.��
3. Plan Approval Number
4. Model or Component Designation •
5. Date of Manufacture lCf 7
All the above information is to be found ,on a plate or sticker which
should be affixed to 'the Mobile Home. Complete above with that information.
•
•
•
•
Town of Queensbury 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 bq. 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
Code Enforcement Officer
DECLARATION: Please sign below after 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•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:
(owner, owner's agent, architect, contractor)
FINAL INSPECTION REPORT
(MOBILE f MODULAR -50
Town of Queensbury
Building& Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256
ARRIVEX(DEPART: )w3tNS
DATE INSPECTION REQUEST RECEIVED
NAME: (70 Y c--NC
LOCATION: oLY, -GI'� ))p
DATE: -3, ! PERMIT#9±_
MO ILE HOME MODULAR HOME
FOOTINGS _ FOUNDATION _ BACKFILL_ FRAMING
1
/ N/A , YES NO
1. foundation support, pi space
per manu — —
2. anchoring per — —
3. water line shut —4. sewer line sup rt c 4 feet
5. heating cross er (dblewide) off grd. —
6. dryer vented utside ..s _ —
7. skirting ven' ted _ —
8. hot water r ief valve piping outside _ / —
9. deck, porches, steps, railing — / —
10. furnace/hot water operating —
11. garage fire proofing — —
12. door closers /13. plumbing fixture _ J
14. foundation insulation (if appl.)
15. smoke detectors —
16. final electrical .—
17. variance required �t —
18. data plate okay
19. mobile HUD seal okay — t
Model # Serial #
•
Manufacturer
Date of Manufacturer
OKAY TO ISSUE C/O YES NO
Comments:
5/4-05
FINAL INSPECTION 9RIEfplopit-r
MOBILE / MODULAR
Town of Queensbury
Building &Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256 •
ARRIVE: DEPART://_6 INSP:.�7i��
DATE INSPECTION REQUEST RECEIVED:
NAME: e_
LOCATION: 76e 'ove l e- i0 VI
DATE: .7/5-- PE' IT# G�7-o61
MOBILE II€%ME MOD • : R HOME
FOOTINGS _ FOUNDA ON _ BACKFI'.i _ FRAMING-
N/A YES NO
1. foundation support, pi•r spacing
per manuf. — — —
2. anchoring per manuf. — — —
3. water line shut,off — —4. sewer line support ®4 --t — — —
5. heating crossover (dble aI•) off gr+. — — —
lJ dryer vented outside ... — — —
7.• skirting ventilated — — —
8. hot water relief valve pipin;.outsi - —
9. deck, porches, steps, railing .... .. _ — —
10. furnace/hot water operating . .. ... — — —
11. garage fire proofing — — —
12. door closers — . — —
plumbing fixture ... ...... . ... . —
foundation insulation (if appl
15. smoke detectors
16. final electrical — 1 17. variance required _ —
18. data plate okay — — —
19. mobile HUD seal okay . — —
Model # Serial# i
Manufacturer
Date of Manufacturer
t
OKAY TO ISSUE CIO YES N o
Comments: ��N 1,4 Gig Cat_
tiSk--C. IT) 0S� �-vUi
-t•'oL� -r 1�,�F l
(1-0 12 ILL 7
FILIAL INSPECTION REPORT
MOBILE / MODULAR ti
Town of Queensbury �36 G►
Building & Code Enforcement
•
742 Bay Road
Queensbury, NY 12804
(518) 761-8256
ARRIVE:?. u DEPART:/ ! INSP: ��✓
DATE INSPECTION REQUEST RECEIVED: I) 161477
NAME: Ta '35G
LOCATION:
DATE:f IDkel lit )q� 2t 7PERMIT# q 7'"06-I
MOBILE HOME MODULAR HOME
FOOTINGS FOUNDATION _ BACKFILL_ FRAMING
N/A . YES NO
1. foundation support, pier ac.
per manuf. _
2. anchoring per manuf.. .. ... ........
3. water line shut off
4. sewer line support @ 4 f r✓ _
5. heating crossover (dbjewi e) o,f g _
6. dryer vented outsider (4LPl
7. skirting ventilated
8. hot water relief valve iping outside
9. deck, porches, steps railing
10. fumace/hot water rating —
11. garage fire proofing — —
12. door closers i/ ��
13. plumbing fixture
14. foundation insulation (if appl.) 1 _
15. smoke detectors
16. final electrical 'i./? .G7.....!a!
17. variance required
18. data plate okay
19. mobile HUD seal okay
Model #1 v►Mo '1\4cl Serial #C01 I6 ` 06A
Manufacturer VL L \f'k (LC
Date of Manufacturer /0 /1) /76
OKAY TO ISSUE C/O YES NO
Comments: Veg-r' AW/Z T�(QU 5 Kt 2T
6G.CO 46-0) 4N6r.to2 t Lc j 5 ri•- c42
��INAL INSPECTION REPORT
MOBILE / MODULAR /, ,ciw/ki
Town of Queensbury 10 1
Building & Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256 ,
ARRIVE: DEPART:/:0 INSP: /!`-
V.
DATE INSPECTION REQUEST RECEIVED: - 7
NAME:\CA\C,C `e)„,(9Arl'1
LOCATION: O2 }i� 1 C O 4i hfril ---;-6,C?
DATE:CO'--fa J '7 PERMIT# -05/1
MOBILE HOME MODULAR HOME
FOOTINGS FOUNDATION _ BACKFILL_ FRAMING
N/A • YES NO
1. foundation support, pie `spacing
per manuf.
2. anchoring per manuf. ...
3. water line shut off .... ....
4. sewer line support @ 4 feet
5. heating crossover (dlewide) off grd.
6. dryer vented outsi.e
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 . _
16. final electrical 3jul.l'7....4/)
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: A % 'To-, A)o i lkJ��� / ci
C-41rU(Ati-%
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03/03/1997 09:21 5187982803 GLENS FALLS M M HOMS PAGE 02
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REVIEWED BY
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APPROVE )," .
Application
FEB 2.8 p,--':(
Zoning A§rninistrator
TOWN OF QUEENSi3URY _
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