98-334 f
r
i
' CERTIFICATE OF %`]C+iCUPANCY
TOWN OF QUEENSBURY
f
WARREN COUNTY, NEW YORK
I
f Date June 22 =9 98
f This is to certify thawork requested to be done as shown by Permit No, 98334
has been completed.
i MOBILE HOME
{ "Mia structure may be occupied our a
LOT 11 HOMESTEAD VILLAGE
6 Location
j Owner TODAY ' S MOBILE HOME
TAX MAP NO . 931 . 2 -- 1 1 . 1 By Order Town Board
TOWNf OF QUEENSSURY
R
Director of Bldg. 1Sc Code Enforcement
f
f
BUILDING PERMIT
VALUE $ 26430 TOWN OF +QUEENSSURY Na 98334
TAX MAP NO . 93 . - 2 - 11 . 1 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to TODAY ' S MOBILE HOME
OWNER of property located at LOT 11 HOMESTEAD VILLAGE Street. Road or Ave.
in the Town of Oueensbury, 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 Oueenrsbury Building and Zoning Ordinance.
1. OWNER'S Address is
LOT 11 HOMESTEAD VILLAGE
+QUEENSBURY , NY 12804
2. CONTRACTOR or BUILDERS Name
TODAY ' S MODERN HOMES
S. CONTRACTOR or BUILDERS Address
54 RT 9
GANSEVOORT , NY 12831
4. ARCHITECTS Name
NEW YORK BOARD
A?MIT&'1V1MRD OF FIRE UNDERWRITERS
6. TYPE of Construction — (Please indicate by X) MOBILE HOME
I } Wood Frame i I Masonry ( I Steel ( I
i. PLANS and Specuicaeions
896 nq FT MOBILE HOME AS PER PLOT PLAN SPECIFICATIONS
a. Proposed Use
MOBILE HOLE
29 June 16 2000
$ PERMIT FEE PAID - THIS PERMIT EXPIRES 19
(If a longer period is required an application for an extension must be made to the Bulldleq and .'Coning impactor of the
town of Chasertsbury before the eKpiration date.!
16 June 1998
Dated at the Town of Oueenshury this Day of 18
SIGNED BY ` . � } � � _ for the Town of Oueensbury
Suild+ng4 and 2oninp Inapaclor
� A, _
REVIEWED BY & ��
FEE PAID : $ °
PERMIT NO .
APPLICATION FOR PERMIT
MOBILE IiOME OR MODULAR
.IUA/ .71 IV-PC ",
A BUILDING PERMIT MUST RE OBTAINED BEFORE PLACEMENT OF M4i3AE 110ME ,
NO INSPECTIONS WILL HE MADE UNTIL A VALID BUILDING PERMIT HAS BEEN ISSUED .
The owner of this property i s :
P . O . Address : � lG ' 2/� � G�7 ` Y,I i �rTu'2 `% Phone Number
Property Location co -,I' fj Tax Map No . ,? ' / f
NAME OF APPLICANT ;
Address of Applicant :
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 : 7�0�e, /j, Je1 l/
C ;
MOBILE 11014E I NF4ItMAT 14N APVH0X I MA 'TE VALUE OF HUMS : $ p{ �� �7I,.a
New flame Yes No % L ZONING INFORMATION :
Replacement Ilonte Yes No Size of Property : 5� ft x 27 ft
Size of mobile home /`L/ ftx 6 ft Existing ITuildirtgs ;
Singlewide .v Doublewide �.
No . of rooms { exclude baths ) ". Proposed bu I T d i ri 1 distance from property lines
� Front Yard __._c� ft Rear Yard fit .
No , bedrooms Side Yards 42ft and �ft .
No . of bathrooms e,7z Occupancy In format
Primary dwell inE Yes No
Fireplace� ZIOWoodstove IiL) Accessory I3uiTdirtg ( s ) :
Foundation style and size : Detached garage ( one car / two car car )
Attaclted garage ( one car / two car car )
Piers- No . of Size ft x ' ft Storage building `-
Other
Depth below grade fit
Foundation- Footing size
Proposed tilr° cemerr t :
Wall material ter,/
Wall thickness Height _ Water Supply : Well Municipal
Total depth below grade ft . Septic permit required ?
Grade to home floor. level_ ft . ,� 1.� 7/4) /tom
FURTHER INFORMATION REQUESTED ON TIIE REVERSE SIDE OF TIIIS SIIEET
NAME OF INSTAI_i_ ER/MOBI l_L IIOME DFAI_ER : Q/� t���.--f! U� l� E/W k � E -
ADDRESS /PlIONE NOMDEI( � ` ' "I `� uoLg j, 1 -103Z�
STATE OF NF (J YORK DIVISION OF 11OLISING AND COMMONITY RENEWAL.
INSIGNIA OF APPROVAL OF TI IE STATE IIII I LD I NG CODE
I . insignia serial number
2 . Name of Manufacturer
3 . P1 an Approval Number
4 . Model or Cornironerr L De s i gna L i urn _
S . Date of ManufucLure
All Ltie strove 1 n forma Li on -is to he f olind nn tti lnl a to or sticker which
sbotrld be affixed Lo the Mobile 110nre . t: orrrp 'IcsLe alrrive wit. l) tbaL inrormaLlon .
bm
Town of Oneensimiry State of New York
County or Warren
AFFIDAVIT
I swear tha L to the hest of my knowledge and lie ] i e f Lhe s to tenrent. s con La i ned
in this application , together wild the plans and speciflcat. ( ons Submitted ,
are a Lrue and complete statement of all proposed work to hg. done on the
clescrihed premises and tbaL al I provIsIons of Elie 1111Ii_ DING CODE , the 70NING
ORDINANCE , and all Other laws pertaining to The proposed work shall be Complieci
with , whether specified or not , and t. ha L such work Is arr LLr r 1 zed by Lhe owner .
.,s
Si gna Crrre t4j
etla��
Owner . ow is agent , arch ect
con Lrac Lor
SPECIAL. CONDITIONS OF PERMIT :
y 1
by ,
Coi1e—F. nforceaie L Officer
DECLARATION: Please sign below after year have carefully read the sfalement.
1'o the best of my knowledge the statements contained in (his applicalion , logether with the plans
aril spec:rricalions submi(led, are a (rue and complete stalemeat of all I7rolx�sed work to be dorlc on
lire described premises and I1iat all provisions of (he Building Code, the Zoning Ordinance and all
other laws pertaining to (Ise irrcrixrsccl work shall be conrlrliccl with, whether specified or noted , and
that such work is authorized by (lie owner. I 'urthc.r•, it is understood that I/wc shall submit prior to a
Cerliricate of Occupancy or Certificate of Comirlianrcc being issued, an AS BUILT PLOT PLAN by
a licensed surveyor; drawn to scale, showing actual loc ,lion of project oil premises.
Signature:
(owner , owner's agent , archi(ect, contraclor)
THE NEW YORK BOARD OF FIRE UNDERWRITERS ► fit-� �
4206784 BUREAU OF ELECTRICITY
F 111 WASHINGTON AVE., $ ALBANY, NY 12210
JUKE ^ 5 1:�19fi 3"1485` 6 / 98 A 1 .34 '" L4
Bate * A fieation N on file
THIS CERTIFIES THAT =111T 98-- 334
only the electrical equipment as described below and introduced by applic reamed on the above application number is in the premises of
AM-MONY Sc T'AHALA DE IE:0 . LUIE ENE RD . {{�L� OT 11 , 4FASTEAD VILLAGE , QUEE�NSIBURY , NY
in the following location, ❑ Basement ❑ 1st Ft. l_I 2nd iFl. OUT Section Block Lot 1 �-
was examined on 'DUNE-' 22 � 1 99'8 and found to be in compliance with the National Electrical Code.
FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS THC.,NDESCr FLUORESCENT I OTHER I AMT. I K.W. I AMT- I K.W. AMT. K.W. hMT. N.W. AMT. H.P.
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS ISPECIAL KC'PT-1 TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET SYSTE DIMMERS
AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A. W. G. AMT, AMP. AMT. AMPS. TRANS. AMT. H.P. NO. OF FEET AMT. WATTS'
SERVICE DISCONNECT NO. .OF S E R V 1 C E
METER NO. OF CC COND. A. W. G- A_ w_ G_ A. W.
c�.
AMT_ AMP. TYPE EQUIP_ 1 0 2W 1 0 3W 3 0 3W 3 0 dW PER 0 OF CC. COND. NO- OF HIAEG OF HI-LEG NO. OF NEUTRALS OF NEUTRAL
OTHER APPARATUS:
FEEDERa #2 #4 FROM DISC TO rill- 1
TC )PLYS HODERN MOVIES L
54 ROUTE 9
GENERAL MANAGER
GANSEVOORT , NY , 12831
239
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.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. 4
�, Fff�AiL ffllsf�HG'1Y"IOMV
MC3011_E / MC3C3UL.LAP1
Town of Que8mbury
Building & Code Enforcement
742 Bay Road
Queensbury, NY 12W4
(518) 761-8256 \ YI C
ARRIVE: r r?�DEPART: ,`INSP: i
DATE INSPECTION REQUEST RECEIVED:
E
ION:U / ' ' / PERMIT #
MOBME HQME t, lwfILU113AC71.&A HOME
FOUNDATION SAC"KFUA.I FRAMING
NIA YES NO
14 foundation support, pier spaces
f
Per manuf.
2. anchoring per manuf. .. .. . » . .. .. I - -- - -
3. water line shut, Off . .. ... .. .4 .» . .. .. .I
4. sewer line support a 4 feet —✓�/
5. heating crossover (dbiewide) Off grd.
6. dryer vented Outside . ..... .. .. .. ... ..
7 skirting ventilated I I I
outside --
g, hot water relief valve g
9, deck, poi ches, steps, r 110. fumacefhot water ()Pe --
I1. garage fire proofing .. .. ... . ✓ — r _-
12, door closers , ». ... .. .. .. ... .. .. . . . .. . - `y
13, plumbing fixture , .. ... ., .. .. .. .. .
14, fousydation insulation Ppl•). . .
15. smoke detectors .
16. final electrical l _
17. variance required . .. ... .. . . .. .
IS. data plate okay .. .. .. . .. .. .» .. , .. .. .. . --
19. mobile HUD seal okay .. ...
Model #
S C', ( ' 1_^ C�' Serial Wj(" --t-
Manufacturer
Date of Manufacturer r
OKAY TO ISSUE CIO � YES
NO
COrnments:
105'
26'
JUN 1
Existing Patio
55'
29 New 1998 Skyline
1 4xs4
S `
15' �
�o .;D G� �y
Lot # 11
Homestead Mobile Home Park
Tony & Tamala Deleso
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70
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V3
IV 140
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