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98-521 CERTIFICA E OF C3��U�'1�I`J +CY i TOWN OF QUEENSBURY A WARREN COUNTY, NEW YORK C\ Date. October 27 98 ff� 19 _ 98521 This is to certify that work requested to be done as shown by Permit No* has been completed. MOBILE HOME This structure may be occupied as a LOT 85 LUZERNE RD . Location WILSON ► TERRI / START{ ► LORRAINE Owner TAX MAP NO . 9 3 . - 2 - 11 . 1 By Order Town Board TOWN OF QVEENSaURY Director of Bldg. & Code Enforcement BUILDING PERMIT VALUE $ 16000 TOWN OF QUEENSBURY No. TAX MAP NO . 93 . - 2 - 11 . 1 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Street. Road or Ave. OWNER of property located at LOT in the Town of 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 Town of Queensbury Building and Zaning Ordinance. 1, OWNERS Address is LOT 85 HOMESTEAD PARK LUZERNE ROAD ¢UEENSBURY , NY 128041 =1 2. CONTRACTOR or SUILDER"S Nana GLENS FALLS MOBILE HOME INC . 3 CONTRACTOR or SUILDERS Address 39 SARATOGA R13 GANSEVDOI NY 4. ARCHITECT'S Name COMMONWEALTH ELECTRICAL AGENCY IIIIIIIIIII 5. AB 11 G11 Hi�'S 7w6 s HAGUE , NY 12836 S. TYPE of Construction — (Please indicate by Xi MOBILE HOME { I wood Frams f 1 masonry ( I Steel ( I 7. PLANS and Specifications 980N§.Q FT MOBILE HOME AS PER PLOT PLAN SPECIFICATIONS 0. Proposed Use MOBILE HOME 35 August 28 2000 S PERMIT FEE PAID - THIS PERMIT EXPIRES 019 {!f a longer period k required an application for an eatansion meal be rr+ade to she SuIkllrq and Zoning inEPactw of ehe town of Qusenibary before the eaoirastion date.) 28 August 1998 pared at the Town of [lueansbury this Day ofAL 1g " far the Town of Qu~sbxlry SIGNED f!Y v u and Zoning IrMpeCtOr REVIEWED BY : FEE PAID : � I'ERMIT No . " APVLlCATION • FOR PURMIT MOBILE IIUME art 140DULAR A BUILDING PERMIT MUST BE OBTAINED BEFORE PLACEMENT OF MOBILE IIOME . NO INSPECTIONS WILL BE MADE UNTIL A VALID BUILDING 'PERMIT IiAS BEEN ISSUED . The owner of this property is : + � a V P . U . Address : Phone Number �MX?,�f(jCs Property Locati I S' Tax Map No . q3 / ! 1 � - NAME OF APPLICANT r Address of Applicantsj'"�� All applicants spaces on tillsC_, 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 11014E INFORMATION GFf APPROXIMATE VALUE OF i1OME : New Home Yes P. ZONING INFORMATION : Replacement Iloisie YeV No "' . Size of Property : ft x ft Size of mobile home �6 ftx.Lqft Existing Buildings . Singlewide Doublewide - - Proposed building-distance from property liner Nom of rooms ( exclude baths ) Front Yarn! ft Rear Yard ft . No . bedroomst5 _ Side Yards ft and ft . Occupancy Information : No , of bathrooms Primary dwellings Yes No Fireplace Woodstove Accessory Buildin+g ( s ) e Detacbed garage one car / two car car ) Foundation style and size : Attached garage one car'/ two car car ) Is — Piers-No . of Size ft x f Storage building t Other Depth below grade ft * * * * * * * * * Ar at 4f Foundation - Footing size x " Wall material Proposed date of placement . Wall thickness It Height " Water Supply : Well Municipal Total depth below grade ft . Septic permit required ? Grade to Dome floor. level ft . FURTHER INFORMATION REQUESTED ON TIIE REVERSE SIDE OF THIS S11EET NAME OF INSTALLER/MOBILE IIOME DEALER & ADDRESS/PIIONE NIIMBER STATE OF NEW YORK DIVISION OF HOUSING AND COMMUNITY RENEWAL INSIGNIA OF APPROVAL OF TIIE STATE BUILDING CODE 1 . Insignia serial number 2 . Name of Mantsfacttorer ------------- - :' •. . 3 . Plan Approval Number I . Model or Component Designation - �Tt 146CJ05 't D r 5 . Date of Manufacture � �� � � �� ' < � All Lite above information is to he found on a plate or sticker which shottld be affixed. to Lite Mobile Itome . Complete above with that information , Town of flrreenslttrry State of New York Courrty of Marren ArFIDAVIIm 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 ba. done on the descritted premises and that all provisions of the IM ILDIN+G CODE . the ZONING ORDINANCE , and all other laws pertainlog to Lite proposed work shall be complied with , whether specified or not , and that such work Is arlLhnrixed by the owner. S i Una L u r-e Owner , wner ' s acicrn architect . contractor SPECIAL CONDITIONS OF PERMIT : By Cnife�TnrorCement 0 r f cer DECLARATI©N:• Please sign beloty ufler yoet lueve carefirlly read the statement. '1'o the best of spy knowledge the statenuastts contained in this applica:[ion . logether with the plans and specifications submitted , are a true and c+on7plete statement of all proposed work to be done on the described premises and that all provisions of the Building Code, [lie Zoning Ordinance and all ollter laws pertaining to the proposed work shall be cornlalicd with , whelher specified or noted, and Uumit such work is aufliorized by the owner. Further, it is understcxxi that I/we: shall submit prior to a Certificate of Occupancy 0r Ccrlilicale of Cornpiiance dieing issued , an AS BUILT PLOT FLAN by a licensed surveyor; drawn to scale, showing actuttl kx:ation of project on premises. Signature: (owner, owner's agent, architect, contractor) TOWN OF QUEENSBURY 742 BAY ROAD, QUEENSBURY, N-Y. 12804-9725 (519) 745-4400 PROCEDURE FOR PLACING AND OCCUPYING A MOBILE HOME OR MODULAR HOME 1 . Application is submitted and reviewed . 2 copies of plot plan and 2 copies of layout must accompany application , along with septic application if needed and electrical inspection application . 2 . Permit is issued , 3 . Permit card is placed on property . 4 . Footing forms are inspected before pouring concrete . 5 . Foundation or piers are inspected before backfill . 60 Home is placed on foundation or piers . 7 _ Septic is inspected , if needed . 8 . Final inspected of electrical connections by approved agency . ( "Phis includes pole to pole and pole to box . ) 9 . Stairs and Platform covering door width and door swing with handrails on both sides of platform and stairs are required for all exterior doors . 10 . Final inspection by Building and Codes Department . Certificate of occupancy issued - home may be occupied '"NcD&IE OF NATUjI:? I.. EE,4 UTY _ _ - A GOOD PLACE TO LIV= ±TLEC ; r=J I F1NA'L. 1N$p�,�-rlow w;t�ti�"��"r T Mp231fi.. S / �/10fi.1fiJ4a►R Town of QU0611sbury Building & Code Entorcement 742 Bay Road k pUJEsbUry, W 12804 wa) 761-8256 ARRIVE- DATE DATE SNSPECnON REQUEST RECEIV E Gy+ NAME: t,QGA110N: PERMIT 0 DATE- lM10 In K011�8 M081L8 1r10FoarMGS FRAMING -- OUNDAT1oN NIA YE$ ONO 1. fovnciation support' Fier per 2, ancliarin$ per rnaou£' '- 3 water line shut, off 4" t . . .. .. 4. sewe y'xpl"errt(d de) off grd �- 7 water relief a piping ts $. hot �+ potclacs 4. fdeimaca • + ratins .. . .. .. . 11. garage 'fire P 12. door closers . . .. _ 13. plurnbing fax Lion (if appl.). .. ... ~- 14, foundation ... 15, make 16. final electrical c ;. . . .. .. .. . -¢ 17. Maria" requiredJ �- l$. data Plate okay i9. mdbile #i W seal okay Serial # Model # marnnfacturer Drate of Manufacturer "~~ YES NO OKAY 'fb ISSUE CIO Co�nents: 1NBPC^� 1C�►N � pprs r �J F{NAL• / Mi�Cs1J1�-A� Mp Town of ©ueensburY guilding & Gode Enforcement 742 Bay Road oueensbury, NY 12804 (518) 76l-8256 ARR1v� gEP AR"T. 1;NS r gA jTgSPECTICN+ RssaVEST Itf CE1V 00 }� l NAME: 1 pCATiQPd: = .�-- pEp,N1TT # I]A'TS: 0Dtn6^a HOliiE 14011MIK *gol Fr MAMING po(ynNGS -- 'FOUtag AT ION aAcKFi NIA NO t. {ration aupport• pier Spaoing per manuf. Z, anchoring per manuf. �- 3, water line sbut,off _ �- -- 4. sewer line suPP©� feet off grd. 5, head Giver (dbiewide) 61 dryer outside 7. y 'ablated .. .. ..... .. ..o ;de hot water re 8. lief valve piping �- 11. garage fire �� ' 12. door closers .. . . . .. .. . .. . :. ..... .. .. ... �-- 1.3. plumbing fixtuae . .. ,. . .. _ 14, foundation insulation (if app" 5, smoke 16. fumd eleecctriI . ..-'. ... . .. . . . 1'7 . variance reciuved .. .. ... . _, 18. data Plats okay ..... ..... .. • '... .. 19. ,mobile HUD seal okay . .. .. serial # Model # l,,�anaufacturear Date of Manufacturer S NO YE OKAY TO ISSiTE CIO �� �i41VAL INBP�GTICII'ti1 1Fs1�1�w�iFs 1` Town of Queensbury o Building & Code Enforcement 742 13ay Road Que.tsbury, NY 12804 (518) 761-8256 INSP: AMVE, DEPART: DATE INSPECTION REQUEST RECEIV —" lQ) NAME. � � ��' I. CATION PP QIDATE: ' -V r ) PE1ZIvlTT # HpgILE Hfar'1dE OrKMAIR H FOOTINGS � FOUNDATION _ BI+CIGF[I L — SING N! YB5 N4 I . fcffi Lion ffWpc` t• p1er spec VI/ per uvanuf. 2, anchoring per manuf,. .. .. . .. .. .. . 34 water line shut.off .. ».. .. .. chi 4 feet .» 4, sewer line support �- 54 heating crossover {dblewicie) off 6. dryer vented outside •.t=! . .. 7. skirting ,_ted B. hot water relief valve p'� alve Pig outs' 9* deck, potdhM steps, railing •. .. . lo. furnace/hot water operating .. . II. garage fire proofing 12. door closers . . . "I .. . .. .. .. . .. .. . _ 13, plumbing f ms tioa (if appl 14. foundation 15, smoke detectors . ..... .. .. ... �- lb, final electrical 17. variance required .. .. .» .. 1$. data Plate okay .. ..., 19. MoWle HUD seal okay Al Model # Serial Manufaacturer Date of Manufacturer OKAY TO ISSUE Cf0 YES NO Cotmnents; % `50y ~ 3 � ALTIi ELECTRICAL INSPECTION SEK'V'%.c•, •,• C4MMCINWE Manheim, PA 17Z MUNICIPAL CERTI [^ Main Office 357 Elwytt Terrace PA rr�� —_7 ELECTRICAL APPROVA F 5927 9 G I 4 Cut-in Card No. .. .. .. . .. Panel Board No, ..- .-. .. ... . . �JCerf. owner ...... /• . ....-.. ...................... _ _...-. ...........,... r� k occupant .-. ./..... .. .. . ... . . . .... �s ��/� � Y, . .� �' . ...... .... -.. �. .. . . _. . . Lt}l:atlOn .,.�0•-. L Installation Cunssstin of .......... ... _ . ck . . ._ )1 cis ". . . .. . .. .. .. . . ... . d . ..... Lic. .#.-.... ,:ertiiicate prsvi«usfS' "'� '''""•" ' emu•v4 - of this certificate, and any Installed BY govern the issurnue The conditions fulio'a'inK R rom t1y made Sur issued is cancelled: — ur alterations. appiication shall be P P This certificate only covers the electrical equipment and installation conditions as ui' date. po ui men[ at . ny tirne, and If its the introduction of add'itio"I eq P riv`sieµe of Makin in_specuo inspection- omPanY shall have the P ertificat lri.speetots of this C ail have the right to revok th _ L/ ... . rules are violated, the ComPa . .. .- • / iNECTCI . er SP -.-....-.. ., J.` �..- ,..-....- ,... Member Date . .-.-. -• � �IIVAL 11\iSi�1�CTIC3N IFit�tPlf�F�tT MC3113SLoR / MCXIPULAR Town of Queensbury Building & Cole Enforcement 742 Bay Road Quaensbury, NY 12804 t 618) 761 - 4 ARRIYKM006EPAR`i s DATE INSPECTION REQUEST RECEIVED: e- 5 �ci � NAME: LOCATION, DATE: �� '� — � _ Pr=Rmrr # MOBILE. HOME MOMWLAR HOME FOOTINGS FOUNDATION _ RACICFI r � FRAMING N/A YES NO F*3water foundation support, pier spacing per manuf. . . . .. .. . — an choring per manuf.. , , ., .. .. . line shut.off .. .. 4. sev v r line support CW 4 t . . .. ... _ 5. heating crossover ewide 6. dryer vented de . ..... .. .. .. .. . .. .... . — 7. skirting _ S. hot water relief valve piping outside — 9. deck* porches, steps, railing , .. .. .. . 10.. furnace/hot water operating ... .. .. . _ 11, garage fire proofing . .. ..... .. I. .. ... . — 12, door closers .. .. . .. .. .. ... . . .. .. ." , .. . _ 13, plumbing future .. ... .. .. .. .. ... .. .. .. _ — 14, foundation insulation (if appi.). .. ... 15. stroke detectors .. .. .. .. ..... .. .. .. .... _ 16. final electrical . .. .. . I... .. .. .. . . . .. . . . _ 17. variance required . . .. .. .. .. ... . . .. .. .. — � — 18, data plate okay 19. mobile HUM seal okay . . . .. .. . . . . ... Model # �76%AC49 71z,� Serial # Manufnbturer _ C� Al Date of Manufacturer e, e; OKAY TC7ti-T � NO Comments* l L - L I 11 , l 1 l L - i l L11/NVG 1p ! i^ '. I_ L . I .. LL_ RNI, L_ €, ROOM ty.-r -tcr `` € .. I._ LLLLLI_ LLLLLI SECOND f MASTERL_ = l I_ L L L_L i _ _ _ cerr,eaw,,� ceturuG sr,wwav {Jf I DROOM BEDROOM BE [ �•-e- K v._� ,,, „ E`, l THIRD K-TCHE]J BEDROOM 3BR, IBA, TWO FRONT BEDROOMS MW147076 I — — — L_ L, 1 -- I - L I_ LaNI .._ , u_ t". LINING 7HIRd SECOND e.. L L L l ROOM MASTER ... , _ L_ L_ L L L L ,e -r u _,ar BEDRt� BWROOM ! ! L BEDROOM . L L L L L L L L (OP'fi DEN) ,v-�- : e -,. j .. _ , � , CAW, E RAL CdUNG STA"OMa o.r L LLk___ _ L... L_ L_ LL_ 4 7 uxW L 1. p KRCHEN- ; ; _ L_Lk �" LL. L L_ Li Manua -Tip '� LLLl � 3BR, 2BA, FRONT CORNER BATH MW147205 a i � I 41L, L L. l . i. I .- L- 'IvECONU MASTER L-..t1 L1_L1L _ cxTu�Garw c wNc srwnMG _ L LL_ _ BEDRd _ LL. L ._ ,_ � � L €_ LLL._ L_ ii . BEDROOM 1- . 1Jj ' . ,x•-,rs , I 9 ! _ L , � , .. L- L L LIVING L KRCNE7N L L- ROOM ar 2BR, 2BA, FRONT BEDROOM MW147238 f NOTICE MONGOFMOKEOK FM6REQtMK 4 { poll E y r � s f TOWN ? '" . .� roxoF QuNsRyr�euuocn� buld on ow yF�,�. urx.mw �„—__. . - �_se�.—r.--..— ----`+w.aa+•y.n�Eran+rrt.+Ml�tn•+.�r�an.r�..,.-.�w.r-..e...,-. .. . i i a