IM Inspection Worksheet_14-11-2023_13-49-32INSPECTION WORKSHEET (MANMODFIN-028888-2023)
RC-0348-2023Case Number:Case Module:Permit Management
11/14/2023 PassedInspection Status:Inspection Date:
Manufactured Modular FinalInspection Type:Inspector:Charles Dyer
Job Address:Parcel Number:52 Petrie Ln
Queensbury, NY 12804
308.6-1-62
Company Name NameContact Type
Applicant Robert Plocharczyk
Contractor Glens Falls Mobile & Modular, Inc.
Granted Permission Queensbury Village
Primary Owner SAMUEL WAHNON
Checklist Item CommentsPassed
Building Inspector Notes False
Final Electrical True provide final electrical / verified 11/14/23
Anchoring per manufacturer 2ft from ends True
Warranty Seal after January 1, 2006 True
Public Sewer Sign-Off False
911 Street number True
Installers Warranty Seal True
Manufacture True Champion
Data Plate okay True
Furnace/Hot Water Heater operating True
Dryer vented outside True
OK to Issue C/O True
Vapor retarder under home 6 mil poly or other True
Hot water relief valve piping outside True
Date of manufacture True 6/22/23
Water line shut off True
Foundation support, pier spacing, per manufacturer True
Model True ESDA25002 / Champion
Serial #True
Foundation insulation [if applicable]False
Smoke Carbon Monoxide Detectors Interconnected True
Skirting ventilated 1 sq. ft. per 1,500 sq. ft.True
Manufactured HUD seal okay True
Deck, porches, steps, railing True
Sewer line support @ 4 feet True
November 14, 2023 Page 1 of 1