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1989-603 41 CERTI A - F OCCUPANCY � TOWN OF QUEENSSURY WARREN COUNTY, NEW YORK f Dote October 19 19 89 'This is to certify that'Worri requested to be clone as shown_ by Permit No. a has been completed. This structure may be occupied as a SlngW fnmil3z wodiflar Location Lot # l 3 Asure Drive chvner Sterling ueiity Homes By Order Town Board TOWN OF QrUEENSBURY i Zr f 1! Director of Bldg. & +Code Enforcement E 1 BUILDING PERMIT TOWN OF QUEENSBURY No. WARREN COUNTY, NEW YORK y 3 r PERMISSION is hereby granted to Sterling Quably Llom S ca OWNER of property located at T nt1�.4 Ayt! e T]ri ye _ Street, Road or Ave. in the Town of Queensbury, To Construct or place a Single 'Family 1R Ar 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. 1 . OWNEWS Address is 26 Lafayette Street to Hudson Fails, N.Y. 12839 t� rti �-H �y 2. CONTRACTOR or BUILDERS Name Modular-Chelsea S.Q. Homes t� 3. CONTRACTOR or BUILDER'S Address —7 4. ARCHITECT'S Name lr 6_ ARCHITECT'S Address 6. TYPE of Construction — (Please indicate by X) e a KYMood Frame ( I Masonry i 1 Steel C7 tr 7. PLANS and Specifications C No. 241 x 48' Single family modular as per plat plan, specifications, and applciation, x including septic and driveway M t=. 8. Proposed Use Single Family Dwelling(Modular) r. C t $ 1 44 i1f1 PERMIT FEE PAID — THIS PERMIT EXPIRES March 1 19 x$ 90 r (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.) _ C Dated at the Town of Queensbury t Day of aut�ttst 19 89 � C C SIGNED BY t for the Town of Queensbury C Building andWilpector r� TOWN OF QUEENSBURY APPI, ICATTON FOR BUILDING ;CNTN PERMIT 1'atc- Rec.iaveta 7 - 3 -CC 17 Rev.i.ewed r, � TOWN OF© 1VE0 SSURY Fy Fee Paid t / Sera JUL 3 i 19Rq WILDING .AND CODES U171AR11TUHT Date 7eaued BLDC. � CODE DJ�PT. DAY and itAVILAND ROADS RD I Box 98 PUEENSOURY, NEW PORK 12804 PeAm-i t No Q Tel * (528) 792-5832 Ext -204 w w • • ie w w w t w w w w w �. : w w w * w w w w w w * • s : w w ■ w w x w A PERfITT MUST B1q OBTAINED BEFORE BEGINNING CONSTRUCTION * NO INSPECTIONS h' ILL BE MADE UNTIL APPLICANIT HAS RECEIVED A VALID ACILDINC PERMIT . All applicable spaces on this application must be completed and the sti mature of the applicant must ap car on the reverse side of this shoot . 'r h e o w n e r o f t h i s p r o p e r t y i s : !-tar "LrL E R L4ASo s - -DAA S71W- 45-- QA W CTV ef{rw� c P . O . Address "d;;A6 � . Y�railT�SOI�./4 _�S lt-?5( 14-Ak3j TEL . ? — 73 property location ! TAX MAP NO , " /�/ 13 jig 11as there been any split of this property since October 1 , 19887,,,,__=/,r_ lto If yes , Planning Board Review is necessary , ye -�" no ' SUBDIVISION NAME . IF APPLIC'AnLE t: A> ,, - - f . 4 LOT NO * 17 The person responsible for supervision of work as regards Building Codes is : NAME M 4 _ C �� P . O . ADDRESS TEL . NO * ldame of bull er �""�- .0 F a w^ =S- Address � d J ,� Tel 74 3 5% Name of Plumber r + Tddress Tel Name of Matson Address Tel r 14ATURE OF PROPOSED 6ORK : ; 70NINC IN1*011HA.TION ( Office use only ) -X.C_onxtruction of :a tsuw building * ZONING DESIGNATION OF PROPERTY Addition to a building ; PERMITTER PRINCIPAL 'PERMITTED ACCESSORY �Altur"tion to a Luilding lino chztng � to excurior rlimenL- ions) w REVIEW REQUIRED - PLANNING BOARD ZONING BOARD Ocher work (dascrils.0 SITE PLAN REVIEW # APPROVED M,MwDATE C kOSS AREA OV V ROVOS ED. STRUCTURE * VARIANCE # APPROVED DATE 1st Floor 1 sq ft Remarks : - 2 n d Floor s q f t . + COMPLUTIZ I,p parimATION hCQU I kED 1l1:LC)Irl . Other Floors se{ ft . .SLza of propurty�; tf'Q F� P11I? + f-& t X fk rt 1- . 901, err. ( not cellar or basement ) 17uil.tiit.] t ::ll Sias ft x rG • TOTAL FLOOR AREA^ Sq ft . + ux"zing buildiny (u ) Uya: i.` i .: ctr" now ::tructur. _ft Xwww sft * � • F'o►ittd:acion-pier/slaL,/crawl/partiul� " kiropo:x4d building , distance troth L�rasiturty ling: (r:irClu one ) * Front yard_ ac) ft Roar yurd r✓- (a ft No * of stories (hubi. t:ablo space ) �� Sida yards t L et and gw? ww P f t Ilsaight (grade to ridqu ) 2.._4 ft . * If on corner , Notback ,from sides ntrooc ft if rosida:ntial, no. of families I Now of rooms ( excluding b"ths } .1i ' ' OCCUPANCY INFOaMATION tlo . of bedroomswwwombomwo -- * PRIMARY D UILAINC Na . of bathroom : *_ � mo1 nwoo Family dwelling Primary Itu: tiluj uyst4tsw ra r G=a t � family dwulliny .lypu "f Multiplo dwalllwng / Number of units No . of fireplac4s to bQ install4dalgx:�.. ' will :a wood! shove k,v inULthud? -''Yt,��v� * �1�ersnunotst aecup:artcy C:4ntral hit cattatitiunin r + 'Pran::it:rat occul,s:utcy `) ' -- �' " A Businous WILDING STYLE, PRIMARY STRUCTURE * Industrial 1c.alta1t ConGompl ,r"ry Lag cabin * ocher 14.ais4.:d raaah Mansic+tt Our,lc:x w If :addition , w16ust will ua:aa but?. :.i 3 ' t 4VQ1 Old atyria d busty.alow " t_zApu Cod Catt:+Csa ochwr '" ACCL'SSOItY BUILD=t+IG- 0 0 :t kow '1`owo ,house ' L' astacharr g arugo/ones czar/ two cur/ czar ( CIRCLL•` ONU PLEASE I * Attatehud g:araqu/ona3 car/ two car/ cur • w r • w w w • w w w r w w ■ Privlato Storuge building ESTIMATED MARXET VALUE OF * --Ocher r Ct]N :;'1' FtUC"1• IGN * INFORM&TTON ON DUILDINC SPECIFICATIONS , ON RVveRSE SIDE OF THIS SEIVE'T, 1Y0 8E COMPLCTEDI Form BPA 10/88 v2 BUILDING PERMIT APPLICATION CONTINUED BUILDING SPECIFICATIONS : Type of construction, wood frame , fire safe , etc . Li—: cc 3> c> -t> cLL &re Will any second-hand or ungraded lumber be used? If so , for what Foundation wall material Gb h c y Thickness Cr Depth of foundation below grade (to bottom of footing ) , Will there be a cellar? Heated or unheated? IC Floor sq. footage . ? fIti` sq ft Will there be a basement? VaJW111 any portion be used as living space? ( If so , what portion? I sq . ft . - - Type of use? Type of roof - sloped/flat/shed/other 6-A43N e.- Material. of roof c� pf.l,q , 7— Size , wood studs 'D " X spacing�"o . co length cql ' ft . -- Joists ( floor beams) lsto floor _"'X '" spacingj.(,."o . c . span __L;&,_ft . *Joists ( floor beams) 2nd . floor "X "` spacing "o . c . span ft . Overlays (ceiling beams ) -"X___g _" spacing' "o. c , span.JI_ft , Roof rafters ''X_ _ ( " spacing- - j(;p o . c . span- 1 7`ft . Roof trusses (pre-engineered) spacing"o . c . span_�ft . Exterior wall finish S'1Vi �: of what material? L..� r5 -t_ Interior wall finish 1 f2 LZ_`e .L1FII 7 e ,44 Icy T 7)pl regh — rA- VL? A4> G�-1 #-OPA'*G'If a garage is to be attached , describe materials to be used for FIRE SEPARATION W_ _: Is there to be an opening between garage and dwelling? Iffso will a Fire-rated door, enclosure , and salf-closing device be provided? Will a flue-lined chimney be installed? � Height above roof �nso4. ft . Depth of chimney foundation below grade , , _ft . C sp '- +�' '� Depth of fireplace hearth fto in . Water supply - ,Municipal or private well Qot t %/ W ,{� — SEPTIC SYSTEM _ Distance from ANY private well ( including adjoining properties. ft . (A separate application is necessary for any repair or new installation of septic system) D E C L A R A T 1 O N 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 be complied with, whether specified or not, and that such work is authorized by the owner. Signature e oLa Owner, own ! nt, architect, contractor SPECIAL CONDITIONS OF THE PERMIT : Hy------------------ --------------_-...__-_ TOWN OF QUEENSBURYQ WARREN COUNTY , NEW YORK ��� . Application. for ; BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK STATE ENERGY CONSERVATION CODE A permit must be obtained before beginning work . ANSWER ALL of the following : 1 . Gross floor area +C Cog fJaS� 2 . Type of heat E L r 7-,r f - 3 . Is the building mechanically cooled ? 4 . Percentage of area of windows and doors' [ 3 PL 0 6 A . over 16 % Only 1 . Uo value of gross area of walls , roof/ ceiling and floors exposed to ambient conditions 2 . Floor over heated spaces YES NO a . Are foundation walls insulated ? YES NO 1 . If YES , what is the R value ? 3 . Slab on grade YES NO a . if YES , what is the R value of insulation around perimeter of floor ? 4 . Is basement heated ? YES NO a . R value of insulation 5 . Type of insulation B . Under 16 % only „ � 1LAP 1 . R lue of roof and floors posed to ambient conditions et go o Z � e r S XP cry 2 . R value of exterior walls 2 - 1� ('s fla '' Ko"O's h'x = 7,�� = �. �. 3 . R value of glazed area w-1 r- - I � E S +v — 3� ter- �2 - + � '3-;L) 4 . R value of doors & t- L V4A-co 7LA" -- f2 L4 -- . "Ci J 5 . R value of floors over unheated spaces 6 « R value of slab edge insulation - unheated slab 1sv _ 7 . R value of slab insulation - heated slabe ' 80 R value of heated basement / cellar walls ( above grade ) olo-" 9 . R value of heated basement/cellar walls ( below grade ) 10 , Type of insulation C . Controls T . Thermostat maximum heat setting 2 :57� � D . Duct Systems 1 . Is duct system installed in unheated spaces ? YES NO a . If YES , R value of duct installation b . R value of duct in other areas E . Piping Insulation / 1 . Size of hot water or cooling carrying a} ent pipes er x' rr 2 . R value of pipe insulation cc , k L4 �p F . Service Water Heating i « Performance efficiency - 2 . Temperature control setting maximum Tdro G . For Swimming Pool Only, 1 . Maximum heating - Telephone No . � � ? _ ( applicant ' s signature ) TOWN ©F Q UEENSU UR Y Cie APPLICATION FOR. SEPTIC DISPOSAL PERMIT DATE_ � . r LOCATION OF PROPERTY FOR INSTALLATIOII Owner's Name: 1 n--+-� � 1 Telephone: 0/J �4 , - ► c ? 7c Address: 26 y Installer's Name:_ 1:2 sr- _Telephone: 7 - cF +j/ Number of bedrooms (residential only) Total daily flow (compute (a 150 gal per bedroom) � Topography: Circle on f lgaL3 Rolling Steep Slope % of Slope Soil Nature: Circle one( Loam Clay Other�_n W ./Depth : I (a Feet Ground Water: At what depth? tp . gyp Feet Bedrock or Impervious Material: At what depth ? ��- J"o -t Feet Percolation test: Circle one: not required required rate min. inch, Domestic water supply: circle one: Municip We1Z Other If domestic water supply is a wells Separation: Water supply from septic absorption feet PROPOSED SYSTEM : Septic Tank gal. (minimum size: 1 ,000 ,gal.) TILE FIELD: Each Trench feet/Total system length feet Size of stone to be used #. o/Depth or Thickness oLl f� t L�{+ ,, feet �,c �`+ •-' �I �-f ti7 � I have read the regulation on the reverse side of this sheet and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance, SIGNATURE OF RESPONSIBLE PERSON: DATE: { OVER. I Septic System Inspections : A . All applications for septic system installation , alteration or repair , as required by the Town of Queensbury Sanitary Sewage Ordinance , shall be submitted to the Building Department at least 24 hours before start of construction and shall include a plot }clan showing : 1 . ) the proposed location of the system 2 . ) location and distance to lot lines 3 . ) location and distance to structures 4 . ) location and distance to any water supply 5 . ) size and dimensions of all tanks , distribution boxes , tile fields and / or drywells B , Nu system shall be covered before inspection and approval by the Building inspector . Failure to comply with this requirement may rLsult in the uncovering; of the system by the installer and a fine of up to $ 250 . 00 . C . An approved copy or the plot plan shall be available on the construction site . Failure to produce said plot plan at time of inspection may result in an immediate work stoppage . D . Should unforeseen problams during construction prevent proper installa— tion , alteration or repair of an approved system , a new proposal must k,t submitted to the Queensbury Building Department before further construction . Town of Queensbury BUILDING and CODES DEPARTMENT Bay and Haviland Roads Queensbury , New York 12804 k.:marks TOWN OF QUEENSBURY BuXzDrNG AND CODES REPARTM.&NT BAY & HAVILAND ROARS OUEE'NSBURYx NEW YOR1C 128,pk TELEPHONE (518) 792-5832 BUILDING INSPECTOR ` S REPORT REQUEST FOR TNSPECTrON RECErVED NAME _...��_._.___._ zOCATxoNf � DATE _ PERINXT APPROVED FOOT'TNGfPIER�r YES NO M01u'0LTTHrC POUR FORMS FOUNDAAT ItOWDAMP—PRUOFir- r BACKFrLL APPROVAL ROUGH PZUMBING PRAMTNG ELECTRYCAZ Rp�G ,_TN TNSULATTON: FOUNDATION F'LFII=KoRS WALLS CEILING �NAL INSP,�TTON: CHIMNEY HEIGHT ROOFING SIDING RXIVERNAL PO CHES/STEPS STAIRS—CLE RA & �%RATLs PLUMBING TXTURES/R T IEF VALVE NTBRIOR TRrM/PRTVAC DOORS GARAGHE FLOORS GARAGE FIRE'PRGOP-TNG DOORSER (S) SMOKE 1 DETECTORS FINAL R ;EC ,ZCAL TNSPEC2ION FXNAL APPROVAL OF COeySTRUCT20—N T A SIGNED CERr-rP-rCATE OF OBTAXAVED FROM THE BUTZDT CUPANCY MUST BE THESE PREMISES ARE DEPARTMENT BEFORE OCCUPTEDI REMARKS: INSPECTOR � - �17 LEII'Z rU� �r�PP II ..f Ga Ll I"L! 13 JFLDING and .ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 % Oueensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME LOCATION DATE ��., PERMIT T NO. Gj I SOII, TYPE Sand - Loam - Clay �^' Percolation Test Required? YES ]O Percolation rate - Min/Inch TYPE of SYSTE4: ' - Absorption field, total Zen h ico Length of each trench J --- Depth of trenches Site of rlravel SEEPAGE i?ITS{Number of) `�---�—� Size- tt. X t Gravel s_P,.ze ' PIPING : Bldg . to tank a Type Tank to mist . box Lust. borax to fief ~ Openings sealed? tfES ; NO Partial LOCATION/SEPAI ONS Foundation to t nk Foundation toft' Scsc rption ft . Absorption to of line Separation of ft' pits to CATION STEM ON PROPERTY (^cirele one ) Front - ear Left side CCMMENTS : _ Right side - r t f SYSTEM USE APPROVED ES NO Bui Inspector 01/8 6 and vl BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R, C1, 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME LOCAT I DATE / PERMIT No. C3 SOIL TYPE - Sand - Loam - Clay Percolation Test Required ? YES - NO Percolation rate - Min/Inch TYPE of SmkSTF.M : Absorption field , total. length Length of each trench Depth of trenches ' Size of gravel SEEPAGE PITS{Number or ) Size- ft. X ft. ` Gravel size PIPING : ize Bldg . to tank Type Tank to dist . box } ` t Dist . box to field/fit Openings sealed? -1YES NO Partial LOCATION/SEPARATItONSc ' Foundation to tank ft, Foundation to absorption ft . Absorption to lot line ft. Separation of. pits ft. LOCATION OF SYSTEM ON PROPERTY (circle one) Front - Reax - Left side - Right side - CCMMENTS : -104 /01 SYSTEM USE APPROVED YES Building I ctor 01/86 and vl TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK I2804- + ' TELEPHONE (518) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEZVED — `l NAME — — LOCATXON f DATE GCS ^ -- s-`� PERMXT APPROVED YES NO FOOTING/PIERS MONOLXTHTC POUR FORMS `"""POUNDATSON/DAMP--PROOFING C� oBACKF-T +L APPROVAL ROUGH PLUMBXNG FRAMING H ECTRICAL ROUGH—XN XNSULATION:' FOUNDATXOi FLOORS WALLS f CEILING FINAL XNSPECTXOlV qI CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/SIPS STAIRS—CLEARANCE &IPArLS PLUMBXNG FIXTURES'/ ELTEF VALVE XNTERXOR TRXMfPRIACY DOORS FXNXSHED FLOORS GARAGE FXREPROOF�t'NG -- DOOR CLOSER (S) SMOKE DETECTORS; FINAL ELECTRXCAL XNSPECTION _ FINAL APPROVAL OF CONSTRUCTION A S.ZGIVED CERTIFXCATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT ,BEFORE THESE PREMTSES ARE OCCUPIED! REMAFtXS: SNSPECTOR Town OF QUEENSBURY BUILDING AND CODES DEPARTMENT op BAY & HAVILAND ROADS r . QUEENSBURYe NEW YORK J 280k TELEPHONE (518) 792-5832 BUILDING INSPECTOR' S REPORT c� REQUEST FOR INSPECTION RECEIVED„ / � ! NAME J F LOCATION + j r DATE+ PERMIT # APPROVED YRSA NO c,i OOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP--PROOFING BACKPXZL APPROVAL ROUGH PLUMBING FRAMING ELECTRI ROUGH—IN INSULATIO FOUNDATI :;M FLOORS WALLS CEILING FINAL INSPECTIO ,x CHIMNEY HEIGHT F ROOFING S-TDING EXTERNAL FORCHE PS STAIRS—CLE'ARAN & ILS PLUMBING FIXTU ES/RE F VALVE INTERIOR TRIM RIVACY ORS FINISHED PLO S GARAGE FIR EP OOPING - DOOR CLOSER ) SMOKE DETEC ORS FINAL ELECTR CAL INSPECTION FINAL APPR L OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS. 7 0" INSPECTOR XT National Headquarters : . 90(Y0 lidI& -Ave!, 1661116dswooidFi.J. A'lbl3 { _ Date: City; Town or Townshi County U.4*'Ad State Location/Address (it Located in Ural Area - Please Attach Directi 1 Pole # Owner „ Occupied As s $u4fdln9. „ r . occupant YWO' * Area in Build" Floor #k etc ]: for: WiJi 3ervi or: LJ Ready-for 1 eetkoa & Remitted. !� Cash Cfieck IG1g -_ abl8 Tv: M,13:I.A. ?ieP x x �xoa x7so 2aoa zzso- U" sao 9aea ? . Num Wjlh C tle#s Elect. Heat StiNitches ��.. Amp. SerO: ' Siafface Unit Disfivina {aer Range I�Igkltlrtg Water Header ,Air Conditioner —Dryer , , i V_' Purnp Reotec �lrtU '% Cep -� l]age. Ursprcelfog..pis Burner .r tlt Feria t Equipment: + FAnt H:P_ 1/'tea . ;11n 1/e 1/fi x! 1/3 S/a SaAi 8 . a . 3 7Nz id 15 $6 a0SS 54 �S bsr OfizeRW 's + : ..t : f r �T6ense Rif" �t tif":4 Nnt's Addre"� G :r LL', Service {.City]' t 1 - ' ��F .. • t - �;: i�c.tw. Phan Ylt �- fil iaa; J4T> RECEIVED: - '• � DATE 4Ni CTiFb•• Correct Location: Same as Above � or: - 6" V :: . r::• . Fled Notic bel Rough Wiring Outlets Surface Unit Oven . witches Rana; l.i t� . A� R tacles Water Heater " •u i =' P br Fixtures hcondlte6ne*F ... .. _Z i; ,* Amp:.Service Equipment Burner, Ylk"iring+�t-0Cor4 0bl9 for Am Am Service Conductors Pump ent Fan3 MOTORS H.P. JjL/L2jjA0jW&AM/6j1/& j 1/3 1/2 /a t 1 s- a' 7 l0 15 24 3 3 _ Mark INS "*P , �r L`I of Each Size Elect. Heat eoo sw xono xsao xsoa x�sn moo xnso s z.�s apmo TT 0 R11W Progress: Mc. 0 LKD Q sY"niractor ` CFT ` �iiletioh: Work Comp: 0 Inc CASH © L/A ".. bwner ' Fee CH K � L/A Munecspai f. Due MCS k u» �]. IPA z -. r. a r - ' . .as i Date: . - C,ti n Card ] Temp Data i w ` - �I [] Final APPL'tCA rjofq poi kM rNo. 25 ost j4j§ t GEE3FtGE iCtJROSAKA .JR, 0 P. E. REv's o; 9/1 rgg BUILDING SYSTEPAS CONSULTANT 13 ARBUTUS DRIVE 9k CUEENSBURY. N.Y. 12110 ( 518 ) 793- 7190 Ir 13 ARBUTUS ORIvF' q:=g i puFENSBURY, MY. 1 2ga4 PFtOr3C S16 ? 92 `1522 BUILDING INSPMTOR % €v C ,. GOIDE ©E101 . re: Factory TOWN. OF 6�,UEEN58URY Manufactured dome TowN HALL - BAY ROAD Installation Certification QUEENCBURY , NY 12g04 Attentions DAVI © HATIN Dear sir . This is to certify that. I have observed and inspected the installation of a "Factory Manufactured Home', ; as defined by the New York State Uniform Fire Prevention and Building Code , Chapter D - MANUFACTURED HOUSSIVG , Article 2 - FACTORY MANUFACTURED HCt4ES , as applicable to your local building regulations ; there appeared to be no apparent structural damage to the units , due to or attributable to the transportation or loading/unloading of the units , herein- after described as follows : Date of Tnstallation: / � � .✓� Site Loocationr Community: TOWN OF QUEENSBURY County: UYARREN Manufacturer/Su,,..�ppprlier : 4fc Address : p Insignia Serial No. 3F Plan .Approval. No. N Y= G> +:� 5: � Manufacturer ' s Model/Component No. s Date of Manufacture : Installer/Supplier : . have also examined the approved Plans & Specifications for the a33ovementioned "Factory Manufactured Home" , and to the best of my knowledge and belief , this "Home" has been installed in accordance with these approved Plans & Specifications , and all other applicable laws codes , ordinances ,standards &/or regulations ., OF NjSF Ir// RESPECTFULLY SUBMI TTEOp V r" cc : mob ,, 4'0, V (dEL7E G,EORGE KUROSAKA .,JR . , P . C. 4. 7� AF 64 NOTE I. CURVE 8 — RAD U'S 200.000 LENGTH 61.76" ANGLE 23-25-4" 0 t. r es 700 Y 4:'7Z ui. Y"t j Z� 24 s"6157- 001- oo E V q�­ A 1000 GAL. SEPTIC ­4 kip -Wct 8902 TREATED 44 DECK 17 4, 0& FRAME ".0 CE 'ESIDEN 3 f". F-4--'t to ix Lo LOT 13`� DRILLEC WELL Ln cl' 1z, �D F JAE 'o R V E D N E 0 jg re STERLING pRop0 s CHRISTOPHE IDRAWN; " 4.