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2006-834 giak TOWN OF QUEENSBURY E474.Z411 VFW 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20060834 Date Issued: Thursday, March 01, 2007 This is to certify that work requested to be done as shown by Permit Number P20060834 has been completed. Tax Map Number. 523400-309-013-0001-010-000-0000 Location: 35 INDIANA Ave OwnerVIRGINIA ELLIS Applicant: ROBERT & BARBARA MALLANEY This structure may be occupiec%wtrkEY & VIRGINIA ELLIS Mobile Home Out of Park By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the C property owner of the responsibility for compliance with Site Plan, p ,ge)t- Variance, or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement Planning Board or Zoning Board of Appeals. TOWN OF QUE ENSBURY Iwo 742 BayRoad,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20060834 Application Number. A20060834 Tax Map No: 523400-309-013-0001-010-000-0000 Permission is hereby granted to: ROBERT&BARBARA MALLANEY JEFFREY&VIRGINIA ELLIS For property located at: 35 INDIANA Ave in the Town of Queensbury,to construct or place at the above location in accordance with application together with plot plans and other information hereto filed and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning Ordinance. Type of Construction Value Owner Address: ROBERT&BARBARA MALLANE 29 INDIANA Ave Mobile Home Out of Park $15,000.00 QUEENSBURY,NY 12804 Total Value $15,000.00 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications 2006-834 mobile home outside of park $38.84 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday, February 05,2008 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the To of ensb , lidl , February 05,2007 SIGNED BY ''v for the Town of Queensbury. Director of Building&Code Enforcement I '•• r • • LY • • TAX MAP NO. 30/ 1•3RMIT OFICE USE O�ON�` /. ISSUED: , • • �J}/l ' I:ECEJVED PERMIT1E E 39)PROVALS: ZONING TOWN CLERK ' ' • NOV 1 • A °rOUVNOF 0113,` ZONING OFFICE URY MOBILE HOME -APPLICATION FOR PERMIT: A building permit must be obtained before placement of mobile home on parcel. No inspections will be made until a valid building permit has been issued. Applicant Information Property Owner Information Name: ,Jeiri Cy .1- Vi/8,,1..0 e1/,'5 Name: .7 A4 ( , /u1Q/ 4 Address: 8 T ,1,\i ct' L 4°/ Address: 2' 9 _Z-",,,c4:44.9 a/L apeA5 b,,ey N I /2(4-'0 / aucens 1x� Al, y' /z8o / Phone No. 6-71P) 793- / 923 Phone No. Parcel Information 35 Proposed Date of Placement: i i j'?fl f O 4, Property Location: f" l rr0l'4n/a / -.t, Road,Street,Avenue Name of Mobile Home Park: (if applicable) Tax Map Number: 309 -/3 /-/d Mobile Home Information Zoning Information Approximate Value of Home:$ J/5""oer2 eo Zoning Classification: New Home: Yes No Size of Property: /Z.0 gft. by S6 ft. b y (GO Replacement Home: Yes No Existing buildings: Il C,oS GICIc0 Q Size of Mobile Home: /,-/ ft. by 910 ft. Setbacks: front yard 3g ft. rear yard 'YO ft. side yards 10 ft.and 3 9 ft. Singlewide: X Doublewide: Number of Rooms: (exclude baths) J Accessory Building(s): circle Number of Bedrooms: �- Number of Bathrooms: l sZ Detached garage: 1-ca 2-car car Circle: Gas Fireplace/Woodstove/Wood Fireplace Attached garage: 1-car 2-car car Foundation Support: Storage building: es No Type Size & Depth Other. Piers `' �Runner� �( 6 Water Supply: well or(municipal Slab Is Septic Permit Required? Yes or No I Continued on back AbA . Town of Queensbury • Community Development Office • 742 Bay Road, Queensaury, iv r lzal14 (COrn t)5 rn ; Name of Installer or Mobile Home Dealer. IIVIG f r i S corn, Address: V G.(1 D(.& er- , tom.eerf5 /Phone: 71a - 57.5r Complete information below found on a'Plate'or-Sticker which is affixed to the mobile home: ✓ Insignia serial number: 19 - 9'4 - 31(-1 - 9Y0(01 .✓ Name of manufacturer: V +Q • I Plan Approval Number: ✓ Model or Component Designation: Z 51 �Aly home only) • Date of Manufacture: y rr-.r��s�.rL-srssszss.rzrsss_-sts,.-stars:stsrsr.rsrrL-..-«.rrrr«--.zsrtrrurrvsrss:rsr'arsr-.rssss.-s�sssrrau-•rrrg . AFFIDAVIT V � J Town of Queensbury State of New York County of Warren 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 c 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 s work is authorized by the owner Signature: �. /WYt�, -- Owner's Agent,Architect,Contractor i SPECIAL CONDITIONS OF PERMIT • By: Code Enforcement Officer Tour of Queensbury• Community Development Office• 742 Bay Road, Queensbury, NY 12804 FINAL INSPECTION REPORT MOBILE. / MODULAR Town of Queensbury Building &Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: DEPART: DATE INSPECTION REQUEST RECEIV'r ' NAME: / LOCATION: ____SE \K)O f tA___ DATE: _ — —• PERMIT I_0_6::2371 MOBILE HOME MODULAR HOME FOOTINGS FOUNDATION _ .BACKFILL FRAMING NIA YES NO 1. foundation support, pier spacing per manuf. 2. anchoring per manuf. 3. water line shut off 4. sewer line support @ 4 feet 5. heating crossover(dblewide) off grd. . 6. dryer vented outside . 7. skirting ventilated 8. hot water relief valve piping outside 4 9. deck, porches, steps, railing .4. / 10. furnace/hot water operating Y 11. garage fire proofing ��.� t12. door Amer* ... {� 13. plumbing fixture 77-- 14. foundation insulation(if apps.) 15. smoke detectors 16. final electrical 17. variance required 18. data plate okay 19. mobile HUD seal okay Model# Serial# • Manufacturer Date of Manufacturer OKAY TO ISSUE CIO V YES. NO Comments: rINAL INSPECTION REPORT d-q MOBILE / MODULAR Town of Queensbury Building & Code Enforcement 4?' Al -1 4-- 742 Bay Road Queensbury, NY 12804 ',. I (518) 761-8256 / , e' e ARRIVE: \74 bEPART: I),-II',PN.'• ' rIII --1 / DATE I ECTION REQUEST RECEIVED: '1/)-'' �G 7 NAM . #--e &ILI s 1 � � LOC ION: r� .-}' ~�`l,_e l DATE:(c7-7 G' / /W PERMIT tx- '--�`3 J MOBILE HO E J" MODULAR HOME FOOTINGS FOUNDATION BACKFILL FRAMING N/A YES/ NO 1. foundation support, pier spacing / per manuf. — �// 2. anchoring per manuf. _ �/ 3. water line shut,off 4. sewer line support @ 4 feet _ 5. heating crossover (dblewide) off grd. i - — 6. dryer vented outside 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 / f 13. plumbing fixture ,// _ 14. foundation insulation (if appl.) _ ✓/ — 15. smoke detectors _ ,//_ 16. final electrical ✓ _ 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: Q -g')1 �' LAKW,1 ,v fki— ILip1,=c u; 12- k---tE:? , i1E1,4 � � .b0 At rvVkF . a) r b tJT uikrTt 4-Rall: !_L��_ R t3 61-V-e 4. r !, s t) ))/ //a/i Foundation Inspection Report 1 f / Office No.(518)761-8256 Date Ins •on request rrceiv , Queensbury Building&Code Enforcement Arrive: /l-v= m, ' . Depart: ? �- - 742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: /n NAME: " ) P,ERNIIT#: -8- V • INSPECT ON: -1,7—t7 LOCATION: � �.� ��� � 7..-- j TYPE OF STRUCTURE: Comments 7 Y i' NLA_ Footings ;-)41--- Monolithic Slab Reinforcement in Place QM-t= R-U cL tJE?_9 The contractor is responsible for / providing protection from freezing � ����-� Q v v for 48 hours following the placement / CT- of the concrete. v A 130 F �Q FILL- Materials l L,- Materials for this purpose on site. Foundation/Wallpour 11,\ TA I-LED Tiktlk?f_D Reinforcement in Place Footing Dowels or Keyway in place Foundation Dampproofing Foundation Waterproofing Footing Drain Daylight or Sump Footing Drain Stone: 12 inch width 6 inches above footing 6 mil poly for wet areas under slab Backfill Approval Plumbing Under Slab PVC/Cast/Copper Foundation Insulation Interior/Exterior R- Rough Grade 6 inch drop within 10 ft. L:\Buiiding&Codes Forms\Building&Codes\Inspectfon FormsVounda ion Inspection Reportdoc Last printed 12/20/2005 9:24:00 AM Septic Inspection Report Office No.(518)761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/pm Depart: 3 f am/pm 742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: 644) NAME: PERMIT NO.: 6 - c3. -a LOCATION: ---C T ) I Pe - INSPECT ON: NM s RECHECK: Comments and/or diagram Soil TypeiKS. .. 4.4,•. Clay Type of Water: _ ••::. /Well Water P Waterline se arms ance ft. Well separation distance ft. �G`, eg-4?-) e-4444Ard2A- Other wells: . ft. Absorption Field: Total length ft. Length of each trench ft. ciAlt" '.)`")' 45' Depth of trenches ,--t— ft. 1t \ 91?)`F Size of Stone '.._. Seepage Pits: Numberkll'ile, t/� 5tY Size: x L Stone Size: l2 Piping Size Type �' -L 3 Building to tank t'` Tank to Distribution Box �� 1 Distribution Box to Field/Pit Opening Sealed: Y/N/Partial Cigi-146-33.0. End Cas /-1-Nt _Location/Separations Foundation to tank ft. Foundation to absorption ft. ' i Separation of Pits Conforms as per Plot Plan /], Y N7N Engineer Report and As-Built `1 Y N Location of System on Property: 1-7ront ear Left Side Right Side Middle Front Middle Rear System Use Sta Approved Partial Approved and needs to be re-inspected,please call the Building&Codes Office Disapproved Last revised 1/6/05 FINAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518)\761-8256 ARRIVE:// " EPART: INSP: Cj DATE INSPECTION REQUEST RECEIVED: NAME: --GG/ LOCATION: i f / //i/ DATE: Z if)&P PERMIT# LI, \0. ii aligr MOBILE HOME MODULAR HOME FOOTINGS FOUNDATION BACKFILL FRAMING N/A . YES NO _ 1. foundation support, pier spacing per manuf. _ — _ 2. anchoring per manuf. — 3. water line shut off _ _ — 4. sewer line support ®4 feet _ — 5. heating crossover (dblewide) off grd. _ 6. dryer vented outside ..: _ _ — 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 _ _ — 17. variance required _ _ 18. data plate okay _ _ _ 19. mobile HUD seal okay _ _ —. Model# Serial # Manufacturer Date of Manufacturer OKAY TO ISSUE CIO YES NO l— Comments: (.77—A_,,D) 1l/d c /11°10 gf7'I4(-. Cq4 4/6"r /A) i)(46(' (/C-‘ FINAL INSPECTION REPORT f''V MOBILE / MODULAR Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 �J (518) 761-8256 c ARRIVE!J �DDEPART: INSPV DATE INSPECTION REQUEST RECEIVED: NAME: J � C_�I LOCATION: 35---1 //9- DATE: I *4, O C� PERMIT# r-d(y� MOBILE HOME MODULAR HOME FOOTINGS _ FOUNDATION _ BACKFILL FRAMING_ N/A YES NO 1. foundation support, pier spacing per manuf. 2. anchoring per manuf. 3. water line shut,off 4. sewer line support ®4 feet 5. heating crossover (dblewide) off grd. 6. dryer vented outside 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 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: [ 1 G- Ccc// ip� C v E S f FINAL INSPECTION REPORT ` MOBILE- / MODULAR Town of Queensbury 06-- Building &Code Enforcement 742 Bay Road . Queensbury, NY .12804 (518) 761-8256 ARRIVE✓ DEPART: INS _ ..--6-- / 0.-' DATE INS ON REQUEST RECEIVED: 14 NAME: _ I l C _ /! V 1 . \----—------ 1/\1' s i\ j'r' LOCATION: tArI 0 %02* rc� r DATE: P 139 #: 0 MOBILE HOME MODULAR.HOME FOOTINGS— FOUNDATION_ .BACKFILL FRAMING NIA . YES NO 1. foundation support, pier spacing Per manuf 2. anchoring per manuf. 3. water liar shut off — 4. sewer line support 0 4 feet . 5. heating crossover(dblewide) off grd. 6. dryer vented outside .. .a::. 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 apps.) 15. smoke detectors. 16. final electrical 17. variance required • . 18. data plate okay — 19. mobile HUD seal okay Madel#/q,91-(>- 1q'4 /q- 9 # . - Man ufactwrer < < ��"< Date of Manufacturer c V) OKAY TO / :YES • • NO 124w 5 Comments: . Pe,& R4N5 tocP - 0 pe.,„nztoo 5c,e 76,(-5,9-59