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2010-439 TOWN OFQ UEENSBURY varo742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number. P20100439 Date Issued: Thursday, November 18, 2010 This is to certify that work requested to be done as shown by Permit Number P20100439 has been completed. Location: 200 LUZERNE Rd Tax Map Number. 523400-309-009-0002-001-000-0000 Owner: HOMESTEAD VILLAGE L P Applicant: CHRIS LUCE This structure may be occupied as a: Mobile Home In Park By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the r / property owner of the responsibility for compliance with Site Plan, rTh / I Variance, or other issues and conditions as a result of approvals by the moo.. Director of Building&Co•= nfo � ment Planning Board or Zoning Board of Appeals. ��,` TOWN OF QUEENSBURY ki 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20100439 Application Number. A20100439 Tax Map No: 523400-309-009-0002-001-000-0000 Permission is hereby granted to: CHRIS LUCE For property located at: 200 LUZERNE Rd in the Town of Queens bury,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: HOMESTEAD VILLAGE L P Mobile Home In Park $24,000.00 4294 ROUTE 5 Total Value $24,000.00 CALEDONIA, NY 14423 Contractor or Builder's Name/ Address Electrical Inspection Agency Plans &Specifications 2010-439 7 Windsong Dr- Chris Luce- 980 sq ft mobile home in park $33.80 PERMIT FEE PAID- THIS PERMIT EXPIRES: Wednesday, September 07, 2011 (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 IvTo �eens , e ;a eptember 07,2010 SIGNED BY �'- \ for the Town of Queensbury. Director of Building&Code Enforcement OFFICE USE ONLY TAX MAP 307 -1 PERMIT NO. /t/ Tei / DATE ISSUED: PERMIT F .7f3-V3 APPROVALS: ZONING TOWN CLERK c31/15 4.- A-er-C.4d e/K(47 ---- . 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 146 1 Name: C ' " 's Lt)C-1 Name: Me-.5+ V 1 I I`f "� j T Address: c , ��j lM' t.�C'eaC, S' Address: (ZOO �.v Z2..F ne 'VA .F-}.- aw, L) Qv�-e-i\s-1)OV1 NY «V4 Phone No. s 3c) Dg Phone No. )--5c `-Z:3 -c2 j ____X--- Parcel X--- SCA- 76(,1---'2-40'0 Parcellnforma a Proposed Date of Placement: Property Location: S? LO - i r». vA,0 , Road,Street,Avenue Name of Mobile Home Park: \ I €E S t (if applicable) Tax Map Number: Mobile Home Information Zoning Information Approximate Value of Home: $ 2Li ) DOD Zoning Classification: New Home: Yes )ftSize of Property: \2b ft. bycg ft. Replacement Home: Yes No K, 96 Existing buildings: ,,r>pIN,12, Size of Mobile Home: 71) ft. by 1,9 ft. Setbacks: front yard'.5 - ft. rear yard 2-2 ft. side yards 7t9 ft. and I 0 ft. Singlewide: X Doublewide: Number of Rooms: (exclu"4e baths) Li Accessory Building(s): circle Number of Bedrooms: � Number of Bathrooms: I Detached garage: 1-car 2-car car Circle: Gas Fireplace Woodstove/Wood Fireplace Attached garage: 1-car 2-car car Foundation Support: Storage building: 1jc No Type Size & Depth Other: V , E \krakC42- Way Piers // Water Supply: well or municipal Runners Slab Is Septic Permit Required? Yes or No Continued on page 2 Town of Queensbury- Community Development Office - 742 Bay Road, Queensbury, NY 12804 Revised March 2010 Name of Installer or Mobile Home Dealer:GC J UL 1\6:r 160IvihA'Or Address: (07 COL:(A Cp Li 3 Phone: ,i 3 ) 661)3 V.---\ waa S1 V \ LlsZ-5 Complete information below found on a "Plate" or"Sticker" which is affixed to the mobile home: ✓ Insignia serial number: a' ` �J t 5 Vi ✓ Name of manufacturer: 6 CU'X el,ksr 01YV€-S ✓ Plan Approval Number: ✓ Model or Component Designation: e � � (New home only) ✓ Date of Manufacture: 1` AFFIDAVIT 1 Town of Queensbury State of New York County of Warren 1 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 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. Installer Warranty will be pr?ujdr at time of C licate of Occupancy. Signature: J Owner, Owner's Agent, Architect, Contractor 1 } / SPECIAL CONDITIONS OF PERMIT ,..,- By: By: e Enforcem- t (Mt r Town of Queensbury- Community Developme Office • 742 Ba'Road, Queensbury, NY 12804 1 v / 1 OFFICE USE ONLY TAX MAP NO. PERMIT NO. DATE ISSUED: PERMIT FEE APPROVALS: ZONING TOWN CLERK MOBILE HOME- APPLICA TION 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: CNrk'S ,,�� Name: `P-(3 r'rit_c \-e Old vi liaise J C_ Address: Address: aX Lit Ze(Y?f e_d RL er s, bi_kr Vi I ' RoV I( � - 71"Z 2t Phone No. l9' �-5 -5°S Phone No. ,- S',j -- 03----- 5,311 Parcel Information Proposed Date of Placement: Property Location: 1 Lk)\ \C\SQA Nv e Road,Street,Ave lxtd Name of Mobile Home Park: 11WileSkj (if applicable) Tax Map Number: Mobile Home Information Zoning Information Approximate Value of Home: $ C3�`‘,DOO Zoning Classification: New Home: YesENO-Th-3Size of Property: lc)-0 ft. by t3 3 ft. Replacement Home: Yes No Existing buildings: R..0-1,\-e- Size of Mobile Home: -7 0 ft. by 1 14 ft. Setbacks: front yard b Z ft. rear yard .a ft. Xside yards '3_1 ft. and (fl ft. Singlewide: Doublewide: Number of Rooms: (exclude baths) 41 Accessory Building(s): circle Number of Bedrooms: 2.. Number of Bathrooms: I Detached garage: 1-car 2-car car Circle: as FireplaWoodstove/Wood Fireplace Attached garage: 1-car 2-car car Foundation Support: ^ter -Storage building: No Type Size & Depth Other: t. fl-1-r .V\.Q 1,60..1 Piers Water Supply: well or municipal Runners - Slab Is Septic Permit Required? Yes or No Continued on page 2 Town of Queensbury• Community Development Office • 742 Bay Road, Queensbury, NY 12804 Revised March 2010 Name of Installer or Mobile Home Dealer: �y(,'V , YQif C' h -- Address: Lgl, COTW171-1/ &Ai? i ) Phone: j 3(R J -0E72_3 -�� oGr4 t y g�� Complete information below found on a "Plate" or"Sticker" which is affixed to the mobile home: ✓ Insignia serial number: a\\ 6' 5G ✓ Name of manufacturer: . - 9-1C ,(34- ✓ Plan Approval Number: ✓ Model or Component Designation: (New home only) ✓ Date of Manufacture: 1 AFFIDAVIT 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 of all 3 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, t. whether specified or not, and that such work is authorized by the owner. Installer Warranty will be • •vi•ed at time of C•rtificate of Occupancy. Signature: _A aift_ Owner, Owner's` :Int, Architect, Contractor SPECIAL CONDITIONS OF PERMIT By: Code Enforcement Officer Town of Queensbury. Community Development Office • 742 Bay Road, Queensbury, NY 12804 Queensbury Building & Code Enforcement-- Manufactured / Mod lar Final Inspection Office No. (518)761-8256 Arrive: 2( 4 _ , a Date Inspection request received: Inspector's Initials: iii NAME: PERMIT* / 1 t 1 LOCATION: I�,1)aD t,1 :::I_S2V _ DATE: i / \ `—` 1 \n Manufactured Home Modular Home Footings_ Foundation_ Backfill_ Framing Comments: Yes No WA Foundation support,pier spacing, Per manufacturer Anchoring per manufacturer 2'from ends ✓ Water line shut off ✓ Sewer line support @ 4 feet J Heating Crossover[doublewide}off gni. Dryer vented outside Skirting ventilated 1 sq.ft.per 1,500 sq.ft. Hot water relief valve piping outside ✓ Deck,porches,steps,railing _ Furnace/hot water operating Garage Are proofing Fire Door 1 Door losers Plumbing Fixture/3"Vent through roof[Modular] f Foundation insulation[if applicable] Smoke/Carbon Monoxide Detectors/Interconnected Final Electrical Variance required Data Plate okay Manufactured HUD seal okay Warranty Seal after January 1,2006 Installers Warranty Seal 18"x 24"access or 22"x 30"attic access , Vapor retarder under A mi ..y or : C''} 911 Street number ' Okay to issue C/C . C/O emp./ °erm.] cuPP- Model# erial# Manufacturer_ Date of Manufacturer L-\Pam Whiting120100udding Codes Forms\ManufacturedMoctular Final Inspection03 04 10.doc f --y /i'frii -J . Queensbury Building Code Enforcement- Manufact / Modular Final Inspection Office No. (518)761-8256 Arrive: - a •1� , a pm Date Inspectionrequest received: ' r � �� Inspector's In NAME: �"� PERMIT 1/Li - "�7L.; LOCATION: 7 L'1111 ei ejn I-.431 DATE: //.- /5 ` IC Manufactured Home Modular Home Footings_ Foundation_ Backfill_ Framing_ Comments: Yes No WA Foundation support,pier spacing, IA, ` VT ��Per manufacturer Anchoring per manufacturer 2'from ends Vi Water fine shut off V Sewer line support @ 4 feet V Heating Crossover[doublewide}off grd. J Dryer vented outside Skirting ventilated 1 so.ft.Der 1.500 so.ft. Y Hot water relief valve piping outside Deck,porches,steps,railing V Fumace/hot water operating _/ Garage Fire proofing �+ V Fire Door/Door losers Plumbing Fixture I 3"Vent through roof[Modular] f Foundation insulation[if applicable] f Smoke/Carbon Monoxide Detectors/Interconnected Final Electrical i Variance required ^- Data Plate okay 'ft.QiV7-0t,f-- Manufactured HUD seal okay !� Warranty Seal after January 1,2006 Installers Warranty Seal 18"x 24'access or 22'x 30"attic access Vapor retarder under home 6 mil poly or other 911 Street number 4"aJMQffj Okay to issue CIC or CIO[Temp./Penn.] / Model# t5 2C.�-� R1>�`4Serial# 2. t51h3 t ✓✓✓ Manufacturer (7�e1=.- (z2 ex 1SQ.r Date of Manufacturer \<NI co L:1Pam Whiting120101Building Codes Forms\Manufac Lured Modular Final Inspection 03 04 10.doc Queensbury Building & Code Enforcement-- Manufactured / M. . . :I inspection r, Alk Office No. (518)761-8256 Arrive: 'i : ,_rt: Date Inspection request received: f ��� Inspector's Initials: /� NAME: L VC l_ PERM! It: TZ O I ?, LOCATION: C7 S / ) R • DATE: 11rz t //`3 Manufactured Home Modular Home Footings_ Foundation Backfill Framing Comments: Yes No NIA Foundation support,pier spacing, Per manufacturer ` \ p\r. V f Anchoring per manufacturer 2'from ends I Water line shut off Sewer line support @ 4 feet Heating Crossover[doublewide}off grd. Dryer vented outside Skirting ventilated 1 so.ft.per 1.500 so.ft. Hot water relief valve piping outside Deck,porches,steps,railing Fumaceihot water operating Garage Fire proofing Fire Door/Door closers Plumbing Fixture/3"Vent through roof[Modular] Foundation insulation[f applicable] Smoke/Carbon Monoxide Detectors/Interconnected Final Electrical Variance required Data Plate okay — Manufactured HUD seal okay Warranty Seal after January 1,2006 J.(7/ Installers Warranty Seal 18'x 24'access or 22"x 30"attic access Vapor retarder under home 6 mil poly or other 911 Street number l! Okay to issue CIC or CIO[Temp./Perm.] ‘,/ Model# Serial# vvv Manufacturer Date of Manufacturer L•\Pam Whiiting\2010\Building Codes Fomis\ManufacturedModular Final Inspection 03 04 10.doc L--W--Z: Queensbury Building & Code Enforcement-- 4/ ; ••ul i Final Inspection Office No.(518)761-8256 Arrive: ate'o'. ._rt icrr. r. Date Inspection request received: Inspector's Initials / NAME: L ► _ PERMIT# I 1 A. LOCATION: ________LZ,_ YEN a 1 L A'( DATE: te —31 — 10 Manufactured Home i � �� O� Modular Home 1 Footings_ Foundation_ Backfill Framing_ Comments: Yes No N/A Foundation support,pier spacing, Per manufacturer Anchoring per manufacturer 2'from ends Water line shut off Sewer line support @ 4 feet Heating Crossover[doublewide}off gni. Dryer vented outside Skirting ventilated 1 sq.ft.per 1.500 sq.ft. Hot water relief valve piping outside Deck,porches,steps,railing Fumace/hot water operating Garage Fire proofing Fire Door/Door closers Plumbing Fixture/3"Vent through roof[Modular] Foundation insulation[if applicable] Smoke/Carbon Monoxide Detectors/Interconnected Final Electrical Variance required Data Plate okay 117 Manufactured HUD seal okay Warranty Seal after January 1,2006 Ir:; -` 1..1 €, 2i — Installers Warranty Seal w`� 18'x 24"access or 22"x 30'attic access Vapor retarder under home 6 mil poly or other 911 Street number / „1/pisitt aOkay to issue C/C or C/O[Temp./Perm.] p—� //C°-� Model# ---f5erial# '�u 1, f-j,'� N V l/ Manufacturer ( EE 13 R P\ t R OM F.,__6 Date of Manufacturer 12) L:1Pam Whiting120101Building Codes Forms1Manufactu ed Modular Final Inspection 03 04 10.doc ez ie? ) i dA2 O► "It V- � i, I73-: __________t.,:'s'•- . .. k — ,. in q i .. i ' ..... O .. . ._ , -,,,., • ,,, . --,,,..) Applicant: / i 5 , , ). 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