2015-404 TOWN OF QUEENSBURY
Fool 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20150404 Application Number: A20150404
Tax Map No: 523400-308-006-0001-070-002-0000
Permission is hereby granted to: DANIEL LECUYER
For property located at: 14 WARREN Ln
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: DANIEL LECUYER Mobile Home Out of Park $16,000.00
14 WARREN Ln Total Value
QUEENSBURY NY 12804-0000 $16,000.00
Contractor or Builder's Name /Address Electrical Inspection Agency
MAURICE COMBS
96 VAN DUSEN Rd
OUEENSBURY.NY 12804-0000
Plans&Specifications
2015-404
Mobile Home out of park
Lot 2 of the Andrew Darnley 2-lot subdivision SB 20-2005
$0.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday, September 14,2016
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the To of Q nsb ; /f ; i . ptember 14,2015
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SIGNED BY - \ for the Town of Queensbury.
Director of Building&Code Enforcement
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Office Use Only
•
MOBILE HOME APPLICATION
C) / all
� Received
DATE: ! 1 a l l Tax Map ID
TAX MAP ID 300- & -I-76-,Z Permit No. Z.C�c� ,
Permit rFee fI �.6y 0
PROPERTY LOCATION: i Lt LO L41� Lex-v2-- LE 1D 1
id
NAME OF MOBILE HOME PARK:
PROPOSED DATE OF PLACEMENT:
SPS �0 .� Std u 2015
TOWN OF QU'EENSBURY
-, LCU ilf� BUILDING&CODES11.41112-
APPLICANT 1
ADDRESS ly "lam.( TQ4' ( s$,fQ, ADDRESS
0\2_0_0nshcL NY 10 Ery
PHONE ! O- t- N 31 PHONE SCP-41U---
.
NAME OF INSTALLER OR MOBILE HOME DEALER Ceffn b5 t ruC-b 1-6
ADDRESS: VOA C !` €02-1 1 (28- ,ZWre j3DOcrilleuLli7
ala2)(r5 r N Y 06a--/ SA-64;1-)in'a ri - 6-i ob-02co 5
PHONE 9L'' ?'W 515
CONTACT PERSON FOR BUILDING&CODES COMPLIANCE: IA', [ 1_481441 6- PHONE: 18- 19&-03/ 1")
COMPLETE INFORMATION BELOW FOUND ON A"PLATE"OR"STICKER"WHICH IS AFFIXED TO THE MOBILE HOME
Insignia serial number
Name of Manufacturer s,rn Q n - jt"AQS
Place Approval Number
Model or Component Designation ),
g�"-i 1p (New home only)
Date of Manufacture: & A i / gg
MOBILE HOME INFORMATION ZONING INFORMATION
Approximate Value of Home $ C kQi ®C:)Cl Zoning
New Home or Replacement Size of property 1 `SO ft.by, (c c.) ft.
Size of Mobile Home I ft.by. 7 0 ft. Existing buildings Mb
Singlewide or Doublewide ea/ng Accessory buildings 140
Number of rooms(exclude bath) LI Storage buildings
Number of Bedrooms a Detached Garage _1 __ 2 _3
Number of Bathrooms l; Attached Garage 1 2 0.
Gas Fireplace;Woodstove or Wood Fireplace' s Setbacks Front yard: ft.
Rear yard:. ft.
•
Side yard: ft,
Foundation Support Size Depth Water Supply Well:
Piers Municipals E.-/`
Runners
Slab N 10 Septic Permit Required? ✓Y.es Na
1
Town of Queensbury Building&Codes
Mobile Home Application July 2014
t
• Procedure for placing and occupying a mobile home or modular home:
1. Application is submitted and review: 2 copies of plot plan and layout must accompany application along with
septic application (if needed)and fee.
2. Permit is issued— Permit card is placed on property
3. Footing forms are inspected before pouring concrete: Home is placed on foundation or piers
4. Arrange for electrical inspection—see "Certified Electrical form" on Town website
5. Septic Inspection, if needed
6. Final electrical Inspection
7. Stairs & platform covering door width and door swing with handrails on both sides of platform and stairs are
required for all exterior doors.
8. Final inspection by Building &Codes Department
9. All mobile/manufactured housing must be anchored to the ground upon which they are site per
manufacturer requirements.
10. Installer Warranty seal must be provided at the time of Certificate of Occupancy
11. If anchoring is not possible due to weather conditions or any other item, a Temporary Certificate of Occupancy
will be issued; Fee-$10; Deposit$100.00 (refunded when all items are complete)
DECLARATION: 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 alt 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 completed with,whether specified or not, and that such work is authorized by
the owner. Installer Warranty will be provided at time of Certificate of Occupancy. ��yy
Print Name: i C y e'r Date: '"l ic) /)
Owner,Agent, Co,tor
Signature: �� Date: 9/2-/5--e•
Special Conditions of Permit:
By: Code Enforcement Officer
2
Town of Queensbury Building&Codes Mobile Home Application July 2014
INSPECTION WORKSHEET (MANMOD-001284-2018)
Town of Queensbury - Building and Codes - Fire Marshal
742 Bay Road - (518) 761-8256 Building (518) 761-8206 Fire Marshal
Case Number:P20150404-42281Case Module:Permit
Inspection Date:02/23/2018Inspection Status:Passed
Inspector:John O'BrienInspection Type:Manufactured Modular Final
Job Address:14 WARREN LNParcel Number:308.6-1-70.2
QUEENSBURY, NY 12804
Contact TypeCompany NameName
Granted PermissionCombs, Maurice
ApplicantLeCuyer, Daniel
Primary OwnerLeCuyer, Daniel
ContractorCombs, Maurice
Checklist ItemPassedComments
Building Inspector NotesYES2/2/18 Final Inspection Partial Approval
-Install 36? high plywood guards on rear landing until steps can be
installed in Spring.
-Installer?s Warranty (Comb?s Trucking)
2/2/18 Final Inspection Partial Approval
Remaining Item:
-Installer?s Warranty (Comb?s Trucking)
2/23/18 Final Inspection Approved-Ok to issue CO
-Received Installer?s Warranty Seal
Foundation support, pier spacing, per manufacturerYES
Anchoring per manufacturer 2ft from endsYES
Water line shut offYES
Sewer line support @ 4 feetYES
Dryer vented outsideYES
Skirting ventilated 1 sq. ft. per 1,500 sq. ft.YES
Hot water relief valve piping outsideYES
Deck, porches, steps, railingYES
Furnace Hot Water Heater operatingYES
Plumbing Fixture / 3" Vent through roof \[Modular\]YES
Foundation insulation \[if applicable\]YES
Smoke Carbon Monoxide Detectors InterconnectedYES
Final ElectricalYES
Data Plate okayYES
Manufactured HUD seal okayYES
Feb 23, 2018Page (9)
INSPECTION WORKSHEET (MANMOD-001284-2018)
Checklist ItemPassedComments
Installers Warranty SealYES2/2/18 Final Inspection Partial Approval
Remaining Item:
-Installer?s Warranty (Comb?s Trucking)
2/23/18 Final Inspection Approved-Ok to issue CO
-Received Installer?s Warranty Seal
Vapor retarder under home 6 mil poly or otherYES
911 Street numberYES
Okay to issue CC or CO \[Temporary / Permanent\]YES2/2/18 Final Inspection Partial Approval
-Install 36? high plywood guards on rear landing until steps can be
installed in Spring.
-Installer?s Warranty (Comb?s Trucking)
2/2/18 Final Inspection Partial Approval
Remaining Item:
-Installer?s Warranty (Comb?s Trucking)
2/23/18 Final Inspection Approved-Ok to issue CO
-Received Installer?s Warranty Seal
Model #YES
Serial #YES
ManufactureYES
Date of manufactureYES
O'Brien, John (Inspector)
Feb 23, 2018Page (10)
^Oct. 14. 2015 12 :42PM MD IA No. 7989 P. 4/12
's�$5e...i•'.. .-Al..'J >G J,\ 4�} �L,.. },:w-., -?y ornc-$ >477.44t1 ,y.Cr�.Y„a r- �‘`p7, {�Avv4 r <r:•ray�:•rte-.�.
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MIDDLE DEPARTMEATT INSPECTION AGENCY, ITC. �,• a
.,(4A, that the electrical wiring to the electrical equipment listed below has been examined and is approved as
P.
7.,.., l
r.Abeing in accord with the National Electrical Code, applicable governmental, utility and Agency rules in effect on the date f�>i
A noted below and is issued subject to the following conditions. a�
J4 Owner Date: rt)
(�`� Dan Lueyer 10/05/2015
.1, Occupant: j
0 p Feeder To Home Location-
Warren Lane '
�5, �a
a) Occupancy' Queensbury, Warren Co. NY
v,
Services
hc Applicant:
Don Beagle
rro
t 1483 Hadley Hill Rd.' el
Hadley, NY 12835 ••••
<<< L J
* Joseph A.Holmes S
59 No. • 03226,5,194646EL ��
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Equipment: t;G:'
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;,.200 -Amp. Service Equipment4/0; 1 -200 Amp Feeder To Home
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.., This certificatez applies to the electrical wiring )5
•`�� to the electrical equipment listed immediately null and void. This certificate applies only to the use,occupancy and �•i
h•. above and the installation inspected as of the above noted date based on a visual ownership as indicated herein. Upon
a Change in the use,Occupancy or ownership 591
0 inspection. No warranty is expressed or implied as to the mechanical safety. effi• of the property indicated above,this certificate shall be immediately null and void. 64 1
~') clency or fitness of the equipment for any particular purpose. This certificate shall In the event mat this certificate becomes invalid based upon the above Conditions, r?
� be valid for a period of one year from the above noted date. Should the electrical this certificate may be revalidated upon reinspection by Middle Department
1C�,K system to which this certificate applies be altered in any way,including but not limit. Inspection Agency,Inc. An application for inspection must be submitted to MiddleCC,``
j� ed to,the introduction of additional electrical equipment and/or the replacement of Department Inspection Agency, Inc. to initiate the inspection and revalidation f(.:j
1 any of the components installed as of the above noted date,this certificate shall be process. A fee will be charged for this service. 5Y
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Rough Plumbing I Insulation Inspection Report
Inspection request received ' \14:t "ZQA 'D
NameInspected on 1111'2-CAS
Location l q �,) Arrive Ore . am
Permit No. 2,0 kcD , rat Inspector's Initials
Type of Structure M 0.1 d-o-
COMMENTS
Y N NA
Plumbing under slab
Rough Plumbing /Nail Plates
Plumbing Vent /Vents in Place
1 V2 inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet/change of direction
Pressure Test
Drain /Vent
Air / Head
5 P.S.I. or 10 ft. above highest connection for 15 minutes
Pressure Test
Water Supply Piping
Air/ Head
, -50 P.S.I for 15 minutes
Insulation/ Residential Check/ Commercial Check A/ 74- `C
N-Wirtdov�i Sealing 1r04
Tyvek or Similar Exterior Sealant
Proper Vent.Attic Vent
Door/Window Sealed (No Insulation)
Duct/ Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly/No duct tape
Blower Door Test
Air Sealing
cOtN1, C7Nrk(2_1 \''2: AilZpl.220-t)
Town of Queensbury Building & Code Enforcement Office No. (518) 761-8256