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2012-178
dvirelikr1 ` TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20120178 Date Issued: Friday, May 04, 2012 This is to certify that work requested to be done as shown by Permit Number P20120178 has been completed. Location: 200 LUZERNE Rd Tax Map Number: 523400-309-009-0002-001-000-0000 Owner: HOMESTEAD VILLAGE L P Applicant: HOMESTEAD VILLAGE L P This structure may be occupied as a: Mobile Home In Park By Order of Town Board S An'U�l�g� TOWN OF QUEENSBURY O Kvt,f� Issuance of this Certificate of Occupancy DOES NOT relieve the property owner of the responsibility for compliance with Site Plan,Variance, or / other issues and conditions as a result of approvals by the Planning Board -- !i- �� Director of :uilding&Code E i. cem �. or Zoning Board of Appeals. TOWN OF QUEENSBURY ea.Ka3" 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518)761-8256 BUILDING PERMIT Permit Number: P20120178 Application Number: A20120178 Tax Map No: 523400-309-009-0002-001-000-0000 Permission is hereby granted to: HOMESTEAD VILLAGE L P For property located at: 200 LUZERNE Rd 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: HOMESTEAD VILLAGE L P Mobile Home In Park $40,000.00 4294 ROUTE 5 Total Value CALEDONIA,NY 14423 $40,000.00 Contractor or Builder's Name /Address Electrical Inspection Agency Plans&Specifications 2012-178 28' x 60' 1,680 sf Mobile Home Redman serial# 12218438 $201.60 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,April 26, 2013 (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 Town reee.ssbuty Th •i , ,April 26,2012 SIGNED BY C for the Town of Queensbury. Director of Building&Co.e Enforcement • + OFFICE USE ONLY I , TAX MAP NO.VCII (r('rr ERMIT NO.c716/c)-17L1�y DATE ISSUED: • at '"` • ,� ?PR • 2��PERMIT FE c) 01.(06 APPROVALS: ZONING TOWN CLERK i 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: o6e r LAv3 c-e... Name: 46-11 [-6la 4436-5-- Address: e --5-- Address: 1). 0 • t3cX 14010 Address: < 2.-1- 5- ("A ,A , oVicens 6,1 , Phone No. (5ps ) 30 Sra I I Phone No.(f55) c - �G Parcel Information Proposed Date of Placement: Li '.011 - 12_ Property Location: c�y 14A c 1dnc �C S� Road,Street,Avenue Name of Mobile Home Park: 1-b 3- It . (if applicable) Tax Map Number: _ Mobile Home Information Zoning Information Approximate Value of Home: $ L{©100C) Zoning Classification: New Home: ❑Yes [[No Size of Property: S3 ft. by 4t.L) ft. Replacement Home: ®Yes LI No Existing buildings: NtIr19., Size of Mobile Home: civ ft. by ( O ft. Setbacks: front yard aO ft. rear yard IS—ft. side yards /0 ft. and /6 ft. Singlewide: Doublewide: )X Number of Rooms:(exclude baths) Accessory Building(s): Number of Bedrooms: Number of Bathrooms: .3 Detached garage:1-car ❑2-car ❑ car El Gas Fireplace❑Woodstove p Wood Fireplace Attached garage: 01-car 02-car n car Foundation Support: Storage building: ©Yes ❑No Type Size & Depth Other: Piers Runners Water Supply: ['Well [❑Municipal Slab Is Septic Permit Required? ❑Yes Q No -Continued on page 2 fa-Town of Queensbunj• Community Development Office • 742 Bay Road, Queensvury, iv r Lamm Name of Installer or Mobile Home Dealer: •P U •-Ir (•' pc 7 Address: Phone(rj/g) g-2,--57 1-- 3 Complete information below found on a"Plate"or"Sticker"which is affixed to the mobile home: ✓ Insignia serial number: ( ( dg`F 36 ✓ Name of manufacturer: AerN � ✓ Plan Approval Number: ✓ Model or Component Designation: (New home only) ✓ Date of Manufacture: 67///:46 i_`i AFFIDAVIT J Town of Queensbury State of New York County of Warren I swear that to the best of my knowledge and belief the 4 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 no : d that such I.! work is authorized by t - • e . 5 Signature: Z. •wner/Owner's Age Architect, Contractor M1 4 SPECIAL CONDITIONS OF PERMIT / 4141 By: / ode Enforce ent Officer Town of Queensbury• Community Development Office • 742 Bay Rof Queensbury, NY 12804 --r h uiLzid6t /-3 (> f lsbury Building & Code Enforcement — Manufactured / Modular'Anal Inspection j\‘-\ Office No. (518) 761-8256Arrive: am/pm Depart: <� am/pm 6. Date Inspection request received: r 3-J a Inspector's Initials: �>;✓l, NAME: M c°. e(51,64 PERMIT#: a--107g. LOCATION: 1 E 1 I‘In r1Ct e K DATE: S -2- 1 Manufactured Home Modular Home Footings_ Foundation_ Backfill— Framing Comments: Yes .4No Foundation support, pier spacing, afi �3/3 Per manufacturer Anchoring per manufacturer 2'from ends Water line shut off Sewer line support @ 4 feet .� Heating Crossover[doublewide}off grd. 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 Fire proofing Fire Door/Door closers Plumbing Fixture/3"Vent through roof[Modular] Foundation insulation [if applicable] Smoke/Carbon Monoxide Detectors/Interconnected Final Electrical V Variance required Data Plate okay t/77/ 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 Okay to issue C/C or C/O[Temp./Perm.] f ; (�1// Model# • Serial# Manufacturer iR 1'" ..V-ly Date of Manufacturer 6\izct.\ L:\Pam Whiting120101Building Codes Forms\Manufactured_Modular Final Inspection_03 04 10.doc I AtL NO. 17690 STATE OF NEW YORK DEPARTMENT OF STATE 1 ONE COMMERCE PLAZA -I99 WASHINGTON AVENUE al 64. ALBANY,NY 12231 INSTALLER'S WARRANTY SEAL THIS SEAL REMAINS THE PROPERTY OF THE DEPARTMENT OF STATE 0 NEW MANUFACTURED(HUD CODE) RELOCATED MANUFACTURED(HUD CODE) A. Manufacturer's name: B. HUD label number r) i ; d - X , ` r Serial number A I >r1 A B C. Retailer's name: . D. Retailer's address: t \ fl - E. Retailer's certification#: f' l �' Telephone#: f 7/ F. Installer's name: . I Cx Installers address: _ , `3 / I 4 It Installer's certification#: _.. l 7h Telephone#: -'i . I. Date installed: - I 1-) Municipality issuing building permit: k u 'e ci t y j (City,Town,Viltage) J. Customer name and physical address (911)where home is installed:/.`j J /1 ! r u ri,Gi f > c f L 4- (-Cut obr -- !'«.t.Jrt:'i-;CC ,NewYork. P ur1'ti '! By attaching this SEAL to this manufactured home,the undersigned Installer of this manufactured home warrants as follows: 1. That the installation of this manufactured home meets the standards of the New York State Uniform Fire Prevention and Building Code. 2. That the Installer is certified as an installer by the New York State Department of State. The foregoing warranties are in addition to and not in derogation of all other rights and privileges which the consumer may have under any other law or instrument.The foregoing warranties are in additign-to,and n in limitation of or substitution for,any and all other warran- ties,express or implied,given or made by the ilffitaller,whether contractu y�or by operation of law. Printed Name of Person Signing Seal: .4 00 ' OC Signature of Installer or Limited Installer: / If you have a problem with your home,you should first contact your installer or retailer.If the problem is not resolved by the Installer or Retailer you can contact the Department of State at(518)474-4073. DOS-1680(Rev.03109) Yellow Copy—Department of State White Copy—Retain for Your Records Goldenrod Copy—Permitting Agency Seal—Affix to Home i � • pLeSt ?Lan 3,44,6- : I ". /6 1 ....., . . L--- --. . . I;:iii 19 2012 .. ! . . 1 ... _,..•- i:1•(-ili:2''NC C., COI:'_-_,., . , , / ri\ ..., , . .......A(,, , ----- NI: _.,-- . . . ..;:: .. , , . :..„.,i / TOWN OF QU ....•, • 7 Ilt' 1 / .. BUILDING ., Reviewed B /TA Af ' t , ' Date: gfillIFIEN ;-,' , ...: , 'R- - / , i . , to ,/ ' 7' ) _ . ? , N •. , , r F r‘o .1.r. 14 PY '---------) . . . , . 2,SACQ 0 , . 5 '\—, /0z --....,,, r6 7 -,, / (,5% ' . -....„..... : • •__, . , , NOTICE : . , TOW1 ' ..r :)uEEf,i(31-URY BUILDING [..:,..PRerivIENT I • CHONG OF MOBILE FRA IS REQUIRED PE 4 ! : Based on our limited examination,complian,, . L - . -, ,,,•-• Nith our comments shall not be construed . . indicating the plans and specifications dares II, NUFAC URERS SPECIFICATIONS — 7 ..)-- , R full compliance with the Building Coeof ., New York State, ' ) - i:1 _ (13 N 0... • a) NOTICE . . -t--- FOAM INSULATION MUST BE CL / 4 72 i BY A 15 MINUTE TI- .M.A1 1 •• • • i:::, (\, • I . , ....) ' . ,. V) , I ..,.. . NI — 4 % 0 ( , • t .2 . ., . •,,,s+•••• — 11 6 „-----7 ' • . < —J .----- --- ---- . - ------ ----- _,—-- ..-- _. -- --- --- ,..-- ,,,------- • . -1' 17 P r 7 -- . ...___. ______. _._ .-,./ . . ___ •_ __ • ___. ... . *1- KRAFT PAPER INSULATION M /ITY:C) / • ' / COVERED BY NONl-Q0MBUSTI BL0.-F BP. 16 Q lr- - • L_.- 1. s\i.• \ ,. ' LL - 0‘ i Road Name: kfrevild4c n 51. . • HornETEAD viLLAGE . . N1:5:1. 1.5g• 157 156 155- 1 i 34 33 32_ 31-: 30 2328 2.? . 26 . . . . . . itpo •- - • 1 • - ._ . . . . . . . . . „.•• _ .. ,. . ..1-__ .r, 4.1-51 131 : 71 --130 1 83 _ - ' :- .82: 35 ' - . 2.-A _-•••• - --•-la : 3 .- i..s3----'152,.---. '' .1/r•: 81 : . -.8a . 31c) . 27, i2843s - 80 3 7 . L b- . -, -A"--t 0......:_:_-- • - '73 _.:, . -.- 3:;, - . ., 1,-L-14.-..1-_ . 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