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2013-110 411110.0. TOWN OF QUEENSBURY 742 BayRoad,Queensbury,NY 12804-5902 (518) 761-8201 4111i. Q ry, Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20130110 Date Issued: Monday, April 15, 2013 This is to certify that work requested to be done as shown by Permit Number P20130110 has been completed. Location: 31 BURCH Rd Tax Map Number: 523400-308-006-0001-003-000-0000 Owner: TERRIE LEE REED Applicant: TERRIE LEE REED This structure may be occupied as a: Mobile Home Out of Park By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the property l 4' owner of the responsibility for compliance with Site Plan, Variance, or �� other issues and conditions as a result of approvals by the Planning Board Director of Building&Code Enforce 'nt or Zoning Board of Appeals. TOWN OF QUEENSBURY e.14. "14. 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 FON Community Development- Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20130110 Application Number: A20130110 Tax Map No: 523400-308-006-0001-003-000-0000 Permission is hereby granted to: TERRIE LEE REED For property located at: 31 BURCH 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: TERRIE LEE REED Mobile Home Out of Park $15,000.00 31 BURCH Rd Total Value QUEENSBURY NY 12804-0000 $15,000.00 Contractor or Builder's Name /Address Electrical Inspection Agency ML CONTRACTING 798-0317 OR 955-8168 34 WARREN Ln OUEENSBURY NY 12804-0000 Plans&Specifications 2013-110 2004 Marle/Shult Model 7014-1633, Serial # t030681; Mobile Home 980 sq ft Res. Septic Alteration all part of installation $117.60 PERMIT FEE PAID -THIS PERMIT EXPIRES: Saturday,March 29,2014 (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 of Queensbu A Fr'. .y,March 29, 2013 • SIGNED BY for the Town of Queensbury. Director of Building& ode E`orcement - cf.\g. 19 -On plcc • y _ TOWN BOARD APPLICATION FOR PLACING A ,;V MOBILE HOME OUTSIDE OFA MOBILE HOME COURHT: l 7013''AFD . r This application for a Mobile Home Permit shall be accompanied by a plot plan ' CRekS'.9/My drawn reasonably to scale showing all dimensions, the size of the lot, the location on',., ""'��� „, the lot of the Mobile Home, the water supply and sewage system. If the applicant is not the owner of the premises, then the application must be accompanied by the written acknowledged consent the owner. Applicant Information Property Owner Information Name: ,f.evC,e�,/// Name: /e/I.Av /Geed Address: Address: 7 0p6� d oitesT,9/ed QLD e,9s B y N f/ /macro V Phone No: Phone No: 3 3 Ye6 Parcel Information Property Location: 3/ Ago/ Oilk-k-ttsed, Tax Map Number: gns, 6 -/ Road,Street,Avbnue Mobile Home Information Approximate Value of Home: $ /55 a-0 of fti,y New Home: Yes No Replacement Home: Yes 6o) Size of Mobile Home: y l ft. by ft. Singlewide: yeS Doublewide: Year: 02 00 V Make: /n/4/e L *l;Lr Model: / e y r / Serial # L C(. V State fully the reasons for this request: 41647 7-0 ,nZ'Ve my //0'1e / 77 /94/ 7'7 /)/t: P,e Admftt3. Applicant's Signature ate Town of Queensbury - Community Development Office - 742 Bay Road, Queensbury, NY 12804 Revised March 2010 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 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: �� ^� p NB_Owner, Agent, Architect, Contractor to ♦:1M.NJ.J:f:Nf:f:Nf:J.'J.J-f.J.f✓:J.f:f.f.J.f.'u:f.f.J.J.J.f.f.fy:J:fJ.f.J.f.f.J.J.f.J.J.I.J.f:f:f:f:i1M.fiJif+l:lY'1JJ444tf:f:Jt1Cl:J:J:f:f FOR TOWN USE ONLY Report of the investigation of the Zoning Administrator and recommendations: APPROVED: DISAPPROVED: OTHER RECOMMENDATIONS: ACTION OF THE TOWN BOARD: APPROVED: DISAPPROVED: OTHER RECOMMENDATIONS: By Resolution Number: of the Town Board of the Town of Queensbury, Warren County, New York. Dated this day of , 20 Town Clerk, Town of Queensbury la Town of Queensbury• Community Development Office - 742 Bay Road, Queensbury, NY 12804 Revised March 2010 r Community Development Office Town of Queensbury • 742 Bay Road • Queensbury, New York •12804 AFFIDAVIT TOWN OF QUEENSBURY STATE OF NEW YORK COUNTY OF WARREN I swear that the following used mobile home that will be transported into the Town of Queensbury for placement will have the following: a. A building permit approved and issued b. Meet all zoning requirements c. Mobile Home's HUD sticker affixed to the mobile home d. Meet HUD requirements for the Middle Zone. As the person responsible for the transport and placement of this mobile home, I accept total responsibility for removal of the mobile home from the Town of Queensbury if it does not meet the requirements for placement. 4(Signature: .t 7_ .� 4—A-1-----11 )3 Mobile H "e/Ow r, w► ;i's Agent, Mobile Home Contractor Date Signature: Town of u nsbuly C.• - Enforcement is Date Town of Queensbury - Community Development Office • 742 Bay Road, Queensbury, NY 12804 if7, tp 6P13H fp; TOWN BOARD APPLICATION FOR PLACING A MOBILE HOME OUTSIDE OF A MOBILE HOME COURT: This application for a Mobile Home Permit shall be accompanied by a plot plan drawn reasonably to scale showing all dimensions, the size of the lot, the location on the lot of the Mobile Home, the water supply and sewage system. If the applicant is not the owner of the premises, then the application must be accompanied by the written acknowledged consent of the owner. Applicant Information Property Owner Information Name: 1.6X,e y ec.o/ Name: /e/e�e5/ /teed Address: c. Address: ? //l0,6d,(a o/resr��eK) Ql� ee/) lay A/1 / '& Phone No: Phone No: 0 3 6 -- ,3 ciC) Parcel Information Property Location: .3/ J3C1,(/t /'1/� (l ,f,(/&(JS� Tax Map Number: .4(3, (� - Road, Street,Avenue Mobile Home Information Approximate Value of Home: $ /5; OW) a ui.x New Home: Yes No Replacement Home: Yes No ' Size of Mobile Home: /4/ ft. by /26 ft. Singlewide: ye5 Doublewide: Year: 2O V Make: ft/A LL-J *, f- Model: L' ! / ' Serial # State fully the reasons for this request: �cJCr'/)7 70 f) j/e � ''tee .40,9C/< 1& DdAr7(/--- --1 Qt.u AReCk_,;•,( •. Applicant's Signature late . 4 Town of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804 Revised March 2010 A • AFFIDAVIT Town of Queensbury State of New York County of Warren is 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. 3 r Si nature: / Ate ? � - g Owner, Agent, Architect, Contractor D to FOR TOWN USE ONLY Report of the investigation of the Zoning Administrator and recommendations: APPROVED: DISAPPROVED: OTHER RECOMMENDATIONS: ACTION OF THE TOWN BOARD: APPROVED: DISAPPROVED: OTHER RECOMMENDATIONS: By Resolution Number: of the Town Board of the Town of Queensbury, Warren County, New York. Dated this day of , 20 Town Clerk, Town of Queensbury Town of Queensbury - Community Development Office - 742 Bay Road, Queensbury, NY 12804 Revised March 2010 Community Development Office ;{ Town of Queensbury • 742 Bay Road • Queensbury, New York •12804 AFFIDAVIT TOWN OF QUEENSBURY STATE OF NEW YORK COUNTY OF WARREN I swear that the following used mobile home that will be transported into the Town of Queensbury for placement will have the following: a. A building permit approved and issued b. Meet all zoning requirements c. Mobile Home's HUD sticker affixed to the mobile home d. Meet HUD requirements for the Middle Zone. As the person responsible for the transport and placement of this mobile home, I accept total responsibility for removal of the mobile home from the Town of Queensbury if it does not meet the requirements for placement. Signature: L(' i t�.c -"(C i' Le I IP� 13 Mobile Home Owner, Owner's Agent, Mobile Home Contractor Date Signature: Town of Queensbury Code Enforcement Officer Date Town of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804 Community Development Office Town of Queensbury • 742 Bay Road • Queensbury, New York •12804 L013 3 M/ Office Use Only #4,1lJ 211I3 TAX MAP NO.3 0 g ((I-I.3 PERMIT NO. ! 3 'II C PERMIT FEE' ' APPROVALS: ZONING TOWN CLERK APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS. APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMIT. OWNER: / eXXV 'QQcS INSTALLER: L- C 0/77-/fAc'.T/A/C ADDRESS: 41 0.b!! o d/4.,d ADDRESS: 3'/ 1 *z, r&7 Z•47/,e PHONE NOS. 3 b - 3 v d O PHONE NOS. W.:9-63//7 9,53-476s) LOCATION OF INSTALLATION: ,/ Aloof /cD/J IUL , t�=GV-�BLIey /Vy �?Yd`f RESIDENCE INFORMATION: NO.OF COMPUTATION YEAR BUILT X = TOTAL DAILY FLOW BEDROOMS (Gallons per bedroom) GARBAGE GRINDER 1980 or older X 150 = INSTALLED? Au 1981 -1991 X 130 = SPA OR HOT TUBA/0 1992-present X 110 ao2O INSTALLED? PARCEL INFORMATION: ✓ TOPOGRAPHY: FLAT ROLLING X STEEP SLOPE %SLOPE ✓ SOIL NATURE: SAND X LOAM CLAY OTHER ✓ GROUNDWATER: AT WHAT DEPTH? ✓ BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH? ✓ DOMESTIC WATER SUPLY: MUNICIPAL WELL (If well:water supply from any septic system absorption is: ft) ✓ PERCOLATION TEST: RATE IS / - PER MIINUTE PER INCH[mpil (Test to be completed by a licensed professional engineer or architect) PROPOSED SYSTEM FOR NEW CONSTRUCTION: All individual sewage disposal systems must be designed by a licensed professional engineer or architect(unless installed in a Planning Board approved subdivision). TANK SIZE: /600 GALLON (MIN. SIZE IS 1,000 GAL.)Add 250 gallons to the size of the septic tank for each garbage grinder, spa or whirlpool tub. SYSTEM TYPE: ti'ABSORPTION FIELD(WITH NO.2 STONE) Total length ca?00 ft. Each trench t2C1 , X 5-0 o SEEPAGE PIT(S) (WITH NO. 3 STONE) How many? Size? ❑ALTERNATIVE SYSTEM Bed or other type? ❑ HOLDING TANK SYSTEM Total required capacity? Tank size? Number of tanks? NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED. For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Queensbury, any permit or approval granted which is based upon or is granted in reliance upon any material misrepresentation or failure to make a material fact or circumstance known by or on behalf of an applicant, shall be void. I have read the regulations with respect to this application and agree to abide by these and all requirements of the Town of Qu ensbury QUESTIONS? CALL 761-8256 OR EMAIL Sanitary Sewage Disposal Ordinance. j codes(@oueensburv.net 1'� /Pt �c VISIT OUR WEBSITE FOR MORE INFORMATION Signature of Person Responsible to www.queensburv.net CASHIER'S DEPARTMENT - TOWN OF QUEENSBURY BUILDING & CODES ✓ Code No. Title Fee Fee Reason for Refund Staff Collected Refunded Initials 01-51570 (210) Demolition Permit 01-52122 (211) Sewer Variance 01-52555 (212) Building Permit 01-52555 (212) Sign Permit 01-52555 (212) Septic Permit 01-52655 (230) Miscellaneous PLANNING &ZONING 01-52110 (220) Zoning Fees 01-52115 (221) Planning Fees 01-52115 (221) Site Plan Review 01-52115 (221) Subdivision 01-380 (222) Technical Assistance Invoice # 01-52655 (223) Miscellaneous 01-52002-0061 Recreation (224) Assessments FIRE MARSHAL 01-51560 (190) Public Safety 01-52655 (230) Minor Sales NAME &ADDRESS OF CUSTOMER PROJECT NAME/ NUMBER ' FFICE USE ONLY Cash C # Total Fee Total Fee �15 Collected _ Refunded Town Clerk/ _ Date Deputes Signature Prepared by: O Building & Codes O Planning O Zoning O Fire Marshal Original (Town Clerk) Canary (Town Clerk) Pink (Customer) Gold (Return to Dept. checked above) CASHIER'S DEPARTMENT - TOWN OF QUEENSBURY &CODES Code No. Title Fee Fee Reason for Refund Staff Collected Refunded Initials _ 01-51570 (210) Demolition Permit 01-52122 (211) Sewer Variance 01-52555 (212) Building Permit 01-52555 (212) Sign Permit 01-52555 (212) Septic Permit 01-52655 (230) Miscellaneous PLANNING & ZONING 01-52110 (220) Zoning Fees 01-52115 (221) Planning Fees 01-52115 (221) Site Plan Review 01-52115 (221) Subdivision 01-380 (222) Technical Assistance Invoice # 01-52655 (223) Miscellaneous 01-52002-0061 Recreation (224) Assessments FIRE MARSHAL 01-51560 (190) Public Safety 01-52655 (230) Minor Sales NAME &ADDRESS OF CUSTOMER PROJECT NAME / NUMBER ,/ OFFICE USE ONLY ' Cash Check # _ Total Fee _ Total Fee t ' Collected / .`.' 'I- f Lr) Refunded Town Clerk/ Date Deputy's Signature -- Prepared by: OBuilding &Codes O Planning O Zoning O Fire Marshal Original (Town Clerk) Canary (Town Clerk) Pink (Customer) Gold (Return to Dept. checked above) `D —/ fr Septic Inspection Report Office No. (518) 761-8256 Date Inspection request received: /3 Queensbury Building &Code Enforcement Arrive: am/ Depart: am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: ,, "' NAME: PERMIT NO.: 3 - /10 LOCATION: 3 L (,�.rc4-. INSPECT ON: #),1171-0/ 3 RECHECK: r,— Comments and/or diagram Soil Type:`8a .d'/ Loam/Clay Type of Water: Municipal/ Well Water Waterline separation distance ft. Well separation distance ')___ _ft. Other wells: v ft. Well Casing Length 50' + / - Y N N/A [150'to well required if NO] Absorption Field: Total length ��w ft. Length of each trench 'c Z ft. Depth of trenches "L ft. Size of Stone Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tankJ Tank to Distribution Box Distribution Box to Field/ Pit Opening Sealed: T N — End Cap N Inlet/Outlet Pipes &Baffles Y N Manholes 12"or less below grade _Y_N [provide extension collar if Yes] Y N Location/ Separations 1 Foundation to tank % Aft. Foundation to absorption ft. Separation of Pits ft. i Conforms as per Pl n N Engineer Report an As-i3 ' AL Y N �'` y � ETU Maintenance on ct _Y_ N 1 provided Location of System of roperty: Front Rear Left Side Right Side Middle Front Middle Rear stem Use S s: Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved L•\Pam Whiting\2010\Building Codes Forms\Inspection Forms\Septic Inspection Report.03 29 10.doc Queensbury Building & Code Enforcement-- Manufactured / Modular - nal Inspection Office No. (518) 761-8256 Arrive: 11%I ' .=it: a pi Date Inspection request received: Inspector's Initials: �iiv>�.t NAME: R eF D PERMIT* \3-\ \C C r LOCATION: cT3\ )�C-V-\ W) DATE: 14 - ri..7 \ 3 Manufactured Home Modular Homez Footings Foundation_ Backfill_ Framing Comments: Yes No WA Foundation support,pier spacing, Per manufacturer4 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 so.ft.per 1,500 sq.ft. ;17/ Hot water relief valve piping outside Deck,porches,steps,railing //t/ . Fumace/hot water operating Garage Fire proofing /4/ Fire Door/Door closers ,./,✓ Plumbing Fixture/3"Vent through roof[Modular] Foundation insulation[if applicable] Smoke/Carbon Monoxide Detectors/Interconnected .)k Final Electrical Variance required Data Plate okay /7/ Manufactured HUD seal okay Warranty Seal after January 1,2006 /(//.17 Installers Warranty Seal 18"x 24"access or 22"x 30"attic access f Vapor retarder under home 6 mil poly or other V / ::: s:::ror CIO[Temp./Perm.] 1-)� \ \) - R. Model# --7()k -l b9 3 Serial# 1 Cy 03 \, Manufacturer t-'\'ac [3C-\--VA� Date of Manufacturer C -15-z_u`c3 L:1Pam Whiting120101Building Codes Forms'Manufactured_Modular Final Inspection_03 04 10.doc 1huA,bc g - 16 Queensbury Building & Code Enforcement— Manufactured / Modu ar Final Ilpection Office No. (518)761-8256 Arrive: ` - part: , = Date Inspection request received: Inspector's Initia NAME: (J r r) ( Se-8 PERMIT • / 3-110 LOCATION: 3J LUL6 -Ni`C JC� DATE: /—// "/ 3 Manufactured Home Y Modular Home Footings_ Foundation_ Backfill_ Framing Comments: Yes o WA 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 grd. Dryer vented outside Skirting ventilated 1 sq.ft.per 1,500 sq.ft. V. / Hot water relief valve piping outside Deck,porches,steps,railing ` Pk" �� 6_> 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 Manufactured HUD seal okay Warranty Seal after January 1,2006 Installers Warranty Seal 18"x 24"access or 22"x 30"attic access k - CAL Vapor retarder under home 6 mil poly or other 911 Street number Okay to issue C/C or CIO[Temp.I Perm.] Model# WQ'lI Serial# 1�, Manufacturer t. � Date of Manufacturer L:\Pam Whiting120101Building Codes Forms\Manufadured_Modular Final Inspection 03 04 10.doc INSTALL NO. 17893 STATE OF NEW YORK DEPARTMENT OF STATE ONE COMMERCE PLAZA 99 WASHINGTON AVENUE ALBANY,NY 12231 INSTALLER'S WARRANTY SEAL THIS SEAL REMAINS THE PROPERTY OF THE DEPARTMENT OF STATE ❑ NEW MANUFAQITURED(HUD CODE) J RELOCATED MANUFACTURED(HUD CODE) A. Manufacturer's name:/r -fl-E B. HUD label number. W779 449146 Serial number: 133 OCt C. Retailer's name: D. Retailer's address: 1 T /JA E. Retailer's certification#: Telephone#: F. Installer's name: - /4,44401:40t � lr+ G Installer's address: 94,Ed/'"' k. � 4)dk;',t H. Installer's certification#: d f'T'�1? Telephone#: e 727,Y'73 cY 1. Date installed: ye/.3 Municipality issuing building permit: re sjr (city;Town, la ge) J. Customer name and physical address (911)where home is installed: -rg.y 4Ej(� 1/ J.*ftt.N 171, 041 4,60(4. ,New York. /04.1.)/4 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 addition to,and not in limitation of or substitution for,any and all Other`warran- ties,express or implied,given or made by the Installer,w her contractually or by operation of law. Printed Name of Person Signing Seal: llf&url/c¢ Signature of Installer or Limited Installer: If you have a problem wit 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.03/09) Yellow Copy—Department of State White Copy—Retain for Your Records Goldenrod Copy—Permitting Agency Seal—Affix to Home i tt e .S 1-3 (3e,,,) Foundation Inspection Report Office No.(518)761-8256 Date Inspectio n . QueensburyBuilding&Code Enforcement Arrive: l% :1 . i , �" Ad/ � 742 Bay Rd.,Queensbury,NY 12804 Inspector's Inti= 04.- i "ii NAME: R ed PERMIT#: 13-- 11 o LOCATION: 3i L'S(,LT'C'J Rd INSPECT ON: 4i— ..-/ '� TYPE OF STRUCTURE: N' 0 koi 1 p }--1e,M ee Comments Y Footings Z— -V‘3 il ‘ F ‘2- Piers Monolithic Slab Reinforcement in Place t �z, The contractor is responsible for — C t 41 0 ,v providing protection from freezing for 48 hours following the placement of the concrete. Materials for this purpose on site. Foundation/Wallpour 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.:WBullding&Codes Forms\Buliding&Codes\Inspection Forms\Foundadon Inspection Report.doc Last printed 12/20/2005 9:24:00 AM 11 '-ou Queensbury Building & Code Enforcement — Manufactured I Modular Final Inspection Y i Office No. (518) 761-8256 Arrive: ` 1_I= giD..-.)•. Q 1 v � Date Inspection request received: Inspector's In .< ." NAME: (LLC ) K-V--� PERMIT* YF 11JQ\ an 13 4 to LOCATION: 7_1 L.3 0001_RIJ ) V v -\ DATE: C3) "2_.(i.)-\ 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 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 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 ariance required ,l /Data Plate okay V Manufactured HUD seal okay /7 4 /- S✓ 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 Okay to' -`- ,*�k„-r Model# r,L I L , " I Itv Serial# I i1jC) 3 C'(- I Manufacturer W7?Y ���1� \�- 3 l� Date of Manufacturer 1 Z- —2EFT2) L:\Pam Whiting\20101Building Codes Forms\Manufactured_Modular Final Inspection 03 04 10.doc pLor PLP1N( — - ________. , ___ _ --A-661- ..-?,Er_____D_- cr21.2L.P.161i I HAVE SEEN OR OBSERVED ALL OBJECTS SUCH AS HOUSES, WELLS, TREES, FENCES, ETC , St;Ob'dN ON THIS DOCUMENT.I HAVE PERSONALLY ME .:,U ' D THE DISTANCE SET FORTH ON THIS DIAGRAM. S -- .l"! ,,, DATE NOTICE ANCHORING OF MOBILE HOME FRAME IS REQUIRED PER MANUFACTURERS SPECIFICATIONS ra �il r:, ('‘(`)?\( B P / -3 - ,„ ,,,„ „... t ; ,., „ 19 TOWN OF QUEENSBURY BUILDING DEPARTMENT Based on our limited examination,compliance w\*pX with our comments shall not be construed as dicrating plans afications in 'I s, infuu compliancethe withano thes Buildeing Codesare of New York State. bO 4 TO \L \ c "') 3 \ > Q°Re LA- At'V" mil' ,t -- 4 r \"\ - TOWN OF QUE 1B,. •Y BUILDING & 0Dr ;I's ,-f, f�-' `��\ Reviewed By. /id �/ 1 U ` �c Date: maw ��' I ,� � �� _ _ MARCH RD At 001O11d1 ?W° -i Q ,uo'J, ?Ca, I I I I 14 i, II - I t W oOkrik`7 - t� f 41 a'ly� � --- nL VI 1 400 4 c1i - s_ 1 d 9