2013-179 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: P20130179 Date Issued: Monday, July 14, 2014
This is to certify that work requested to be done as shown by Permit Number P20130179
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
59 Alpine Ave. TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the property
4
owner of the responsibility for compliance with Site Plan, Variance, or A-'
other issues and conditions as a result of approvals by the Planning Board Director of Building&Code Enforcement
or Zoning Board of Appeals.
0.k* TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20130179 Application Number: A20130179
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
4294 ROUTE 5 Total Value
CALEDONIA,NY 14423
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2013-179 59 Alpine Ave.
Mobile Home 14'x 66'
$0.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,May 14,2014
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the To Qu nsbu ; T • ,', Ma 14,2013
SIGNED BY `'�' G for the Town of Queensbury.
Director of Building&Code Enforcement
•
i OFFICE USE ONLY I
II TAX MAP N . 06/.9-` EI MIT NO. )t 3 " I 7 9 DATE ISSUED: + Date •
I I I
3 'APPROVALS: ZONING TOWN CLERKi
PERMIT FEE d OD. Stamp
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00 I
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MOBILE HOME -APPLICATION FOR PERMIT:
A building permit must be obtained before placement of mobile home on parcel. No inspections will be made until a
valid building permit has been issued.
Applicant Information Property Owner Information
Name: FotYl PS 4.Ad if if./it Name: ( (IL. 140rvl.13
Address: cOO /___() e'rile' Address: `/, S 4- 5
Phone No.(58c) 30. -502(1 Phone No. (585-) Z26 -6/,$mob
Parcel Information �'� sty
Proposed Date of Placement:. 13 Property Location: 51/a%in C'. A oe
ll II � __ II Roa ,Street,Avenue
Name of Mobile Home Park: /7b/1'ecle �d viihr (if applicable) Tax Map Number: 3095 9-.2 - I
Mobile Home Information Zoning Information
Approximate Value of Home:$_37, Oa) Zoning Classification:
New Home: ®Yes ❑No Size of Property: 5 ft. by 4-26 ft.
Replacement Home: Ii Yes ❑No Existing buildings: /ion e—
Size of Mobile Home: i t-{ ft. by Lao ft. Setbacks: front yard 2/) ft. rear yard /5 ft.
side yards/D ft. and /0 ft.
Singlewide: )( Doublewide:
Number of Rooms: (exclude baths) (_ Accessory Building(s):
Number of Bedrooms: .3
Number of Bathrooms: Detached garage:❑1-car ❑2-car ❑ car
El Gas Fireplace 0 Woodstove 0 Wood Fireplace Attached garage: ❑1-car ❑2-car ❑ car
Foundation Support: Storage building: ❑Yes EgNo
Type Size & Depth Other:
Piers
- Water Supply: ['Well [,Municipal
Runners
Slab Is Septic Permit Required? ['Yes vgNo
Continued on page 2
Town of Queensbury• Community Development Office • 742 Bay Road, Queensvury, iv r Lamm
05/06/2013 13:52 5852266059 r AGL SERVICE PAGE 02/03
Name of Installer or Mobile Home Dealer: Affordable Great Locations
Address: 4305 Avon Caledonia Rd., Caledonia, NY 14423 Phone: 585-226-6150
Complete information below found on a"Plate" or"Sticker which is affixed to the mobile home:
✓ Insignia serial number:
✓ Name of manufacturer:Giles Industries
✓ Plan Approval Number:
✓ Model or Component Designation: Heritage#14463
(New home only)
✓ Date of Manufacture:
AFFIDAVIT
T• own of Queensbury State of New York
County of Warren T.
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
o• f 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, a,d that such
11 w• ork is authorized by the owner.
r.
Signature: J
0 • er.Owner's Agent,Architect, Contractor
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SPECIAL CONDITI.ONS OF PERMIT
By:
Code Enforcement Officer
u-�r
,4fr. ,` Town. of Queensbury ■ Community Development Office • 742 Bay road, Queensbury, NY 12804
Queensbury Building & Code Enforcement— Manufactured / Modular Final Inspection
Office No. (518)761-8256 Arrive: .am/pmDepart 1C`t) am/pm
Date Inspection request received: Inspector's Initials:
NAME: Holl s+e-Q.cL PERMIT# • —I
17
LOCATION: sq -pitt, iirle #v cd DATE: ! -',q— it
Manufactured Home
Modular Home g 5.-3 03 --,5- 111
Footings_ Foundation_ Backfill_ Framing
Comments:
Yes No NIA
Foundation support, pier spacing,
Per manufacturer
Anchoring per manufacturer 2'from ends
A.V;/
Water line shut off ,/
Sewer line support @ 4 feet 1/
Heating Crossover[doublewide}off grd. ✓
Dryer vented outside7/1
Skirting ventilated 1 sq.ft.per 1,500 sq.ft.
Hot water relief valve piping outside
Deck,porches,steps,railing f
Fumace/hot water operating
Garage Fire proofing Y
Fire Door/Door losers /'
Plumbing Fixture/3"Vent through roof[Modular] V17
:,..
Foundation insulation[if applicable] /
Smoke/Carbon Monoxide Detectors/Interconnected z.
Final Electrical
Variance required / .
Data Plate okay7 _
Manufactured HUD seal okay
Warranty Seal after January1,2006 1//
Installers Warranty Seal f
18'x 24'access or 22"x 30"attic access 7
Vapor retarder under home 6 mil poly or other
911 Street number f
Okay to issue C/C or CIO[Temp./Perm.]
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Date of Manufacturer )- ! 6 [1-7)
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BUILDING DEPARTMENT NOTICE
Based on our limited examination,compliance ANCHORING OF MOBILE HOME
with our comments shall not be construed as FRAME IS REQUIRED PER
indicating the plans and specifications are in
full compliance with the Building Codes of MANUFACTURERS SPECIFICATIONS
New York State.
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BUILDING & CODES D PT. _
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Clifton Springs, NY 14432
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Due to continuous product development and improvement,prices,specifications,and materials are subject to change without notice or
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