2013-184 J ; TOWN OF QUEENSBURY
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742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20130184-39892 Date Issued: Monday, March 13, 2017
This is to certify that work requested to be done as shown by Permit Number P20130184-39892
has been completed.
Tax Map Number: 309.9-3-74
Location: 14 VERMONT AVE
Owner: Clute Enterprises,Inc.
Applicant: Clute Enterprises,Inc.
This structure may be occupied as a:New Mobile Home
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the �,j ,d1,t-
property owner of the responsibility for compliance with Site Plan, Y
Variance,or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
FOI$1 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20130184 Application Number: A20130184
Tax Map No: 523400-309-009-0003-074-000-0000
Permission is hereby granted to: CLUTE ENTERPRISES.INC.
For property located at 14 VERMONT Ave
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: CLUTE ENTERPRISES, INC. Mobile Home In Park
6 HOLDEN Ave
Total Value
QUEENSBURY,NY 12804-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2013-184
Mobile Home 14'x 68'
S114.24 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday,May 13, 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 f Quee bury �p ''Mo ,y/May 13,2013
SIGNED BY 1J/ . 4 for the Town of Queensbury.
Director of Building&Code Enforcement
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, OFFICE USE ONLY ,•
TAX MAP N . PERMIT NO. ! 3'I g DATE ISSUED: i •
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i PERMIT F // `t , s�,IAPPROVALS: ZONING TOWN CLERK 'o Stamp p ••
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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: Las-1-1 L 9_ CL) ke Name: -L_
Address: Co -( i&#— e. Address: OLL tI� , �.�•c
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Phone No. ( S � -7i 7,77 Phone No.
Parcel Information
Proposed Date of Placement: Property Location: /L-1 Uer—i-_ -01- AJC_
Road,Street,Avenue
Name of Mobile Home Park: (if applicable) Tax Map Number' 9! ---7y
Mobile Home Information Zoning Information
Approximate Value of Home:$ k2t5-40° Zoning Classification:
New Home: ❑Yes o Size of Property: ft. by ft.
Replacement Home: 'es 0 No Existing buildings:
Size of Mobile Home: ('1 ft. by &Fit. Setbacks: front yard ft. rear yard ft.
side yards ft.and ft.
Singlewide: Doublewide:
Number of Rooms:(exclu baths) 5— Accessory Building(s):
Number of Bedrooms:
Number of Bathrooms: Z Detached garage:❑1-car ❑2-car ❑ car
ace Attached garage: 01-car 02-car ❑ car
Foundation Support: Storage building: IT Yes El No
Type Size & Depth Other:
Piers Water Supply: ❑Well El Municipal
Runners
Slab (L1 X( (off G. I' Is Septic Permit Required? ❑Yes ❑No
Continued on page 2
:- Town of Queensbury• Community Development Office • 742 Bay Road, Queensvury, iv r La5U4
Name of Installer or Mobile Home Dealer: ( ,o-.e..4�� (...—...\r-i.,c..6
Address: Phone:
Complete information below found on a"Plate"or"Sticker"which is affixed to the mobile home:
✓ Insignia serial number: 07 L tpj -7 b
✓ Name of manufacturer: 1:---ir- -17
✓ Plan Approval Number:
✓ Model or Component Designation:
v=19 (New home only)
✓ Date of Manufacture:
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AFFIDAVIT
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Town of Queensbury State of New York
5 County of Warren
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I swear that to the best of my knowledge and belief the s
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statements contained in this application, together with the plans s
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 ONING J
r ORDINANCE, and all other laws pert...* g to the • .pos-• work s
shall be complied with, whether s• -cified or no,: . • such a
work is authorized by the ow. -r. / s
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Signatur-• "
•wner,Owner's Agent,Architect, Contractor
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SPECIAL CONDITIONS OF PERMIT
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By: l'� bf-
II4
..a Enforcemen (b fficer
x : Town of Queensbury• Community Development !ffice • 742 Bay Road, Qu•ensbury, NY 12804
AtA
Queensbury Building & Code Enforcement -- Manufactured 1 Modular Final Inspection
Office No. (518) 761-8256 Arrive: , % elP410i:
Date Inspection request received: Inspector's Initials:
NAME: C L )T€ PERMIT ler ‘,
L CATION: 5'4 vJtsJO!Jott,)_6 DATE: —Co 1Z
{how\es--+e Cla3 9. 9-j -/
Manufactured Home
Modular Home
Footings Foundation_ Backfill Framing_
3(a\-7 (o Comments:
Yes No N/A
Foundation support, pier spacing,
Per manufacturer w
Anchoring per manufacturer 2'from ends -1 �" � ' " v e
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 I Carbon Monoxide Detectors/Interconnected
Final Electrical -''
Variance required
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Data Plate okay V n
Manufactured HUD seal okay
Warranty Seal after January 1,20� /l7
Installers Warranty Seal
18"x 24"access or 22"x 30"attic access D
Vapor retarder under home 6 mil poly or other
911 Street number
Okay toi: ' • s :u. •. ..
Model# YEA `'1, [Zb'j Serial it i)Ctb\g 2 7
Manufacturer --� it rai\
Date of Manufacturer \�— \c\`'<\LQ
L:\Pam Whiting120101Building Codes Forms\ManufacturedModular Final Inspection_03 04 10_doc
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I TOWN OF QUEENSBLWI , • . ' i
BUILDING D EPARTME WI° 0006. . . ! ; .
lea.qn our limited e amiqatior,corppliatic • 1
ait 1 cur comments sh iii not be •:,•onStrueol as •• ; • ' I -i I .. 1 .,
_iculs-,atjil,g_tja.plan a d sRecificationos ae4 oin. . . ....
ful compliance iiith the Buifdig . d 1 I . .
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FRAM t is REQUM?ER i
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