2013-430 9_3111111A TOWN OF QUEENSBURY
742 Bay Road,Qucensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20130430 Date Issued: Friday, February 27, 2015
This is to certify that work requested to be done as shown by Permit Number P20130430
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
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the propertyI
owner of the responsibility for compliance with Site Plan, Variance, or x,/'
11‘
other issues and conditions as a result of approvals by the Planning Board Director of Building&Code Enforcement
or Zoning Board of Appeals.
0164 TOWN OF QUEENSBURY
F 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
F
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20130430 Application Number: A20130430
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
4294 ROUTE 5 Mobile Home In Park $38,000.00
CALEDONIA,NY 14423 Total Value $38,000.00
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2013-430 90 ALPINE AVE.
Mobile Home in Park Giles Ind. Heritage 14663A
$110.88 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday, September 11,2014
(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 ensbu • WA,i. e• i ay, September 11,2013
SIGNED BYfor the Town of Queensbury.
Director of Building&Code Enforcement
Town of Queensbury Building & Codes Office Use Only
MOBILE HOME APPLICATION Received
I >f 9� 13
Ta Map I D: 30 6).(+-a--!
A permit must be obtained before placement of mobile home on parcel. No Permit No.: / 3 0
inspections will be made until a valid building permit has been issued. Permit Fee: $ if() ,i,S'
Applicant /kneikAl IA ri/A . Property Owner AL"1L t'w .��
Address ,22Co ivze</ L-J Address +--I ()._S-- (L+ ,--
qu ei) ,_,LN-`j, .13- (7 V4 (A 1& .b r t\ k t - 73
Phone ,ST-S-- 303.- 15-o2-1 Phone ,cf(S 2ZCE= -6 i_5-0 (3 f q
Contact Person for Building&Code Compliance: (.--0e_rl LAu t oLk_ Day Phone:,5�fS-.3Cj3`SZ\
Name of Installer or nn 1 Proposed Date of Placement 7-2,5----(3
Mobile Home Dealer 1kaL 1-Ta - Name of Mobile Home Park / ?c51eilet /4/41-5,---
Address L--1'23- (2k S 0c c t c ‘ k)j) Property Location 90 j-/pit. '(1`-e--
Phone ,, S-Z 26 -6/,S-0 ti 1k 31 V Tax Map ID 325'. ': - Z ---C
Complete information below found on a "Plate"or"Sticker"which is affixed to the mobile home:
• Insignia serial number:
• Name of Manufacturer: C't i,,,,/
• Place Approval Number:
• Model or Component Designation: /Je?r11,4f.e_ /414_ 4,7 4 (New home only)
• Date of Manufacture:
Mobile Home Information Zoning Information
Approximate Value of Home $ 006 Zoning
New Home or Replacement Aie,l,J Size of property 53 ft. x 1i0 ft.
Size of Mobile Home /"-/ ft. by ‘‘ ft. 1 'f- Existing Building(s) I40 L
Singlewide or Doublewide ci.75 . - Accessory Bldgs. 1\40 u ..Q__.
Number of Rooms(exclude bath) G, Storage Building(s) N-lvtr-c--
Number of Bedrooms .3 Detached Garage _1 car _2 car _3 car
Number of Bathrooms L. Attached Garage _1 car _ 2 car _3 car
Gas Fireplace Setbacks Front Yard: .O feet
Woodstove — Rear Yard: % S feet
Wood Fireplace — Side Yard: /0 feet
Foundation Support Size Depth Water Supply Well
•P¢I y Piers Municipal X
Runners Septic Permit Required?
Slab . MO
Town of Queensbury Building&Codes Mobile Home Permit 518-761-8256
Procedure for placing and occupying a mobile home or modular home:
1. Application is submitted and reviewed: 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 the Town's website
5. Septic Inspection, if needed
6. Final Electrical Inspection
7. Stairs and 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 sited 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-
$10.00; Deposit-$100.00(refunded when all items are complete)
✓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 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.
Print Name: ?c,\LIer K LA Wti Nc-s?--
Signature: Y`� .-
Owner,Owner's Agent,Contract
Date: ?--
Special
Special Conditions of Permit:
By: Code Enforcement Officer
Town of Queensbury Building&Codes Mobile Home Permit 518-761-8256
Queensbury Building & Code Enforcement— Manufactured / Modular Final Inspection
Office No. (518)761-8256 - /- 7/ f Arrive: .►� ar!, i=•- . 2-'-i---,1 ;
Date Inspection request received: I Inspector's Initials: „a,,,,g
NAME: H " 4 �4 eVi /1/-yP— PERMIT 4t: l 3 - t/ 30
LOCATION: '1 0 -I I,A,`.� t /am`- - . DATE: 2/2 /1/ a
/
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.
li
Dryer vented outside ,✓
Skirting ventilated 1 so.ft.per 1.500 so.ft.
Hot water relief valve piping outside II'
Deck,porches,steps, railing
(7---.1
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 _
',/Data Plate okay /11//,/
L� •
Manufactured HUD seal okay �f.-7i.-7"
Warranty Seal after January 1,2006 `�
Installers Warranty Seal /2 V
18"x 24"access or 22"x 30"attic access YY
Vapor retarder under home 6 mil poly or other
911 Street number �. `T.
Okay to issue C/C or CIO[Temp./Perm.] R
Model# y(0\�Q.-141,4p3RN\y Serial# b GI 0, 1•72 7? 31 13
Manufacturer L Nir' L _
Date of Manufacturer Cl -2-1 - ), .)l'-.-
L:\Pam Whiting\20101Building Codes Forms\Manufactured_Modular Final Inspec tion_03 04 10.doc
Queensbury Building & Code Enforcement — Manufactured I Modul. • inal Inspection
Office No. (518)761-8256 Arrive: `D •ZQMP• AB: •art:
Date Inspection request received: Inspector's Initials:
NAME: QHO N\ l� \1 L (-� PERMIT .
LOCATION: 1b Ptl 11G_ Pt 1 C- DATE: Z 71 15
Manufactured Home
Modular Home
Footings Foundation_ Backfill_ Framing_
Comments:
Yes No NIA
Foundation support, pier spacing,
Per manufacturer
Anchoring per manufacturer 2'from ends
Water line shut off
Sewer line support @ 4 feet ,v/
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 N DV`
4
Fire Door/Door closers Z
Plumbing Fixture/3"Vent through roof[Modular]
Foundation insulation[if applicable]
Smoke/Carbon Monoxide Detectors/Interconnected
Final Electrical
Variance required
Data Plate okay4
Manufactured HUD seal okay
Warranty Seal after January 1,2006
Installers Warranty Seal V
18"x 24"access or 22"x 30"attic access
Vapor retarder under home 6 mil poly or other
911 Street number
Okay to issue CIC or CIO[Temp./Perm.]
Model# 1-1,(otlecklt-1(cto31 MI Serial# ,6 C,St t,32TT
L
Manufacturer � L ! ]�00_6— 3
k t�
Date of Manufacturer ` 1— 7 " l�3
L:1Pam Whiting120101Building Codes Forms\Manufactured Modular Final Inspection 03 04 10.doc
•
<;:r.v-vjt,. -,tit W 6: t/' t t:*& •, w5=tet•.'t -•Tn 1 `:vt:o, t,-,t, t;s�t„tet-o w) .v/wt T. ,
N MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
"6-'ex/0.'e.; that the electrical wiring to the electrical equipment listed below has been examined and is approved as
N being in accord with the National Electrical Code, applicable governmental, utility and Agency rules in effect on the date
0 noted below and is issued subject to the following conditions. i
.v) Owner: Date:
i Homestead Village 11/26/2013
Occupant: Location:
Pi Mobile Home Homestead Village Lot#90
Queensbury, Warren Co. NY
l Occupancy:Single Family Dwg.
P
`�
wApplicant:
'....p77 Bob Lawrence
(
f ;'491
184 Adirondack St
1
(% 4
Queensbury, NY 12004 1.4
l
t__ J ;?,
10,
4 Joseph A.Holmes ,”
e� No. 318014155938EL '
Equipment: --- -- --- ---- -� — - - - — -- 1
ig
1 1 - 100 Amp Feeder To Home ./'
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✓ Op
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Zvi This certificate applies to the electrical wiring to the electrical equipment listed immediately null and void. This certificate applies only to the use,occupancy and ,4
qlyV) 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 iC�
inspection. No warranty is expressed or implied as to the mechanical safety,etti- of the property indicated above,this certificate shall be immediately null and void. ,�"7
'�'�) ciency or fitness of the equipment for any particular purpose. This certificate shall In the event that this certificate becomes invalid based upon the above conditions, (
, 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 >v
�1) 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 Middle •y4
4 ed to,the introduction of additional electrical equipment and/or the replacement of Department Inspection Agency, Inc. to initiate the inspection and revalidation
s,�sa01-.•
any of the components installed as of the above noted date,this certificate shall be process. A fee will be charged for this service. i�p
��a s •9'�•'-'\•-.• �•9---vr•.•4•-•-:9 •• •s-••- •-•--.9-\•----..-.•, ic •i.• •-.f,�• ••-..•-+b •••-•••R s •. '�>� •.i- • •'�rn-\'.�5�.i-;.:rr'".�sr�s7,,.4jt�
S✓•1.0,;,;WPS15 ,1S rS 3.�•y'�kc,4<rS4S� v�yry�j-4y 1 N��:�0:— I�.T $14ai�:l� ✓�.�'✓.si'.�'�:6�V y. :•eAL.�l.(.yk✓i:a : aS:•si�•''.�'••y`'.i.'�i 4P:?A
.�+`,� '4 Ste. �.�.4�,4�..�,�.4 :�ti`�4�.�i�. ��4`.�.�. �.6�.4�.�. .�.�`,�.`,.S,`.•.`,t� .�.1:�..\✓.%�.-%�.�✓,•v.`✓.�.�✓,`✓,:�_`�:`/?
Queensbury Building & Code Enforcement— Manufactured / Modular Final Inspection
Office No. (518) 761-8256 Arrive: 3 1 d art: am/pm
Date Inspection request received: Inspector's Initia •.
NAME: r(1 .SAV cstcl PERMIT it / 3- T 3 0
LOCATION: 91) A I p t f� lo DATE: I Z - 10 - I 11Manufactured Home I
Modular Home �j /
Footings Foundation_ Backfill Framing I_ " -i �l I y
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[f 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
Vapor retarder under home 6 mil poly or other
911 Street number /
Okay to issue C/C or CIO[Temp./Perm.] J /
Model# Serial#
Manufacturer
Date of Manufacturer
L:1Pam Whiting12010\Building Codes Forms\ManufacturedModular Final Inspection_03 04 10.doc
RX Date/Time 09/1112013 11:08 P.003
Sep 11 13 11:09a p.3
{eritdge
,SFr ~ 7 ?013
' Model 14663
�� 3 Bed/2 Bath
14`x66'
Homestead Village MHC
Queensbury, NY 12804
SPECIAL MODEL HOME FINANCING:
ASK HOW WE HELP PAY YOUR HOME LOAN*
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`Special financing program valid on select model homes placed in Homestead Village MIIC.Some restrictions apply.Call for complete details.
^ `.,
HOMESTEAD VILLAGE AGL HOMES
—_ r
200 Luzerne Road 4305 State Route 5
Queensbury,NY 12804 l'k AGL Homes Caledonia,NY 14423
85-3
5 03-5211 - . 585-226-2727
www.aglhomes.com 585-259-6099
Due to continuous product development and improvement.prices,specifications.and materials are subject to change without notice or
obligation. Square footage and other dimensions are approximate. Images such as renderings.photos,and floor plans may be shown
with optional features and/or third-party additions that may not be available in all regions orsituations.
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