Loading...
RC-000218-2015 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development-Building&Codes (518)761-8256 CERTIFICATE OF OCCUPANCY Permit Number: RC-000218-2015 Date Issued: Tuesday, February 16, 2016 This is to certify that work requested to be done as shown by Permit Number RC-000218-2015 has been completed. Tax Map Number: 309.9-2-I Location: 138 Adirondack ST Owner: AGI Homes Applicant: Homestead Village This structure may be occupied as a:New home in Homestead Mobile Home Park By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the property owner of the responsibility for compliance with Site Plan, J49 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 QL 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development-Building&Codes (518)761-8256 BUILDING PERMIT Permit Number: RC-000218-2015 Tax Map No: 309.9-2-1 Permission is hereby granted to: Homestead Village For property located at: 138 Adirondack ST 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 Tvoe of Construction Owner Address: 4305 State Route 5 Mobile Home $38,000.00 Caledonia,NY 14423 Total Value $38,000.00 Contractor or Builders Name/Address Electrical Inspection Agency Robert Lawrence Plans&Specifications New home in Homestead Mobile Home Park $110.88 PERMIT FEE PAID-THIS PERMIT EXPIRES: (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 ens 9' SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement Town of Queensbury Building & Godes Office use only 11 Received: lo/2,7�aG l5 MOBILE HOME APPLICATION OCT 2 7 Uttlx Map ID: 30q, 9-a A permit must be obtained before placement of mobile home on parcel No Permit No.: C-000-I 8,-'k U I S inspections will be made until a valid building permit has been issued. Permit Fee: $ �r S� mar (p Applicant �iy]e5 �e1 [l//�A�G Property Owner (ALn L Ho Me 5 Address aT,12 &2e. roe_ /ec1 Address LI k)s 4,P-4-, S CPL&=em S r-V ,/V Y'>Z Yy�/ CAkAcc% i ra N � ( L4'42-3 Phone _<as- k�a I ( Phone SScS r Z,;C& —&5-0 SX4 -9/1/ Contact Person for Building&Code Compliance: ao 1 pwce-r co— Day Phone:SBS-X03-5 1 Name of Installer or Proposed Date of Placement Akv In, 7q S Mobile Home Dealer�I�A�� n/ Name of Mobile Home Park lyomeS-L-,a,( G/7/,r Address < O Property Location 21V) A)i Phone `75�U� c>�' y�/y Tax Map ID Complete information below found on a "Plate"or"Sticker"which is affixed to the mobile home: • Insignia serial number: • Name of Manufacturer. k n/ • Place Approval Number. • Model or Component Designation: :4;Av'11'�41, 71-11q-;VQ(New home only) • Date of Manufacture: ///Z6— Mobile Home Information Zoning Information Approximate Value of Home $ e o c o Zoning New Home or Replacement ezc7 Size of property 5 3 ft.x-Z20 ft. Size of Mobile Home �` _ft.by�6 ft Existing Building(s) cKsb Singlewide or Doublewide Accessory Bldgs. r Number of Rooms(exclude bath) Storage Building(s) kq� Number of Bedrooms Detached Garage 1 car 2 car 3 car Number of Bathrooms Attached Garage 1 car _ 2 car _3 car Gas Fireplace Setbacks Front Yard: r�O feet Woodstove Rear Yard: feet Wood Fireplace Side Yard: Meet Foundation Support Size Death Water Supply Well J Piers _ _ Municipal pied P/905 Runners_ _ Septic Permit Rpnrdrp.d? Slab RC-000218-2015 Town of Queensbury Building&Codes Mobile Home Permit Homestead Village 138 Adirondack Street 14 ft. by 66 ft. mobile home (new) 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 (d 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-$100.00(refunded when all items are complete) ✓I swear that to the best of my knowledge and belief the statements contained in this application, together with the plans and specifications submitted, are a true and complete statement of all proposed work to be done on the described premises and that all provisions of the BUILDING CODE, the ZONING ORDINANCE, and all other laws pertaining to the proposed work shall be completed with, whether specified or not, and that such work is authorized by the owner. Installer Warranty will be provided at time of Certificate of Occupancy. Print Name: c r V, • ) Av cen c e_ Signature: k� - Owner,Owners Agent,Co tractor Date: /0 -27 -/ -i Special Conditions of Permit: By: Code Enforcement Officer Town of Queensbury Building&Codes Mobile Home Permit 518-761-8256 Rat PLO n 1 10 W p ' I [F17LE=COPY NOTICE ANCHORING OF MOBILE H H K FRAME IS REQUIRED PE MANUFACTURERS SPECIFICA I IONS TOWN OF QUEENSB RY LUc Ja ed BUILDING DEPARTM NT Based on our limited eaaminatio ,compliance �S i LOT with ou cc nm?gqt hnl' not' onstrued as odic puna i ations are in full co pliance with the Building Codes of New York State. r 0 1 [n FI } W O1c 4 "j TOWN L 1- TVWN OF QAli BUILDING. SReviewed Ba Date: TE O U 2 N E i 3 � O 4 � pO a`1) U E o > _ C o (� c c N Q Q 0 E co Q 2 (lrt 27 215 . '. V.. 'u._I_nobj RY ti BUILDING CODES p Road Name:r 1d,TZ,46AGV � 09-24-'14 07:32 FROM-agl. homes 15852268909 1=774 Y000hlWbb6 F-846 ,. =y m. UOJWA MAn&WJWAId 4pPlaan Ad ti �lh4DQ m � \✓ HHHH o --p `ys1 CP 3 • ���c� M ���6eP_ OCT 2 7 21115 BUILDING r Sl I _3O_-3_' -10' 1: _____ __ _______ I I I I 51 'J 1'1 I I 1 I I I I 1 I r LLL I I I I Ir-r I I — _ I I s]IrT6aP I I I I I NN 0r0P I I 1 I I I I 1 I I I 1 I I I I 1 I I Ef I -- a----------------------- ---------------------TJ$�-- --------------------- LB' l 14• l 24 -U, - 1 NI v 1I iJ-o - Illi Jo.-G. PAI am. mnlQ prnQ 1Mp ©.QFrnlot� �.wr 2 rPrw6>w w•wm un TNIS OIRGRPM IS N0T RAPIA-APPRN7C AND IS BEING PROVICEO ®•v^°n"ml'cnc w. QO •orr awnK vv RS F CONVENHNYS FOR ESTIMATING PURPOSES ONLY. REFER -0 �'[^LL'wa vrc mlc �•a21an 'NF OAPIR ArRCVEO INSTRLLBTICN >-NULL FOR THE OFFICIAL PIER LOAD, �•\nLL/w wu'\°a[pr« wMr u LOTITP6 la wanrPrz Q•YPrsr um ar.Tar. SPACING, AND FOpi INC REOJIREJKNTS DILAQ Yf:LFN iYI1.O P1L9gO W 4O Obr ®•9/rVrVP MIFG 4r 3!f•AIY IL q[O r..9.O.I'M lP lan p�fl. 4)Y Y.O aY\wIU - OWA6mvvluaRN➢.M Rrllm mml[. FRYLRO LYb v.W Q.YgIRi1.O1r P6[r[vr Mµl[v14.v IfI.OLd OM A. O.'pIW IO la1LQ 9rM SLIM •Lvf510.9 N OIR •[vLt IrOr[f Av'611ML nv[ 4.rL w MARLETTE MOIL ronu6 Arawwnwwa wRw.nnrwua p p •� m 933 wnwaL2wlwlL[rwrm lws2ux 1 IE5E1 nKr wmla Irm c. 99 1/2 BEAM 6PAC I N 996 Hx66 1B -iBA auoTEi7B6B CYN YANUPACNRINOr INC. wrw maws wM 125,2 warn ATR O6'isR019 06R9R019 2I-PS-99 r LL, o 00 I Elo Do sn '• `�• �' fv '� �� •+� .ui �� .v, �If> �If� 'IfT N 1�11� 1 wo e110111Alip IoG k, wk o c off- t cid It ccnn Lr COP t, vim_ IV � irIH r MM 1t- u, Aa _ COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC. Main 0(rece 176 Doe Run Road-Manheim,PA 17545 MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL Pan-nit No.21.8.m�201.f............Cert.W 42272 Cut-in Card No..................................... Owner................... ......... .......................................... ............................................. Location.....J.-AR........ ..................... IV......................... Installation Consisting ..4.4o..h4.1L ........................ ............................................................................................................................................................I.................. .............................. .......................................................I.,....................................................................... InstalledBy....... ............._.....................................---Lie.No......................................._.......... The cooidiflom following governed the issuance of this certificate,and any certificate previously issued is cancelled:- This certificate only covers the electrical equipment and installation conditions as of date. Upon the introduction oradditional equipment or alterations,application shall be promptly made for inspection. Inspectors of this Company shall have the privilege of making inspections at any time, and if its rules are violated.the Company shall have the right-iii revoke this certificate. Dato.....m7...... ................ INSFECrOR,.j�-2- . ...........11......................... Member NARA,LALLI. Z9 39Vd o-lgwnW NOH 089186L II:zT 910Z/00/z0 INSTALL NO. 21946 STATE OF NEW YORK DEPARTMENT OF STATE ONE COMMERCE PLAZA 99 WASHINGTON AVENUE ALBANY,NY 12231 INSTALLER'S WARRANTY SEAL j THIS SEAL REMAINS THE PROPERTY OF THE DEPARTMENT OF STATE [3'NEW MANUFACTURED(HUD CODE) ❑ RELOCATED MANUFACTURED(HUD CODE) A. Manufacturer's name: y 1n � a'Q B. HUD label number: � i/y I -6 �1 �� 5 Ll � Serial number: L-f r J C. Retailer's name: (' Y e_ CA L o c c,_A t o'A S D. Retailer's address: � �A• S C �")Q cj()NN E. Retailer's certification#: ` �T O O. C P — 0 D I \ Telephone#: F. Installer's name: , O Installer's address: C i")i a �A -./,.t N f i.��O H. Installer's certification#: I /J7 0 9 I i.j L I Telephone#: S'3 -S(O 1 I. Date installed: t Cb_ .:iN i C�1 �D Municipality issuing building permit: 0, J r (City,/Town,�uk ) J. Customer name and physical address (911)where home is installed: vl t' to �U 61(k 5 )s6J,0. 7S?. '1 , I��, J, .', New York- 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,whether contractually or by operation of law. Printed Name of Person Signing Seal: I ` Signature of Installer or — ;1 Limited Installer: V �t i 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—Permiting Agency Seal—Affix to Home