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2009-437 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building &Codes (518) 761-8256 CERTIFICATE OCCUP-A-N- C...N. Permit Number, P20090437 Date Issued: Tuesday, December 15, 2009 This is to certify that work requested to be done as shown by Permit Number P20090437 has been completed. Location. 200 LUZERNE Rd Tax Map Number. 523400-309-009-0002-00 1-000-0000 Owner. HOMESTEAD VILLAGE L P Applicant: HOMESTEAD VILLAGE L P This structure may be occTAWYi "MOFFITT Mobile Home In Park By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the t property owner of the responsibility for compliance with Site Plan, )4vpw 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 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20090437 Application Number: A20090437 Tax Map No: 523400-309-009-0002-001-000-0000 Permission is hereby granted to: THERESA MOFFITT 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. Tyne of Construction Value Owner Address: HOMESTEAD VILLAGE LP Mobile Home In Park $38,000.00 4294 ROUTE 5 Total Value $38,000.00 CALEDONIA,NY 14423 Contractor or Builder's Name /Address Electrical Inspection Agency Plans&Specifications 2009-429 84 Alpine Ave - Theresa Moffit - 1280 sq ft mobile home in park $76.80 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday, September 15,2010 (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 Tow i of Q 7)nsbuy !� T e d , September 15, 2009 " ��" Town of Queensbury. SIGNED BY for the o Q ry Director of Building&Code Enforcement a OFFICE USE ONLY TAX MAP NO. PERMIT NO,gr) 07__467IDATEISSUED: f / PERMIT FEE APPROVALS: ZONING TOWN CLERK ' ------------------- �'�- - 'w------ 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: er IW4 AWj Name: 21�hj�� Address: 3 ' 1� Address: Phone No. yp Phone No. Parcel Information Proposed Date of Placement: 9Q-(-� Property Location: O 'T' tome, Alle t.� Road,Street,Avenue Name of Mobile Home Park: &Q(gga(&ff (it applicable) Tax Map Number: Mobile Home Information Zoning Information Approximate Value of Home: $ 3 1?�Q© Zoning Classification: New Home: ❑Yes ®No Size of Property: ft. by ft. Replacement Home: XYes ❑No /Z Existing buildings: ► P�� Size of Mobile Home: (4 ft. by SCE ft. Setbacks: front yard ft. rear yard ft. side yards ft. and 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 ❑Gas Fireplace Love Wood Fireplace Attached garage: ❑1-car ❑2-car ❑ car Foundation Support: Storage building: ❑Yes No (,,w �viuw•� Type Size & Depth Other: Piers Water Supply: ❑Well ❑Municipal Runners Slab Is Septic Permit Required? El Yes ❑No ............................................................................................................................... ................................................................................................................................................................................................................... Continued on page 2 T7'wn of Queensburtf ° Commit f Development Of{rce • 742 Bay Rork(, Queeiisvioy, lv ) j_.,6u t Name of Installer or Mobile Home Deoier: ri. Ll"� ` 411,? Address: 15 N 0 Phone: e) 7 9/3 _. Z Complete information below found on a"Plate"or"Sticker"which is affixed to the mobile home: ✓ Insignia serial number: r� L 6 6 - 3 ✓ Name of manufacturer. L lit°li ✓ Plan Approval Number: ✓ Model or Component Designation: fy 9 (New home only) ✓ Date of Manufacture: `"f AFFIDAVIT Town of Queensbury State of New York Countf 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. SignatuVZ re: Owner, Owner's Agent, hitect, Contractor SPECIAL CONDITIONS OF PERMIT By: Code Enforad,,Queensbitry, ent Officer Town of-v Tof Q11eensbury • Col)inninity DeT,elopnte Off ce - 742 Bi2y R NTY 12804 t ©r711 ttity Development Office T0, Quecushury - 742 Bay Road - Queeushutay, New York -12804 PROCEDURE FOR PLACING AND OCCUPYING A MOBILE HOME OR MODULAR HOME: 1. Application is submitted and reviewed. a. Two (2) copies of plot plan and two (2) copies of layout must accompany application, along with septic application (if needed). 2. Permit is issued. a. Permit card is placed on property. 3. Footing forms are inspected before pouring concrete (Outside mobile home park). a. Home is placed on foundation or piers. 4. Arrange for electrical inspection 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 manufacture requirements. 10.If anchoring is not possible due to weather conditions or any other item, a Temporary Certificate of Occupancy will be issued. a. Fee: $10.00 b. Deposit: $100 (refunded when all items are complete) QUESTIONS? CALL 761-8256 OR EMAIL codes@gueensburv.net VISIT OUR WEBSITE FOR MORE INFORMATION WWW.auensbunr.net B 9-LTR 11-05 1 Town of Queensbury Building & Codes Fee Sc hedule Activity Fee 1 &2 Family Dwelling (includes septic system permit) $0.12 per sf Additions: Commercial Alterations: Commercial $0.14 per sf: Minimum$100 fee Additions: Residential $0.12 per sf: Minimum$ 50 fee Alterations: Residential $0.12 per sf: Minimum$75 fee Boathouse w/Sundeck $0.10 per sf: Minimum$40 fee $50 Building Permit Renewal: Extends permit for period of 1 yr. $25 Certificate of Compliance & Use $20 Certificate of Occupancy No fee Commercial, Industrial, Public Assembly, Day Care Center, etc. $0.15 per sf: No Maximum Commercial/Industrial: Unheated structures (i.e,warehouse $0.05 per sf: No Maximum Deck, Porch $0.10 per sf: Minimum$40 Demolition $20 Dock $30 Fire Marshal Inspection (Includes Solid Fuel burn permit, installation of chimney/wood $25 per inspection stove) $100 per special projects Floodplain Development Permit $25 Garages $0.10 per sf: Minimum$30 House Moving Permit $30 Mobile Homes (includes septic system permit) $0.06 per sf Pool $25, Above Ground;$35, In- Ground Septic Systems: Alteration or New System Only $25, Residential;$35, Commercial Septic Variance (requires Town Board of Health review) $50 Sheds/Storage Structures, Pole Barn, Picnic Pavilion, Misc. $20 per inspection Signs: Permanent $2 per sf Signs: Temporary $ 10 per 12 days/$50 cash deposit Townhouse, Condo, Apartments, Multi-family $0.14 per sf: Minimum$100 Revised 1-17-07 i Coniniififity Developiiient Office vznn vfQutetrshury • 742 Bath liou ?tceenshttry, NowYork •12804 Electrical Inspectors THE FOLLOWING ELECTRICAL INSPECTION AGENCIES ARE CERTIFIED BY THE TOWN OF QUEENSBURY TO PERFORM ELECTRICAL INSPECTIONS: NAME&ADDRESS OF BUSINESS INSPECTOR CONTACT NUMBER(S) Commonwealth Electrical Inspection Services Donald Loveland Local Offiice:1-800-562-9934 176 Doe Run Road Ron Mumblo Ron: 518-798-0905 Manheim, PA 17545 Main Office: 1-800-873-6432 Middle Department Local Office: 1-800-479-4504 143 Troy Schenectady Road Ray Novak 518-273-0861 Watervliet, NY 12189 (Office Hours: 7:00—9:00 AM) Ray:369-6614 The Inspector, LLC Richard Moon Main Office: 1-800-487-0535 4755 McConchie Rd. Douglas R. Hull Local Office:(518)882-6140 Galway, NY 12074 Brian D. Sweet David J. Irwin New York Board of Fire Underwriters 40 Fulton Street-61h Street Walter Sonntag Local Office: (518)373-7003 New York, New York 10038 PLEASE NOTE: WE CANNOT RECOMMEND AN INSPECTOR, HOWEVER, PLEASE ASK YOUR CONTRACTOR WHO HE PREFERS TO INSPECT HIS WORK. 3/28/07 COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC. Main Office 176 Doe Run Road-Manheim,PA 17545 MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL Permit No...�J..�.......:.t..��: r.......Cut. N2 1 1 2 0 6 Cut-in Card No..................................... Owner.................... / m.l`'2{ ............................................................................................................ Location..... ... .. cif„ C p t ......... ... . ..............................1.. ........ 4r ... ....... Installation Consisting(-.-.5 „!,1„T 2CfLs................................. ........................................9-Pr..:..........=......................................................................... . .........................................................................................................................� .......................................................... InstalledBy.....2?;..5 ��.r .........................................Lic.No................................................... The conditions 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 of additional equipment or alterations,application shall be promptly made for inspection. Inspectors of this Company shall have the privilege of mak3'pg,,inspectjons at any time, and if its rules are violated,the Company shall have the right to oke th' cer'fic e. Date.....`.^..� ,��............... INSPECTOR... r .. ......................4................................................ COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC. Main Office 176 Doe Run Road-Manheirn,PA 17545 MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL ......... .......... Permit No...0'7'--35_`z- cc- NO 112 12 ct_m card No..................................... 5.1.....TI-2.0........................I................................... ................................ ...i ............ Owner............/ . Location........'Lk.2..... .......215� .... ............................. ...........I...... Installation Consisting of 10 1?e—C6—_Pj...�2_.4j 7W5 .................................. 2-3-e ..... .................................. .........................I......I.......................................................................................................... .................................................................................................................................................................................. Installed By........ A_).0 P__ .................................................................Lic.No....................__.......................... The conditions 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 of additional equipment or alterations,application shall be promptly made for inspection. Inspectors of this Company shall have the privilege of ma�"i pections at any time, and if its t4 rules are violated,the Company shall have the right to r^o th cc icale, Date..//—/.7—(j .................. .................. INSPECT g ................................. .......... .......................... 1-- �5 /&1-14'� Z— FINAL INSPECTION EP�Z MOBILE / MOCULAR Town of GueensWry BuiWing &Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 1� 7 ay �W ) 6 ARRIVE-MDEPART- QUEST DATE INSPECTION REQUEST RECEIV NAME: LOCATION: DATE: /Z PERMrr# MOBILE 110ME MODULAR 110ME FOOTINGS— FOUNDATION RACKFILL FRAMM NIA YES No I. toundation support, pier g per manuf ...........7 2. awhoring per manuf shut off ................ . 3. water lie, 4. sewer line support 0 4 fed ....... 6. dryer vented outside x................... 7. skirting venfiblited ....... ......... .. 8. hot water relief valve piping outside 9. deck, porches, steps, rading ........ 10. furnace/hot water operating ..... 11. gaftm fixt;Floofing .................. 12. door-ckme. ........................... 13. plumbing fixture ...................... 14. fixindation insulation (if appl.)...... IS. smoke detectors ....................... 16. final electrical ........................ 17--V "Mro-TeTt, JM MA .................... 18. data plate okay ....................... 19. mobile HUD seal&ay J�060'-)2-'C� Model #T�D Lt�97-6-6( Serial# Manufacturer Date Of MantifiLcturer oKAY To ISSUE CIO YES % NO Comments: 7-0 Vk U�) TAt)Y— ef---0 PF \j r-� -t-, "3 u ez 4 3� --- FINAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury Building &Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 (r ARRIVIk- DEPART_aa- K>mP ' DATE INSPECTION REQUEST RECEIVED:' NAME: �A©GGF F i1 : LOCATION: U L � DATE: — per MOBILE HOME MODULAR ROME FOornms_ FOUNDATION_ BAAcKFH.d FRAmm NJA , YES NO 1. foundation support, pier spacing per manuf ........................ — 2. anchoring per manuf. ............... 3. water lice shut off ................... 4. sewer line support a 4 feet ....... — 6. dryer vented outside ..:................... 7. skirting ventilated .................... — — 8. hot water relief valve piping outside _ 9. deck, porches, steps. railing ........ _ _- 10. furoaceRtot water operating ..... ....._---------------------- 13. plumbing fixture ...................... 14. foundation insulation (if appl-)...... — — I5. smoke detectors ....................... 16. final electrical ........................ 18. data plate okay ..••. ................ . 19. mobile HUD seat okay. ............ Model# Serial# Manufacturer Date of Manufacturer OKAY TO ISSUE CIO YES NO Comments: Z7Ta— \ � 1.1- FINAL INSPECTION REPORT MOBILE / MC31OULAR Town of Queenstxjry Building &Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE:V,)44­6�ART- DATE INSPECTION REQUEST RECEIV NAME: D F F= 1—i— el LOCATION. qLPl�E- DATE: PERMIT# MOBILE HOME MODULAR MOM F<xynNGs FOUNDATION BACKFML FRAMM N/A YES NO 1. foundation support. pier-spacing per manuf. ........................ 2. anchoring per manuf. ............... 3. water line shut off ................... 4. sewer line support a 4 fed ....... S. heating crossover(dblewide) off grd. 6. dryer vented outside x................... — — — 7. skirting ventilated .................... — — — 8. hot water relief valve piping outside porcbw 9. deck. .....—skW-o'ling -io. furnace t water ope ........ Ir 11. garage fire proo .................. 12. door closers ........................... 13. plumbing fixture ...................... 14. foundation insulation (if appl-)...... 15. smoke i .� ' .16. final e4ectrica ... 17. variance required ..................... 18. data plate okay ....................... 19. mobile HUD seal okay .............. Model # Serial # Manufacturer Date of Manufacturer OKAY TO ISSUE CIO YES NO Comments: i CommuniN Development O ice TOWN Of QUEENSBURY BUILDING UEFrR Town of Queensbury • 742 Bay Rd. Based on our limited examination, Queensbury, New York •12804 PLOT PLAN compliance with our comments snall not be construed as indicating me Show all existing and pr d structures. Indicate the setbacks of all structures and M �ac�oni are in to a New York State. SIDE PROPERTY LINE 7 i I V 1 in 11C JI _.L..... __.. ......, 1...- .1-. . t._ : -;- , AME t.... a._..._.F �.-. 1 -- �. .. ,....f. -. . ION � Ep P AtU ACT - : P CtflC. €�S , _...L...._..E a___.- ...., .__ ..._.._. ..... : : i 13 z �. : I 0 WJ. �..._ �. i........ ..... { IL Of CL ..... _ _ .... , - {I : i z LU _._ ... . ;.._.............._.,.._....- ,. _ _. .. _ : : ' I _ I __..�.......... ... .............. . -.,.__..,J...._....... _-.... . ... �. ...I...... : , , : - _.- . I ; SIDE PROPERTY LINE 1 SQUARE = FT. HornEtTL 159 157 JS6 5' \ 34 ,35 3Z 31: 3ti 2.9. 2$. 77 . Z� zs_ .1.30 l 83 � �� 24 15. 3 JZZ. ' 1z9 '$ 1(038- S5 80 37 ,1b9 15� 139 p ` 12� 8� �'" 7q 38 `— 1 5 250 " 13s �.2 b 87 �7g :! � z 2D �29 8$ -' - r77Cl 0 1-� ��. _. 1 r7s 170 _ 71 `1 4 µ1g1 12D 93 72. A5 �-73.Y -- - 179 ' 11'7 96 9`�„ b8 �9r ~i�� - 9 V 1p"7 9 tit 17 7 j-ug i . 9,. frl 179 1A1. �4 5 3 RI 5,1 �► �J� f 161 181 � � 1.8�--• ion- �9 �s. � - 3 Ad ''KL a No Crrcmunity Development Office Q1-10) of Queenshury • 742 Bray Rend - Queeushury, New fork •12804 PROCEDURE FOR PLACING AND OCCUPYING A MOBILE HOME OR MODULAR HOME: 1. Application is submitted and reviewed. a. Two (2) copies of plot plan and two (2) copies of layout must accompany application, along with septic application (if needed). 2. Permit is issued. a. Permit card is placed on property. 3. Footing forms are inspected before pouring concrete (Outside mobile home park). a. Home is placed on foundation or piers. 4. Arrange for electrical inspection 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 manufacture requirements. 10.If anchoring is not possible due to weather conditions or any other item, a Temporary Certificate of Occupancy will be issued. a. Fee: $10.00 b. Deposit: $100 (refunded when all items are complete) QUESTIONS? CALL 761-8256 OR EMAIL codes(ft uee ns bu ry.net VISIT OUR WEBSITE FOR MORE INFORMATION WWW.auensbury.net B 9-LTR 11-05