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2005-118 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF OCCUP-ANCY Permit Number. P20050118 Date Issued: Monday, October 22, 2007 This is to certify that work requested to be done as shown by Permit Number P20050118 has been completed. Location: 200 LUZERNE Rd Tax Map Number. 523400-309-009-0002-00 1-000-0000 Owner. HOMESTEAD VILLAGE L P Applicant: EDNA ALVARER 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 property owner of the responsibility for compliance with Site Plan, Variance, or other issues and conditions as a result of approvals by the Director wilding&Code nforce ent 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: P20050118 Application Number. A20050118 Tax Map No: 523400-309-009-0002-001-000-0000 Permission is hereby granted to: COLV1N ROBERT 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 $5,000.00 4294 ROUTE 5 Total Value $5,000.00 CALEDONIA,NY 14423 Contractor or Builders Name/Address Electrical Inspection Agency Plans &Specifications 2005-118 96 ALPINE AVENUE ROBERT COLVIN 924 SQ FT 1984 MOBILE HOME $30.44 PERMIT FEE PAID- THIS PERMIT EXPIRES: Wednesday,March 22,2006 (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 QuepMbury; Tuesday,March 22, 2005 SIGNED BY ' z/ /Xlk- for the Town of Queensbury. Director of Buildlplg&We Enforcement �G Application for Permit— Mobile Home Town of Queensbwy, 742 Bay Road, Queensbury, NY 12804 (518) 761-8256 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 In formalion Office Use Name: D. � -� �!� File Permit No. Address: , G, , `�r Fee Paid u .�S ,�,� r.• i° Reviewed By: Phone No. �� d Property Owner Information Parcel Information Proposed Date of Placement: " Name: Q/✓Ir�� L/. L�� .! r� �� Property Location. Address: Rom,gftret,Avem c t ,r' c rat 42 sal Name of Mobile Home Park: _Cf applicable) Phone No. -� Tax Map Number: Mobile Home Information __ _ _ Zoning Irrforrnution - -- Approximate Value of Home: Zoning Classification: New Home: Yes Size of Property: o ft.by o ft. Replacement Home: <::5� No _ Existing buildings: Size of Mobile Home: ft. by 4 G ft. Setbacks: front yard S_ ft.; rear yard,�ft. Singiewide: Doublewide: Side yards ft.and 5ft. Number of Rooms: (exclude baths) �:/_ Number of Bedrooms: —Z Accessory Building(s): circle Number of Bathrooms: Detached garage: 1 car; 2 car, car circle: Gas Fireplace/Woodstove/Wood Fireplace Attached garage: 1 car; 2 car, car Storage building: Yes No Foundation Support: Other: TYPE SIZE&DEPTH Water Supply: well or unicipal Piers x Runners x Is Septic Permit Required? Yes or No Slab x Further information requested on the reverse side of this sheet � Name of Installer or Mobile Home Dealer. Li; Address: Phone No. z 12- -7 c/ 3 Complete information below found on a"plate"or"sticker"which is affixed to the mobile-home. 1. Insignia serial number 2. Name of manufacturer. ke A.) 3. Plan Approval Number: 4. Model or Component Designation: (New Home ONLY) 5. Date of Manufacture: -- AFFIDAVIT Town of Queensbery _._ _ -- ----State of New Stork County of 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. Si owner,owner's agent,architect,contractor J' Special Conditions of Permit By Form: 11l1911999sh Code Enforcement Officer FINAL INSPECTION REPORT MOBILE / MOOIJLAR Town of Queensbury sp Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: DEPART: INSP: DATE INSPECTION REQUEST RECEIVED: NAME: I� Y" LOCATION: lvo Ale- DATE: PERMIT# 0,5 MOBILE HOME MODULAR HOME FOOTINGS- FOUNDATION, BACKFILL_ FRAMING N/A YES NO 1. foundation support, pier spacing per manuf. ........................ 2. anchoring per manuf. ............... — — —_ 3. water line shut off ................... 4. sewer line support @ 4 feet ....... — — 5. heating crossover (dblewide) off grd. — — — 6. dryer vented outside ..:................... 7. skirting ventilated .................... 8. hot water relief valve piping outside — — — 9. deck, porches, steps, railing ........ 10. furnace/hot water operating ........ 11. garage fire proofing .................. — _- 12. door closers ........................... — 13. plumbing fixture ...................... _- 14. foundation insulation (if appl.)...... — — — 15. smoke detectors ....................... 16. final electrical ........................ — — 17. variance required ..................... —_ 18. data plate okay ....................... — 19. mobile HUD seal okay .............. — — Model # Serial # Manufacturer 1)ate of Manufacturer OKAY TO ISSUE C/O YES (ENO Comments: a vk c)4 k(- �a I f�r- 1,s o� 0-� C A/ I fte.AU� h'y - u C� 2 0q RINAC IN�P�gTInNEPORT MOBILE / MODULAR Town of Queensbury --- Building &Code Enforcement J 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: DEPART-/0_�-0NSP: DATE INSPrE—CTIO�N REQUEST RECEIVED: NAME: F�L�1°VA� -� LOCATION: �—v DATE: -c PERMIT MOBILE HOME MODULAR HOME FOOTINGS FOUNDATION RACKFILL FRAMING N/A YES 1. foundation support, pier spacing per manuf — _ 2. anchoring per manuf. ............... _ 3. water line shut off ................... . 4. sewer line support a 4 feet ....... TZ 5. heating crossover (dblewide) offgrd — 6. dryer vented outside _'2Jc�Pl�� 7. skirting ventilated .................... — — 8. hot water relief valve piping outside — — 9. deck, pouches, steps, railing ........ _ 1 water ... 11. garage fue prop .................. 12. door closers ........................... -- — 13. plumbing fixture ...................... _ 14, foundation insulation (if appl.)...... — — 15. smoke detectors ....................... _ 16. final electrical ...................... - 17. variance required ..................... �[ — 18. data plate okay ....................... _ — 19. mobile HUD seal okay .............. — Model# n 2A e—ULSerial kntE-IMd� Manufacturer Date of Manufacturer OKAY TO ISSUE C/O YES NO Comatent�'nR $%I or FINAL INSPECTION REPORT MOBILE / MOOULAR Town of Queensbury Building &Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: DEPART: INSP, DATE INSPECTION REQUEST RECEIVED: NAM: LOCATION: DATE: PERMIT# MOBILE ROME MODULAR HOME RXYMGS— POUNDATION — BACKFELL— FRAMING 1. foundation support, piers NIA YES NO spacing per manuf. ........................ 2. anchoring per manuf I ............... 3. water line shut off ................... 4. sewer line support @ 4 fed ....... S. beating crossover(dblewide) off grd. 6. dryer vented outside ...c................... 7. skirting ventilated .................... 8. hot water relief valve piping outside 9. deck, porches, steps. railing ........ 10. ftirnace/hot water operating ........ 11. garage fire proofing .................. 12. door closers ........................... 13. plumbing fixture ...................... 14. foundation insulation (if appl.)...... 15. smoke detectors ....................... 16. final electrical ........................ 17. variance required ..................... 18. data plate okay ....................... 19. mobile HUD seal okay .............. Martel# Manufacturer Date of Manufacturer OKAY TO ISSUE CIO YES NO cbmirients: CJ� r N ti yv O ar _ N v lti y r Zy-� —71 67 71, 77 5. s f J TY► rcr �, .� ,Scr ApkW c� a4,t � f} •. r y,7 0�. BUILDING & COQES DEFT. REVIEWED BY DATE ___M ,-r _ TOWN OF QUEENSBURY BUILDING DEPARTMENT COPY Based on oUr limited examination, . comppliance with our comments shall not be construed as indicating the plans and specifications are in full compliance with the Building Codes of New York State. 'RT gh 'w ' 4-+ 4_4 -T T + _J II 4Z _�f A, 4--- Apm _17R [AM FOR THE PUR PbSE, THE.], __PFAN -ApPbU-�Tlbv :,TO r --ALE,SIC CHOOSE SCALE ON LEFT eet squ_are___,_ te_e_t square 1p-j - ----- inch or squares _Iuc ic feet UR OWN 11 in' h c r 4 squares ;= 40 feet C _nty-