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2005-119 TOVN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 (zt Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number. P20050119 Date Issued: Tuesday, October 23, 2007 This is to certify that work requested to be done as shown by Permit Number P20050119 has been completed. Location: 200 LUZERNE Rd Tax Map Number. 523400-309-009-0002-001-000-0000 Owner. HOMESTEAD VILLAGE L P Applicant: DONNA FLEWELLING 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 of Building&Code EXforcernlent 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: P20050119 Application Number. A20050119 Tax Map No: 523400-309-009-0002-001-000-0000 Pern ission is hereby granted to: DONNA FLFAAT.1.I,1NG 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 Builder's Name/Address Electrical Inspection Agency Plans &Specifications 2005-119 DONNA FLEWELLING 115 ADIRONDACK STREET 1064 SQ FT 1990 MOBILE HOME $38.84 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 To of Que bu ;� T ,March 22,2005 , ,, SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement %S Application for Permit— Mobile Home Town of Queens&wy, 742 Bay Roac>; 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 Information Once Use IName: File Permit No. OS j i Address: Fee Paid C i Reviewed By:47 Phone No. Property Owner Information Parcel Information r, Name: i j,� ` L ,, Proposed Date of Placement.- Property Location: Address: �,f z� %���� "�r 4�- C, — Road,Street,Avenue Name of Mobile Home Park:_ 0,,`�ter r a. l:cable Phone No. 2� , r l d Tax Map Number: / � l Mobile Home Information_ __. Zoning Information f Approximate Value of Home: Zoning Classification: New Home: Yes No ,� Size of Property. A ft.by $. Replacement Home: ( x�/ No � ��----�� Existing buildings: Ic'� - �� Size of Mobile Home: -/L� ft. by �ft. Setbacks: front yard ft.; rear yard ft. Singlewide: Doublewide: Side yards fly_$.and ft. Number of Rooms: (exclude baths) Number of Bedrooms: Accessory Building(s): circle Number of Bathrooms: Detached garage: 1 car, 2 car, car circle: Gas Fireplace/Woodsto,.v<Wood a Attached garage: 1 car, 2 car, car Storage building: Yes No Foundation Support: Other. ����^ ,��� TYPE SIZE&DEPTH Water Supply: well or e Piers x Runners x Is Septic Permit Required? Yes or No Slab x Further information requested on the reverse side of this sheet W Name of Installer or Mobile Home Dealer. _ Address: Phone No. 3 Complete information below found on a`date"or"sticker"which is affixed to the mobile home. 1. Insignia serial number a � ( 2. Name of manufacturer <e-A 'z,Z S 3. Plan Approval Number: 4. Model or Component Designation: (New Home OM19 5_ Date of Manufacture: AFFIDAVIT - - - Town of Queensbury ----State ofNew-York 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. R Signature: owner,owner's agent,architect,contractor Special Conditions of Perinit By Form: 11J1911999sh Code Enforcement Officer w Commercial Final Inspection Report Office No.: (518) 761-8256 Date Inspection request received: Queensbury Building& Code Enforcement Arrive: am/p Depart: am/pm 742 Bay Road, Queensbury,NY 12804 Inspector's Initials: NAME: �rr� PERMIT#: LOCATION: (�� DATE: COMMENTS: Y N NA Chimney/"B"Vent/Direct Vent Location Plumbing Vent Through Roof 6"/Roof Complete Exterior Finish/Grade Complete 6"in 10' or Equivalent Interior/Exterior Guardrails 42 in. Platform/Decks Interior/Exterior Ballisters 4 in. Spacing Platform/Decks Stair Handrail 34 in.—38 in. /Step Risers 7"/Treads 11" Vestibules For Exit doors>3000 s . ft. All Doors 36 in.w/Lever Handles/Panic Hardware,if required Exits At Grade Or Platform 36(w)x 44" 1)/Canopy or Equiv. Gas Valve Shut-off Exposed&Regulator 18" Above Grade Floor Bathroom Watertight/Other Floors Oka Relief Valve,Heat Trap/Water Temp.110 Degrees Maximum Boiler/Furnace Enclosure 1 hr. or Fire Extinguishing System Fresh Air Supply for Occupancy/Ventilation Combustion Low Water Shut Off For Boilers Gas Furnace Shut Off Within 30 ft. or Within Line Of Site Oil Furnace Shut Off at Entrance to Furnace Area Stockroom/Storage/Receiving/Shipping Room(2 hr.), 1 '/z doors > 10%> 1000 s . ft. 3/4 Hour Corridor Doors&Closers Firewalls/Fire Separation,2 Hour, 3 Hour Complete/Fire Dampers/Fire Doors Ceiling Fire Stopping, 3,000 s . ft. Wood Frame Attic Access 30"x 20"x 30"(h),Crawl Space Access 18"x 24" Smoke Vents Or Fan,if required Elevator Operation and Signa e/Shaft Sealed Handicapped Bathroom Grab Bars/Sinks/Toilets Handicapped Bath/Parking Lot Si na e Public Toilet Room Handicapped Accessible Handicapped Service Counters, 34 in., Checkout 36" Handicapped Ramp/Handrails Continuous/12 in.Beyond [Both sides] Active Listening System and Signage Assembly Space Final Electrical Site Plan/Variance required Final Survey,New Structure/Flood Plain certification,if reg. �" c As-built Septic System Layout Required or On File Building Number or Tenant Address on Building or Drivewayhc`?�`,- e�e Water Fountain or Cooler Building Access All Sides b eable Surface 20'wide Okay To Issue Temp. or er anent G iz,- Okay To Issue C/C L:\Building& Codes Forms\Building&Codes\Inspection Forms\Commercial Final Inspection Report.doc FINAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury Building &Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: DEPART7INSP DATE INSPECTION REQUEST RECEIVED: NAME: C LOCATION: DATE: L/ PERMIT 1 C MOBILE HOME MODULAR HOME FOOTINGS _ FOUNDATION _ BACKFILL_ FRAMING N/A YES NO V I. 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, notches, steps, railing ..... _ — 10. fiunace/hot water operating ........ j 11. garage fire proofing .................. 12. door closers ........................... — — 13. plumbing fixture ...................... 14, foundation insulation (if appl.)...... — — 15. smoke detectors _ 16. final electrical ... htig. — 17. variance required ..................... _ 18. data plate okay ....................... _ — 19. mobile HUD seal okay .............. — Model# Serial# ro ManufacturerU�> Date of Manufacturer 15n F) OKAY TO ISSUE C/O YES NO COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC,� Main Office 176 Doe Run Road-Manheim,PA 17545 e MUNICIPAL CERTIFICATE - ELECTRICAL APPRO14AL ?erinit No........................................Cert. N2 89573 Cut-in Card No............................. :)wner..........2)......... *Z-164** '-ocation......& A01/2 installation Consisting of........................ ..................................... ... ... ........ ............. ..1�............. ... AI-V-ein............ .......................................#......IP............................................................................................................................... .................................................................................................................................................................................. InstalledBy........................................................................................Lic.No.................................................. The conditions following governed the issuance of this certificate,and any certificate previously issued is -ancelled:- This certificate only covers the electrical equipment and installation conditions as of date. Upon the ntroduction of additional equipment or alterations,application shall be promptly made for inspection. Inspectors of this Company shall have the privilege of mak' ,—P�pcctions at any time, and if its e_rt_17t i-ules are violated,the Company shall have the right to re no e 7th'�certificat 3ate... .............. .. ........................................ ..................... INSPECTOR._kV.......................................................................... FINAL INSPECTION REPORT MOSILE / IMOOULAR Town of Que&m" 8uikiing & Code Enforcement 742 Bay Road Queensbury, NY 12804 a (518) 7614 256 ARRIVE: DEPART:° 10,NSP. DATE INSPECTION REQUEST RECEIVED: NAME: t,OCATION: DATE: PERMIT MOBILE HOME MODULAR HOME FOOTINGS_ POUNDATM 4 .RACKFIIL_ 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®4 fed ....... — 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. furnacelhot water operating ........ _ 11. garage fire proofing .................. —_ 12. door closers ........................... — � — 13. plumbing future ...................... _ 14. foundation insulation (if appl.)...... _ 15. smoke detectors _ ✓ 16. final electrical _ � �� — 11, 17. variance required ..................... _ 18. data plate okay ....................... 19. mobile HUD seal okay .............. Model# " /3eriai# — Manufacturer c K V C Z Date of Manufacturer OKAY TO ISSUE C/O YES NO FINAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury Building &Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 g r� r ARRIVE: i? DEPART: INSP: +✓_` DATE INSPECTION REQUEST RECEIVED: NAME: _ LOCATION: / DATE: ""_ PERMIT# MOBILE HOME MODULAR HOME FOOTINGS_ FOUNDATION _ RACKMI L_ 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 /V. I.,.�4TV 9. deck, pouches, steps, railing ....... Alee'7 yV..- z ,10. fiunace/hot water operating ........ _✓ — 11. garage fire proofing .................. 12. door closers ........................... - 13. plumbing fixture ...................... --A&-� 14. foundation insulation (if appl.)...... _✓� — 15. smoke detectors ....................... — 16. final electrical ........................ — —_ 17. variance required ..................... — — 18. data plate okay ....................... V5 — 19. mobile HUD seal okay .............. Model # Serial# Manufacturer Date of Manufacturer OKAY TO ISSUE C/O YESQ NO Comments: tA j).�- fk 0 _ n, o�s 7 c ;7 ......... � RUILDI G & c REVIEWE BY DATE FILE COPY TOWN OF QUEENSBURY 6UILDIN'(3,DEH�,M;i mc:,\ Based on our iimitpd exarT+irlabojl, m with our(;omrnents shall Cn0otrc(q)n strued as indicatIN the plans and Wilcations are ir, fijll compliance with 'hu building. k'auuovl of New York State. v — - f � F to .,. still S h d ( �; t.. , �'P°'^ � � try t/, � (n' �7 ( y �';• • ��Y ('� out its Zt Rot 14 1 h z 1 1' - _ -- = -- �, �x , l,:��� � i .,I � `l %K{l;` ` .�� � -•;.. �1 r ss 1 z9� As' As mow yak 1, h �, d Ct` �L sty „o 13 I e : "z {) 1 s• ` t;S z.s t 1 h h h Ik a bz $ti>, �k� l f L I a,;' �o.�.U, ;C \I \ \,Cs ,•. M J .Z• �i r� S a lvi p A TA 5.: fi }}. : ��rn' �-�, � �t'y I 'r' �c�.{� � �"�, i t E9 L S 6 0� i� 21.• �, r r tr� $16"_nz# t,z �� �Z Z Jon? w' W ;. RSCHODER RIVERS Evergreen Professional Park ASSOCIATES 453 Dixon Road,Suite 7, Bldg. 3 Consulting Engineers, P.C. Queensbury,NY 12804 Tel. (518) 761-0417 Fax. (518) 761-0513 Town of Queensbury August 14, 2006 Community Development Department SRA#04-488 742 Bay Road Queensbury, NY 12804 Re: Arrowhead Equipment Waste Water Disposal System Attn: Dave Hatin Dear Dave, Schoder Rivers Associates has been retained by Arrowhead Equipment to provide design and construction phase services for the new addition to their existing facility on Luzeme Road in Queensbury, NY. As part of these services, we provided periodic construction review and inspection services for the construction of the on-site waste water disposal system. This included conducting additional percolation tests to determine the percolation rate of the on-site modified soils. We state that, to the best of our knowledge, information and belief, that the construction of the on-site waste water disposal system has been completed in conformance with the construction drawings and specifications. If further information is required, please contact us. Sincerely, Shaun M. Rivers, PE cc: William Ehlert-Arrowhead Equipment T, w OR T"' a Fr r- w- 4-4 4—-4— t 4-4 —7 7 T i L 4 1 L-4- ' 4-� 4- AD , -J— L L ---4�-- r Q) -4-----+- i IQ� J? -4� V'\ --z ORITHE-7 PYRPPSE 4 TC TlbN TO ----------- 'CHOOSE SCALE ON LEFT Cwh I ct e-04 wol s4uare =;-- 'l 0 feet-- --- i fe0t OWN-.-- inch or 4 squares 40 feet S ' inch or ;square —feet ntv.