2002-132 TOWN OF QUEENSBURY
742 Bay Road,Queensbuty,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Niimber: P20020132 Application Number: A20020132
Tax Map No: 523400-309-009-0002-001-000-0000
Permission is hereby granted to: DANIELLE BLAKE
For property1ocated at:
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 19,500.00
4294 ROUTE 5
CALEDONIA,NY 14423 Total Value 19,500.00
Contractor or Builder's Name Address Electrical Inspection Agency
SHO MOBILE HOMES
4294 ROUTE 5
CALEDONIA,NY
Plans &Specifications
2002-132 DANIELLE BLAKE
14'X 60' MOBILE HOME AS PER PLOT PLAN SPECIFICATIONS
$54.00':' PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,March 08,2003
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the-T-omM of Qu ensbury- Friday,March 08,2002
SIGNED BY for the Town of Queensbury.
,-P-- &101vtoK iry
Director of Buj ode Enforcement
Application for Permit— Mobile Home
Town of Oueensbwy, 742 Bay Roam Queensbury, NY 12804 -(518) 761-8256
A building permit must be obtained before placement of mobile home on parcel. No inspections will be made
until a valid building permit has been issued.
Applicant Information
Office Use
Name: File Permit No �
LEO
Address:
l nl In Fee Paid
(Qj-eenSbj- 1-VReviewed By:
............................._.........................—
Phone NO. / RECEIVED
Property Owner Information Parcel Information MAR 0 5
Proposed Date of Placement: TOWN.OF QUEENSBURY
�_
Name: " �} t e�. BUILDING AND CaDE
il_- Property Location:
Address: > �J`Yl�,. ' Road;Sumt,Avenue
Name of Mobile Home Park:
J (I applicable)
Phone No. Tax Map Number:
Mobile Home Information Zoning Information
Approximate Value of Home:$
Zoning Classification:
New Home: Yes
Size of Property: ft.by ft.
Replacement Homer Yes No
Existing buildings:
Size of Mobile Home: - � ft. by .� .
Setbacks: front yard ft.; rear yard ft.
Singlewide: Doublewide: Side yards ft.and ft.
Number of Rooms: (exclu • baths) t0
Number of Bedrooms: 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 szzE&DEPTH Water Supply: well or municipal
Piers Y
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. I'�c"1 �QAI-es
Address:
Phone No. f3
Complete information below found on.a"plate"or"sticker"which is affixed to the mobile home.
1. Insignia serial number T�
2. Name of manufacturer. � f f h
3. Plan Approval Number:
4. Model or Component Designation:
(New Horne ONLY}
5. Date of Manufacture: a
AFFIDAVIT
Town of Queensbury State of New 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-
Signature:
owner,owner's ageK architect,contractor
Special Conditions of Permit
By. L-
Form: t tn4/i999sh. Code Enfo ement Officer
-,OOOF
-r(:>vvn CA Clula nst:)Ury
Ouilclinig SL (::<>Cc3,- ,E-=nf<>rc09m�nt
� '742� Oaty Ftpawl
C)ucaonst3ury, NY 12804
(518) 761-8256
DATE INSPECTION REQUEST RECEIVED:
NAME: J-67
IFC-)4C)rX'JU**TC3S 13A0=*C-IFII-J-
1_ foundation support„ PILO--r S
Perrna--nxlf- ---------- ----------- -
per rrumaxaf- --------- - -
- -
vvittcanr liru-- shutoff --- - - ----------- --
st--vvt--r Illaf-- S"ppc).r-t 4 eet . .. ...
dryer vented outside --- -- ------------
skix-tixlg -%'-fa-l-Itilatfad -------- ----------
8_ hot NV.-Lte--Ir lroalie--r valve PirlL outside
9- deck, P<>Xx--Ile�s, S, IrAilizi --- ----- -
10- Furimace-AmcA -&,kttt--r upf--ratirlo --------
IB.-Araoe- fire- prc),oIixlg ----------- - - --- -
12-- cic>c>r- closers ---- --------- - - ------- ----
13. plvum"bi s fixture-- ---- -- - - --------- -- --
14- fc3xxrxdati<>xx insulation (if -appl-)- ----
i,-z- Srx<>Rc-- dg--tt-,ct<xrs --- ------ - ---------- --
16- final ---------------- -
17- -var-iax3tc--t-- re4qxxixoU --- -- ------------ ---
Is. CI.ELt.-t Plntc-- 6k--XY -- -------- -------------
1-17E_J]E:> seal c>lc--Ly ------- -- -----
ji,
-rc3wn- c)if' (::Iuqe nst>ury
Building SL (-,cx:IiB E-=nfc>rc*3rn*3nt
74:2 -E3aty Flocexcl
Clue nst.*)ury, NY 12804
(518) 761-8256
.
DATE INSPECTION REQUEST CEIVED: -
NAME: J
slippcwt, p far space 9
pf--r XxIaxl-uf.. ....... .......
\
U3-TkXlF. ..........
3- water luresshutrr off ----- --------
--
4- - sf---vvt--jr 113a#-- support (W 4 eet ------
46- dryer -%rv_-xxtc_-d[ Cn,t_sidt_._ _,_":---- ---------- - ----
7. skirting ventilated --------- - -------
8. ---
hc:)t water relief salve pip- c3lits'
10- filryvaot-MlICA VVELtt_-r rating ---- -- -
11- garage fire prc>cAirxa ---- - -- --- - -- - -
IZ- cic>c>r- C_-16sf_-rs -- - -------- -- ------ -- --- Ae
13- pluxWokillm fixture-- ____------ ---- ---- ----
14- f-busidaticma insud"ticwx (if mppl-). - ---
15- sx� okt-_ detectors —-1— ------
IL6_ finial electrical .. ......... .
17- -v.-*x-iajn<>e_ re4udrt_-d ---------- - ------- -
IS- data plate <>"y ------------ - ---------
--------- --- -
3
Manufacturer Z I—NL
3 mate of Manufacturer '
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MAR 0 5
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Bt'1CDING AND����y
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TOWN OF QUEEINGBURY
BUILDING & PT. , RECEIVED
•RSVIEWED BY FILE COPY
MAR 0 5 2002
®A'T`E
TOWN OF OUEENSBURY
BUILDING AND CODE
TOWN OF QUEENSOURY BUILDING DEPARTMENT
Based on our limited examination,
compliance with our corIlments shall
not be construed as indicating the
1 plans and specifications are m full
compliance with the code./
NOVICE
ANCHORING OF MOBILE HOME
.FRAME IS-R-E.QUIREI)TER
MANUFACTURERS SPECIFICATIONS
FLOOR PLANS
BEDROOM C=1 EDROOM
#3 #2
3 BEDROOM MODEL 802 14'x 70'
AcrOAL DIMENSIONS 13'-4'x 66=0"
TOTAL.AREA = $80 SO. FT OPTIOr»2AL
OPTIONAL FULL BATH
i HALF BATH
----- - ,-T ,;
- DINIrIiG BEDROOM l BEDROOM
LIVING ROOM 03 ' fz
8'-cr x 8-.3"x 12'-8-
MASTER
r---
BEDROOM � �® KITCHEN i
'-„t • '