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2002-947 . TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518)761.8256 `T I ATE OF QCCUPANCv CAR IF C Permit Number: ° P20020947 Date Issued: Friday,December 27,2002 This is to certify that work requested to be done as shown by Permit Number P20020947 has been completed. Tax Map Number: 523400-309-007.0002-036.000-0000 Location: 36 FELD Ave Owner: JOAN DILLON Applicant: VALUED MOBILE HOMES This structure may be occupied as a: By Order of Town Board Mobile Home Out of Park TOWN OF QUEENSBURY Director of Building&Code Enforcement TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20020947 Application Number: A20020947 Tax Map No: 523400-309-007-0002-036-000-0000 Permission is hereby granted to: VALUED MOBITY-HOWS For property located at: 36 FELD Ave in the Town of Queensbury,to construct of 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. Tne of Construction Value Owner Address: JOAN DILLON Mobile Home Out of Park 36 FELD Ave Total Value QUEENSBURY,NY 12804 Contractor or Builder's Name Address Electrical Inspection Agency Plans&Specifications 2002-947 Installation of an 840 sq ft mobile home as per plot plan and specifications. Septic System currently exists on property. Town Board Res.No. 408.2002 authorizing revocable permit to locate mobile home outside of mobile home court. $25.40 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday,November,18,2003, (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 To of ;: v a ovember 18,2002 SIGNED BY - A, - for the Town of Queensbury. V NA Director of Building&Code Enforcement Application for Permit—tseptic Disposal System Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256 1. OWNER INFORMATION: ....................................................................................._...._............................._..__..., Office Use Location of installation: i File Permit No. Tax Map No. 320. 2- I-a-6— tt Owner's Name: QQ Y'1 P t ®i 1 Fee Paid € ,-- // ........................•........................._..........-._.._......................... ..............: Address: ��jtta ✓ /`� l e CLJ t?-2 ikV . i D-d' ©v 2. INSTALLER'S NAME _ PHONE NO. 3. RESIDENCE INFORMATION: (circle year of dwelling,indicate#bedroom(s) and multiply# of bedrooms with applicable gallons per bedroom to equal total daily flow) Year of House: No. of Bedrooms x Computation = Total Daily Flow 1980 or older x 150 gal/bdrm = 1980- 1991 x 130 galtbdrm = 1991 -present :�3; x 110 gai/bdrm = Garbage Grinder Installed yes / no Spa or Whirlpool Installed yes_ f no 4. PARCEL INFORMATION: (circle applicable information&indicate measurements) T o ra Soil Nature Ground Water Bedrock or Impervious Material Domestic Water Su 1 (Plarby at what depth at what depth municipal oiling Ioam � feet feet well �fl fv1 Steep slope , clay if well;water supply �%slope other from any septic-system depth: absorption is ft. other Percolation Test: (To be completed by licensed professional engineer or architect) Rate: minute per inch 5. PROPOSED SYSTEM: For New Construction: All individual sewage disposal systems must be designed by a licensed professional engineer or architect(unless installed in a Planning Board approved subdivision). Add 250 gallons to the size of the septic tank and leach field for each Garbage Grinder,Spa or)t7lurlpool Tub. Septic Tank: gallon gallon(min. size 1,000 gal.) lc Tile Field: each trench ft. Total System Length: fi. } �O Seepage Pits): number of size of each: ft. by Size of Stone to be used: # I depth or thickness feet Bed System Size: x Alternative System: length andlor size 6. HOLDING TANK SYSTEM: (if required) � Number of tanks: / Size of each: gallons /TOTAL Capacity: gallons _1Yote. Alarm System and associated electrical work must be inspected by a Town approved electrical inspe""etibn agency. -- - - - __ _. _ _ 7. SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON(please read) For your protection,please note that pursuant to Section 136 29 ofthe Code of the Town of Queensbury, any permit or approval granted which is based upon or is granted in reliance upon any material misrepresentation or failure to make a material fact or circumstance known by or on behalf of inm applicant, shall be void. I have read the regulations with respect to this application and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. -52 ignature of responsible person D e Alijit-mlix C= t SPA'ARA'I'ION ItI��Cj1.I1It1;IlII�;N'I' i Pow) t 11pt_I Sf. C=s � c�E y,�• jt�sy," _-!I I C>uSt_. Y� -__-_ VIA l+tYrt7SLPltcl f PiR•t t> SIX_1 -- — 7. SIGNATURE &INFORMATION FOR Rl�SYUNJILSLr- Application for Permit=- Mobile Home Town of Queensbury, 742 Bay Roark Queensbw y, 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. Acant Io�tnatipr� Office Use Name: /"�.t'C��. G'�' �G`"" _ File Permit No.' Address: ��� i Fee Paid_ �` Cy r l�► s ��� ............ _ .. Phone No. 1�7���-l�� NOV .1 200'2 e Owner Information TOWN OF QUEENSBURY Parcellnformation Property rtY f BUILDING AND CODE Name: 1 c3Q0 1 t o h Proposed Date of Placement: "I Up U a� 1 Property Location:3(P ram/£IP 4 y� Address: Road,street,Avenue Name of Mobile Home Park: �,19 �—' applicable. (� Phone No. Tax Map Number:30 Mobile Home Information Zoning Information Approximate Value of Home:$Jni - Zoning Classification: � U New Home: Yes No .Size of Property: ft.by //E) ft. Replacement Home: Yes No Existing buildings: a/d- ff)o h// f)o-na- Size of Mobile Home: A( ft. by ft.' Setbacks: front yard ft.-; rear yard--- -5 ft. Singlewide: Doublewide: Side yards LD ft.and .02S ft. Number of Rooms:(exclude baths) Number of Bedrooms: % _ Accessory Building(s): circle Number of Bathrooms: Detached garage: I car, 2 car, car circle: .Gas Fireplace)Woodstove/Wood Fireplace Attached garage: I car, 2 car,. car Storage building: Yes No Foundation Support: Other: ,/O �51tQC✓ TYPE SIZE&DEM Water Supply. well or municipal / 0 Piers x . Runners x Is Septic Permit,Required? Yes or No Slab Further information requested on the reverse side of this sheet ��. Name of Installer or Mobile Home Dealer: V-l�.N Address:, Phone No. 1� Complete information below found on a"plate"or"sticker"which is affixed to the mobile home. •t 1. Insignia serial number. 0 S'/ 2. Name of manufacturer: QAA:; ,_: 3. Plan Approval Number: . Zo ! cz �4 4. Model or Component Designation: (New Home ONLY S. Date of Manufacture- ///a2 00 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_ owner,owners agent,architect,contractor Special Conditions of Permit By- Form: 11lt9ltssgs, Code Enforcement Officer -F=I"AMN.L— I N%R ISM M Adr -rc)ivvn of C�ua nst:)ury Building 8L G(D64a enfcwcamtant 742 E3exy FIcnexcl C?uensbury, NY 12804 (518) 761-8256 SIP: x>A_a-JF_ 1IP4S1PE_?C-rIC)T-J I_C>CAA,rIC)P4: t -Z- 1. R>imadaticwx support, VIIF-*Ir SPIXt--ijam perITIAXIAlf.. ........... . .. .......... 2. am<_-Ilc3rirlg per rriaxilaf- ----------_ -- water lijmo-- shxit, off ---------------- -- - 4- rt--vvf--Y- liyxo-- support 4 F*_-et -off c3fF &vr4l- dx-yex- -vf_-Xxtemd CnitsicIt-- --------------------- - 7- - slcirtirip, -%r�tilmtecl vv -----:- --- ----------- atf--T- k, porches, steps, rallirig - -- ----- 'Watf_-r- c3pc_-r-ati3ajg -------- d fiXt-_ PX-CK3fi3ag ------------------ 12, c1cmDm- c1c3st--rs ---- ----------- ----- --- --- - (:13 Ixxua,bixio fix-ftirt-- ------- ------------- -- 14- R),imacLaticni ixx_sxAatic>xx (if *Lppl.)------ IS- sxiac)okoe_- detectors ---------------- ------- 16. final electrical ....... ..... ............ 17- %ruriaixe— r4aqtiircc4d - ----- ------- -------- ILS. data. plate <Acay ----------------------- 19. mobile I-YIJIE> seal c3pkay -------------- Model Manufacturer Hate of Manufacturer QKAY -rci3 lss1CTiF_ C!Q YES ND PlNA� lN�PECTlON l�EPO T - Tc)lwn` CA, C:We - nsbury - Bui#ciin+g S C:b+d+a 1=nfcwce3lm*3pnt 742 E-3ay Ft c»iid C:Wo nsbury. NY 12804 (51 8) 761-8256 ARRIVE: "row DATE INSPECTION REQL3EST RECEIVED. - M�>�ILL I��[]►ME MO�LTLAR Ht�►ME FCK7TZNe.xS F+CC:7►►�[..,7NDATIe'.aN I3ACI..FTLL FRAMING" 1. fc►u xdatioz3. suppc►rt, gie-r spacing permanuf_ ..................... ...... 2_ anchoring per iX arnuf- ---------- ----- 3. water line shut off ------------------ - 4_ sewer Iine support CZD 4 feet _____-- 5_ heating crossover �dblewide3 c3ff grd_ 6_ dryer vented outside- _--c---------------- - 7_ skirting ventilated --------------------- - water relief valve piping outside 1� 9. declt, porches, steps, railixrg _-•_--__ �� 14_ f;�rracelhot water-operating --- ----- s 11_ garage fxre proof-s.ug ----------------- 12_ door closers .......... ... f 13_ plumbing fixture __-.__ _________________ 14_ foundation insulaticon Of aPP'I-)------ 15_ smolCe✓ detectors ______________________ r'r"l 16_ filuxl e-ld ctr-o*t . ________________________ 1 7_ variaxzce requfred- --------------------- 18_ data plate okay ---- - -- ----------------- 19_ rn©bile HLJD seal okay ------------- - -- - .7- Model # C� �� � - Serial # �i •—�C� 7 c1— y Manufacturer- I mate of Manufacturer �/ CJKA.Y rc3 ZSsTLTE`C/c> -YES NQ C"omx I Ients: _ O,fflce Use -GENERAL INSPECTION REPORT Inspector: Town of Queensbury Ready at time'. Dept. of Community Development Request received: f Z 6 Zr Meet: Building& Code Enforcentent At time: 1__12 742 Bay Road ' t Queensbury, NY 12804 ARRIVE am/pm: DEPART Kanvlpm No� (518) 761-82M Inspector's.Initials r NAME: ! PERMIT#_ � ��7 LOCATION: 7 (? �; kn INSPECT ON(date): I . TYPE OF STRUCTURE: RECHECK _ N/A YES NO COMMENTS otirtgs/P� ie-'�rs� 'onolithic Pour Form Reinforcement in Place The contractor is responsible for providing protection from freezing for 48 hours following the placement of the concrete. 'Materials for this purpose on site Foundation/Wallpour_ J Reinforcement in Place ! Foundation/Dampproofng Backfill Approval Plumbing Under Slab Plumbing VentlVents in Place Rou Plumbing H tin Rou`gh�In� �* ulation o dation Walls Interior R- Founds 'on Walls F ten R- FloorsU.v '� Walls R- Ceiling R- _ Duct work or piping in unheated spaces R- Proper Vent,Attic Vent Framing w____� Jack Studs/Headers Bracing/Bridging Joist Hangers _ Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1,2,3,hour Penetration Sealed Fire Wall 2,3,4 hour Firestopping I _ L:\SueHemingwayOBuilding.Codes.Inspection.FORMSIGENERAL INSPECTION REPORT-doe Project Name: -1(mn I for) BP# (7 �ufdzrsa: lJ4 . ��xom���nbxn�/wimn RECEIVED ��0__x'��_U� �K�~��` ^ ~ ���-� ^��� �� ��U � ' T Checklist NOV 1 3 20O7 TOWN OFC>UEENS8URY All items below must be checked either yes,no or not applicable prior to s MAMA permit to the Town of QueensburyBuilding Department. If any of the below items are lacking,the permit will not be accepted until such time as the application is deemed complete for submission. 1. Building Pem-iit Application Completed .- .., .- -. .~ -. ..- .., .. .. .- .. ^ h yes [-lmo ncu/a 2, Energy Form orCzockNhoe Energy Cc)de Compliance Forum Complete_ [:]}as [:]no B/no/u 3' Energy Code Report from Checlddate Program. ... ,. ...... ., [-l}eo [-]oo E KnIu 4. Septic application completelyfilled out(if ~.._ ,_ ,._ ._ ~,_._` F-1 yes [-1 no a ' 5. Solid ' or{�uo �oxoz,. .. .. .. .'.. .. .. -'-,-. .. .��`�" [-l"° ;n//a ~ ^^ -_' -6. Electrical Inspection Form... ... ... ... ...... ,. ... ... ... ...... ... ... ... ...^~ .. .. Dyes [-loo [Jo/u 7. Two ( ) complete sets of structural drawings... , ... ... ...... ... ... ... ...... ... . K2� [-loo [-�z/u floor plan; 6 cross sections:60elevations; ` o}window-and door schedule 8. structure tobe bat ... ...... ... [D4y [-[ao [-n/a location of well or water lines,location ofseptic system or sewer fine. 9. Setbacks from property lines no new structure ... ............ ... ... ......~' . [9vno nno [-Jo/u 10. Setbacks to neighboring wells and septic systems, oomite well... . [�lyes Doo Zn/a and septic systems (if applicable) 11, DrivewayPermit... .. ......... -. .. .. ~. .- ,. ., ........-.. -. .. .. .,' .- ..' - Dyes. }�a [-�zo Wnla - Staff Initial: ' - ~_^_ I R „IVED > OFCIUEENSBURY ,.•�� TOWN BUtLD1NG AND COD �� r -CQiJG• �JE,Pf1t.."CtgrJ4L. I LJ �' t f i'' •ft`'•t �1'F.Fw�.M..•++�'{+c'"''''Y"'"'ol,... �, :t1 in IL r� NOT FAING OF MOBILE HOME t�����l�sii�U Llt�,a,= �v l���c��R�t)Lc� ( ;� E IS REQU RED PERTURERS S IFICATIONS.tati ,. \6 �� -- -,. _--� u ------ -_ /_.. t}>u S n — l \�(7 Itt Ui�i`3� } g 1ycJ `e9 ono r limited exa inatioF��RTMJNTpc-�_____� .,.f `""�,✓,,}`•.�J�� pliance pith our cotnrrtentssteal ---- t1t1k \et t J not be cans ed as indicating the .- plans and specliications are in full - FOAM 4i compliant with the code. - - - NSULA�ION MUST BE COVERED TOWN OF, UE� ,�� ���,`) �i��„BY A 15 M►Nj M AL BUILDING " - -- REVIEWED BY DATE NOTICE KRAFT PAPER INSULATION MUST SE + — COVERED BY NON-COMBUSTIRI I` PARr)irrj { Birchfie w. 0 Id Zoo Z-q 47 RECEIVED 14/16 Series NOV 1 3 2002 TOWN DING AND CODEY Standard features LIVING AREAS ADDITIONAL FEATURES •Carpet • UL Classification&Inspection •Valance w/Mini Blinds *Cathedral Ceiling Throughout • Dinette Light •Shingle Roof •25 Year Shingles KITCHEN • Front g Rear Hood • Raised Panel Cabinet Doors • Vinyl Double 4"Lap Siding • Deadbolt at Front 6 Rear Door w/Residential Hidden Hinges • Housetype Front Door w/Storm * Lined Overhead Cabinets w/Adjustable Shelves • '/2 Jalousie Rear Door •Stainless Steel Sink • Carpet in Hall * 15 Cu. Ft. Double Door Frost Free Refrigerator •Carpet Pad Throughout • 30" Gas Range w/Lighted Power Hood • 'h" Rebond Carpet Pad •Valance w/Mini Blinds • Prefinished Door Jambs • Metal Door Knobs BATHROOMS • Gas Furnace • 40 Gal. Electric Water Heater • Decorative Mirror • Delta Faucets Throughout • Privacy Locks • Plumb for Washer • Raised Panel Cabinet Doors •Wire for Dryer w/Residential Hidden Hinges • Detachable Hitch • Power Vent Fan •Single-hung Windows • China Sink w/Over Flow 9 Pop-Up Drain • Insulated Vinyl Windows w/Low "E"Glass • Elongated China Commodes •Window Grids • Egress Windows in Bedrooms BEDROOMS • 100 Amp Service Entrance • T-6"Sidewail Height •Carpet •2 x 6 Floor Joists (14' w) Valance w/Mini Blinds *2 x 8'Floor Joists (16' w) •Ventilated Wire Shelving *Graduated Fiberglass Heat Duct SStF • Perimeter Heating w/Baseboard Registars UL Classified as conforming to the ®ap fF� •Toekiek Registers at Kitchen S Bathrooms Federal Manufactured Home *Copper Wiring Construction and Safety Standards. ® � •Smoke Detector w/Battery Backup g False y Alarm Control ® • Exterior Receptacle w/GFI Breaker ® � • Electrical Breaker Box •Code Insulation BRINGING Awn Hom BRINGING AMERn FuN. • Iron Light Piping w/Shut-off VDv srs Visit us at our web site at www.skylinecorp.com W For your comfort and safety, Skyline home designs are approved and each home is inspected by Underwriters Laboratories for conformance to Federal standards. rn ' Dimensions stated to industry standards.Width and length dimensions are nominal and are not to be used for setup of home on site;consult selling retailers for exact specifica• o sons.Overall length does not include approximately four foot hitch.The square footage is approximate and based upon nominal exterior floor size.Room sizes are measured from floor ends and wall centers. - o r * <�'002"- q ql -B'rchf 1eld 14 Series ' CATHEMAL ThFILLM A p r RECEIVED 0o [ , _ to L J' BEDROOM -, 1 KITCHEN LMNG ROOM N O V ]. 3 2002 No.1 -- - T-S' 14' D(T. , wASN/ DINING TOWN OF QUEENSBURY ;W,, ; DRY OPT r AREA «A�DDnR BUILDING AND CODE C716CT140141BEDROOM-CATHEDRAL THRU-OUT(546 SCIST.) \ / OPT apJ/ CAT.C.I . , --_-----------_ i' (0 MASTER / `�0P1 KITCHENIDINING LNING ROOM B BEDROOM $( 12' 15.2" BEDROOM No.1 No.2 f 12' ��A 4 i IT BEDROOM No. 2 j� 12' 1 C758CT15614 2BEDROOM-CATHEDRAL THRU-OUT(765 SQ.FT.) FB OPTION 112 BATH �0 ns BEDROOM No.2 12' . OPTION GARDEN TUB BATH f/ OPTION 314 BATH ____--____ (C!/Hl WAFT!/DRT \ / OPT 1\ CATEORAL TNRN.DD[ ______--__ [BE:DROM npT LMNG ROOMMASTER 0 KITCHENOINING 14-10" BEDROOM BEDROOM `� 11'-8" No,3 No.1 A a0 p 3 IT /J _ C701CT16014 3BEDROOM-CATHEDRAL THRU-OUT(820 SQ.FT.) OPT OCTAGON k, KM1TCHENYDllNlNG i2A� 1-TI (�I iLJIEl (o( TO WN OF Q LIEENSR UR Y Bay at Hav-7and Raad, Queensbury, NY 72804-9725--51&-792.5&32 TOWN OF QUEENSBURY.BUILDING DEPT. PROPER METHOD FOR SUPPORTING A MOBILE HOME SHOWN_ FOR USE WITH A .SINGLE WIDE MOBILE HOME ONLY FOR USE WITH A DOUBLE WIDE USE SAME METHOD UNDER EACH SIDE SLAB TO RUN FULL LENGTH OF THE TRAILER_AS SHOiiA TRAILER BODY TRAILER FRAME c� b val.1�1 CEMENT BLOCKS . F.tt OFF RcseAA $,=i - . - �" C��GRCTc SL�,� - " � r '• GRAB w:UP�> PIADC co V c 'E!� lDL.o UC5 JrgM E �5 OPTIGn1 r—2Af �1 f