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2002-994 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518)761.8256 C ERT I FICATE OF OCCUPANCY Permit Number: P20020994 Date Issued: Tuesday,July 15;2003 -:This is to certify that work requested to be done as shown by Permit Number P20020994 has'been completed.', . Tax Map Number: 523400-309-009-0002-001-000-0140 Location: 140 HOMESTEAD Vlg Owner: HOMESTEAD VILLAGE LP Applicant: DONALD CLARK This structure may be occupied as a: By Order of Town Board Mobile Home In 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: P20020994 Application Number: A20020994 Tax Map No: 523400-309-009-0002-001-000-0140 Permission is hereby granted to: DONALD CLARK For property located at: 140 HOMESTEAD Vig 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 Value In Park C/O DORIS D STILES Total Value 140 HOMESTEAD Vlg QUEENSBURY,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications 2002-994 100 Alpine,Donald Clark Location of a 1,232 sq ft mobile home in park per plot plan and specifications. $48,92 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday,January 06,2004 (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, of Que sbury; onday,January 06,2003 SIGNED BY for the Town of Queensbury. Director of Buil ng& de Enforcement BLDG. PERMIT NO. 200.2-994 APPLICATION FOR A TEMPORARY CERTIFICATE OF OCCUPANCY A TEMPORARY CERTIFICATE OF OCCUPANCY is hereby requested for the property located at; 100 A2pini e, Home-Stead Viage DONALD CLAW, for the following uses. Mobite HOme F ebn. urury 20, 2003 DATE SIGNATURE OF APPLICANT TEMPORARY CERTIFICATE OF OCCUPANCY The TEMPORARY CERTIFICATE.OF OCCUPANCY is hereby ( PPROVED '( )DISAPPROVED with the following conditions: Wti6 ieaLc oA Occupanaut to be iz a" upon compzeti.on o4: 'JnztaU-atjon opiMobiZe flame AnchoAi,Ko. �A TEMPORARY CERTIFICATE OF OCCUPANC` - EE: O$10.00 DEPOSIT: ( 4100.00 received on Febfaany 20,- 2003 Date-of Issuance Director of Bldg. nforcement THIS TEMPORARY- CERTIFICATE OF OCCUPANCY EXPIRES 90 DAYS . FROM THE DATE OF"ISSUANCE. NOTE: This Certificate' is-NOT VALID unless signed by the Director of Bldg. & Code Enforcement or his designee. 10. Application for Permit— Mobile Home Town of Queensbury, 742 Bay Road, Queensbu7y, 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: UA,d—t File Permit No. Address: Fee Paid 2 70 `fir Reviewed E3y: ............. ........................... Phone No. 1 7Y J - Z Property Owner Information Parcel Information Proposed Date of Placement: Z k 7 Name: lec 4 Property Location: 166 )ql pl'ke_ Address: u,7_,e1,te Road,Sheet,Avenue Name of Mobile Home Park: HWAJ_-k2zJ L/t, (if applicable) Phone No. ~7 93'2qdd lqo Tax Map Number: Mobile Home Information Zoning Information Approximate Value of Home:$2e Zoning Classification: New Home: Yes Size of Property:, IZO ft.byLb ft. Replacement Home: Yes Existing buildings: Size of Mobile Home: M ft. by z_lq ft. j,Z 7 Setbacks: front yard_ ft.; rear yard ft. Singlewide: Doublewide; /V Side yards fL and ft. Number of Rooms: (exclude baths) Number of Bedrooms: Y - Accessory Building(s): circle Number of Bathrooms: 2— 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: TYPE SIZE&DEPTH Water Supply. well or�m Acipal Piers x Runners x Is Septic Permit Required? Yes or Slab x r-0) Further information requested on the reverse side of this sheet NO- Name of Installer or Mobile Home Dealer: pxne lli r aAl eoy,;? Address: Ll7 0 q7 C6L&n l��iiA A, , (' L2=0&f Phone No. (3r1 f l 7? 7 Complete information below found on a"plate"or"sticker"which is affixed to the mobile home. 1. Insignia serial number. 7, � 2. Name of manufacturer. �� `,r�, 3. Plan Approval Number: 4. Model or Component Designation: (New Home ONLY 5. Date of Manufacture: AFFIDAVIT Town of Queensbuixy 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 WELDING 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: t lf&j x owner,owner's agent,architect,contractor Special Conditions of Pennit By. Form: 1111911999sh CocVe Enforcement bfficer -rc~n of C:Iuac3nst>urV MuMfino Zk C:;cx:iqa E=-nfc3rcx3mEmt E3cexy RoadRoad 74.2 Cjueensbury, NY �12804 (518) 761-8256 tt n ca-99 1. FC>xnxCLmti<>Ix sxxppC>rt, vif--r spa<--I*x:Ig P*.-3r rillum"r- ------------ ------------ 2. anchoring per maaxxxxF- --------------- 3. vwtwr- lilac-- stilit"CAF -- ----------------- - 4- sewer- lirxo-- jsiap%>c>rt 4 feet ------- S. heating crc>sscover (cII-*R--vvicIt--) off grct. 6- clz-yt--r -v4mmtecl outside-- ---------- ------------ &Icilrtixxg ventilated -----:------- -------- HCA VvExtf--r relief valve piping outside deck, pouches,. steps, railing ......... 10- fxIrIImC4,-/H<A vv"wr cyp*--vatfuma ........ 11. gsxr.-&g<-- fire proof xg. ........ .... . ..... 12. dx3c),x- c--Ic>sf--3rs --------------------------- 13- Plvvmi:)Pija&- facture-- ______________________ 14- Ebmiumclatic),xi ixxsuLl*xtic>xx (i-F Etppl-)o------ 15. srrroke detectors ....................... 16. final electrical ........................ 17- variance lr-e4qtxix-e4d --------------------- 18_ data plate cpIcay ----------------------- 19. mobile I-IT-JIDO se.-al- 4z)."y .............. Af Manufacturer - Date of 3VSanufactuurer - 09C UKAY -rC) ISSUE 9--/C:3 NWOOOO" 'Y-IF-S F=1"AMLL- N%ACME31L-E= I 9%ACM=II LJL-AAkk FM -rown' cA Cluoianstaury 8L C::E3u!"ino cxJ49 E=nfc>rc4qm4qnt 74P- E3ay Fk3ELO 77",Ooo/ C2uiacnsk3ury, NY 12804 (518) 761-8256 1*-TAJN41F-: 5SA oef per . ........................ 2. xymixtar- - -------------- 3- VvgLwr line. stilit off --------- ---------- 4- se--vvt--r line support (W 4 feet - ------ S_ heating crossover (4j1:Ac-%Ao,7xdAO)l CWT S-rcl. cliryo--r -vc--Xxte'd c>xlt-sicjk-- -------------------- 7. skirting ventilated ---------- - --- 8- lintwater relief valvepiping outside 9- deck, porches, Stf--pS, railing ---- 10- ftu-rmcx--Ax4zot water operating --- ----- 11- gariL&vv, fire- prc>cAirxg ---------- --- - ---- I'>. dcocor closers ---- - - - - ----- --- ------ -- --- 13. plxlr"Indrlg fIxtilre. ........ . . ........ .. .. 14- fo--sxxtxd.-ttic>xx ixisillaticiia (if -appl.)------ IS- SX3MC3R*-- Clg--tAOctCIOX-S ______________ _________ i6_ final V1cctriu11 ------ ---- -- --- --------- 17- -v.-rriaxicx-- required --- -------- -- -------- IS- data plate okay ----- ------------------ 19. 141-T]E> seal okay --------- ----- Mc>d,c--1 # IVlanufacturer of: <3KAokl TO ISSUE 4--/(:> YES. .............. rAnc=MIL-m .00, ircown- C4 Clu4e nst3ury Ouilclino SL C: od*3 E=-nfc>rcc3m49nt 742 E3c-xy F:tc3c-tcl C)uc onst3ury, N"Ile 12804 (51 8) -761-825,6 NIF DATE INSPECTION REQUEST nf-HC3--IINFE I-C>IC C>11-T: *-N— 1_ foundation support, pier spacing per IrLaxx-"r- -- -------------------- --- xruumixF- --------------- ------------------- water 4- st--vvt--r line support (W 4 Fc-,et ---- --- r>- dx-ye--r -*rv--xite4d cnxum;icIr-- -------------------- 7_ skirting ventilated --------------- hcpt vv"te-jr relief valvepIpJIqrq3,, Q1utsiclt-- 9. C145<--k, 10- fimm.ace-AbLoot vvatt--r pp4a—r - garage firc-- VircmDfiri4g -- ----------- - ---- - ------------ ------------ -- fTt>ctxlrc. .. ............ ........ 1.4. fcmimclaticwi insulation (if aPPI-)------ ------------- ---------- 16_ final electrical ------------------------ required - -- ------------- ----- 18. data plate 6kmy ------ -- --- ------------- IL9- vmcA>iIc-- 14T3'1> seal okay --------- Model # Af .or 13"tc- of Manufacturer F F=I "AL- wmmPawm"T - Town of Queensbury E3uilding 8t CC >Ce Enfc:oro4am*3nt 7442 Bay Read Queenslc:)ury, NY - 12804 (518) 761-8256 ��,.RR.IVE: DEPART: `s I•NSP: �� . DATE INSPECTIOP�T. REQIJFST RECEIVED: �C� G� -2 oc— Mi�l►�IL.E H6J' 11�E :A�+�►Y]RY.TZ..A1�. HQi�4+IlE - FOdTINGS FOUNDA'TIt3N BACKFIi -� - FRAMING NJA- YES N+i©► 1_ foundation support, pier spaciang perrilar.u£ ------------------------ 2_ per marxuf_ ----------- -- --- 3_ water line shut off -------------- - ---- 4. se vvt--r limit-- si aRppcart CW 4 fit _ ___ 5_ heating crossover (dblevvid+�) off grd_ _ - 6_ dryer vented outside _.--=----- -------------- 7_ ' skirting ventilated - ----- ---------- ---- 8-_ hot water relief valve pipirig outside deck, porches, steps, railing ._. . _ _._ fu - ceJhot water operating _--_--__ II_ garage fire proofing ---- --------- - --- - 12_ door closers ---- - - - - ---------------- --- 13_ plumbing fixture --------- - - -- --------- 14_ foundation insula.tiori (if appl.)- - ---_ IS- smoke detectors --------- -------------- 16- final electrical -------- ---------------- 17_ var-iarice required --- -------------- ---- 18_ data plate vlcay ______________ _ ________ 19. mobile 14UX seal okay ___________ Model # Serial # �r Manufacturer Date of Manufacturer - - C1KAY 'I-C3 ISSU^p- CJc) YES Cf Comments: �y-� - �j s' VA �' �, ""�',�, �/,, ��-�-ram..- '�►�--�'". ..•zr/",� �-.,t� �; ... �::.- ����' .•- F=mr%mldmL- Rr**Asw5=m=-=-Irvcm" -57 -rc>wn of Clue nsbury Building SL C;<3a*a E=-nfc>rcsmc3nt 742 E3=-ty F:kc>c-tcl - - C�uta nst>ury, NNr 12804 (51 S) 761-W?S6 - - alb DATE INS�-PE�CTIflN REQi3EST RECEIVED: NIA le]F-S 1#44c> 1_ foundation support, pier spacing perrriaxlxlf- ------------------ ------ 2. Pf--:r Xxu3xl'Lxr. ............... vv.-ttt--r lime slxlxt C&F ------ ------------- 4- so---wt--r lixim-- support (W 4 feet ------- 41:3f7f U:rCl- 6- clx-yt--x- ------- -------- ----- 7- skirting -%r4--ritil--tte4d -------------------- 8- hot -Watc--r relief valve piping C>Xltsicle 9- deck, porches, steps, r--tilirlg --------- ILO- fmrrvaoe-/lx4zot water pp-f--ratillo -------- 11- garage fix-t-- prc>c)-fi",g -------- -- ---- ---- 12- c1c>cn- C46sf--rs --- - ------------ ----------- 13- PIVEMIAXIS fix-ttiz-6 -- -------- ---- -------- 14. fcamaUaticwx ixistil-Ettiami OF - ----- 15- SXjjC>jCe- dA--tAE-,OtCXrS ---------------------- - I Cx- final electrical ---------- -------------- 17- variance required -------------- ------- 118- data plate co1c.-xy --- ------------- ---- --- 14-4- xxxcibile-- --------- ----- t mc>cjjc--1 # Serial AF NI anufacturer C*<A:N' 'rC► ISSUE 4"-/C� -'Ylas 1*4 Ck fy� zrc tl< Office Use -GENERAL INSPECTION REPORT Inspector: Town of Queensbuq Ready at time:. Dept. of Community Development Request received: Meet: Building& Code Enforcement At timer 742 Bay Road Queensbury, ATY 12804 -ARRIVE am/ EP a -m Notes: (518) 761-8256 Inspector's Z NAME: DO-0 k PERMIT# X2 LOCATION: r jr-&,: INSPECT ON(date): _/-Z/N TYPE OF STRUCTURE 4, RECHECK C, N/A YES NO COMMENTS Footings/Piers Monolithic 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 Reinforcement in Place Foundation/Dampproofing_ Backfill Approval Plumbing Under Stab Plumbing Vent/Vents in Place Rough Plumbing_ Heating Rough-In Insulation Foundation Walls Interior R- Foundation Walls Exterior R- Floors R- Walls R- Ceiling R- Duct work or piping in . unheated spaces R- Proper Vent,Attic Vent Framing Jack Studs/Headers Bracing/Bridging Joist Hangers �''` Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1,2,3,hollk-- Penetration Sealed Fire Wall 2,3,4-hour Firestopping_ L:\SueHemingway'\Building,Codes.Inspection.FORMS\GFNERAL INSPECTION REPORT-doc rvui uI ts�� Jf!1 : '44 A 4v:� ACTUAL 6IZE: 23'-411 X 3 6 1-01111 «_.«_-. ca~� ------- TOTAL AREA: 840 sa FT. l4 MASTER BEDROOM Ll pit Gx pRO®pf 1 BEDROOM 12 �m•r. e'•r x s-�. MDDEL 92BEDR1 aN a.o - ' TOWN , 3 BEDROOM,2 BATH NOMINAL SIZE: 24 X 44 O sON wa b, "" : '��® ACTUAL SIZE: 23'-4"'X 40--011 TOTAL AREA: 534 sQ Ft. MASTER LIVING ROOM BEDROOM r'-+'X IV-1w BEDROOM 12 11'-3'X iff-1L' � 9'4'X tID'-IO' FILE CONT K11,11,v OFQUEENSSURY BUILDING DEMRT 18INT NOTICE TOWN 011F Q EENSBURY i3ased on our limited examination, ANCHORING OF MOSILE�HOME BUILDING & 0 Q T FRAME`!S REQUIRED PER , Compliance with our comments shall not be construed as indicating the plans and specifications are in full MANUFACTURERS SPECIFICATIONS REVIEWED BY cr;mpliance frith the code. 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