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2001-784 _ TOWN OF QUEENSBURY 742 Ba Road ueensb NY 12804-5902 518 761-8201 Y ,Q �Y, � ) Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20010784 Date Issued: Tuesday, November 27, 2001 This is to certify that work requested to be done as shown by Permit Number _ P20010784 has been completed. Tax Map Number: 523400-309-009-0002-001-000-0000 Location: LUZERNE Rd Owner: HOMESTEAD VILLAGE L P Applicant: HARRIS SHAFER JR This structure may be occupied as a: By Order of Town Board Mobile Home In Park TOWN OF QUEENSBURY (3ej Director of Building& Code Enforcement TOWN OF QUEENSBURY 4-1 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20010784 Application Number: A20010784 Tax Map No: 523400-309-009-0002-001-000-0000 Permission is hereby granted to: HARRIS SHAFER JR For property located 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 1,900.00 4294 ROUTE 5 Total Value 1,900.00 CALEDONIA,NY 14423 Contractor or Builder's Name/ Address Electrical Inspection Agency Plans &Specifications 2001-784 HARRIS SHAFER JR 93 ALPINE DRIVE 924 SQ FT MOBILE HOME AS PER PLOT PLAN SPECIFICATIONS $29.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Wednesday, October 23,2002 (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 n o uee u ; s` y, October 23,2001 SIGNED BY '� for the Town of Queensbury. r Q n' Director of Building&Code Enforcement Application for Permit— Mobile Home Town of Oueensbury, 742 Bay Road, Oueensbury, 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: /-IATZ1L S sl-\AFE (Z File PermitNo:2>V0_l Address: Lo4 93 ac,?x NE p Fee Paid �J ;DO J_nP j CAN Q e s 4.-)Y Reviewed By: — - Phone No. 7 (o ( ace W0g5 Parcel 9n > ah8,P 01 Property Owner InformationT OF QUEENSBURY Proposed Date of Plac lNC AND CODE Name: Property Location: cj 3 -Al ; Address: Rmli Street,Avenue Name of Mobile Home Park: 1-16 u,.0_ s--e a c _ (if applicable) Phone No. q� / 02 / l ir- I Tax Map Number: Mobile Home Information oa Zoning Information Approximate Value of Home: $ 1 • Zoning Classification:M8fi�r2U �1/�-e- 1-1: New Home: Yes :' C Size of Property: ft.by Replacement Home: Yes No Existing buildings: Size of Mobile Home: J LJ _ft. by (o(o ft. Setbacks: front yard ft ; rear yard ft. Singlewide: Doublewide: Side yards ft.and ft. Number of Rooms: (exclude baths) Number of Bedrooms: 2-- 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 SWF&DEPTH Water Supply: well or municipal Piers Runners x Slab Is Septic Permit Required? Yes or No x Further information requested on the reverse side of this sheet Name of Installer or Mobile Home Dealer: C o rr,`j S Trv.r \c \n� Address: V A -Ls€r, tA. Phone No. 7 - Complete information below found on a"plate"or"sticker"which is affixed to the mobile home. 1. Insignia serial number a-p- 1 2. Name of manufacturer. ')e r 0 5. . — 3. Plan Approval Number : 4. Model or Component Designation: (New Home ONLY) 5. Date of Manufacture: q— 15 - 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'ag t,archit ,contractor �, Special Conditions of Permit By: - Form: 11/19/1999sh Code Enforcement Officer FINAL INSPECTION REPORT. MOBILE / MODULAR Town of Queensbury Building & Code Enforcement 742.Bay Road Queensbury, NY 12804 / ,`G (518) 761-8256 n ARRIVE: DEPART/6 �• 5INSP: ��1i DATE INSPECTION REQUEST RECEIVED: 1 / NAME: ! � �/" G_ di LOCATION: l��_JL I ` DATE: I( ��7J�0L ( PERMIT II_( J� MOBILE HOME t MODULAR HOME FOOTINGS FOUNDATION BACKFILL_ FRAMING_ N/A YES NO 1. foundation support, pie spacin per manuf. — — • 2. anchoring per manuf. — �`— • 3. water line shut off sewer line support @ feet — —/ — 5. heating crossover (dbl wide) o grd. — — — 6. dryer vented outside — — — 7. skirting ventilated — — — 8. hot water relief valve pi in outside — — 9. deck, porches, teps, rai g — _ — 10. furnace/hot wate • •t• — — 11. garage fire proofing — — — 12. door closers _ — 13. plumbing fixture — — — 14. foundation insulation (if app .) — — — 15. smoke detectorss. 43 final electrical 1 Fj u�.:.��5'�.� — 17. variance required 4(1.Z..'. .�• — — 18. data plate okay — — — 19. mobile HUD seal okay Model # S•rial# Manufacturer Date of Manufacturer OKAY TO ISSUE C/O YES NO Comments: Pr��Ui 0 P!5 FILIAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: DEPART: I �/ ' INSP: �l✓ DATE INSPECTION REQUEST RECEIVED: NAME: LOCATION: %L/PCG'S/'�� D I/ L - DATE: ii/A5/0V PERMIT# o(- /1/ MOBILE HOME MODULAR HOME FOOTINGS FOUNDATION _ BACKFILL_ FRAMING N/A , YES NO 1. foundation support, pier sp: ing per manuf. - 6 anchoring per manuf. 3. water line shut off ® sewer line support @ 4 feet .. ... 5. heating crossover (dblewide) grd. 6. dryer vented outside 7. skirting ventilated . 8. hot water relief valve piping outsi,e 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 final electrical 17. variance required 18. data plate okay _ _19. mobile HUD seal okay — — — Model # Serial # Manufacturer Date of Manufacturer OKAY TO``I,,SSUEC,1/O YES NO A Comore Tip 1 � rl6zuG— , V-C_C 4C 6rhAf''- - ti6 e6-5.442y /r2 s .Q-.s. _ A 4 o C•9-�� I=r�2 / C/-1 (/< FINAL INSPECTION REPO-,T MOBILE I MODULAR 40 Town of Queensbury ' I Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 lz( ) y�j� ARRIVE: DEPART: 0 / INSP: 3 d'" DATE INSPECTION REQUEST RECEIVED: i/ / M NAME: ( Q_ r / ✓ � LOCATION: �l -� �� /1 �� 1��"`P,f hCof f"�' DATE: // .0.6/ ERMIT # Ob`-/Q.`� >J MOBILE HO E MODULAR HOME FOOTINGS _ FOUNDA S _ BACKFILL_ FRAMING_ N/A YES /NO 1. foundation support, pier 'lead g per manuf. — '� / 2. anchoring per manuf. ..... .... .... — / t/ • 3. water line shut off .......... .... ... ---1 V /' 4. sewer line support @ 4 feet / _ / 5. heating crossover (dblewide o grd. v - 6. dryer vented outside ..ti ✓ 7. skirting ventila -• _____ N.,(/ 8. hot water relief valve :. •utside 9. deck, porches, steps, railing — �— 10. furnace/hot water operating — 11. garage fire proofing — — 12. door closers ✓ _v — 13. plumbing fixture — 14. foundation insulation (if appl. _ V 15. smoke detectors — — ./1 16. final electrical — — — 17. variance required — — — 18. data plate okay — / 19. mobile HUD seal okay — 7L. Model # r 70 F3 Fx Serial # 7....2-15- Manufacturer V<�Ke.5-2 r Date of Manufacturer (( 6i ✓g Z-/ OKAY TO ISSUE C/O YES /NO Comments: A-Li6IJ At±f4t7t r sILt& i'tkCl.iof` . woL— FINAL INSPECTION REPORT r r MOBILE / MODULAR Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: DEPART: ' INSP:v DATE INSPECTION REQUEST RECEIVED: NAME: 1 kF e� LOCATION: 5'3 A-cv9//lJc-2 (� DATE: L Lit- 0 PERMIT# (�f/` Mti � � J MOBILE HOME MODULAR HOME FOOTINGS _ FOUNDATION _ BACKFILL_ FRAMING N/A . YES NO 1. foundation support, spacing per manuf. - 2. anchoring per man — — — 3. water line shut off 4. sewer line support ti :•t — — — 5. heating crossover (4 , - de) off grd. — _ — 6. dryer vented outsid: — — 7. skirting tilated . — — — 8. hot water retie' a v, piping outside — — — 9. deck, porches, steps, railing — — — 10. furnace/hot water ope ating — — — 11. garage fire proofing — — 12. door closers _ _ — 13. plumbing fixture _ — — 14. foundation insulation (i'appl.) _ — — 15. smoke detectors _ — — 16. final electrical — — — 17. variance required — — — 18. data plate okay — — — 19. mobile HUD seal okay — — — Model # Serial # Manufacturer Date of Manufacturer OKAY TO ISSUE C/O YES NO Comments: /)f 4 „`„1 • �4. 9111) / • Yer r • • QU<)-1 ' :3U k G A- ' — < - DE!",- EPT. p-q - dR004, r vsGi::UI� .Q BY .�-� / 23 d OCT 17 2001 'OWN OF QUEENSSURY FiEy u TON OF QUEENS BURY Bt}l!t ii4G GEPARThENT . • .:` "+ = Based on our limited examination, " co,,pliance with our comments shad no be construed as indicating the NOTICE pl•ns and specifications are in full co pliance with the code. SMATSCTOkARE REQUIRE! IN BEDROOMS, ADJACENT TO BEDROOMS, AND ON E CH FLOOR LEVEL INCLUDING CELLAR OR CONNEC ED ON AML LEVELS. OKE DETECTORS SHALL BE INTE • No Q9� Td 0 ' : -.:'. ' -; '. Q) O \ /'0'� I `mod ) WOO. ( g . ti0 O O y1 � 'OO.) 900)—L-1.8if , A1 re- 7LrG5Q. * ECENE • WI; Nr Se c-: 21'r(o OCT 1 7 2001 mcke_1 -7 00 f 3 i`F TOWN OF .0 :�b lAtAcS l f4 prSoL, tg1`l ?FSqp(srooc -,v►rV=.. vAcAAA S-,dSCE\ wa �. . . . . 2QCr 9c,S ev W�`i`1 zt �iV yKLa r ‘1 Az' o - OCT 17 2001 TOWN OF O U,Np CODEcr DU _. \,