2000-127 TOWN OF .QUEENSBTURY
742 Bay Road,Queensbury,NY'12804-5902 (518)761=8201
Community Development-Building& Codes (518)761-8256
CERTIFICATE OF OCCUPANCY .
C/O Number: 0000117 C/O Date:, Friday, August 11, 2000
Application Number: .1000127
Permit Number: 2000127
This is to certify that work requested,to be done Vhown by"Permit Number. 2000127
has been completed.
GLENS, FALLS MOBILE HOMES
This structure may be occupied as a Mobile Home Lot 143, Homestead Village
Tax Map Number: 523400-093-000-0002-011-001-0000
Location: LUZERNE Rd
Owner: HOMESTEAD VILLAGE L.P.
By Order of Town Board
TOWN . � ENSB Y
Director of Building& Code Enforceme t
BUILDING PERMIT
Town of Queensbury, 742 Bay Road, Queensbury,NY 12804
County of Warren (518)761-8256
VALUE $ 33000 Building Permit No. 2MOO127
TAX MAP NO. 9 3 . -2--11 . 1
Permission is hereby granted to GLENS FALLS MOBILE HOMES
Owner of properly located at LOT 143 HOMESTEAD VILLAGE
in the Town of Queensbury,to constrict or place a MOBILE HOME
at the above location in accordance to 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.
Owner's Address:
39 SARATOGA ROAD
GANSEVOORT, NY
Contractor or Builder's Name:
GLENS FALLS MOBILE HOME INC.
Contractor or Builder's Address:
39 SARATOGA RD
GANSEVOORT, NY 12831
Electrical Inspection Agency:
NEW YORK BOARD
NEW YORK. BOARD OF FIRE . UNDERWRITERS
Type of Constriction:
MOBILE HOME
Plans and Specifications:
960 SQ FT MOBILE HOME AS PER PLOT PLAN SPECIFICATIONS
Proposed Use:
MOBILE HOME
$ 35 PERMIT FEE PAID—T-IIS PERMIT EXPIRES March 2 8 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 Town of Queensbury tl#s 2$ Day of March 2000
SIGNED BY A^ for the Town of Queensbury
)Co)dcEnforcement Officer
Application for Permit— Mobile Home
Town of Queensbury, 742 Bay Roach Oye',nsbury, NY 12804 (518) 761-8256
+ •64 . .. 1 y ice;, i4 . '.(Y,� :, .
A building permit must be,obtaizied befare,placement of mobile home,oti par"cel4j,.,No inspections will be made
until a valid building permit has Been- ssued.
Applicant Information
Office Use
`l yea
Name: 4P File Permit No. � i` .
Address: Fee Paid `� BAR 2 . 2000
Reviewed By: �fat&�t�ir t;s Di
Phone No_
Parcellrrformafion
Property Owner Information
Name: PA"
Proposed.Date of Placement:
.
-Property Location: � `f�>
Address: Road,street,Avenue
c
Name of Mobile Home Park:
(if applicable)
Phone No_ 240 0
Tax Map Number:
Mobile Home Information ` Zoninglnformation
Approximate Value of Home:$ 33 4 a io IA-
Zoning Classification:�v_e_
New Home: No
Size of Property: ft.by $.
Replacement Home: es No I
Existing buildings:
Size of Mobile Home: ft. by ft.
Setbacks: front yard & ; rear yard ft.
Singlewide: Doublewide: Side yards ft.and ft.
Number of Rooms:(exclude baths) 5-
Number of Bedrooms: Accessory Building(s): circle
Number of Bathrooms:
Detached garage: 1 car, 2 car, car
circle: Gas Fireplace or. Woodstove Attached garage: 1 car, 2 car, car
Storage building: Yes No
Foundation Support: Other:
TYPE SIZE&DEPTH Water Supply: circle
Piers
Runners
Slab we ' municipal
Further information requested on the reverse side of this sheet �'
J
Name of Installer or Mobile Home Dealer:
Address: 3 �y ^
Phone No. _ � r
State of New York Division of Housing&Community`Renewal=
Insignia of Approval of the State Building Code
Complete information below found on a"plate"or"sticker",Aich'shoul'd be affix`'i -to the,
mobile home.
1. Insignia serial number: (c,(0 Y u
2. Name of manufacturer:
' t ,
3. Plan Approval Number: 162- 2-S-2--- S
s
4. Model or Component Designation:
(New Home ONLY)
5. Date of Manufacture: -3
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 agent,architect,contractor
Special Conditions of Permit
By:
Fonn: 11/18t1999sh Code Enforcement Officer
IF=I a- IINGMN=M= -
__ raw®®i�11�.�- o �io►t�rulL�I�t-. - - - _. -
Town- c)f- CQueensbury
Building SL Code Enforcement
742 Bay, Foacl A
G2uee:nsburyr, NY 12804
(518) -761-8256
ARRIVE: I3EPART: '- ��� I S _
I>A"TE INSPECTION RE"QLJE;.'sT i2.L-�CE?IVEI
LOCATION= -
FQOri`I2�TG3 Ft3i II�TI3A'I'ION BAGKFILL FRAII�IING-
I- foundation support,. pie spacing
per rr,arauf- --- --------- -----
_ aactiorisIg perurmtzf_ ----------- ----
3- water line shut off _- _______________
4. sew+ r lirxe stappocwt C feet .......
_ 5_ he.atirag crc►ssover (db wide] .off g d_
6_ dryer vented c3utside" - --------------- ___--
?_ ski rung ventilated - - - -_-------_ -
8_ hart water relief valve iping ou ide
9- dec1�, gorclxes, steps, r ding ---__
10_ water opera 9 .. ......
11_ garage fire proofing ----- - - --- ----- -
12_ door closers z- - - _.---: ------ ---
13_ plum ng bi fix re tu _ _ __ __ _ ____
14. fouadatic mi ixxsulatic>n (if a 1_>... . . .
is. samok+e detectors -------------- -______`
16- fiscal electrical - _______________ _ -____-
17_ variance required -------------- -- ---
-18_ data plate okay -------- --- ------- ---- -
19_ mcabile HUa seal ®key _-_ __ -__- ----
St-- -al At
Rflanufac Curer -
I?ate ¢af Manufacturer
aKAY -FC) ISSUE C/O - YES ND
C`c�rrzmen.ts� - .
ca
-rawn' c),f Cluie nsbury
Building 8L GcxJoe E:-nfc>rcamiqnt
74.2 -E3ety F=tc:)c-tcl
CZ?u4a nst3ury, NNO' 1 .2804
(518) --761-8056
IEXA.-PE INSPECTION REQUEST RECEIVE
LOCATION: _
P*ZCWIMXILIEC JHZ43PPO3IM P#94001M W- ,IEL *94mftall-r
fcoimaclatic),xi support, piers cirig
P4--r rrialaxif. ... ............... ....... ool�
2_ anchoring per kylBLTIXIF- -------- -- ----
3- vv.-tt4f--jr lirxt-- strut cAF -------------- ----
4- sewer lijac- support (gp 4 feet ---- --
5- lae-ELtil-10 cAF
6- cl3ryt--r- -voaxite-a c>-utsiclv-- -- ------------- --- - -- -
7- skirting -v4--xltilntc-a- ------------- ---- ----
S. hc>t water relief valve Pipvao outside
10- fturrmoc-Amc3t vv"tt--r c>13c-matijao --------
11- garage fix-#-- prod fyua&- --------------- ---
UZ. door ol6sc--rs ---- ---- - --------------- - - -
13. pi"r"toirls filctuwt-- -------- - - - --- -------
14_ fcnxxxchxtic>xx ixis-uRtticwx (if ap-pl-)P-----
-
Is- sxxxc3ke- clk--tt--ctcms ---------- ---- ---------
16- ftn�al --------------------- ---
17- -variance required -------- -------------
JLS- data plate okay ------ - -- - - ----- ---
119- mobile 7FIiJD sear okay --------------
N4 a x i t u fim t c--t x:t x-va-x
clKIACY- TO ISSIJIF- C/401 YES NQ
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GANSEVOORT, NY 12$31
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