1999-030 : CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW, YORK
Apri 1 30: 99
Date 19:
' 3061 ; 9
This is to certify that work requested to be done as shown by,Permit No. 99030
has been completed.
MOBILE HOME
• This structure may be occupied as a
, LOT .15 HOMESTEAD VILLAGE
Location'
LA •POINT, JASON
Owner
TAX MAP ,NO. 9 3 2-11 . 1 By 'Order Town Board
TOWN OF QUEENSBURY.
•
•
Director of Bldg. & Code Enforcement
:
• BUILDING PERMIT
,TOWN OF QUEENSBURY
VALUE $ 30000 No. 99030
TAX MAP NO. 93.-2-11 . 1 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to GLENS FALLS MORTLE HOMES
OWNER of property located at LOT tc HOMF.STRAD I1TT.T.AGE Street,Road or Ave.
in the Town of Queensbury,To Construct or place a MOBILE HnMF:
at the above location,in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
39 SARATOGA ROAD
GANSEVOORT, NY
2. CONTRACTOR or BUILDER'S Name
GLENS FALLS MOBILE HOME INC.
3. CONTRACTOR or BUILDER'S Address
39 SARATOGA RD
GANSEVOORT, NY
4. ARCHITECT'S Name
NEW YORK BOARD
5. ARCHITECT'S Address.
6. TYPE of Construction—(Please indicate by X)
MOBILE HOME
)Wood Frame ( )Masonry ( I Steel (
7. PLANS and Specifications.
960 scOft MOBILE HOME_AS PER PLOT PLAN SPECIFICATIONS
13. Proposed Use
MOBILE HOME
35 PERMIT FEE PAID —THIS PERMIT EXPIRES February 17 200119
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.)
Dated at the Town of Qu nsbury this 17 Day of February 1999 19 -
SIGNED BY for the Town of Queensbury
Buil ing Zo Inspector
IF V
6•. .
, •
i
f4.
viii • O WN OF Q UIJENs13 UJZ y
REVIEWED BY:
; e S
-�.��'E�'V FEE PAID: $ `E
FEB IDV99 PERMIT NO. n—.Q3
TOVVN101=QUEEN 'I'.�ATI(lN FOR PERMIT
EUILDIfVO,q�p iN LE HOME OR MODULAR
A BUILDING PERMIT MUST BE OBTAINED BEFORE PLACEMENT OF MOBILE HOME.
NO INSPECTIONS WILL BE MADE UNTIL A VALID BUILDING PERMIT HAS BEEN ISSUED.
The owner of this property is: 0Fo /2- , z.._
P.U. Address: Lc2,-e i0 e 12.__D a{,e.P,uSbcleyPhone Number ��fZ -Lia CD
Property Location Li 15 7 Tax Map No. / /
NAME OF APPLICANT: G/ '/ S . /ls Ma i/r No cP -��c
Address of Applicant: 39 S wter 4h Al :Y
All applicants spaces on this application MUST be completed and the.
signature of the applicant MUST appear on the reverse side of this application.
•
PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES:
•
MOBILE HOME INFORMATION ?60 APPROXIMATE VALUE OF HOME: $ �l 'd -c9
New Home 11, No ZONING INFORMATION:
Replacement Home ONo Size of Property: ft x ft
Size of mobile hoirreLJO ftx ft Existing Buildings:
Singlewide Doublewide x
No. of rooms Proposed building-distance from property line:
(exclude baths) S Front Yard ft Rear Yard ft.
No. bedrooms ,j Side Yards ft and ft.
No. of bathrooms ? Occupancy Information:
Primary dwelling: Yes No
Fireplace Woodstove Accessory Building(s) :
Foundation style and size: - Detached garage (one car /two car car)
Attached garage (one car /two car car)
Piers-No. of Size ft x ''ft Storage building _
Other
Depth below grade . ft
* * * * * * * * * * * * A. * * * * -
Foundation-Footing size " x '
Proposed Wt ,placement:
Wall material �- �-//
Wall thickness " Height " . Water Supply: Well Municipal_
,_ ;Total depth below grade ft. Septic permit required? Ara
Grade to home floor level ft.
FURTHER INFORMATION REQUESTED ON THE REVERSE SIDE OF THIS SHEET
NAME OF INSTALLER/MOBILE HOME DEALER: W r+r-02_ 14'.K41 4644A-16-713"117
A r
ADDRESS/PHONE NUMBER td !4 f f
STATE OF NEW YORK DIVISION OF HOUSING AND COMMUNITY RENEWAL
INSIGNIA OF APPROVAL OF THE STATE BUIL//DING CODE
1. Insignia serial number /Je AJ 071' (e / g5-X Vl
2. Name of Manufacturer
3. Plan Approval Number
•
4. Model or Component Designation
5. Date of Manufacturer •
•
• All the above i n forma ti on is to be, found on a plate or sticker which
should lie affixed: to the Mobile Ilome.• Complete above will) that information.
•
•
•
Town of Qiieensbury State of New York
County of Warren -
AFFIDAVIT •
I swear that to the best of my knowledge and belief the statements contained
in this application, together wi th the plans and specifications submitted,
are a true and complete statement of all proposed work to bg. done on the
described premises and that all provisions of the BUILDING CODE, the ZONING
ORDINANCE , and al1 • other laws pertaining to the proposed work shall he c.ompiied
wi th, whether sped fled or not, and that such work 1s authorized by the owne . •
Signature 5rt,(4/( )
Owner, owner' s agent, architect,
contractor .
SPECIAL CONDITIONS OF PERMIT:
By
Code Cnforc t Officer
DECLARATION. Please sign below after you have carefully read the statement.
'I'o the best of my knowledge- 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 noted, and
that such work is authorized by the owner. Further, it is understood that I/we shall submit prior to.a
Certificate of Occupancy or Certificate of Compliance being issued, an AS BUILT PLOT PLAN by
a licensed surveyor; drawn to scale, showing actual location of project on premises.
Signature:
(owner, owner's agent, architect, contractor)
03/25/1999 09:47 5187982803 GLENS FALLS M M HOMS PAGE . ,04 ;C ; .
ici
MAIN OPICE . ATLANTIC-INLAND,'INC,'
897 McLean Rd. :i,;;i;;
Cortland,New York 13045 NEW YORK • "'' ' .'
MEMBER OF N.F.P,A.AND I.A.E.I.
Phone: (eO7) 953.711U FIRE IJNDERWRITERS
•r . 1
(807) 7d33-7@OU (Electrical and Fire Inspection-Enforcing and Consulting Service) C 2 f Q 5®2' . +'..' ;'
(807) 753-138(3 7T c.
(lrxorporated In the State of New York) �_ Ili fi i
D55lr1ng Certificate of Approval, appllcatlon Is made for InepeCtlon of electrical installation In the premises described below. On demand eppliceni'agryee6,10ipay„•;.•,
for inspection eervice In accord with schedule of charges. s.,4. '
APPLICATION FOR ELECTRICAL INSPECTION — PLEASE PRINT OR TYPE ' , ..
.
mi
THIS SECTION TO BE COMPLETED BY APPLICANT PATE OF ApPVCt7ipN T Z % 1
�y `
CITY.TOWN,VILLAGE `9(� ,V-0 ',l_.. COUNTY STATE ' _
STREET // 666
ADDRESS [6 /j.41 'e---p'
BUILD.NO:.
04RECTIONB ` POLE NO. ii 'i
//,� / /� � {
NAME R' .a �/le �( 1 eA�f/ �rf �+�-�- OCCUPIED AS ��. ':i •
OCCUPANT a/f"'iV-1.. BUILDING-New W-61e 0 WORK-New 0 Addiclo.,eIA' I ',-,1 -
•
Addrsra P,O." j
Address �4/"i�+.r�'r-1 ;
APP.FOR—ROUGH WIRING l I PixTUREB 0 OR READY FOR INSPECTION 113
FEE REMITTED—e CY CHECK 0 CASH 0 MONEY ORDER 0 MAKE PAYABLE TO ATLANTIC-INLAND.INC.—NEW YORK ,
Number Of Rough Whin;Donets Fbrtu ell Add Insl.Ilalion
Swtdl BTlnp Room. KW Plod. MOBrd Fluor, 500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000
Heal Rate Seee
Else1.Hai
Amp.San,,ce /LI,4 Wafer Mr. Burner Alr Cond. •
Sudsy!.Une Oven Rungs Or.prop. Dian W.�••,_,,;•
Dryer es F,Pump .. Ex.Fen Hooe
OTMER EQUIPMENT iVoaeiN Type t Capso tiaU .
TYPE OF SIZE OF SUB. BRANCHES NO.OF
WIR N 0 THER MAIN LIMN CIRCUITS
SIGNATURE
ELECTRICIAN'S -( /0'/4-4,,. UCENSEI PERMITI
ELECTRICIAN'S �`' ///' G//� NAME OF
ADUREgs l P t r'. S r�Tl RH.►beet, '7 d , — -.. NTI
OFFICE TO
ern' STATE ZIP COOS BE NOTIFIED
;PT(:E t--;-LOW FOii USL 01 INSF'EC;111HS ONLY •='•
ROUGH WIRING AMP SERVICE K.W.SURFACE '
o+mfsra . /0 el EOUIPNIENT UNIT '
— SWITCHES tAAMP SERVICE K.W.OVEN
11P4✓` COUCTORB-- - .
'nn/ M.P.DARDADE ,
RHCUPTACL>4$ ,0,�4/ lre,/l • H.P.PUMP DISPOSAL UNIT
MEDIUM BASE K.
}+ / W.
Pr4TURER • .�1, Y/,Q._ K.W.DRYER DISHWASHER .
MOGUL SASE 1 K.W.WATER
P17rrURcs JP - • HEATER K.W.RANGE
—fLU -$CLN'r i M.P.AIR AMP. RECEPTACLES
EDcrUReS Awe)
o No,t1ovER
Efg UFRY VAPOR WIRI CONTROLS FOR BURNER SMOKE FRAC.M.P.
QUARTZ FIXTURES , DETECTORS VENT FANS
MOTQR$,M.P. 1/20 1r12 1/10 ire 1/0 1/4 Vs 1/2 We 1 I1/2 2 3 5 LL 71/2 10 15 20 25 30 40 50 75 —100
MARK NUMISSFI
Of EACf4 SIZE •
e00 ' 750 1000 1250 I S00 1750 2000 2250 2500 2750 3000 ,
APPARIJ J5 Beet M_E! '
TMI8 MUST BE OOMP6FTG • 1Y-11; ' •
Received I, c4 FW this rsa4res2 1®r lrlspeceon been made of reVleWed Of ❑PROGRESS - TOTAL 6 d
any other WSW 0 Yes ❑NO ❑DaIitaC rrn . . ,I mr
� / r O R a,. 1 r �~ creek No.
MISC. 0. dL 6+�f GK1Y�1 0 Temporary SM.t6` v _ Money Oder
k.2. r 2,....�.� t0 „Weems.= r . Z-.> /- s (.
(149eawich. /e t, an* .Si:isip-c.a.daft . • . _ r •
Mon.-Fri. 6.7:30A,IM 0 MUNICIPALj'__-- -_. 1 /t. /
'-C
518.692.9295 l
518.638.633% `, .*minasATTN: .—r'�
63/25/1999 69:47 5187982803 GLENS FALLS M M HOMS PAGE ';_,03. ! ;. •::.' i
V •� St} t,: f,
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•
it
•
INFORMATION FOR - j;,i.'�„
BUILDING I�Ep
LENDING AGENCY AR 1V? !' 3
At d Inc ispores
pc in the process of issuin a
Occupan cY/Compliance for the electricalg Certificate of
construction in on project as covered installation/
our main officeapplication filed with
__ /2_7_..,, _____________-7_._________.
Da te
Inspector
�/ NEW�"pRIC`4T LA►N IC-INd qN�
•
/i -' ✓/ -t ,Le. , INC-
FINAL INSPECTION REPORT
, MOBILE I. MODULAR
Town of Queensbury t
Building & Code Enforcement .
742.Bay Road �-�L�-
Queensbury, NY 12804 ('cr)
(518) 761-8256
ARRIVE: DEPART:
DATE INSP CTION REQUEST RECEIVE : 1 3O [
� 1
NAME:
O LOCAT�I fN: /1/*[
DATE`'? --36---C19 PERMIT.I/ D
MO:ILE HOME MODULAR HOME
FOOTINGS FOUNDATION _ BACKFILL ING_
N/A YES NO
1. foundation support, ier spacin
per manuf. — / —
•
2. anchoring per manuf. _ / —
•
3. water line shut off / —
4. sewer line support t@ 4 f t — — —
5. heating crossover (dble 'de) off grd.
6. dryer vented outside — �/ —
7. skirting ventilated -
8. hot water relief valve piping outside — — —
9. deck, porches, steps, railing — —10. fumace/hot water operating — —11. garage fire proofing -
12. door closers — —13. plumbing fixture — — —
14. foundation insulation (if 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: 1 v U 5 Sc- ( 1'
Ac_e— o 5— 0 ‘<.
FINAL INSPECTION REPORT
MOBILE / MODULAR
Town of Queensbury
Building & Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256
ARRIVE: DEPART: k'C)bNSP:
DATE INSPECTION REQUEST RECEIVED:
1
NAME11r` ,47
LOCATION: lett I S � C9
DATE: L _ato` PERMIT.# 9O3O
MO ILE HOME MODULAR HOME
FOOTINGS FOUNDATION _ BACKFILL FRAMING
N/A . YES NO
1., foundation support, pier spacing
r manuf. — —
horing per menu
3. water lme shut of —
4. sewer line support @ 4 feet —5. heating crossover (dblewide) o' grd. —
er vented outside
. skirting vent :ted — — —
8. hot water reli•f valve pip' _ outside — _ —
9. deck, porches, teps, rail'. _ — —10. furnace/hot water operat'•g — — —
11. garage fire proofing -
12. door closers13. plumbing fixture -
14. foundation insulation, f appl.) — —
15. smoke detectors — N./ —
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: ') . R �d c
SuPeol
5jc-PT,L /�c-P4/ I4
I
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name L,Pa ( r
Location Lc 7,,,L1�7 G4,6
Date 40°rpci Permit # — O3O
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length
Length of each trench
Depth of trenche s
Size o`t stone
SEEPAGE PITS: N mber
Size f . x ft.
Stone si -
PIPING: Size Type
Bldg. to Tar
Tank. to Dist. fox
Dist. Box to F eld/Pit
Openings Sealed? Yes No Partial
LOCATION/SEPTIONS:
Foundation ti Tank feet
Foundation t: Absorption feet
Separation .f Pits feet
Conforms .s per Plot Plan Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
(6,077C-- 6RErg--. /1PC:" 41" 145-
Ca uc—R C-ate
SYSTEM USE APPROVED: YES NO
Arrived:
Departed:
Building Inspector
3 cp
FINAL INSPECTION REPORT
MOBILE / MODULAR
Town of Queensbury
Building & Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256 ,
D
ARRIVE: DEPART: ' INSP:
DATE INSPECTION REQUEST RECEIVED:
r-
NAME: �Acairu 7C.=
LOCATION: Loi l 1.-- A «?G J U`-c--
DATE: 4 7/619 PERMIT# %TC)3 0 J
MOBILE HOME V MODULAR HOME
FOOTINGS FOUNDATION _ BACKFILL FRAMING_
N/A YES NO
1. foundation support, pier spacing
per manuf. — .—
2. anchoring per manuf. — / \
3. water line shut off .— t
/ /(
4. sewer line support ®4 feet —
5. heating crossover (dblewide) off grd. — /
6. dryer vented\outside — / —
7. skirting ventil ted — rrr-111 —
8. hot water relic valve pipin tside — // —
9. deck, porches, Ceps, rail g .. ..... — V / —
10. furnace/hot wate operat g .. ... /
11. garage fire proo ✓/ — —
12. door closers �/
13. plumbing fixture / — —
14. foundation insulation (if appl.) ,J —
15. smoke detectors — —
16. final electrical — — —
17. variance required .— -/ _
18. data plate okay — ✓/
19. mobile HUD sea okay — C—, —
2
Model # 6. T - Serial #0SL`(�� I5 0 1
Manufacturer L t ri2T`' A1S
date of Manufacturer L I-2-1 I TA
OKAY TO ISSUE C/O YES NO
Comments:
Co v.,,PEE-` ' A nrc_1-012(0(9 i 6 u('0962T
56 P i 14- 1-1 ,0C— / D RY_L•tR ;AkkoST U& T ic..
C`/--7----2/012
0 en—pc\0 F`\N//L C.c_6 _. ,
6 U tip&-it1C.- 0 P /e-P 71 Fri-(Lu 2 — /A)
14S 'VtT)
FINAL INSPECTION R PORT
MOBILE / MODULAR
Town of Queensbury
Building & Code Enforcement
742 Bay Road •
Queensbury, NY 12804
(518) 761-8256 .
ARRIVE: DEPART: INSP:
DATE INSPECTION REQUEST RECE ED:3 atcji
NAME: t
LOCATIONy`j. S bad like.'. e J I -..•
DATE:�� ��.G ' PERMIT I/
MOBILE HOME MODULAR HOME
FOOTINGS FOUNDATION BACKFILL_ FRAMING
N/A YES NO
1. foundation support, pier spac..
per manuf. •• — /
2. anchoring per . uf. ... — �/ �/
3. water line shut o — / —
4. sewer line suppor (0 4 f. t . —
5. heating crossover •ble e) off grd. — —6. dryer vented outside
7. skirting ventilated -
8. hot water relief valve pi r g outside — — —
9. deck, porches, steps, rai ing — — —
10. furnace/hot water operat' g — —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:
A 01 Re.1 (
TO N°F QUEFNSR�RY
GLENS FALLS M & M HOMES,INC. • covi.Basa nourko(/ILOIN(DEP
39 SARATOGA RD •• not be nce with our exam/oaf/0 "WENT
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FEB 1 0 1999
TOWN OP OUEE
b\ir V9- DBUILDING A(VDNSBURY
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CODE