1999-090 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
April 27 - 99
Date 19 __
This is to certify that work requested'to be done as shown by Permit No.` 99090
has been completed.
1995 MOBILE HOME
• This structure may be occupied as a
LOT 183 HOMESTEAD VILLAGE --
Location .
Owner SHO MOBILE HOMES
TAX MAP NO. 93 . -2-11 . 1 By Order Town Board
TOWN OF QUEENSBU
(Lijaa,
Director of Bldg. do Code Enforcement
•
BUILDING PERMIT
VALUE $ 23000 TOWN OF QUEENSBURY No. 99090
TAX MAP NO. 93.—2-11 . 1 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to SHO MOBILE HOMES
OWNER of property located at . LOT 183 HOMESTEAD VILLAGE Street. Road or Ave.
in the Town of Queensbury,To Construct or place a 1995 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 Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
4294 ROUTE 5 -
CALEDONIA, NY 14423
2. CONTRACTOR or BUILDERS Name
SHO MOBILE HOME BROKERS/
3. CONTRACTOR or BUILDER'S Address
SARATOGA HOUSING '3048 ROUTE 50 •
SARATOGA SPRINGS, NY 12866
4. ARCHITECT'S Name •
•
•
COMMONWEALTH ELECTRICAL AGENCY •
5. ARCHITECT'S Address
PO BOX 706
-HAGUE, NY 12836 •
6. TYPE of Construction—(Please indicate by X) •
MOBILE HOME
( )Wood Frame ( ) Masonry (- )Steel ( )
•
7. PLANS end Specifications
14' Ot3• 66' MOBILE HOME AS PER PLOT PLAN SPECIFICATIONS
• 8: Proposed Use
•
1995 MOBILE HOME,
Apr i 1` 1 • 2001
$ PERMIT FEE PAID -THIS PERMIT EXPIRES • 19
(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.)
1 .. April 1999
Dated at the Town of Queensbury this• Day of- 19
SIGNED BY for the Town of Queensbury
Building a Zoning Inspector
r .. e , b ', t1$ 5�6i 70 (
•
Tl) ,rN OF Q I J i'I NS1.1 ( ■Z ■T
111•4"1 : ' REVIEWED BY: _ z), -
-
FEE PAID: 3
PERMIT No. CACI - 09 0
APPLICATION FOR PERMIT
4 MOBILE I IOMI OR MODULAR
A BUILDING PERMIT rillS.f BE MAIMED BEFORE PLACEMENT Or ronll_E (HOME: .
NO INSPECTIONS WILL BE MADE MINlI1. A VALID BUILDING PERWI1 HAS BEEN ISSUFI).
•
The owner of this property 1 s : Wa0403a GM-1 ) c ,D )S
P.O. Address: i Y L/ P'of - Ort,o iv kfl- = Phone NumberYh -y', -b(.l2
Property Location141 1 ` /161,► : LnAmr1 D•Tax Map No. q3/ / 11.1
NAME OF APPLICANT: OP07/1 ege.tvi. i _'
per,,� (1 ,,,,,,__,L____O____1218.03
Address of /1pp11cant _3 d rjrU�: �w j ST, S+�- - ei '"s
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 IIOI4E_ INFORMATION AI'I'I(OX I MA I F VALUE OF HOME: $ (� 3) Cv 0 .__.
New Ilome Yes ; ZONING INFORMATION:
Replacement Home. No SIze of Property: 7Cf ft x 9-60 rt.
Size of mobile home JY fix 6,61t Existing Buildings:
' Singlewide i(' Doublewide `--�
Proposed building-distance from property line:
No. of rooms (exclude baths) Y Front Yard __Iii (—Ofl: Rear Yard Pi rt.
0 Side Yards ft and a° ft.
No. bedrooms
Occupancy Infor'matI
No. of bathrooms I Primary dwellIng: `es No
Fireplace Woodstove Accessory nuilding(s) :/V ''
Detached garage (one car /two car car)
Foundation style and size: —Attached garage (one car /two car car)
Storage building
`
Piers-No. of �I Size 1,ft x - ft Other
Depth below grade -! ft * * * * * * * * * * * * * * * * *
Foundation-Footing size iii4" x "
Proposed date of placement:
Wa11 matoria': C)lcOIh Vim k;f.r)
Wall thickness la " lieiglit " Water Supply: Well "MunfcIpal _
Total depth i,elow grade - - ft. Septic hermit required? .
Grade to home floor. level — ft.
FURTHER INFORMATION REQUESTED ON TIIE REVERSE SIDE OF THIS SHEET
RIME-or INS TA I. E11/MQUIL.i_ I I) Al.EIt: _kg o mz-j.
AI)I)RESS/1'IIONE NUMBER T-11- 114111)(--��' t-ir
STATE OF NEW YORK DI VISION OF HOUSING AIII) COMMON I TY RENEWAL
INS I GN IA OF APPROVAL OF THE STATE BUILDING CODE
I
I . Insignia serial number 0 /0 ° F(gi.--.--------------.._ -.
2. Name of Mann lac t; firer 5g1/4/ G __---
3. Plan Approval Number ____
4. Model orComponent Des I gna 1.i on 3 -------__-_-- •' A
p
b. Date of Manufacture FO �� _ nit('
All the above In forma 1:1 on Is Lo lie found on a jiIato or slicker whIch
shun]d be affixed I:o the Mobile Complele above wil.h that. Informa1.Ion.
•
Town of queensbttry S La to of New York
County of Warren
AFFIDAVIT •
I swear that to the best: of my know'edge and bet ief the sLaLemenIs con toitied
In Lhls app1 Ica tIon , Loge tiler w1Lh the plans and spec IIIcal.Ions submIt Led ,
are a true. . and complale sLaLenten1. of a II proposed work to bp. done on the
clescr•Ibecl premises and Ilia ' al l provisions of the DU II DING CODE , the YONING
ORDINANCE , and all other laws per lalnllig to the proposed work shaII be complied
wl l.lr, whether spec I f led or not , and that such work I s attl. tom• zed by the owner.
SlynaLure _
Owner, otter•' s anent, archl ect,
con Ira Lor
•
SI'ECIAI_ CONDITIONS OF PERMIT:
•
By
Code l'nforcement Of ricer
DECLARATION: Please sign below after you have careficlly 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 clone on
the described premises and !lull all provisions of the Building (:'tic, the %oninq;Urdinancc and all
either laws pertaining to the proposed work shall be complied with, whether specified or nolcd, and
that such work is authorized by the owner. Further, it is understood Ibat 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)
FINAL INSPECTION REPORT
1
MOBILE / MODULAR
Town of Queensbury tako
Building & Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256
c�
ARRIVE: DEPART '�� INSP: O.
DATE INSPECTION REQUEST RECEIVED: TiC-0X— ,./
NAME: _ v ��IIl .i„��
LOCATION: __�A IA /►� AI&
DATE: ��_ 1 PERMIT#
--
MO ILE OME MO LAR HOME
FOOTINGS — FOUNDATION _ B CKFILL FRAMING
\\ N/A YES NO
•
1. foundation support, pier spacin if I
per manuf. —
•
2. anchoring per manuf. �••\ I I i
—
3. water line shut off / _
4. sewer line support c@ 4 feet....4.
5. heating crossover dblewide) ofFd. // _.(6. dryer vented outside � f
—
—
7. skirting ventilated — //
8. hot water relief valve piping outside — V
9. deck, porches, steps, railing — 1//—
10. furnace/hot water operating / ✓
11. garage fire proofing —12. door closers -/
13. plumbing fixture /
i
14. foundation insulation (if appl.) VVV—15. smoke detectors •••••• — 7 4 —
16. final electrical /!►..7. •••iT4-• — —
17. variance required — — —
18. data plate okay — /
19. mobile HUD seal okay — i/
Model #'((RN o320-VS Serial # 3 01 O`e682--2:
Manufacturer SK�L /06-
Date of Manufacturer (1
1416—
OKAY TO ISSUE C/O YES NO
Comments:
Marii.itact irer'8 Name and Address HUD No ., •
j
�'D 11.1 1 V 1 PA --
Plar>I# No - Model Designation Serial No. Date of Mfg.
WO 6654
• ., . f K1�1 . - 7A _--. ,
This manufactured holno Is designed to comply wilh the Federal Manalecturorl Home,Conslrucllen and Safoly Slandard in force I
at the lima of nlanlilaclwo, Design Approval by Undorwritors Laboralorles, Inc.
• Factory Installed Equipment Includes:
MODEL RATING OF FACTORY INSTALLED CIRCUIT EQUIPMENT
•
EQUIPMENT MANUFACTURER DESIGNATION (APPLIANCE NOT FACTORY INSTALLED) SERIAL NUMBER
Cornfert Healing 1 -16ILta U_ —12136A- - —/ -- 1 _11113B9; Q"„i173___
Air CondllIonIng 2 _Mt __ ___}A __pig__ 2 _N
Cooking Range 3 _at__ t ci3iyti — --/ 3 -1 2 7.Q7P
' - Buill-In Oven 4 litil -- —ilttA - _ 4 .NA —__
Counter lop Cooking Dali 5 NA _ __� _� G _�
x ftolrigerator 0 I - . 'I 1 _-- —/ —_-- -- a 1775795
x Water Healer 7 MATE78 —f__----- — 7 _N9511971_ _
4.1 . Clothes Washer a _H__— __ A 1AfSV a _/
w ' Clothes Dryer 9 ._lid -N — -23 — 9 -i--- 1
- . Dishwasher ' 10 .. N► 1[tA 19_�?t}_-
1 M,.. 11 -._I!A. , .., ,. _j t4Yi — 11 NA
Smoke Deloclor 12 _ 12Ui _ _/ .____.-...- 12 _/ —
Fircplace 13 _1Vth_-- - - - - -.-- 13 �o
- -• 14 NA JUIA .--.1%A — - 14 . _ --
Instructions for all work to be performed in the field aro boated in the kitchen drawer,
The maps In[his box define iho design loads for each goojraphloaI HOME Cou3111UC1ED FOI L�lnno I4 ' ❑ Zono it ❑ Zono III
c, area. This manufactured home has boon designed for the roof and lobs lwrlw nc9 Imt uoDu doslctndCt tiliZeillol,or wb)donroaomo and unchmrh,U txoulDlons rogWal far
o wind loud zones as chockodr mcowoiiie eDl owo9 olxi uhDukl not bD 1Dculud wnhUl 1G of RIDCoauiorJ In ho cru o II luhd III,tnlonbo
o the boom cod IL9 ulwhmbl�7 mnl lounduilwl uyslonl I,uvo INIDn doDlenod for IhD humus()motto:momu
CI uponitiod lotExpoouro a In ANBWASCG 740,
❑ North 40 PSF D South 20 PSF Thin hoop hn9❑IIWID sot❑boon cttult rod with 9Lonn eirullorD or DIher plofool1vo co.or/ u for window')
PSF extoller door o))wnhloo For hoops douI ro,l to bo locale?b Whirl Zones II and III,wblchirovo nrn boon
I- [ Middle 30 PSG • ❑Other - padded with ululloio 01 egLJIVuJI It covolre dooIcoo,Jf Is OIIWlelp 10cooppio ldod That Ibo Ilo)nD 110 made
r— - ---- ROOF LOAD wary to bo oqufppod will,fhoso dovlhoo bL uccoldwn-o with Iho nrolhix rocornnio dod In 500oifacfuroru
- pliotad b,slrlullulls,
1q �. NORTtIiWIND LOAD
MIDDLE MIDDLE 4----11]-________,
•
,���------..c\ -
�1 i fut DbLE iti-1-'
Jo?u�
� _ ZONE1 Z
_
. Lill
A.
—So � 1 - 4,- 20NEIIofie
.14 PA
o NORTH �S Zo E I
\ ��:::1-V-----^••-•,o• ' A 2ory�/+,, ZONE III
;a {t : d;siI ID �{: LONE III
rUN[:U
- -- — SKY210 7(fl l
04/01/1999 14:00 518-587-4939 SHO BROKERS PAGE; '01 '' '.;
•
„ -"" APR-01-1999 13!a7 GREEN TREE NY 6� 19005454016 P. /,0s
all»►w - a ,5
C. ,..t r„
l dlz 517 ROAD .
YAWN HOMES
� cis �. �' ;,f
RR #9 BOX 57 R1' 1 - NORTH11=0 sox ?f',1•i'.
OSNSGbp NY 13126 RD 8P>OR ate. PA 17523
(717)733-0471
Td$NGLEWOOD�w�Gw- a�1.GRfi TRBL NANCIAI. 3 0 ', :•.a,';'
ATTN: ACCOUNTS PAYABLE TO FA N DSVS Pd'tE%�T INc.�
PO BOX 940 FAWN HOMES a;,,
ALP13Ai�bT"TX_, GA 30239-094D RR 09 BoX 57 RT 1 - NORTH :RO; .'''''
�u*'nvr i rgt�rryr� - , O W O NY 3 2 6
,, ‘
R$BEGCl1 941018889 10118 199s wa �`' "" �'r` ►�{g `� c� i, 1 l - ,; .,,,
,c
c1�011►1/k11 OM - OTM� ��."� f 9 t ?-.. ... 4, 1.Ji 05.00- . . '
SICYFIN w r . �t r.+.•... -
5 4 BROWN SHUTTERS
11/a8/2g95 cOgt�ur O"d"' at. 011%tti 0ote 1 CATH CEILim; LR/KIT ' , 3'a0.00 +` !,'`
osvolvs, ' tt/9a/1901, 1 30# ROOF LOAD W/16" OC
ow OW TaoDate) louse :`133.00
11 02 1995 FLOYD 1 30 CAL BLEC WATER HATER 50.00
11 08 1995 5 WATER SHUT OFFS: 2 KIT/ 50.00
' 1 TILE ENTRY #9056
_1 2'- B - s 0- _,tD;,..A' ` vI - - 16'nt�► 1 LINED OVERHEAD75.00
.00
CABS
mo0e2. ----_` AIAC- 1 1/2 SHELF KIT BASE 15.00
,,t 'r , ;;'�:a = ,T � .. .: 1 CERAMIC EDGING 100.00
-:x .�.,. _• 2 SIOLVES WASHER/DRYER
S' 14 o t.w+iur.. 1 WALL @ W/D AREA 25.00
+praanwtr*orfog4Prn 1 BUFFET g OH CABS85.00
T IN�wrroN 1 TUB oVERMuD 185.00
*woo..a.egen IWYto bNo. .rw+n.., APE BATH A 20.00
1 .HOUBE TYPE DOOR FRONT 125.00
ar0t-22 7" 1 1/a JAL REARDOOR
R-19 6" 3 HINGED CLOSET DOORS 45.00
ti 75.00
via._. a 1 ,,ELF STORING STORMS 205.00
' Z"4 1 WALK-IN-BAY 1Y WINDOW HITCH 350.00
Tw t«., 3 13KYLI'IE BATH B 159.00
ULZ-416 /S 1 WIRE 6 SWITCH PADDLE FAN 40.00
2 PHONE JACKs (SEE PRINT) 30.00
3 TV JAdKS (SEE PRINT) 40.00
"V0LummINCEfi1VlPROGRAM 1 B3A-066 GAS FURNACE
330.00
!mowtt�, y �. 1 WIRE FCORR DWASHgR 40.00
65.00
l- ,, 464,111�� 1 CLXTZ PACKAGE #1 3 7 5. 00
'I'13I8 PACAACE INCLVDE3:
5
01 -- �- 2&9t. 1 HALLMARK SALSA BORDER
1 LR/HALL
1 DELUXE DRAPES
�- Wt P..fr 1 NIV n(.4 1 SPICE
I" PRIMERACK
PAD
't'YVTA t .............to,,,,t t 0.e Wyi.iq n.v. ea. .v w ....
1-1) 66, ND. )qm -.P.) 1---trT 1-g3 .-i-ori\&17-Jrceiy3 V0-14arce, -
ON‘co4/lh,- \NL/Q IC
t
Y
6 Pli K,)PP
5i3 -) - (° ? v `l
TOWN OF QUEENSBURY BUILQIN ®N I
Based on ouk limited examination, PR ECT SITE AT
compliance with our comments shall �� TIMES
I�E� FOR I
not be construed as indicating the
plans and specifications are in full THE -� ,, 'ION OF
•
compliance with the code, �y�_�+�'
I CO , 7 UCTIOAI / ,
TOWN OF QUE NSBURY I
BUILDING & C • 1
REVIEWED BY47 •
DATE
6P1/4 ( (i1-. Ocle,
MAR 5 7999•
NOTICE % ��'c 'rav��v o c�� s �u
ANCHORING OF MOBILE HOME BUILDING AND Cor
FRAME IS REQUIRED PER
MANUFACTURERS SPECIFICATIONS
i , 0) ti
S i (17ii.: 1 f
\ �/ ��
W
1
1
1.L\►CA
I
1.:-:-:-... ( Lt ...,---..._..3
t (00` P• �� 1
V