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1999-087 CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK June 24 99 Date 19 This is to.certify hat work requested to be done as shown by Permit No. 9908:7' '- has been` completed. • • MOBILE HOME • ,This structure may be occupied as a LOT 116 HOMESTEAD VILLAGE Location Owner BURTON, BRUCE" TAX MAP NO. 93.-2-11'.'1 By Order Town Board - TOWN OF QUEENSBURY / Director of Bldg & Code Enforcement BUILDING PERMIT TOWN OF QUEENSBURY VALUE $ 19000" '` . . No. 99087 TAX MAP NO. 93. -2-11 . 1 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to . BURTON, BAUCE OWNER of property located at LOT 116 HOMFSTF.AT) UTT.T.ACF Street,Road or Ave. in the Town of Queensbury,To Construct or place a Mr)RTT.F. 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. OWNERS Address is 36 JACKSON RD EXT . SO. . GLENS. FALLS, NY 12803 2. CONTRACTOR or BUILDERS Name VALUED MOBILE HOMES 3. CONTRACTOR or BUILDERS Address • 36 -JACKSON.RD EXT SO.. GLENS._ FALLS,,-.NY 12803 4. ARCHITECTS Name COMMONWEALTH ELECTRICAL AGENCY 5. ARCHITECT'S Address PO BOX :706 . HAGUE, NY 12836 6. TYPE of Construction—(Please indicate by X) MOBILE HOME. ( I Wood Frame ( 1 Masonry ( )Steel ( ) 7. PLANS and Specifications. 95n•SQ FT MOBILE HOME AS PER .PLOT PLAN SPECIFICATIONS 8. .Proposed Use MOBILE HOME $ 35 PERMIT FEE PAID -THIS PERMIT EXPIRES Apr 1 7 19 2001 (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 Queensbury this 7 Day of Apri 1 19 1999 SIGNED BY for the Town of Queensbury Building and Zoning Inspector • FINAL INSPECTION WIEIFaiGropir MOBILE / MODULAR Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: DEPART: INSP: /0 `I DATE INSPECTION REQUEST RECEIVED: • NAME: G U Rn N LOCATION: LOT- 1 I L, \CO114\. iG ' DATE: 14/6 PERMIT/!f I - 067 MOBILE H t.AME MODULAR HOME FOOTINGS _ FOUNDATION _ BACKFILL_ FRAMING N/A YES NO 1. foundation su j..rt, pier spacing per manu — — — 2. anchoring per ..uf. — — — 3. water line shut, ff4. sewer line su... @ 4, feet _ — 5. heating crossove (dbl- '••) off grd. — _6 dryer vented outs de . _ — r skirting ventilated — — — 8. hot water relief va • -.iping outside — — — 9. deck, porches, steps. railing — — — 10. furnace/hot water • ,-rating — — — 11. garage fire proofin — —12. door closers — —13. plumbing fixture — — — 14, foundation insula;on (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: 17 C0.1 S 5 l FINAL INSPECTION R EPCJI=1-r MOBILE / MODULAR Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: DEPART: /Li •/LNSP: DATE INSPECTION REQUEST RECEIVED: r 1 NAME: a ,6 LOCATION: Lbl NS \i\(}lNk(L7ST \L DATE: PERMIT# / 7 7 MOBILE HOME 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,.ff — — 4. sewer line sup.. @ 4 f•: 5. heating crossove (dble '•-) off 's. — — 6. dryer vented outsi.. 0• skirting ventilated ... . 8. hot water relief valve 'I.' g outs' - _ — 9. deck, porches, steps, .ailing — — — 10. fiunace/hot water .. ating — — — 11. garage fire proofing — — — 12. door closers — — 13. plumbing fixture — — — 14. foundation insulatio. (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: S PP > 5 FINAL INSPECTION REPORT'S'. MOBILE / MODULAR Town of Queensbury Building & Code Enforcement 742 Bay Road • Queensbury, NY 12804 (518) 761-8256• / • ARRIVE: DEPART • �� INSP: 1� DATE INSPECTION REQUEST RECEIVED: NAME: ! Lit?, 6" LOCATION: Lo-c It l.e. klll.650i r �o ,ii DATE: d_ PERMIT.# CF. 58 7 J MO ILE HOME 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 f l 4. sewer line support c 4 feet _✓ 5. heating crossover,(dblewide) off :rd. _ ( _ • 6. dryer vented outside 7. skirting ventilated .... 8. hot water relief valve pi•ing • tside 9. deck, porches, steps, railin 10. furnace/hot water operating 11. garage fire proofing / _ 12. door closers (/_ 13. plumbing fixture / 14. foundation insulation (if appl.) 15. smoke detectors _ 77,_ 16. final electrical :7ik .���G/. _ ✓ _ 17. variance required — 18. data plate okay -19. mobile HUD seal okay _ Model # C V O-2J Serial # C L/21 3 I Manufacturer °O �- Date of Manufacturer OKAY TO ISSUE C/O YES n NO • Comments: iAl-sri zc_ 06.4fj 2 t PA-AfEre-S COMMONWEALTH ELECTRICAL INSPECTION SERVIC I C. (� Main Office 176 Doe Run Road-Manheim,PA 17545 -.Q b MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL Panel Board No Cert.N2 66086 Cut-in Card No. Owner //C�f�/Q �T�� �/ /� Locatioi 0L(I.IU ` W W�! D V /4, f..}�ue. Installation Consisting of m® i l L 64ti» .6 C7�vi e O4..tG/ Installed By..gone Lic.No. The conditions following governed the issuance of this certificate,and any certificate previously issued is cancelled:- This certificate only covers the electrical equipment and installation conditions as of date. Upon the introduction of additional equipment or alterations,application shall be promptly made for inspection. Inspectors of this Company shall have the privilege of making inspections at any time, and if its rules are violated,the Company shall have the right to rev e t j`J icate Date... INSPECTOR C FINAL INSPECTION REPORT MOBILE? MODULAR Town of Queensbury Building & Code Enforcement 742.Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: DEPARTg 35msp: DATE INSPECTION REQUEST RECEIVED: r NAME: P61M,<-S-rE4-1:, L. LOCATION: 1, (�, _ — `� 7 DATE: _ /U PERMIT 1/ '6006 J MOBILE HOME 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 .. — — — 4. sewer linelsupport 4 feet' — — — 5. heating crossover blewide) off grd. — — • — 6. dryer ven ou ide ..ti / — — — 7. skirting ven' — — — 8. hot water r1i valve iping outside — — — 9. deck, por es, steps, railing _ — — 10. furnace of water operating — — — 11. garal- fire proofing — _. — 12. a.•r 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 /f Manufacturer Date of Manufacturer OKAY TO ISSUE C/O YES NO Comments: W R©AJ Pc t( C.4'2D �.p6ye too ea,,,„ 4. , k tia -f J . i i EIV MAR 2 5 1989 l•OwN"r�V tENS® r • . TOWN OF ' Q ,N.513 UR 1' a Nq,INa coDE Y .e.g* REVIEWED BY: � -2e- FEE PAID: $ Vi/ PERMIT NO. qg -O APPLICATION FOR PERMIT tt MOBILE DOME 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: P.O. Address: Phone Number Property Location JL // 4/0 •�,e S/-20,e/eW4yx Map Nog3/v -/ /l NAME OF APPLICANT: / & j Address of I1pp11canrL: 7� Jac- ` Soli //� �j� �� JO �� '��5 /�j %, " All applicants spaces. on this applicatIon MUST be completed and the ,l signature of the applicant MUST appear on the reverse side of this application. PERSON RESPONSIBLE FOR SUPERVISION F WORK AS REGARDS BUI LDING CODES: • MOBILE 11014E INFORMATION d�/,6e1 APPROXIMATE VALUE OF IIUME: $ y,� GGo4 New Home Yes No '�1 ZONING INFORMATION: Replacement Home Yes(�[o2 �� Size of Property: ) ft x /720 ft Size of mobile home / "ftx1Fft / Existing Buildings: • Singlewide v//Uoublewide No. of rooms (exclude baths) Proposed building-distance from property line: Front Yard ft Rear Yard ,CY ft. No. bedrooms 6� Side Yards /rJ ft and • 3� ft. No, of bathrooms j ... Occupancy Information: Primary dwelling: 40 Na • . Fireplace/Vv. •Woods love �� Accessory Building(s) : Detached garage (one car /two car car) Foundation style and size: Attached garage (one car /two car car) x Storage building Piers-No: of. - :S..i'ze� ft x ft Other Depth below; grade L_f t 11 * * * * * * * * * A. ,k ,k * * * * ..' , u Foundation-Footing size x Proposed da a ofplacement: Wall malaria': / '/�� Wall thickness 1/ " Heigh " Water Supply: Well : Municipal (/ Total depth below grade ' , ' ft. Septic permit required? _ Nei • Grade tohome- floor, levelft. G FURTHER INFORMATION REQUESTED ON THE REVERSE SIDE OF TIIIS :SIIEET • NAME OF INSTALLER/MOBILE HOME (DEALER: ADDRESS/PI,IONE NUMBER �• 5; ,i A;77.r y • • • • STATE OF NEW YORK DIVISION OF DOUSING' AND COMMUNITY RENEWAL INSIGNIA OF APPROVAL OF THE STATE BUILDING CODE 1 . Insignia serial number (7L / qj/' 2. Name of Manufacturer CG , -a_aYs�/- _ 3. Plan Approval Number 4. Model or Component Designation • 5. Date of Manufacitrre / ' All the above i n forma Li on '1 s Lo be found on a Irl a to or s I:i cker wit I ch sho111(I be affixed to Lhe Mobile Home. Complete above with (ha 1 in forma LiOn. • Y i • Town of Queensbury Stale of New York • • County of Warren AFFIDAVIT I swear that to the best of my knowl edge and bellef the sLntemenLs contained in this appl Ica Li on, t:ogeiher° wl lb the plans and spe(:i fical:ions submitted, are • a 'trite and compseLe sLa Lemon L of all proposed work to by, done on the (lescrlbe(L premises and that all provislous of the IIIIILUING CODE , the 'ZONING ORDINANCE , and all other laws pertaining to the proposed work shall be compiled with, wl►etiter sued fled or not, and ghat such work Is authorized by the owner. S1gnaLure • z,zrt • Owner, owner' s agent, architect, contractor • SPECIAL CONDITIONS Of PERMIT: • By _ Code I'n1orcement Officer DECLARATION: Please sign below after you have carefully read the statement. To 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 propose(( 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) • 0ii I595 de:3'3 51674544.37 DEPT OF COMM DE'JEL 4;k;l c, ' 4 r r E Ih f? 1 _iafif-- . • r r� ,' i p9:; TOWN OF QUEEN :BURY /� 1o'�v�vo a, > rvs,F s;li.' BUILDING , t �- § -. ilt . r' ! � 1:ctron ,t � . REVIEWED BY I1% Y 24 4:0,.:.„,,Vf: .. k 4,4 $j. L. 0 at Mn I. ii . DATE j �� r 11 �r 1 s •M�i5 . I TOWN OF QUEENSBURY BUILDING DEPAR l MENT I.J, ; f,r , 1; Based on our limited examination, I `'-'`j compliance with our comments shal \ 1 not be construed as indicating the `��° l plans and specifications are in full .��� compliance with the code. i i I i N. • 4 NOTICE. • 19,t �, �,, ate ANCHORING OF MOBILE HOME �'ot$,� �� I� FRAME IS REQUIRED PER � �41110p ,99 ���Q�F� �' 'MANUFACTURERS SPECIFICATIONS • ___� — _� -- r f I--- ---'- - -- _..__..._.- -'- ..._ . �. _.---. r 5 (/ 7//C .