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1999-221 CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK June 18 99 Date 19 This is to certify that work requested to be done as shown by Permit No. 99221 has been completed. MOBILE HOME • This structure may be occupied as a LOT 37 HOMESTEAD VILLAGE Location • Owner CUBBERLY, ' DOLORES TAX MAP NO. 93 . -2-11 . 1 By Order Town Board TOWN OF QUEENSBURY Director of Bldg. do Code Enforcement :BUILDING PERMIT TOWN OF . QUEENSBURY .99221 VALUE- $. 22000... . ...';. . . .. . No. TAX MAP NO. 93 . -2-11 . 1 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to CUBBERLY, DOLORES OWNER of property located at LOT 37 HOMESTEAD VILLAGE Street, Road or Ave. in the Town of Queensbury,To Construct 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 Town of Queensbury Building and Zoning Ordinance. 1. OWNER'S Address is LOT 37 HOMESTEAD VILLAGE QUEENSBURY, NY 12804 2. CONTRACTOR or BUILDERS Name SHO MOBILE HOME BROKERS 3. CONTRACTOR or BUILDERS Address USED MOBILE HOMES. 3048 ROUTE 50 SARATOGA SPRINGS, NY 12866 4. ARCHITECTS Name • 5. ARCHITECT'S Address 6. TYPE of Construction—(Please indicate by X) MOBILE HOME ( I Wood Frame ( )Masonry ( )Steel ( I 7. PLANS end Specifications No. 8. Proposed Use MOBILE HOME May 12 2001 $ 41 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.) 12 May 1999 Dated at the Town of Queensbury this Day of 19 SIGNED BY for the Town of Queensbury Building and Zoning Inspector r1-61-\tAt f . • TOWN OF Q(J1.;1_NSI3 (_IIZY REVIEWED BY: IL,/ OD FEE PAID: PERMIT NO. APPLICATION FOR PERMIT • MOBILE HOME OR MODULAR A BUILDING PERMIT MUST BE Oil I A I NED BEFORE PLACEM[N r or MOBILE HOME. NO INSPECTIONS WILL BE MADE UNT I I. A VALID BUILDING I'EIUrI I T HAS BEEN ISSUED. The owner of this property is: -Qm -�. ,- /e1c4po3 P.O. Address: a9 Y 0)— ( Pism(1 f ('hone Number it,- 2 - "6 in.) Property Location k ¶) JjDr .&P\J1i4_qc-c.4.. Tax Map No. 9 /. NAME OF APPLICANT: * YeS c_L2 .,. Pam)( _" Address of Applicant: 3 j,) YSj' (cl ,� S i7 All applicants _spaces on this application MUST be completed and Lhe signature of the applicant MUST appear on the reverse side of this applicati on. EIVED PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES: MAY 0 7 1999 TOWN OF QUEENSBURY /06 BUILDING AND CODE MOBILE (TOME_ INFORMATION AI'I'IZUXIMAIE VALUE OF (TOME: $ / New Home Yes Ion ZONING INFORMATION: Replacement Home Yes No Size of Property: �cft x 00 ft C� n Size of mobile home J1 fix 1111 Existing Buildings: 'YID-A,- ' .Singlewide )( Doublewide - —' Proposed building-disLance from property line: No. of rooms (exclude baths) Front Yard 0 ft Rear Yard 2.../ ft. Side Yards 947 ft and aLi ft. No. bedrooms Occupancy Informat No. of bathrooms y ic Primary dwelling Yes No Fireplace -----Woodstove Accessory Building(s) : Detached garage (one car /two car car) Foundation style and size: Attached garage (one car /two car car) A-2' Storage building Piers-No. of Jsizeui x ft -Other Depth below grade ` ft * * * * * * * * * A * * * * * * * Foundation-Footing size )' " x '2,'." Proposed date of placement: S/ Wall materia` _415 7 Wall thickness " Height " Water Supply: -Wel1 Ounicipai- Total depth below grade ft. Septic permit required? Grade to home floor level ft. FURTHER INFORMATION REQUESTED ON TIIE REVERSE SIDE OF THIS SHEET dyNA1.11: or INSTALLER/MOB iI.I: NOME IlI:Al.I:It: 573-5T7 —(07 nIlI1R1:SS/I'IlOtlf NIR1lll:ltSty - e-)Y (24-- S IA I I. Or NEW YOIIK DIVISION OF Illltlti I rU, AND COIIrIUN I I Y UI (II tlA1. `- I NS I GII IA (IF AI'r'ROVA1. (IF THE SI A I E I111 I I.I)I NG CODE 1 . insignia serial number ��� } �� ✓� -Iv 2. Name of Manufacturer :. ,.. . . 3. flan Approval Number A! T i�' .�- 4. Model or Component Des IllnaI. Ion 5. Da Le of Manufacture -L� 9 ''9. 7.s - All the alcove Information Is to be found on at Irlalc or sticker whIch should be affixed Lo the Mobile Nome . Complete above wIIh IhaI. Information. • Torun of gneensbur•y Stale of New York County of Warren AI'I'II)AVII • I swear I.haI. to the hesI. or my knowledge and bet lef the sl.atemenl.s con LaIlied in LIiIs ai►1►I IcaLlorr, tocle[lier• wl I It I he 1►lans and slier. i f Ica [ I slll►ml Ll.ed , are a trim and comb 1 e Le s La Lemen t. o f it I I 1►rol►osc!tl took to I►ct done on I he described I►remIses and ha I. a I I Irrovlslons oI the ItliII Ill N CODE , the /ON1tll; 01(1)I11AIICF , and all other !MIS Ircr•Litlnlntl to the I►rnl►oWd work shitll l►t' t'onil►IIeil wll.lt, whether spec Ifled or not , and ha I. such work I ; auINor Izetl Ivthe owner. S I clan Lure _ C ' - — (h•mr.r• , o►•►n 'r s agent, architect , contractor / SI'ECIAI_ CONDITIONS or I'I:RMII': • Hy - --- emtle (Tutor% .nleii 1. Ol f f rer DECLARATION: Please sign below oiler you have carefully read the slnleinenl. 'I'u the best ol. my knowledge the statements contained in this application, together with the plans • and specifications submitted, arc a true and complete statement ol. all proposed work to be done on the described premises and that all Lnovisions of the Ituild!_I.P _c_t►dc, the l.crniill'_Oidina c_e and all oilier laws pertaining to the proposed work shall he complied with, whether 5lrc•eilicd or noted, and that such work is authorized by the owner. I'm Ihcr, it is understood That I/we shall submit prior to Certificate of Occupancy or C'crlilicate of Compliance haunt; issued, an AS IIUII;I' PI..O'I' PLAN by a licensed surveyor; drawn to scale, showing actual location of project on premises. Signature: _ _ (owner, owner's agent, archilect, contractor) MemberfJ.F.P.A.&I.A. Electrical Ce/ tificate • ATLANTIC - INLAND, -INC. - NEW Y®RK Electrical and Fire Inspection-Enforcing&Consulting Service 997 McLean Road,Cortland;NY 13045 DATE: 07/07/ 999 CERTIFICATE NO.: C- 229504 4 OWNER: Dolores Ca�Sbf�i^` AS APPROVED FOR: Homestead Village Lutt37 Mobile Home: ADDRESS:C!ueensbury, NY laiDfluip feeder o ilyXXXX 92,d k=. / .. ,,,. .. This certificate applies only to the electrical wiring and equipment listed above on the noted date. ' warranty is expressed or implied on this visual inspection.This certificate shall be valid for a period ELECTRICIAN: Joseph Del ski- _, _: 3'', one year from the above noted date.Should the electrical system be altered in any way including,but Rd. ,',, limited to the introduction of additional electrical equipment this certificate shall become void. S` Parkhurst-`��. �'�"I >, , , addition,this certificate applies only to the occupancy use and ownership as indicated herein.I ADDRESS: ri"ASisE'�,t?o to t \ (�•_TEI3 1 ' � _ change in the use, occupancy or ownership of the property indicated above the certificate st ram_ t��' ` Immediately become void.If for any reason this certificate becomes invalid due to the above mentior /� �c nd'lions,a •re-inspection by New York •Atlantic-Inland, •Inc.is •necessary to validate •the installation. f\,...,^, AI-27 tri FINAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: DEPART. , INSP:cQ1r DATE INSPECTION REQUEST RECEIVED: 4' / 7 11 i NAME: / rrw� re •- r LOCATION: "J , 1nv , , I' > ' e, //C DATE: ice'- I ERMIT# ("l j. : f MOBILE HOME MODULAR HOME FOOTINGS FOUNDATION _ :A LL_ FRAMING N/A , YES NO 1.`'foundation support,pier s cing per manuf. — — 2. anchoring per manuf. — — — 3. water line shut off — — 4. sewer line support ® feet 5. heating crossover (d ewide) off grd. — — — 6. dryer vented outsid — — —. 7. skirting ventilated — — 8. hot water relief va a piping outside — —/ — e: deck, porches, steps, railing _ / — furnace/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: ALA ( iz RAT l O-S Pg61)totb tD� P FINAL INSPECTION I tElr;Poa rr� MOBILE / MODULAR Town of Queensbury a/-* ( Building & Code Enforcement ,S4 e wk., 742 Bay Road be e.-C.- Queensbury, NY 12804 • (518) 761-8256 ARRIVE: DEPART:1 INSP: DATE INSPECTION REQUEST RECEIVED: / /4 I NAME: �d 1 U J`eS LA._ b€-( LOCATION: d---ar 37 LJ M JC to ke-'-fiA41} DATE: 6,11- L 3 PERMIT# 49-- dca J MODIILE HOME MODULAR HOME FOOTINGS _ FOUNDATION _ BACKFILL_ FRAMING N/A YES NO 1. foundation support, pie spac'\g per manuf. , — — 2. anchoring per imanuf. V — ! 3. water line shut,off\ iv 4. sewer line support 6., feet 1 —5. heating crossover (dbl 'de) o grd. 6. dryer vented outside — — 7.• skirting ventilated — �— 8. hot water relief valve iping outside /' 9. deck, potches, steps, ling — — �/ 10. furnace/hot water oper ting — 11. garage fire proofing / — — 12. door closers V — 13. plumbing fixture / .T — 14, foundation insulation (f appl.) — 15. smoke detectors ... .,/.. . _ 16. final electrical C?.1....f.1.1.. L` — 17. variance required 18. data plate okay — f — 19. mobile HUD seal okay — ✓ — Model # 3F P-9( r 79. Serial# A F% o t8 3 4 Manufacturer ASTRC) Date of Manufacturer � 17-4' C?5- OKAY TO ISSUETCTO YES ' v'' NO Comments: Co‘,,,,,PL6-`r- R Mc..._ F EkR, fog c-A -,04jI FokiU. Ge- i ' 6 Tr'if — : • 0 4 cDkc>il- r t y c cc, die l(I FINAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury Building &Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: DEPART:6 INSP: DATE INSPECTION REQUEST RECEIVED: NAME: LOCATION: s vyik ! / `��' Qtec DATE: !9 PERMIT# MOBILE HOME MODULAR HOME FOOTINGS FOUNDATION _ BACKFILL FRAMING N/A . YES NO 1. foundation support, pier spacing per uf. — — — 2. anchoring per manuf. —— — 3. water line hut off 4. sewer line upport (i, 4 f••t 5. heating cros•over i blewi.e) off grd. 6. dryer vented •utsibe 7. skirting ventil.ted _ 8. hot water relie valve pip g outside 9. deck, porches, s ps, rai g 10. furnace/hot wate lopera mg — — — 11. garage fire proo h g 12. door closers 13. plumbing fixture 14. foundation insul.tion (if appl.) 15. smoke detectors 16. final electrical ., _ y- 17. variance required 18. data plate okay _ 19. mobile HUD seal okay Model # E11 `3 Serial # O(8$ Manufacturer AS l`�O Date of Manufacturer Ck '26 1 OKAY TO ISSUE CIO YES /NO Comments: \C 1`"i bl Nan...Q___ cc - ,I - OK r3 / • RECEIVED _--------A � ----- - MAY 0 7 1999---- _ TOWN OF QUEENSBURY _ -- BUILDING&ND GOOF _ _ _ _ _ Ing TOWN N OF QUEENSBURY BUILDING DEPARTMEP - - ----Based-on-our limited-examination, cA compliance with our comments shall -----..- . -- _._-- --_---------------_---- !y not-be construed as indicating the plans and specifications are in full — -- compliance with the code. 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